The 'De-Skilling' Of Nursing - page 2
What should be our greatest concern for the future of nursing? We must fear the day if (or when) registered nurses (RNs) and licensed practical nurses (LPNs) will be less needed in healthcare due... Read More
Aug 25, '12ADNRNStudent reply says it all in one short sentence. We as nurses are allowing others to take away our profession. Hospitals want magnet status. What does it do for hospitals, not a darn thing, stating that outcomes will improve as the level of education is "ELEVATED" Give me a break. Nurses face the same issues all over the US; time behind the computer charting has taken time from our real patient care that used to include passing meds, pt assessments, VS, IV infusions, cath care and insertions. HAIs' are on the rise so hospitals throw in hand sanitizer, gee that still doesn't decrease HAI's! Scrub the hub, half the US wipes the hub of their IV line, i know i have been a traveler. I have watched with disgust, even had one nurse say it doent matter their all on antiobiotics, Hospitals once again spend money on products that are going to decrease HAI, gee, swab cap, has it helped?
Magnet status will require monitoring of clinical data, another job created for what.
The more we give up as Nurses the more likely it is to plan that the next time you are in that hospital bed your medication aide will provide your med/iv infusion, CNAs will assess and provide your care.
Lets think about where we are headed!
Aug 25, '12PTs doing wound care, can almost get it. RTs doing blood gases, can almost get it. Apparently we now have RTs that are hanging blood.
If I put O2 on a patient, no charge. Once an RT comes into the room and charts the pulse ox off of the pulse ox that I put on along with the O2 amount that I set the O2 at, now there's a charge.
Those who make money will have jobs. Those of us that just cost money, won't.
Aug 25, '12It's not just that nurses are being let go, but that now, with the task-based nursing aides, the hospital can load more patients on less nurses. The responsibility is still there for the nurse, but the time needed to ensure that tasks are done safely and properly is not. The PTB don't know, or don't care that many of the tasks still require the knowledge and expertise of the nurse to assess underlying causes and implications of the tasks, such as evaluating wound healing, response of the patient to medication changes, disease process, family support, etc. People are dying for lack of nurse assessment and intervention. The CNA's do not have, and are not trained to have, critical thinking skills. They do a task. There is no care for the intangible needs that patients and their families have. We are all warm bodies, there to fulfill the needs of the "staffing grid," without taking into account patient needs and acuity. As far as being "less needed," we are less needed by the corporations and hospitals, but we are far more needed by the patient in the bed, who are now being cared for by staff who do not have the wherewithal to detect serious complications until it is far too late.Last edit by Wise Woman RN on Aug 25, '12 : Reason: added some thoughts
Aug 25, '12We, as nurses, have an obligation to inform and EDUCATE the public as to what is going on, and how it is negatively effecting the care and safety, in the hospital, and also doctors' offices, and clinics. MA, answering the phone and identyfing themselves, as, "doctor so and so's nurse, ", nurses aides referring to themselves as nurses.
Nurses need to take a page from teachers. Teachers are almost 100% unionized. They can speak without fear of repercussion, can and do, organize large gatherings in very public places, to inform the public about changes in the that are determental to the students. They miss no opportunity to voice their concerns to the parents.
Why this is admirable, lets face it folks- no one ever died because they could not do long division or diagram a sentence. But how many patients are experiencing poor outcomes because of deliberate short staffing, that hospitals take no responsibilty for.
Why are peoples' lives being put at risk and we sit around and do nothing but complain to each other, but not to the people who can force change- the patients who we care for and who DO care about dangerous staffing and poor outcomes.
It will not change unless we organize under a strong unbrella of an organization who has OUR best interests at heart, and our patients.
Think about calling the NNOC, and get a unionizing campaign started. This is for your and your patients. You cannot defend your patients is you fear losing your job and getting blackballed!
JMHO and my NY $0.02.
Lindarn, BSN, CCRN
Somewhere in the PACNW
Aug 25, '12How long until the task-specific unlicensed techs become a majority and decide they have no further need of US? Throw together a couple medication aides, a wound tech and a "data collection specialist" and it's all over.
Aug 25, '12No nurse was able to save a patient's life without the help of a teacher.
I agree with the fact that nurses are being de-skilled right out of the hospital, but minimizing the impact teachers have had on our lives is just petty.
I'm a member of NNOC. They don't represent nurses in my area, but I am ever-hopeful.
I don't think most patients care about short staffing. As long as someone shows up with their Cokes and sandwiches, a lot of them could give a rip if the person on the other side of the bed is an RN, LPN, UAP, RMA or M-O-U-S-E.
Aug 25, '12I have an ethics situation I'd like to ask about. Where is the best place to post and have questions asked? It's been too long since I was here last.
Aug 25, '12My response was not meant in any way to denigrate teachers. I was just pointing out that because teachers have a strong union, they have prevented the de skilling of the teaching profession, unlike nurses, and because they have a strong union, they can and have, made it their business to go public anything that inpacts their jobs and their ability to teach. Which, by the way, is the reason that teachers did unionize years ago, to protect their academic freedom. What is the difference in protecting your academic freedom to teach, and protecing a nurses ability to protect his/her, ability, to care for their patients with proper staffing? And being able to whistle blow insafe practices in a hospital or nursing home withour fear of retaliation?
Is a teachers' ability of academic freedom more important than a nurses ability to save a patients life due to being forced to take an unsafe assignment of too many patients? I think not. That does not mean that I do not respect teachers and their contribution to society. I do believe that my need to advocate for a patient's life is more important than a teacher having the academic freedom to teach their students a subject that is not popular with their PTB.
I did not mean to minimize the impact of teachers, and I have no idea how you read that into my response. That is what I meant with my statement.
Patients don't care about short staffing becaus WE lead them to believe that everything is hunkydory with the staffing, and your ability to care for too many patients.
But everything is not OK. Bedside nursing is a nightmare, and the name of the game is to get out of bedside nursing as fast as you can after graduation. Why is that? I don't hear PTs,OTs, even RTs, running away from their practice as fast as they can. Bedside nursing, and how it is being practiced around the country is unsafe for anyone, and most nurses cannot be the patient advocate that they are required to be by the Nurse Practice Act because they fear for their jobs.
Why do we allow it? Because we have no strong organization to watch our backs, and advocate for us. And we allow it. JMHO and my NY $0.02.
Lindarn, RN, BSN, CCRN
Somewhere in the PACNW
Aug 25, '12Quote from TheCommuterAs was anesthesia.Also, obstetrics was once within the strict realm of nursing (midwifery).
I'd prefer to see the 'skills' be emphasized and have technology utilized to reduce the time spent on documentation.
"EMR" is getting a bad rap due to selection of lousy systems and resistance of many nurses to its adoption. If done well, EMR could free up nurses to spend more time 'nursing' and less time 'charting.'
There is also an incredibly large variation in the skill, judgment, knowledge, wisdom, and maturity of nurses which promotes, I think, the taking away of skilled work from the generalist nurses and handing it over to "specialists."
Aug 25, '12As a Registered Nurse, I agree with what you wrote. I see it all the time cna/ pca are doing the skill aspect of our job. Which in my opinion is very dangerous. I am not trying to offend anyone, but the knowledge and skills that a R.N or LPN know is more than a pca or cna. It is offensive when I see the cna working as R.N because it is cost effective to hire them as oppose to R.N or LPN. It is about time stand up a unite especially in this upcoming elections and have our voice heard regardless of our race, religion, or political background. We need to have the same of power in D.C as the AMA. I could remember reading articles years ago of how jobs where being taken over by other medical professions. The medical doctors in the U.S banned together and made the voice heard. They set the tone on their profession. It is about time nurse really unite and stop getting trampled and passed aside.
Aug 25, '12I am a new CNA. While I am still looking for my first job, I have aquired skills over the last 10 years while caring for my wife after her stroke. I learned critical skills in observation in the years since the stroke. I can look at her and tell if something is wrong and whether a call to the doctor is in order or a trip to the ER. Done it more times than I wish to count. I was trained to do wound care on her by the wound care doctor and staff after we found out that the visiting nurse was watching TV and trying to get my wife to do her own wound care on the backs of her knees with a mirror on the couch. The nurse was fired by me and dismissed from her agency. As a CNA I know my scope of practice and would never over step those boundries. I feel that most CNAs want to learn. Some are in school to become RNs. I have also had asthma all my life. When a patient is having breathing difficulties, who better to work with them until the RN arrives, coaching them to take slow deep breaths and urging the patient to try to relax, the CNA who is there. And what about the lowly CNA? Can we join the union also to help us? Some things to think about. I'm not there to take your job or do your job, RNs. I'm there to care for our patients and help you out and learn from you.