The 'De-Skilling' Of Nursing - page 8
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 26, '12Quote from kellieskornerTo be fair it wasn't just nurses "giving" away anything which has caused certain previously exercised functions such a mixing various drugs and or performing certain proceedures/treatments.I am an RN in Australia.Having a strong union is the only way to go.We have some of the best benefits in the world as well as high wages, low pt/Staff ratio.6 weeks paid holidays,paid CE money and great working benefits.We mix our drugs,do our own ABGs.We don't rely too much on pt or rt.In ICU and the wards everything is done by the nurses.Including the ventilators settings, auctioning, ,ABG's,In recovery room.Nurses insert LMA's and have a lot more responsibiltys/scope of Practice than Nurses do in the USA.I'm licensed in the USA.I would highly recommend American Nurses to come work in Australia for one year.All nurses in Australia have Bachelor degrees but an ADN from the USA is licensed here as an RN.Scary days lay ahead for nursing in the USA if unions aren't able to be your voice.Absolutely silly to give our profession away so easily.
Rather the very litigious culture of the USA and various levels of skill proficiency of nurses would lead to errors which in turn lead to adverse outcomes which lead to lawsuits. Hospitals, their insurers and various regulating bodies researched and or otherwise looked into matters and decided certain things were best taken away from nursing staff and placed elsewhere.
For instance, and one forgets exactly when or who did the study but nearly a majority or clear majority of RNs a studied area made huge errors related to reconstitution of meds. It therefore came to pass that facilities began transferring the responsibility of such meds to the pharmacy and they arrive on the floor ready for administration.
Aug 26, '12I always wondered why nurses don't liberate themselves and bill for our own services. Other professions do this why not us?
Aug 26, '12My point is that R.N, ADN and LPN/LVN need to join forces together collaborate and stand as one. It does not matter if there are extra credentials behind your title we need to unite. I know the light has been turned on because we are having this discussion. I know we can mobilize in all 50 states. It will not be an easy task, but together we can come together. The leadership behind the American Nurses Association is not really standing for us as NURSES in D.C nor in any elections. How many times does an elected official make a comment about nurses? In the hospitals how many nurses are on the board? Other professions are telling us what we as NURSES need to do in order to complete our job? Where are our nurses? There are nurses who have worked for many years.....they know what it takes and how to get the job done. Why are they not speaking up for us. We need to get the notion of I AM LOOKING OUT FOR ME ....forget everyone else. It is imperative for us to have the motto e pluribus unum. If we truly want to advance as a profession.
Aug 26, '12Quote from passionflowerInpatient billing is covered by DRGs, outpatients can and are billed for specific specialized care given.I always wondered why nurses don't liberate themselves and bill for our own services. Other professions do this why not us?
Aug 26, '12Errors happen but rarely happen here in Australia.We are mandated to have two nurses check and give medications.We have to calculate drugs, doses, volumes and we have drug books that are for the individual drug as to constitution, compatibility, and every thing we need to know.Two nurses for S8, and we inject cardiac medications,mix potassium infusions, scope of practice and safety measures sometimes checked 4 times.Takes longer but makes you think and not just hang what pharmacy gives you.Almost gave a lethal dose one time in the US that I checked prior to hanging from pharmacy.Found an error.Nursing around the world is at risk of under skilled people getting the jobs just to save money.Cna and LPN should not be devalued as they are our eyes/ears at times, but I do agree they do not have the critical thinking or assessment skills.CNA or MA should not be telling patients they are anybody's nurse.This is a hot subject and I mean no offense.The same issues are everywhere
Aug 26, '12Quote from luv2What has the ANA done or not done that you are displeased with? Are you displeased with the actions the delegates voted on or the governance structure itself?My point is that R.N, ADN and LPN/LVN need to join forces together collaborate and stand as one. It does not matter if there are extra credentials behind your title we need to unite. I know the light has been turned on because we are having this discussion. I know we can mobilize in all 50 states. It will not be an easy task, but together we can come together. The leadership behind the American Nurses Association is not really standing for us as NURSES in D.C nor in any elections. How many times does an elected official make a comment about nurses? In the hospitals how many nurses are on the board? Other professions are telling us what we as NURSES need to do in order to complete our job? Where are our nurses? There are nurses who have worked for many years.....they know what it takes and how to get the job done. Why are they not speaking up for us. We need to get the notion of I AM LOOKING OUT FOR ME ....forget everyone else. It is imperative for us to have the motto e pluribus unum. If we truly want to advance as a profession.
Aug 26, '12Quote from passionflowerMany nurses may not want to take on the responsibility of independent billing when they learn what they may face. Independent billing still would entail adding to our skill and knowledge set as I pointed out earlier in a post. To bill for services, you would have to know about clinical code sets and reimbursement; you would have to make sure that you are performing evidence-based practice to prevent being overly scrutinized by third party auditors; you would need to know a third party payer's policies, and I can tell you Medicare/Medicaid is very complex; you would need to be willing to talk with third party payers and auditors when they deny your services; your documention would need to be stepped up several notches in order to meet the criteria for payment from third party payers and demonstrate quality care; your rates would skyrocket; you would become even more exposed to litigation. Is this something you think the average RN or LPN at the bedside could deal with or afford? Would the current scope of practice for LPN/LVNs and RNs warrant these additional headaches? I realize the scope of practice varies from state to state.I always wondered why nurses don't liberate themselves and bill for our own services. Other professions do this why not us?
I stand by my mantra that standardization is one way to address the conflicts that nurses face. Yes, let's grandfather whoever needs to be grandfathered, but we need unification through standardization.
Aug 26, '12Quote from lindarnWe, 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
If you allowed LPN's to join the NNOC or ANA, you would add thousands of voices to the cause...unions have split the two apart. Why? We are nurses, you know!
Aug 26, '12Quote from Asystole RNThere is no "Aide" in Licensed Practical Nurse. One assists the nurse, the other is a Nurse!!!CNA
mc3Last edit by mc3 on Aug 26, '12 : Reason: because I wanted to
Aug 26, '12Quote from neurorn6Welcome to the new Nursing. We had let for profit and nursing organizations devalue nursing for years. While RT and PT can bill separately, we continue to be listed under bed and board. Yet, we have to carry malpractice insurance because we are professionals. We have let the ANA make decisions for us, which has done more harm than good for nurses across the board.
Computerized charting has taken us away from the bedside, customer service has us acting like waitress instead of professionals and administrators think that we are a dime a dozen. Yes you can replaces us but you can't replace our experience.
I have worked all over this country. I have worked in the NE, out west and in the south. I have worked Union and Non Union and For Profit and Non Profit. There is a huge difference across the board. The one thing that does stay the same, is that unless nurse come together under one banner, we will fall by the wayside.
We need to come together, LPN, LVN, RN, BSN and so forth. If we don't stand together, then we have on one to blame but ourselves.
Absolutely! We're only hurting ourselves and look at what's happened.............
Aug 26, '12I get the desire for standardization, but there's benefits of having a multi tiered system. I actually think there is some merit to the idea of *forcing* nursing to be a career taken on a step by step basis. A requirement to get into a LPN program is having worked for a year first as a CNA. A requirement to get into a RN program is having worked for a year as a LPN. Thus no new RN could possibly step into a RN job without already having solid nursing experience. Nursing schools do such a pi** poor job of preparing nurses for the real world, some real world experience could only help.
Aug 26, '12Quote from Asystole RNCould you explain to me why LPN's shouldn't be included. Honestly, are our goals different? Do we both not want to take care of and help patients? Then all nurses would be working together on these issues. One powerful voice. Sorry, but your remarks remind me of a Jr. High School clique (i.e. why don't you go hang around with the other kids that are more like you....)Maybe they do not see you as a nurse... :kiss
To be fair, the organization predates LPNs. Why don't you start your own all inclusive association?
Aug 26, '12Quote from mc3Splitting hairs.There is no "Aide" in Licensed Practical Nurse. One assists the nurse, the other is a Nurse!!!
We can debate this further on at the next professional nursing organization meeting...oh wait.