What can nurses really do to help our dying profession? - page 3

I was thinking about the question of "are nurses overworked and underpaid?" Well, of course the answer is yes. And, we have all said as nurses we need to do something to change it. Well, what can we... Read More

  1. by   jtfreel
    Boy did you ever hit a tender spot! It has taken me years and a lot of experiences and observations to even begin to have any real thoughts about your concerns. Nursing, unfortunately, is NOT the angel of health care who's worth is universally recognized and who's value is a given. To many organizations, nursing is a COST CENTER to be carefully controlled, defined and managed.
    On top of this is the reality that nursing is populated with many dedicated, committed, educated, caring, compassionate individuals who are sincerely professional and usually possess high personal and professional standards. How do you meet the needs of this group AND control them at the same time? For many other professions and organizations, that was a quandry. Unfortunately, with the best of intentions, this was assisted by many well meaning changes. JCAHO has continually placed more and more requirements on institutions which have translated into more and more documentation and review requirements placed on the staff RN. At the same time, managed care and the need for financial profits pressured organizations to squeeze more and more out of less and less staff. Coupled with this is the reality that the primary "customer" for many health care organizations is NOT the patient, but the physician. To further complicate matters, the presence of and the role of the registered nurse is required in acute care facilities by law. ( I have heard CEO's and CFO's even discuss this necessary evil!) The reality is that nursing and staff nurses in many facilities are powerless in the big picture. Now back to control: we can't let them know that. So hold them accountable for everything. Promote empowerment opportunities, teamsmanship and excellence guidelines. Few nurses will realize that whoever allows empowerment...can also take it away. Why do you think that the CNO position is viewed as short term? The CNO tries daily to balance the needs of the PATIENTS, with the staffing requirements to meet these needs, considering the needs of the staff, the physician culture, the regulatory guidelines and the financial realities of the organization.

    And, in my opinion, Nursing is not very good about promoting the profession or its value (diploma vs BSN vs AD: still raging). We are still having articles and research attempting to PROVE that we are a profession. Add to this confusion the fact that nursing students are graduating with less and less clinical preparation (which is forcing the organizations to provide preceptorships, to demand that existing staff orient/train new grads, or accept the "eat their young" mentality) and you have the recipe for stress.

    I love this profession and refuse to give up on the right of patients for quality professional nursing care-even when the "bottom line" is the profit margin, the need for meeting JCAHO and other institutional standards, and the need to stay current in a rapidly changing field.
  2. by   ForMoe
    It is my wish that we get past the degree debate. We all had to pass the same state boards to get the right to place RN after our names. There needs to be one goal today. That goal is for health care facilities to maintain proper staffing levels to ensure patient care and safety. There is a nursing shortage and in some states it is critical. This shortage was caused by the health care industry itself because they treat nurses like the coal mines treat the miners. Loosing money? Cut the workforce. Works great for coal mine owners but is not so good for hospitals that treat the sick. We need to speak with one voice that we will no longer tolerate the cycle that brings a shortage every ten to fifteen years. We are a grass roots effort to educate the public on this issue. The hospitals do not fear unions or the government. They do fear an informed public. Our founding members are from all over the country. Some in home care, others in major hospitals and still others are educators. We are the CNG (Concerned Nurses Group) and we are fighting for you and your patients. Our sponsor is at www.hospitalhub.com Come and read our artcles, give us your input, and maybe join our fight.

    ForMoe
    President CNG

    PS - Shee1a, we are not all girls.

    [This message has been edited by ForMoe (edited January 28, 2000).]
  3. by   ecb
    I Have a Philosophy about nursing, and it is "if I do my job right I will be out of a job" I teach residents, patients, other nurses, CNAs other parents all I can to help them not need my care, to be able to help themselves. I am a supervisor and the administration was thrilled to get me, and they spent 4 of my orientation days teaching me about PPD ratios and how staffing is regulated in this facility. I have taken wheat they gave me and am using it to agitate for another part time CNA for my Night shift team, and in so doing have shown how short the evening shift is as well. I have used their own criteria to my staffs benefit, and I am currently making up a data base to try to come up with an aquity scale (anyone who can help me figure this out PLEASE DO!! It is harder than I thought) so I can keep the staff assignments more fair, and even assign the VERY heavy people to 2 CNAs to facilitate TaPs when the med nurses are busy doing charting and meds and treatments.
    I work most nights with 2 LPNs who have streangths I hope someday to be able to get close to, and I make a point of letting the npowers that be know that the great Idea they just thanksed me for was from one of them, not me. I have implimented a mini reward system, and am working to improve moral on at the least My own shift, and so far it is starting to bleed over into Evening shift, and I am finding more and more people are willing to do OT to help out my shift even though I am MUCH more tough than the last supervisor (or so I keep getting told, I just see it as different styles) I have tried to get the nurses to stop bad mouthing anyone, and going with a here and now philosophy of "if it is a sin someone was left like that, DON'T leave them like that" and it is working, I have had one person get fired for insubordination, and annother quit and came back twice (that is another problem) If we work at making small attitude changes, and improve the bad feelings I think we can get back to the team style we all think we remember (I keep getting told it was NEVER that good)
    and as to the idea that I am a part of a Dr, I believe Drs take care of Parts, I take care of the whole person, and I have seen excptions to this rule on BOTH sides, but not many.
    I am sure this is not what some people want to see, but it is what I can do about the problems I see, and I can only take so many steps, and I can only lead. No one wants to be forced to change, and when they do it is rarely for long.

    Nuff said?
    Yeah {sorry about the spelling}

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    *** May we all have the serenity to accept what we cannot change, and the determination to change what we cannot accept. ***
  4. by   Tara
    An LPN is trained to work a floor, An ADN is trained to manage a patient's care ( most ADN programs provide more clinical experience than BSN programs), A BSN is trained to manage a group of nurses and A MSN is trained more in philosophy. So, I gather that the BSN who started this topic should go back to school and learn how to get along with the people she works with. Diversity is good. Most ADN are better prepared to handle a patients needs and you can get that verified by the people who hire new grads. The BSN is not better or worse. It was developed to serve a different need.
  5. by   jimbob
    living and working in new zealand as i do, i don't understand all the abbreviations you chaps use (lpn, bsn, adn and so on)
    all i would like to say is that it is important for us as nurses to remember that we will only be considered a professional group by our peers (be they medical or some other professional body) if we hold ourselves in high esteem first.
    let's fight the whiners and whingers who say that "book learning" is no way to become a nurse, by contradicting them when we hear it, and confronting them - by reminding them that we ARE proud of what we have achieved and that change is constant and we need to look after and out for our younger colleagues
    when the auxhiliary staff in hospitals no longer hear nurses back-biting and ******** at each other, i'm sure they will eventually have respect for us too
    having said all this, i've worked with some fabulous nurses too - it's not all bad news - but when it is bad we should all have the confidence and courage to confront and deal to the detractors - let them go and take up some other profession where they might get some satisfaction (and let us secretly hope they never get sick on MY ward!!!
  6. by   pmcgovney
    Originally posted by scg:
    BSN nurses are better educated. I resent working with AA nurses who get paid the same and the ANA & NLN should put a stop to it. As nurses we should have a great attitude tword ourselves and each other. We are not a separate entity from the MD. We are an extension of the MD, and always will be (BSN or MSN). The medical profession dosent have half the trouble that the nursing profession has. (brought upon its self)
  7. by   pmcgovney
    Originally posted by scg:
    BSN nurses are better educated. I resent working with AA nurses who get paid the same and the ANA & NLN should put a stop to it. As nurses we should have a great attitude tword ourselves and each other. We are not a separate entity from the MD. We are an extension of the MD, and always will be (BSN or MSN). The medical profession dosent have half the trouble that the nursing profession has. (brought upon its self)


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    pmcgovney
  8. by   pmcgovney
    Originally posted by scg:
    BSN nurses are better educated. I resent working with AA nurses who get paid the same and the ANA & NLN should put a stop to it. As nurses we should have a great attitude tword ourselves and each other. We are not a separate entity from the MD. We are an extension of the MD, and always will be (BSN or MSN). The medical profession dosent have half the trouble that the nursing profession has. (brought upon its self)
  9. by   pmcgovney
    Originally posted by scg:
    BSN nurses are better educated. I resent working with AA nurses who get paid the same and the ANA & NLN should put a stop to it. As nurses we should have a great attitude tword ourselves and each other. We are not a separate entity from the MD. We are an extension of the MD, and always will be (BSN or MSN). The medical profession dosent have half the trouble that the nursing profession has. (brought upon its self)
  10. by   pmcgovney
    Originally posted by scg:
    BSN nurses are better educated. I resent working with AA nurses who get paid the same and the ANA & NLN should put a stop to it. As nurses we should have a great attitude tword ourselves and each other. We are not a separate entity from the MD. We are an extension of the MD, and always will be (BSN or MSN). The medical profession dosent have half the trouble that the nursing profession has. (brought upon its self)
    I am new to this forum but have enjoyed reading all the concerns/issues that nurses have. Most are the same salient matters expressed 20 years ago and continue today. The conflict over which degree is acceptable in order to be called a nurse is probably one of the oldest which many in all areas of nursing do not agree on. It is obvious that nursing education has had a dynamic history. And it is believed that nursing will have a dynamic future. It is time for nurses to stop apologizing for the many and varied approaches to licensure, certification, and continuing education. It's time to applaud the innovations that exist and to perfest the quality of the education available. Only then will the public reap the benefits of the creativity. Last, but not least, for the past 2 years, I have been trying very hard as a FNP/PA-C, Associate Professor (I teach 1st year med students at UCD) and as a School Nurse, to have our colleagues and peers refer to all areas of nursing with our professional titles especially FNP's. WE ARE NOT EXTENDERS OF PHYSICIANS. We are not Allied Health, and we are certainly not midlevels. It is condescending when others insists upon describing us in physician-relative terms. What is more bothersome is another nurse referring to the entire nursing profession as physician extenders. We are unique and have skills that the physician does not. Remember, nursing is a profession not a nonphysician career. Your term and evaluation of the nursing profession is demeaning and uninformed. Your superior attitide that the BSN's skills and knowledge transcend all other "lower" degree's of nursing is arrogent and egoic and warrents some introspective evaluation to gather insight into why you would make such a disdainful comment. I hold 3 degrees, BSN, BA-Dev Psy, BS-Bio Sci, dual cert as a FNP/PA-C MSN, Cert as a School Nurse, Associate Professor @ UCD School of Medicine, and I can say without any hesitation that some nurses without all that behind them know more than I do. Stop being what I refer to as a "toxic coworker" and support and listen to the other nurses you work with and maybe you just might learn something about yourself and the profession!
    Pamela


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    pmcgovney
  11. by   JillR
    WOW!!! Pamala!! Yours is by far the most intellengent post I have read on this forum ever.

    Are there others out there like you? If so, get them together and please encourage them to post here. Great post.
  12. by   PPL
    Pamela, will you be able to support us during the Million Nurse March? Your voice would be greatly appreciated and well received!
  13. by   Tim-GNP
    This was indeed a volatile topic. It's amazing how a question about solidarity could cleave such chasms. It is clear that a great deal of resentment does exist in the profession. Some people consider it cliche to say 'nursing eats their young.' I contend that if you read the multiple posts, it becomes apparent that we not only eat our young, but each other.

    Whether or not anyone wants to admit it... the Diploma versus ADN, versus BSN debate has segregated nurses like no other debate in nursing. It is a lack of unity that have kept nurses at odds for years. The debate has also been fueled by some nurses with advanced degrees and bad attitudes. Unfortunately, by continuing this debate and keeping nurses at each others throats, nurses are prevented from being unified enough to demand better pay rates and working conditions. A previous poster gave excellent advice on joining your state's nurses assocation. If you really want to improve things... start there!

    We also need to stop assuming that nurses with different degrees means that one is a better nurse than the other. I'm happy to say that I also have advanced degrees and certifications in nursing... M.S., R.N., A.P.R.N./B.C.[G.N.P.], C.R.N.P., L.N.H.A. and am working on a Ph.D. I am also happy to say that I am a great nurse, and my patients appear to like me! My degrees don't make me better... they give me the ability to put my own 'spin' on my nursing care. I have worked and continue to work with nurses with ADN's and Diplomas who are excellent nurses. I have seen some nurses who also have M.S. and Ph.D.'s that are just plain idiots! So, the degree does not the nurse make... HOWEVER, in terms of professionalism, and assuring a proper wage, it does matter...

    In terms of the original post, which set these wheels in motion, about nurses being underpaid, I will offer my humble opinion as to why based on my knowledge as a Licensed Administrator: In the end, yes... as long as nurses hold less than a B.S. degree, they will make less money. End of subject. As an Administrator of a facility, I would have no choice but to pay more money for a higher degree. ESPECIALLY if I want to recruit the individual. Someone with a Master's degree will usually make more money than someone with a technical diploma [within reason, of course someone with a master's in 18th century poetry probably won't make much money at all].

    Does anyone ever hear physicians arguing like this over education? I have NEVER heard a physician say "oh, well... he only has a diploma from his medical college"... or "he's a 'degreed' physician, and doesn't know anything" Has anyone???? I would be shocked if you did. Physicians all have a uniform education [not that I am an advocate of uniformity], but it would help to eliminate the argument. It makes my blood curdle to think what members of other professions [especially physician's] would think if they ever read some of these posts.

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