®Nurse, MSN, RN (8,197 Views)
Joined Feb 26, '08.
Posts: 939 (61% Liked)
that's the role of a CNL after they have several years of experience. I've yet to work with one who *didn't* work in a regular bedside position. Every RN I've seen who does what you're describing has been a CNS.
Black American here.
No that is an not a cultural behavior. That is just being rude.
Our directors are very fond of saying "evidenced based practice" when telling us what to do..like hourly rounding, bedside report, safety huddles, etc. etc. I usually have no problem with any of this. I'm a "go with the flow" type of person.
Next up is a mandatory report sheet we have to use to give bedside report, in the SBAR format. Again, I'll go with the flow and I helped create one for our floor and sent it for approval (but they lost it and it's not saved..doh). A director was talking to our unit about it, siting "we're modeling ourselves after the airline industry that greatly improved safety over the years. Hospitals have the worst safety record of all industries. Evidences shows lack of communication is one of the things that cause mistakes and evidence shows this SBAR report will help with that."
Me: "I have one word to say: ratios. Evidence based practice over and over shows this improves safety and outcomes".
They want it all...safety, great customer service scores, high profit, but don't address the one elephant in the room.
This is an interesting subject matter, one that comes up often in the medical field today. We have a very distinct hierarchy of skills, degrees and pay grades in the medical field. This hierarchy strokes some peoples ego's and diminishes the feelings of self worth in others. It really is a shame that the medical culture feels the need to rank the "importance" or relevance of a person based on where they fall on the spectrum of education or skill. I do believe that LPN's working in home health, long term care facilities, physicians offices, etc is a cost saving measure and a needed one. If LPN's were phased out and ADN's were all forced to go back to school for their BSN's then the pay demanded by all RN's to staff these LTC facilities would break the medical field bank, so to speak. The expenses would be astronomical.
You'll see this push for all RN's to be BSN's, no LPN's in the hospital setting, nursing assistants being forced to get their CNA license, BSN's going back for their NP's and CRNA, current CRNA's and NP's being encouraged to get their doctorate. The nursing profession is attempting to gain more relevance, autonomy, political power, respect and impact on the overall picture of healthcare. From the beginning of healthcare it has always been 100% MD ran with nurses being background handmaidens with very little academic education and mostly "on the job" clinical training. The medical field is changing and with it will change the amount of education required to practice in it. I could take a high school student and have them insert an IV or Foley 100 times in clinical practice over time and I'm betting they would get pretty good at it. In order to gain autonomy and political power for change in the healthcare industry we can not be seen as a very minimally educated person who has learned a basic skill very well. The measuring stick that we are inevitably being held up against are MD's and D.O.'s with 8 years of didactic education and many years of residency following. In order to be a viable member of the discussion it's fair to request we at least show the dedication, ambition, intelligence and commitment to obtain our BSN's.
I enjoy this article because it does highlight that LPN's have a very specific and valid role. They are needed and appreciated for their hard work in Long Term Care facilities and for taking care of our Grandparents and disabled. I believe where the conflict comes from that this author discusses is when a student goes to LPN school in order to obtain an RN-BSN position and pay grade but without having to commit to the time, money and work to obtain the BSN degree. That would be like me getting my BSN and going to work in the CV-ICU and getting mad that I don't get the same pay and position as the CV Surgeon. There are no quickie degrees and easy paths in the medical field. You will have to work for everything you obtain. That's free advice.
"I would never want you as my nurse" is analogous to invoking Godwin's Law.
Once you say that, you've pretty much lost your argument.
Nurse practitioners are still nurses, our advanced education is fostered so that it builds on an assumed foundation.
I don't know what to tell you about your particular position, OP, but I received my RN license last year and immediately enrolled in an MSN NP program. I'm currently working as a sexual assault nurse examiner, and hope to work in women's health as an NP when I eventually graduate.
Do whatever you need to do to reach your goals. That's what I'm going to do.
I worked in Obstetrics for more than a dozen years and then slowly moved to Quality. I'll be honest, it was an emotionally difficult change and continues to be, although I enjoy what I do now.
The difficulty for me was not feeling like I "made a difference" anymore although rationally I still do. Actually I have the ability to make a difference to MORE people than when I worked bedside, I just don't visibly SEE it like I did when I worked bedside I also miss "my babies" since I'm no longer in OB.
What DON'T I miss? The stress. The stress of having MD's induce a bunch of patients before they leave on vacation. The stress of taking care of more patients than is safe. The stress my body was under for 12 hours at a time.
Is there a way you can do some projects on the side for the Quality department before you give up your Critical Care position completely? Possibly doing some chart reviews to get a feel for what that is like.
I am literally "in charts" for 75% of my day. It can feel isolating sometimes with less social interaction than you currently receive as a bedside nurse. That may or may not be something you would like. After having my attention pulled in a million different directions as a bedside nurse for years...it is a joy to be able to concentrate on one thing at a time now!
Where are you located? Curious about use of FNP's within the inpatient side.
?? Research? Clinical trials, maybe. NP friendly teaching hospitals with research going on?
What do you want to do? See patients as a provider, write orders and direct treatment. Or provide nursing leadership on the unit or in the hospital? I would guess that the NP would help you be more competitive for CNL jobs. Not sure how a CNL would help you as an NP. You would probably be more systems-savvy which might work into a leadership type NP role. You would probably have to create your own role and get someone to hire you. Maybe a clinical program director.
Hair SHOULD be pulled back in a "drab" ponytail, otherwise it gets in the way and is an infection risk. Per my facility's policy we are required to have our hair pulled back. I have short hair and can't put it in a ponytail, but I frequently wear a nice headband to keep my bangs out of my face and the rest of it from falling into my face while providing patient care.
I come into work everyday with neat (not wrinkled) scrubs and my hair nicely blow-dried. I do not wear makeup and it's not part of my job description. I have sensitive eyes and makeup just bugs them. It's not my responsibility to be a "pretty" nurse- that is so condescending. I've never had a patient have a problem with my makeup free face. Also, why should I put makeup on when I am just going to probably sweat it off in a patient's room who has the heat set on high (especially if I'm wearing an iso gown)? Maybe the people in ICU are too busy doing their jobs and saving patients to worry about looking "as beautiful as they can" (and no, I'm not an ICU nurse).
There is a big difference between looking professional and "as beautiful as can be". Professional is coming in with neat hair PULLED BACK, neat scrubs that fit well (are not clingy, don't show cleavage or butt-cracks, etc.) that are wrinkle free, no perfume or cologne, and not wearing nightclub makeup. Nowhere in being professional does it state I have to put on foundation, mascara, eyeshadow, lipgloss (for my not pulled back hair to get stuck to), etc. I am there to work, not act like I'm on a set of a soap opera (ie. General Hospital).
That is absolutely ridiculous and it pains me to see other CNAs or individuals sayin things like "That's just how it is, it's not gonna change." Why not? Because we as CNAs refuse to do anythin about it?? We are LICENSED professionals. Your scope of care and practice is with your residents, not the offices of your team leaders. Most LPNs and RNs would be offended (and would most likely refuse) if administrators assigned those kinds of tasks for the sake of saving a buck but you're expected to just do it because you're a CNA and not viewed as they same professional as your RNs and administrators. I'd bring this issue up at a staff meeting, explain why it's not your responsibility to clean up after an entire facility, that it's beneath your scope of practice and I'd start a petition.
We had a program here called the star program. It required a CNA to remain on the floor for an additional 4 hours if someone on the on-coming shift called off. Once the program was implemented there was a serious rise in call offs and CNAs were having to stay an extra 4 hours constantly. Eventually we got sick of it and threatened to start a petition. The admins got wind of it and sat us down to ask us what was wrong with the program. We explained, they tried to convince us it was for the best and we told them we will start a petition and send it to their bosses, we would go over there heads. They cancelled the program the following month.
I picked THIS point in the thread to find out what the "General Noise Discussion" was all about......
As you can see, it's a good appoint as any...
Interesting discussions on this board are becoming increasingly rare, and almost impossible to find. They get lost under all the arguments over whether wiping butts is something nurses should do and rants from CNAs who feel like they're disrespected.
Talk, Discuss, and Share your experience at your favorite Nursing School.
Advertise With Us