The 'De-Skilling' Of Nursing - page 9

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

  1. Visit  Asystole RN profile page
    0
    Quote from mc3
    Could 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....)
    mc3
    I think LPNs should be allowed to join ANA, I also think CNAs should be able to too.

    I do not believe this will ever happen though because, although similar, our occupations are too different with the main difference being in educational preparedness. The current trend in registered nursing is to eliminate the ADN and Diploma nurses in favor of the BSN nurse, just think of what the opinion on LPNs is.

    Considering that LPNs have been around how long now and they have not formed a national nursing organization themselves, I do not think there is much interest.
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  3. Visit  Mijourney profile page
    1
    Quote from BrandonLPN
    I 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.
    Brandon, I agree with you that nursing school typically does not provide real world experience. However, at least in my state to my knowledge, one is not required to have prior nursing experience to become a nurse-particularly at the ADN, BSN, or MSN levels. In fact, as I write, there are people entering the nursing profession that have no intention of "wiping butt" beyond their schooling. They seek to go into administration or specialize in non-physical contact areas.

    It's all about getting that buck for many people who enter nursing. Even though most bedside nurses do not feel they're getting well-compensated, nursing does provide a decent wage and some measure of security depending on where you work and who is in top management.

    To mitigate any problems with your step by step recommendation, nursing could go back to the days of old when nurses worked as "techs" in between semesters (back then it was a source of free help; I would not recommend no pay today) or nursing internship programs could be established.
    gummi bear likes this.
  4. Visit  Dragonnurse1 profile page
    0
    Quote from kellieskorner
    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.
    <br>
    <br>
    In the ER that I worked in Pharmacy did not mix our drugs we, the nurses, did. I cannot tell you how many times I mixed dopamine, dobutamine, bi-carb, nitro drips, antibiotics, drips for diabetics, caffeine drips, and so many others that I do not remember them all. We pushed meds for rapid intubations, mixed anti-venom drips and gave meds for cardioversions. All this in the ER but the one I was most afraid of was levophed. My first overdose I had to push methylene blue with only a drug book to tell me how. No one in the hospital had experience with that one. I guess that is one reason I really liked my ER, we nurses really did everything except suture and that was because the hospital would not let us not because it was beyond our scope per the state nursing board.
    Last edit by Dragonnurse1 on Aug 26, '12 : Reason: quoted wrong section
  5. Visit  Asystole RN profile page
    1
    Quote from Mijourney
    To mitigate any problems with your step by step recommendation, nursing could go back to the days of old when nurses worked as "techs" in between semesters (back then it was a source of free help; I would not recommend no pay today) or nursing internship programs could be established.
    I could not agree more with the part I bolded. Nursing is far too complicated to be able to provide a truly adequate and quality hands-on experience within nursing education. I believe that nursing would do well to copy the physician model of education where there is a theory part of the education and then a formal residency portion.

    Leaving residency up to the individual hospital to determine the length and quality provides for mixed results.
    GeneralJinjur likes this.
  6. Visit  aquarius04 profile page
    0
    i totally agree. PT doing wound care is really foreign to me. And for some reason I feel like with the concentration their schooling is directed towards, wouldn't wound care be out of their scope of practice? Of course they could incorporate it, but the thought their primary goal was to help rehabilitate the patient?
  7. Visit  BrandonLPN profile page
    1
    Quote from Asystole RN
    Splitting hairs. We can debate this further on at the next professional nursing organization meeting...oh wait. Just kidding.
    I can't tell if you're being serious or facetious. Do you really think saying there's a difference between CNAs and LPNs is "splitting hairs"?
    mc3 likes this.
  8. Visit  Asystole RN profile page
    0
    Quote from BrandonLPN
    I can't tell if you're being serious or facetious. Do you really think saying there's a difference between CNAs and LPNs is "splitting hairs"?
    The "just kidding" was not a clue as to my intentions?

    I 100% believe that you are practically a nurse.

  9. Visit  BrandonLPN profile page
    1
    Quote from Asystole RN
    I could not agree more with the part I bolded. Nursing is far too complicated to be able to provide a truly adequate and quality hands-on experience within nursing education. I believe that nursing would do well to copy the physicianmodel of education where there is a theory part of the education and then a formal residency portion. Leaving residency up to the individual hospital to determine the length and quality provides formixed results.
    Wouldn't forcing applicants for a RN program to have been first a CNA, then a LPN be the best way to ensure all RNs begin practice with hands on experience under their belt?
    gummi bear likes this.
  10. Visit  tothepointeLVN profile page
    3
    Just a question that no one seems to answer. If for some reason the phase out of LPN's ADN's and diploma RN's was successful who would work at the nursing homes? or home health? Medication Aides? Long Term Care Technicians? Home Health Assistants? The problem with bringing the education level up is lower level nursing still needs to be done but nobody will want to do it if they are trained to do SO much more.
    tnmarie, gummi bear, and BrandonLPN like this.
  11. Visit  Asystole RN profile page
    0
    Quote from aquarius04
    i totally agree. PT doing wound care is really foreign to me. And for some reason I feel like with the concentration their schooling is directed towards, wouldn't wound care be out of their scope of practice? Of course they could incorporate it, but the thought their primary goal was to help rehabilitate the patient?
    Highly depends upon the various state laws and how they define, or lack thereof, what medical tasks licensed and unlicensed personnel can or cannot perform. Many of the allied professions have somewhat open SOPs.

    The tasks being performed as described by the OP occur, and may be common in a particular state, but are definitely not the national norm. Here in AZ RTs can place PICC lines but this is something that is definitely not normal.
  12. Visit  Mijourney profile page
    0
    Actually Asystole, the MSN model seems to be similar to the physician model of education. Most MSN programs do the theory prior to the practicum. Usually, the practicum is done last in the MSN program. Generally, this practicum is a real world experience.
  13. Visit  BrandonLPN profile page
    0
    Quote from tothepointeLVN
    Just a question that no one seems to answer. If for some reason the phase out of LPN's ADN's and diploma RN's was successful who would work at the nursing homes? or home health? Medication Aides? Long Term Care Technicians? Home Health Assistants? The problem with bringing the education level up is lower level nursing still needs to be done but nobody will want to do it if they are trained to do SO much more.
    Trust me, LTC facilities would loooove to replace LPNs with medication aides and techs if they legally could. This is the problem with raising the entry point to nursing to the BSN level. You wind up with the former practical nurse jobs being filled with grossly underqulified UAP. Or overqualified BSNs who will also likely be underpaid and will leave the job at the first opportunity.
  14. Visit  Nolli profile page
    1
    Been an ER patient a few times, was a medic, now a nursing student. I may be kind of biased, but I don't see a problem with having assisting staff as long as they are not displacing the staff. When I was going through medic school we gobbled up IVs and EKGs med admin(some things we could administer), ETTs, and defibs in the ER. But there was only one of us one at a given time and the nurses used us as assistants. We did not replace them. Same for the unit I'm on now. Even with the nursing students on we don't replace the nurses.

    During my last ER visit I had a tech come in and do an EKG and transport me to xray, but it was the nurse was the one who did everything else.

    So as long as they are not being completely replaced and still are able to perform those tasks numerous times per day I don't really see a problem with a little help. I think it becomes a problem when they flood you with help and take away a good part of your job, often because it is cheaper.
    gummi bear likes this.


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