To grad students and advance practice nurses - page 2

I had an epiphany of sorts last night whilst at work. For the last few months I have been struggling with working full time and trying to get my requirements done so that I can get into nursing... Read More

  1. by   Glad2behere
    llg,

    Sorry it took so long to respond, hope I am forgiven. I think your anguish is something I can identify with, as well as many other nurses. It is sad that an individual of your education level is not compensated fairly. I cannot imagine all the hell you went through to achieve it, and admire you for having done so.

    I realize there isn't much that can be said to make you feel better except that you are looked up to, admired, and respected. You'll feel better soon I am sure, and I trust you will continue to tow the line.
  2. by   WashYaHands
    I realize there isn't much that can be said to make you feel better except that you are looked up to, admired, and respected.
    llg,

    I wanted to repeat this, as these are my thoughts too. It's a shame that one persons personal opinion can impact professional positive input from all others that you work with in an eval.

    Adrie,
    Have you considered looking into a psychiatric CNS grad program?

    Linda
  3. by   adrienurse
    Linda,
    Well that's the thing. There is no psychiatric stream in the general graduate studies program in my local city. This may be a good excuse to leave this frozen godforsaken town, but I don't know if I'm ready for that. It may be a good choice for me, though because the University of Manitoba is looking more and more pathetic all the time.
  4. by   lalaxton
    adrienurse,
    I too had a similar experience to 'Dan' in my last position. I was hired as a CNS, and although I was trained as an NP and was reluctant to take the job because I had no experience as a CNS, I was assured by staff and physicians that I would get lots of help etc. I was also able to name my price so I thought how bad could this be? I basically saw no one for the first 3 months, never got any direction or help and finally found out I was hired because a very influencial surgeon (also on the board of directors) pushed to have a 'body' in the job. (Same guy who expected me to 'magically' appear when he did rounds) Thank God we had to move back to Canada for family reasons, I was going out of my mind!
  5. by   llg
    Wow! You guys are terrific. I felt a few pangs of regret after posting so many details of my recent job eval. But getting it off my chest helped -- and your responses have made me feel much, much, better.

    To Adrienurse: Unfortunately vague job descriptions and expectations, unclear and even conflicting expectations, and intense politics are all commonplace in CNS roles. Unfortunately, everyone in the health care system has expectations of the CNS and sometimes, those expectations don't match. If you please the staff nurses, you make the physicians angry. If you support the head nurse, some of the staff nurses get angry. etc. etc. etc. Making it worse, each of those people believes they have a right to tell you how to do your job -- and they exercise that right repeatedly, saying that THEY could do the job much better than you.

    I have come to the conclusion that it (the above stress) is a fundamental part of the CNS job -- and will remain so until the nursing culture changes. Nurses as a rule do not respect a person's previous accomplishments or qualifications and will not accept a person in a leadership position unless that person is continually doing something to please that person. It's a "what have you done for me lately" type of attitude.

    If the CNS wishes to be effective in improving practice, he/she must have the support of his/her colleagues -- at the staff level, within nursing administration, physicians, etc. Therefore, all of those people must be continually "pleased" in order to maintain their support. After a while, you feel like your main job is just to suck up to everybody. (And remember, I got nailed on my eval by a secretary, so I DO mean everybody!) Also remember that catching up on the latest literature to teach a class, writing an article, etc. doesn't make your colleagues' jobs any easier, so those types of activities don't please anybody and most consider you to be "not working" when you work on those types of activities. Most only care about what you did that directly made their work easier.

    In the end, I don't regret having spent 15 years as a CNS because I enjoy the variety of the things I have been able to do. Also, looking back over the years, there are accomplishments of which I am proud and I know that I have made a positive difference in many people's lives. But it has been very hard work and it has been emotionally challenging.

    For those of you who think of the role as an escape from the common stresses of being a nurse, think again. CNS's are expected to be "super-nurses" -- the epitme of nursing -- the embodiment of the nursing ideal -- experts at everything -- the person who can always be counted on to save the day -- the person who pleases everyone. Think about it. Isn't that what most people want of a CNS? Is it reasonable to expect anyone to be that perfect? The challenge for everyone is to come to terms with the fact that CNS's are human, too. We need to be tolerant of the fact that CNS's are not perfect. Until the nursing culture changes to accommodate those imperfections, CNS's will continue to struggle with their inability to walk on water.

    llg
  6. by   Q.
    Originally posted by llg
    For those of you who think of the role as an escape from the common stresses of being a nurse, think again. CNS's are expected to be "super-nurses" -- the epitme of nursing -- the embodiment of the nursing ideal -- experts at everything -- the person who can always be counted on to save the day -- the person who pleases everyone. Think about it. Isn't that what most people want of a CNS? Is it reasonable to expect anyone to be that perfect? The challenge for everyone is to come to terms with the fact that CNS's are human, too. We need to be tolerant of the fact that CNS's are not perfect. Until the nursing culture changes to accommodate those imperfections, CNS's will continue to struggle with their inability to walk on water.

    llg

    EXCELLENT!
  7. by   globalRN
    llg,

    The evaluation obviously bothers you greatly while your supervisors think everything is 'hunky dory'. They may honestly
    not perceive that they have done anything 'wrong'

    Given how deeply you feel about this, why not bring up the subject with your bosses?

    Evaluations usually require the employee's signature as to whether they concur or disagree with the evaluation.
    Did you sign off the evaluation?

    You loved your job until you were broadsided by this evaluation...what do you have to lose then to readdress this issue with your bosses?

    You are always insightful and considered with your responses...
    I am sure you would handle reopening the discussion of your evaluation gracefully.

    As to accepting a CNS job when you are prepared as a NP....I turned jobs like that down. The CNS role really does require an educational preparation that my NP program did not prepare me for.

    As for aspiring CNSs....there are still plenty of jobs ...in fact when I was looking for a job...there were more CNS jobs than NP jobs in the area I wanted to work in.
  8. by   lalaxton
    globalRN,
    Believe me I will never make the mistake of taking a CNS job again. I was not prepared for it but I was in an area that had limited opportunities for NP's or CNS's. Next time I would rather work as a staff nurse. Don't get me wrong, I am in awe of CNS's and what they do, just not a job for me. Keep on keeping on llg, your commitment to excellence in patient care will shine through even if a secretary has an attitude problem!
  9. by   llg
    globalRN: Thank you for your kind and generous, but I think it is really better in this case to simply "let it go." If a good opportunity comes up for me to discuss it with one or both of my bosses, I will bring it up ... but I am not going to force the issue. It's important to pick your battles carefully, and I think I should let this one die a natural death.

    I don't expect to leave my job this year, so I should have no reason to need that eval. If something does happen in my personal life that causes me to leave, I am on good enough terms with the Director of Nursing to bring it up at that time. I believe she would sympathize with my position and give me some assistance. If something happens at work that causes me to leave ... well ... that might be another story. But I think that is unlikely and I would probably survive that event by improvising and using other documents to support an application -- such as program evaluations, previous evals, my published book chapter, conference speaker reviews, etc.

    I just don't think it is worth it to rock the boat at this time.

    Thanks again,
    llg

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