Content That ixchel Likes

ixchel, BSN, RN 55,623 Views

Joined: Jun 3, '11; Posts: 5,173 (75% Liked) ; Likes: 19,987

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  • Apr 3

    Quote from avengingspirit1
    I completely agree about nurse staffing levels being a factor in mortality rates. But the topics of staffing levels and nurse education and their effect on mortality rates are mutually exclusive and should have been examined in that way if the authors really wanted to imply that RN education levels affected patient outcomes.
    They aren't mutually exclusive at all. Hospitals that are interested in improving outcomes can improve staffing ratios, increase the the education of the nursing workforce, and improve nursing work environment all simultaneously. Many hospitals have done this recently as part of achieving Magnet status.

    Quote from avengingspirit1
    I can not trust based on just their say-so that they completely and objectively factored all impertinent data while they factored in only relevant data.
    Of course science is not perfect and it is never possible to account for "all" factors but that is why we have statistics. The authors are able to conclude that the results noted are not due to chance alone. And in this particular case, they also controlled for unidentified confounders and found they were not statistically significant in aggregate.

    Quote from avengingspirit1
    It was not original research. I also must ask why they didn't want to take the time to do a completely original study on nurse education levels. And then looking at who supported the study, I question as to whether it was truly unbiased. Don't know if Aiken is still teaching classroom nursing courses, but I highly doubt she would have accepted a paper from a student that was built on a previous paper handed in. I spoke with a couple of Univ. of Penn nurses and they didn't even know who she was.
    This is original research. It used existing data but the rest of the study was entirely new. The vast majority of clinical research uses databases of retrospective data (like NHANES and WHO). This is very common in research and it covered in 100-level research method courses.

    As far as your "contacts" at UPenn not knowing who she was, she is the Director of the Center for Health Outcomes and Policy Research. I am not sure what you are implying by that other than that your contacts were ignorant.

    Quote from avengingspirit1
    You seem to like the word conspiracy. I really haven't heard the word used much since Oliver Stone's JFK movie. But I am merely saying that there are multiple organizations benefiting from people being driven back to colleges and universities. It's not conspiracy; it's business.
    Look up the definition of conspiracy and conspiracy theory. That's why I use the term.

    Academia is absolutely a business. But this research is consistent across multiple countries and multiple authors, some of which have universal education.

  • Apr 3

    Quote from avengingspirit1
    The information about using gross estimations and then and then making an estimation about what MIGHT happen if there was a 10% increase in BSN nurses are buried in the body of the study.
    I am not sure you understand the purpose of the study. The study built on previous studies which had identified that improved staffing levels, improved work environments, and increased nursing education were all associated with improved patient outcomes (lower mortality). The design of this study was to take the outcomes data from a large number of hospitals and patient encounters and use that data to build a model. The model could then be used to predict the effect on patient outcomes if the modifiable risk factors were adjusted (staffing, environment, education) while keeping everything else the same.

    Quote from avengingspirit1
    Funny, one of my former nursing professors , who did have a doctorate left my nursing school to help run a dept at a four year nursing school. She had always been one to defend 3 year nursing diploma education. But when I went to see her at the university, she did a complete turn-around and even quoted a statement from the March 2011 "It's Academic" article in Nursing Spectrum. I understand she had to tow the company line and we both nodded to each-other as I told her I understood. I understand it's a business. And I would respect those pushing it if they would come out and admit instead of this phony nonsense about elevating the profession.
    Or maybe, rather than her being involved in a multinational conspiracy from "BigNursingAcademia" she read the data and changed her mind. And maybe your assumption that support for 3-year diploma is mutually exclusive to also supporting advancing nursing education: it's not. These studies (and Aiken's are only a part of it) suggest that more education makes individual nurses better nurses: I feel like you think these studies suggest that nurse A, AN is a worse nurse than nurse B, BSN and they absolutely don't.

    Quote from avengingspirit1
    If I had solid proof that taking courses such as "Sociology of Nursing", "Theoretical Foundations of Nursing" would help heal patients, then I would agree that having a BSN could help patients.
    There are numerous studies across many countries that have shown consistent results.

    Quote from avengingspirit1
    This may be hard for you to believe, but I am about helping people and doing what's best to accomplish that. My mother died a few months ago because I believe the staff did not recognize the early signs of Sepsis. When I visited her the first day and saw her vital signs, I asked if she was being evaluated for Sepsis protocol. They just told me they were working within hospital parameters. How about a BSN program to teach nurses how to better recognize early signs of sepsis, diabetes complications or new wound healing methods or new methods to accelerate healing and speed recovery. Give me those things instead of just writing more APA format papers and I'll agree that a BSN is worthwhile and needed.
    I am sorry about your mother.

    I would argue that education does help. While going from and ADN to a BSN might not directly teach a specific thing (like early recognition of sepsis) it does (in theory, and supported by data) contribute non-directly. Increasing nursing education does many meaningful things for the profession including increasing nursing research, critical clinical thinking, EBP, etc which sum up to improved outcomes, and in the end, your mom maybe could have been in that reduction in mortality the studies have suggested.

    We should improve nurse staffing levels. We should improve nurse working environments. We should improve nursing education. These are all modifiable risk factors or patient mortality that nursing can impact.

  • Jan 8

    Thank You Beth Hawkes! We are so thrilled to have you speak on April 26th 2018 in DC. We love your support. Nurses across the country must act. No time to waste. Talk to your colleagues. Come to DC. Stand up for patient and nurse safety. Your voice DOES matter. #NursePatientRatiosNOW
    Sign and share Nurse Patient Ratios | Petition For National Nurse Patient Ratios

    Doris Carroll BSN
    NTDC Organizer

  • Jan 8

    Did she seriously just respond twice to the same post with a consecutively more inflammatory response? Trump is clearly still President and must have just got his Nurse Practitioner certification.


  • Jan 8

    Quote from FullGlass
    Trump is still President. What are you?
    An experienced, practicing NP. You?

    Seriously though, not to "lecture you" anymore, but a thicker skin will serve you well.

  • Jan 8

    Who needs experience when you have the two greatest assets: mental stability and being, like, really smart.

  • Jan 8

    Quote from FullGlass
    You are the one who is confused. Is English your native language? Let me try to make this comprehensible to you:
    1) I said that primary care NP jobs usually do not require RN experience.
    2) I said that an exception to #1 is oncology and the job listings I saw for oncology clinic NPs usually specified that RN experience in oncology or an ICU is required.
    3) I never said that being an ACNP is required to work at an oncology clinic.
    4) However, since you mentioned hospitals, I pointed out that I am a primary care NP and therefore, not applying for hospital jobs.

    As far as my finances, since you are so concerned, I paid mostly cash for my BSN because I was successful in my previous career. My MSN didn't cost me very much because I won a full ride Nurse Corps Scholarship, which BTW, is a competitive process. So I don't have substantial student loan debt.

    I changed careers once, from business to nursing, because I committed to public service. That is to be lauded, not denigrated. In addition, my executive management and leadership experience, along with my technology, consulting, strategy, and sales skills can be very valuable to healthcare organizations.

    Your energy would be better spent on improving your own career, not worrying about mine. In fact, you could channel that energy into obtaining some fancy degrees of your own, so you aren't so threatened by someone like me. Your comments betray deep insecurity.

    Oh, and I am a pleasure to work with. In my previous career, people transferred over from other projects and practices specifically to work for me. My teams were high-performing and happy. My clients were satisfied. I worked hard to mentor my people and also to help their career advancement.

    Finally, I got nine NP job offers. As they say, you can't argue with success.

    Now, I'm going to decide which offer to accept. I'll be sure to let you know of my decision.
    I've been following your posts throughout this thread, and as a fellow DE grad, I fully support your path and agree that you can be a successful primary care/clinic NP without RN experience. Some people have been somewhat disagreeable and condescending. That gets hard to listen to over and over. I understand your desire to defend yourself, the DE track, and the choices you've made. You have every reason to be proud of what you've accomplished.

    I am dismayed to see this last post of yours, as you really do come across as arrogant, rude, and over confident, and that detracts from anything positive and true you might have previously written. As Boston FNP previously stated, you haven't even worked as a NP yet. No matter what your previous accomplishments were, you are now a rookie again. Keep that in mind as you see your first patients. They won't give a rat's arse that you hit your sales numbers every quarter or mentored numerous underlings. You will be a brand new, NOVICE NP that they are putting their trust in. That's an awesome responsibility and one that should not be taken lightly. An overconfident provider is a dangerous provider, IMHO.

    This last post of yours came across to me as just as rude and condescending as some of your detractors. Why would you want to lower yourself and further support their doubts about you and DE grads in general? I'm not saying you should shut up or not support your beliefs. However, it is better to express yourself in a manner that is dignified, thoughtful, and courteous. DE grads are underdogs, for lack of a better word, and unfortunately, the burden of proof is on us to show that we are prepared, competent,and capable. Becoming overdefensive, snarky, and bragging about oneself does not help with that battle. I've said on several posts that those who have not worked as NPs really can't say for sure if RN experience was necessary. You have not worked as a NP either, so you are really not in a position to say for sure that you'll be successful. You've had job offers and have your choice of positions. That's the easy part. I think you likely will be successful, but please go into that first job with the intention of doing a lot more listening than talking, and keep in mind that despite your education and training, you know very little about working as a NP. None of us did as new grads, regardless of how smart we are and how much success we had in the past. You still have much to learn. Let your work speak for you.

  • Jan 5

    Quote from EDAPRN1215

    I am saddened and disheartened by the direction we are moving in as a profession but I am only one voice in a sea of many.
    If you do something to exterminate the current culture of antiintellectualism and lateral violence toward new grads where you work, then you will help to eliminate one of the main factors which pushes our profession wrong direction.

  • Jan 5

    Quote from kadphilly
    Don't worry, we don't want to see you either. I already have a 2,000 patient following.
    I took this as being tongue in cheek, not childish.

  • Jan 5

    Quote from Susie2310
    There was a similar thread recently titled: "Seeking Advice: Direct Entry Blues." Several people, including myself, pointed out the value of actual bedside nursing experience prior to assuming an advanced practice nursing role, and provided situational examples, which didn't go down too well with some of the "No nursing experience experience necessary for NP folks."

    I am so glad that my family sees a highly qualified and experienced Internal Medicine physician for their primary care. We also always state that we want to see a physician and not a NP/PA when we go to the Urgent Care.
    Don't worry, we don't want to see you either. I already have a 2,000 patient following.

  • Jan 5

    I'm going into my last semester of my DNP studies. I've been an ER nurse for a long time. Will that experience help me? Yeah I think it will. Do I think that it is necessary for becoming a successful NP. Nope!!! Not in any way. Nurses have a culture of ripping down their own and casting judgement on things like "he or she didn't pay their dues" Dues to who??? If a young, smart NP can do the job then god bless them & to hell with what judgement may be cast upon them by nurses who did not make the effort to become an NP themselves. As far as DNP studies I personally think much more time should be spent on clinical experience and hands on training as opposed to the many, many wasted hours writing a CAPSTONE that most likely contributes little to the profession and will almost certainly go unread

  • Dec 29 '17

    If you are just starting out, what you will find is like with everything else, each aspect of your education or work experience you encounter will come with its own hardships and set of challenges. Meaning... when I finally finished RN then BSN schooling I felt like I was on top of the world. Then I started working at a very busy ER just to find out that I had to start from scratch at the very beginning again (it is humbling). Once you have been on the job for awhile, you will find your confidence builds and it does get much easier. I think that is what gave me the boost to go back to school and get my FNP. And yes, you will always continue to learn and grow as a nurse no matter what area of nursing you are in.

    What you need to figure out now (along your journey) is what works best for you, what makes you happy, and what you are comfortable enough enduring, regardless if it is a new RN job or your nursing education. When it is all said and done, the journey from the very beginning (RN school) to the very end (your RN job/career) will all have their own hardships, challenges, and ups and downs. Along the way you will just have to find the right balance with school, family, and career to make it all work. And always remember to be true to yourself and do what you love and makes you happy and it will feel like less of a struggle. Good luck in your nursing career!

  • Dec 28 '17

    Quote from MoonlightRose
    Really? Why not just say she blabbed my secret pregnancy on social media and that is how friends and family found out at 6 weeks along I am pregnant and now I don't trust her anymore. Why cover for her? If you were the office manager wouldn't you want to know the truth? Because after being embarrassed in social media infringe of 500 people I don't feel like I have anything to lose anymore.
    If you didn't want anyone to know about your secret pregnancy and if she wasn't that close a friend, why did you tell her in the first place? Really -- this has nothing to do with her job. Keep the office manager out of it. And you might want to think about why you're so fixated on this vindictiveness rather than being excited about your secret pregnancy.

  • Dec 28 '17

    How old are you, if you don't mind sharing? I know pregnancy is scary when we start getting labeled as "advanced maternal age," "elderly pregnancy," or my favorite - "geriatric pregnancy." Haha. I could only laugh! Please ignore the statistics and focus on being a healthy mama, that's all you can do. When I was 5 weeks pregnant and had lower right abdominal pain, I went to a local ER. My hCG was high but the ultrasound only showed a tiny sac. The ER doc tried to keep it real, you know - "At your age, these don't usually work out, it doesn't look good." But hey, I just needed one good egg! My "doesn't look good" is almost 6 month old, and wonderful! I wish you the best.

  • Dec 28 '17

    Quote from MoonlightRose
    and she's was getting close to the line of HIPAA without crossing it. I guess until I found out she's done anything more I need to drop it and move on. I guess I feel like she got away with something. My husbands mother was really embarrassed and his dad didn't even know (parents are divorced). It was low.
    No, she didn't come anywhere near the line of HIPAA. Again, unless she obtained the information by providing your care or by accessing record, HIPAA isn't even within the same universe here. It was a crappy move by a crappy friend, and nothing more. If she were not employed in health care, would HIPAA even enter your mind? It shouldn't, and it shouldn't just because she happens to be employed in health care when the info wasn't gotten through her job. Just remember: once something is out in the world, no matter how much you trust the person, it can and likely will spread.