®Nurse, MSN, RN 13,986 Views
Joined: Feb 26, '08;
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I was an RN with years and years of vast nursing experience, spanning the spectrum from Hospice to ICU bedside care, before I became an MSN CNL. There are Many RN's out there who come to the bedside with a new MSN/CNL who have years and years of experience.
These RN's who go back to college to get their MSN/CNL are steadily growing in number. Additionally, hospitals and other healthcare employment areas are realizing the value of having nurses who are not only adept at taking care of patients at the bedside, but are also highly educated and not stuck in a 'silo of care' focus.
How am I holding up as a CNL grad? I'm doing awesome! I haven't regretted getting my MSN CNL at all, and consider myself very fortunate to be on the receiving end of a wave that is building towards utilizing more CNL's in my area of the world (Left coast).
I enjoy the respect of having my MSN degree with a focus in Clinical Nurse Leadership, and no one has ever dared to approach me and stated that a CNL is a worthless investment. Working with students in an RN program, and alongside other RN's at the bedside, I frequently am asked to give impromptu explanations of how they can get to where I am at with my MSN/CNL.
I am able to enjoy way more job prospects as a MSN versus a BSN in a Magnet hospital, and also am able to teach at a local college because of my MSN degree.
If I desired to return to college to be, say, an FNP or ACNP if I so desired, I would NOT have to get a second MSN degree. I would just obtain a post masters certificate in the area I desired.
Life is good - from a happy 28 year old Nurse, and a 4 year old MSN/CNL.
I am presently enrolled in direct entry CNL program. I already plan on working at the bedside after graduation. I know that my degree my bestow me with a BSN but I will need actual work experience. Personally, I think my program in no different than direct entry NP programs. Yes, I know that I will not graduate with a specialization. However, new graduates of direct entry NP programs ( depending on the setup of the program) will never have worked as a RN much less as an NP ( outside of school based clinical hours). Does that mean they are not competent? Not necessarily, they just need clinical work experience. Right now CNL is the new kid on the block and there is a bit of fear, misunderstanding, and lack of information where it is concerned.
As a CNL I will not be a nurse manager or unit leader. I will simply be making sure that all the people in the health care team are working for the best favor of the patient and other roles. I know I want to work at the bedside and eventually I know I want to become an NP but I plan on honing my skills on the floor. I think direct entry CNL programs are great for those who do not know what specialization they wish to enter or simply do not want to enter a particular NP field so early in their career.
This may help answer some of your questions: CDC - Safe Patient Handling and Movement (SPHM) - NIOSH Workplace Safety and Health Topic
Preventing Back Injuries in Health Care Settings | NIOSH Science Blog | Blogs | CDC
To put it simply, it is usually not one single episode of heavy lifting. If you’ve ever heard the story about holding a glass of water, it is very relevant: "[FONT=verdana, arial, helvetica, sans-serif][COLOR=#292f34]A psychologist walked around a room while teaching stress management to an audience. As she raised a glass of water, everyone expected they'd be asked the "half empty or half full" question. Instead, with a smile on her face, she inquired: "How heavy is this glass of water?" Answers called out ranged from 8 oz. to 20 oz. She replied, "The absolute weight doesn't matter. It depends on how long I hold it. If I hold it for a minute, it's not a problem. If I hold it for an hour, I'll have an ache in my arm. If I hold it for a day, my arm will feel numb and paralyzed. In each case, the weight of the glass doesn't change, but the longer I hold it, the heavier it becomes." She continued, "The stresses and worries in life are like that glass of water. Think about them for a while and nothing happens. Think about them a bit longer and they begin to hurt. And if you think about them all day long, you will feel paralyzed – incapable of doing anything." It’s important to remember to let go of your stresses. As early in the evening as you can, put all your burdens down. Don't carry them through the evening and into the night. Remember to put the glass down!”[/COLOR][/FONT]
[FONT=verdana, arial, helvetica, sans-serif][COLOR=#292f34]Reference : [/COLOR][/FONT]https://www.reddit.com/r/GetMotivated/comments/19bn9s/how_heavy_is_your_glass_of_water/
I've worked for a trauma center hospital that was non-Magnet when I started. After being an floor nurse for three years, they decided to pursue Magnet status.
Shared Governance was brought on scene, "shared decision making", Team Cooperation, how-to-treat-and-respond to your coworker.
It was an interesting journey, to be sure.
Experts were brought in, consultants were consulted, and so on, and so forth.
The final (requisite) step was an accounting of BSN's and ADN's.
If your hospital does not have 80% of their staff with a BSN or higher, things may really start to suck in a big way for the ADN's on staff.
My hospital closely watched the "BSN - meter", and when the tipping point didn't happen by the required target date, they decided that if the ADN's didn't go back to school by "x" time, they would be fired.
We eventually got Magnet status.
A LOT of ADN's went back to school for their MSN's ~ like, A LOT.
Now we have all these MSN's running around, working at the bedside, leaving the bedside, and the staffing shortages are horrific.
Many RN's had limited options until they got their MSN's. Then the sky was the limit for them once they graduated. A fantastic proportion of them left to be all that they could be.
Magnet means that the nurses who are forced to go back to school, can now say goodbye to their current position if they choose.
See, the real thing is this:
In order to achieve Magnet status, you have GOT to have a lot of leadership.
Cue the Managers, and Directors, and Quality, and on, and on, and on.
Then, you have the staff return to school for BSN or higher.
However, there is now very little upward mobility, because the positions have all been filled from outside.
Where do you go with a new MSN, or BSN degree, and a good amount of nursing experience if you aren't allowed to be anywhere but the bedside?
(That's a rhetorical question, of course: You leave!).
You can take remedial classes, if needed, at the community college for your LPN/LVN.
You will take a placement test at the college, and will then learn what you need to focus on.
Do NOT pay that God-Awful amount of money for something that can be obtained for a tiny, tiny fraction of that amount.
Speaking with former instructors from the for-profit schools that charge you the ridiculous amounts of money to attend their programs; what you DONT KNOW IS that they purposely wait until the very end to fail a student who was obviously not going to pass early on in the program.
You're still on the hook for tens of thousands of dollars whether you pass or not.
You are MUCH safer, and more supported at a local community college.
We had a group of students in which it was suspected that a number of them were doing just that: cheating with the test bank questions.
Our NCLEX pass rate dropped from 98% to 62% because of that group for that one year, then it bounced back up again. Hmmmmm... Seems that reading the questions just to memorize the answers and NOT the content really came back to bite them in the behind.
Cheating is wrong, and a very un-nurse like behavior. However, things tend to right themselves once NCLEX time comes around. The final joke is on the students who cheated.
Personally, I’ve found that I can only tolerate a month or two of the undesirable behavior before I start to catch myself falling into the same cattiness that I abhor (hence, taking a long break), or finding myself being appalled at what is stated and condoned on this site. I think it is a form of a defense mechanism that spreads like the norovirus among posters once you reach a certain exposure of postings.
Hoping that all people can conduct themselves in a manner that the profession of nursing SHOULD be elevated to is a noble endeavour. However, human nature is not going to allow perfect behaviour as much as it is so desperately needed to be demonstrated.
I just heard my Mother’s voice in my head finishing up this post with the saying “If you can’t stand the heat, get out of the kitchen”. lol.
The thought of what could go wrong, is far to great a barrier for me to even attempt such a thing. I've spent too many years working on degrees to risk all of that on something like diversion of narcotics.
I have a lot of experience in the ICU, and you've got to be thinking long term for your patient.
Sure....THIS dose might do the trick, but what about one, two, or three hours from now?
I just don't have that kind of time to be dealing with all that extra covert action. Get the script and get on with taking care of the patient.
Eating is a hobby...
Valium and Ativan were not counted in the drug count
Glass IV bottles were the norm.
Reyes Syndrome was new.
You actually had time to feed a patient.
Heat lamps were used on decubs
Treatment and med pass 1"X1" cards were color coded per shift so you would know what was due and when.
Shift report was given by the head nurse who read through the patient names on the kardex along with their whole life history in a nutshell.
The patients hairdresser could walk in and inquire about the patient and no one would bat an eye.
You could score a breakfast tray a lot easier if you were hungry.
The hospital provided coffee, toast, butter and jelly for the break room.
Central processing would try and resterilize anything they could get their hands on.
They would Not tell you the sex of the baby if you had an ultrasound. (Just a bunch of Killjoys)
It cost around $3000 dollars total to have a baby!!
We all just take turns. We are a level 1 PACU, so we have a Primary and a Secondary RN per patient. We function in teams for the day, so both nurses will take turns being primary and secondary RN. As far as the CNA goes; we do not have a CNA in the PACU. No one is really deciding who is getting the next patient coming out from the OR except the nurse-teams. It’s really hard to hide the fact that you’re sitting there picking your nose while another RN team is taking patient after patient.
I think that people develop different coping skills as well as technical skills at their own unique pace. Sans a rigorous rubric/scoring tool that evaluates a person for the daily grind of the floor, the whole definition of “fit” is dependent upon the sole observer.
My hospital requires an interview for every single position change - be it from nights to days, part time to full time, unit to unit, or floor to management. With each opportunity, the interviewee is evaluated based upon a hiring panel as to whether or not they are a certain caliber or not.
It just doesn’t seem right for one single, solitary person to decide whether or not a person is a “fit” for that particular specialty. Something like that should require more than a few people to weigh in and give merit to the observations that are being seen.
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