Too much emphasis on "caring"

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Susie2310

2,121 Posts

I agree with the person that said nursing is an art and a science. It should NEVER be about being either/or. If the caring component isn't there, all the science and evidence-based practice in the world will only go so far.

Caring, compassion, as well as balancing critical thinking and the science of practice should always be paramount. It's not just a business, and it's not just a science. It is an applied science that demands CARING and COMPASSION in order to achieve true excellence.

Please stop dividing the two. Furthermore, the caring must extend not only to patients and families, but to each other as colleagues.

Again, it's not an either/or kind of thing.

I agree completely.

Guest343211

880 Posts

I agree completely.

Thanks Susie! I was getting a little nervous over this thread. :)

PMFB-RN, RN

5,351 Posts

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
I disagree. Watson's caring science has influenced my life and practice more than anything else in my education or experience.

*** In my RN to BSN program I wrote a paper with the title "We Can Be Good Nurses Inspite Of Watson". The instructor was a huge Watson fan and didn't reall appreciate my take on Watson at all.

Specializes in ORTHO, TRAUMA, MED-SURG, L&D, POSTPARTUM.
I applaud everyone's passion on this issue. But in the US, there is zero chance that nursing services will be billed separately because future reimbursements are moving into 'outcome' based mode - whereby everyone who participates in the care will have to share a lump sum - and that amount will be adjusted based upon how well the service was delivered, the quality of the outcome - and (ta da!) how well the patient liked everything. Rest assured that this state of affairs is not going down well with physicians either, who have been used to billing the patient whatever they choose. But our current situation has just too many fingers in the pie and our care delivery systems are struggling to survive under the increasing juggernaut of paperwork that is required to support our financial hairball. It has to be simplified.

Keep in mind that Nursing care=hospital care. The only reason that patients are admitted to inpatient status is because they require continuous nursing care. "Room charges" are currently based upon all the 'stuff' that supports that stay, including nursing care. The problem is that nursing has never been viewed as a revenue center by the powers that be or accurately quantified in a meaningful way that can be confidently applied .... so they are at liberty to mess with us however they please - whether it is reducing the number of RNs or ratcheting up the workload. In actuality, nursing is the primary revenue center - because the need for our services is what drives admissions.

I'm as old as mud, and have been a nurse for plenty-one years which gives me a bit of perspective. Every few years, the "charge for nursing care" issue bubbles up in popularity but dies down again due to lack of follow-through. Only in the last decade has there actually been any clear evidence of the role of nursing care in determining health care outcomes. Thanks to the work of nurse researchers/leaders like Linda Aiken and Tim Porter-O'Grady, we finally (!) are accumulating sufficient information to affect legislation and policy. But you know the drill - it takes ~ 17 years for research findings to actually be integrated into business practice. So - maybe next decade?? I hope all of you young ones will finally benefit. (fingers crossed)

Thank you for addressing this topic. I was thinking the same thing myself. Obama's health reform act will push healthcare payment based on outcomes. However, never say never, because legislation can always be changed. The next elected president could blindly derail the the whole obamacare plan. Nurses are a large group of professionals. There is power in numbers and we can help influence healthcare legislation in the future. I do agree that having solid research to back our arguments is key to our success. Maybe we need more nurse researchers to fuel a nursing revolution?

Specializes in OB.
*** In my RN to BSN program I wrote a paper with the title "We Can Be Good Nurses Inspite Of Watson". The instructor was a huge Watson fan and didn't reall appreciate my take on Watson at all.

What is it about Jean Watson that you object to so much? She came and spoke at my hospital and I thought she was extraordinary. She travels around the country, implementing changes in hospitals to make them more nurse-friendly, based in the theory that a cared-for nurse will care for patients better. I found her to be intelligent and extremely devoted to improving work conditions for nurses. Some people hear words like "therapeutic touch" and have to immediately start flaming that person for being a New Age hippie, without giving it a chance.

Guttercat, ASN, RN

1,353 Posts

I applaud everyone's passion on this issue. But in the US, there is zero chance that nursing services will be billed separately because future reimbursements are moving into 'outcome' based mode - whereby everyone who participates in the care will have to share a lump sum - and that amount will be adjusted based upon how well the service was delivered, the quality of the outcome - and (ta da!) how well the patient liked everything. Rest assured that this state of affairs is not going down well with physicians either, who have been used to billing the patient whatever they choose. But our current situation has just too many fingers in the pie and our care delivery systems are struggling to survive under the increasing juggernaut of paperwork that is required to support our financial hairball. It has to be simplified.

Keep in mind that Nursing care=hospital care. The only reason that patients are admitted to inpatient status is because they require continuous nursing care. "Room charges" are currently based upon all the 'stuff' that supports that stay, including nursing care. The problem is that nursing has never been viewed as a revenue center by the powers that be or accurately quantified in a meaningful way that can be confidently applied .... so they are at liberty to mess with us however they please - whether it is reducing the number of RNs or ratcheting up the workload. In actuality, nursing is the primary revenue center - because the need for our services is what drives admissions.

I'm as old as mud, and have been a nurse for plenty-one years which gives me a bit of perspective. Every few years, the "charge for nursing care" issue bubbles up in popularity but dies down again due to lack of follow-through. Only in the last decade has there actually been any clear evidence of the role of nursing care in determining health care outcomes. Thanks to the work of nurse researchers/leaders like Linda Aiken and Tim Porter-O'Grady, we finally (!) are accumulating sufficient information to affect legislation and policy. But you know the drill - it takes ~ 17 years for research findings to actually be integrated into business practice. So - maybe next decade?? I hope all of you young ones will finally benefit. (fingers crossed)

Excellent post. Well-written.

Thank you for the interesting perspectives and thoughts.

SushiJoe

62 Posts

Excellent post. Well-written.Thank you for the interesting perspectives and thoughts.
Thank you

veggie530

249 Posts

Specializes in CCRN, ED, Unit Manager.
Robots are becoming evermore common roaming the floors.

"Here is your call light."

Nurse Maru

51 Posts

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"Here is your call light."

OK, that made me actually LOL. Thanks :-)

I must say, I think this is the most intelligent and thought-provoking thread I've read in a long, long time. I love it, and I hope the conversation continues.

joanna73, BSN, RN

4,767 Posts

Specializes in geriatrics.

Agreed. Yes, I care about people, or I wouldn't have switched careers for nursing. However, IMO, nursing is still a job, like any other. I don't want to work tons of overtime, and I could care less about the staffing issues. We didn't create the system. Administrators should be held more accountable. So, my goal is always to do the best job I can, but I try to leave work at work. First and foremost, I care about my own well being, in order to extend care to others.

kmcguirern

23 Posts

I have also thought about changing fields for the very same reason. The bottom line is.... Pt.s aren't being taken care of. One nurse for 10-20 Pt.s have become the norm. It's impossible to properly assess all of these pt.s. Things get missed, the Pt. declines or dies, and we as nurses either get the blame or feel as if we should have been able to see it. It's very sad, and my heart has a hard time dealing with it. I don't know what the answer is either. I hate to give up on the profession, but if I can't do the job and sleep well at night, then there's a problem. It's our license on the line! We have a Nurses Association though I am not a member. They have done walks in Washington. They meet with Congress about issues. If I actually saw something positive come out of the work they are doing, I would join and support them. Are they fighting for us as well as the pt.s? Does anyone know what they've been able to accomplish? Maybe we need a nurses union? I don't know, I'm just throwing stuff out there. I hope something changes soon......It's become a crisis!:unsure:

AngelRN27

157 Posts

Only read the OP, but.......

Maybe I haven't seen enough on a regular Med-Surg floor to really feel what you mean. I just got my first nursing job in LTC and we have PLENTY of autonomy. As a matter of fact, sometimes I wonder if it's too much when I consider the level of knowledge some of my co-workers have! We also have a big voice as nurses with the company I work for, and we even get a some say in regards to our patient assignment.

Although all of that is specific to my job, I'd have to say that I do see nursing moving forward, albeit slowly. At least in FL, now Nurse Practitioners will require a Doctorate to practice after 2015 (unless grandfathered in prior to). I think that already begins to show how our requirements and level of knowledge/expertise is growing. Also, although there is no "law" to back it up just yet, every hospital in my area seems to be requiring LPN's to get their RN immediately, and they are hesitant to hire RN's who have an ADN and not a BSN... just some evidence that we are moving forward...

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