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- Jul 20, '12 by woohQuote from dudette10I've been told just to talk about what I'm doing as I do it. As if that takes no extra time.Too many NMs feel that any nurse can precept without any reduction of workload or any special training.
The ridiculous thing is, it's not just that we don't get a workload reduction for training. We'lll often get more work piled on because we have "help."
- Jul 20, '12 by nursel56Quote from Burn-Unit-RNThat's a wonderful thing to do, but I don't think we were talking about volunteering or giving back to the community. We were talking about doing a regular job that puts a roof over our heads and food on our table. Mixing those two things together sounds like an attempt to hint that people who rightfully expect a paycheck just aren't altruistic enough and that is not fair.For those of you jumping down the OPs throat in stating that he would not consider it a calling if it were for minimum wage for free, that's not true. I volunteer on a homeless van 2 days per week which visits the poorest parts of the city to provide basic care for the homeless. I do not get paid for this.
I think you'll find it quite common that people enter nursing because of a transforming event they or a member of their family experienced. In my case it was the care my little brother received after he was was diagnosed with leukemia.
- Jul 20, '12 by WildcatFanRNQuote from dudette10this model sounds good, but what hospital would be willing to put in that kind of educational support towards new nurses like they do for new md's? many places i've applied to tout the fact that they are teaching hospitals, meaning they have residencies for multiple medical specialties. some seem proud of the expertise and education they provide for their nursing staff as well as the baby docs, some not so much. i think it would be wonderful if hospitals were as eager to advertise how big their nurse residencies were as much as they are for their medical residencies. also, the baby docs have the support of thier profession.thank you for the correction. the didactics you speak of fall into my definition of "classroom," but the rest (except for journal clubs...not sure what that is) are expected of mds throughout one's career.
our conferences of late consist of "customer service" programs. at my facility, nurse educators are holed up in their offices (doing what, i'm not sure...haven't seen one since orientation) except for a very good diabetic nurse educator who comes around quite often.
the biggest point i was trying to make is your model of learning and the culture within the medical world that supports it. we don't have that consistently, and at some facilities, not at all.
- Jul 21, '12 by woohQuote from nursel56Goodness, can you imagine the NETY people going into the police force? "I have to walk a beat before I get to be a homicide detective????" Becoming an attorney? "They expect me to do document review before I get to sit first chair for a homicide?" (Yes, I watch too much L&O and only think about homicide. I especially think about homicide when I'm at work, is that bad?)Medical education is so completely different. The strict pecking order involved there would have the "nursing eats it's young" people immobile with apoplexy.
- Jul 21, '12 by studentdrtobeQuote from dudette10It's where residents present articles and dissect them. Ex. the results of a large, potentially practice-changing clinical trial are published. A resident presents this data, along with a thorough background (which includes past clinical trials, retrospective studies, etc, and their pros/cons), the basic science mechanisms, their interpretation of the results, etc. And then, the presenting resident (and, often, the other trainees in attendance) are grilled with questions by the attendings (ex. "What would you do when a patient with XYZ comes in? Would you consider extrapolating data from this trial? What would your first step be? How would you proceed if the patient is refractory this your first-line treatment?", etc).Thank you for the correction. The didactics you speak of fall into my definition of "classroom," but the rest (except for journal clubs...not sure what that is) are expected of MDs throughout one's career.
It can be exciting, but downright scary! But, for the most part, they're very educational since it pretty much forces all the trainees to study so they don't look like fools in front of the entire department!
Quote from dudette10Yea, I agree with ya there. I love the medical education I've received so far and it has been, for the most part, very well-organized. We're incrementally given more and more autonomy as we progress through our training and show that our clinical decision-making is sound. As another poster mentioned though, there is a very rigid hierarchy in medicine and you have to conform to it. Attending > fellow > senior resident > junior resident > intern > med student. No ifs, ands, or buts. You have to put in the time and effort to work your way up the totem pole. You disagree, as an intern, with the treatment plan the attending decides on? Deal with it. Once you become a senior resident, you're much more likely to engage in academic discussions with the attending regarding the subtleties of patient care and convince them that your plan is just as good or better. The hierarchy is there as a way to provide appropriate level of supervision (based on where you are in terms of training) as well as being a net for catching mistakes.The biggest point I was trying to make is your model of learning and the culture within the medical world that supports it. We don't have that consistently, and at some facilities, not at all.
Additionally, residency spots get funding from Medicare. Not sure where the money comes/would come from for nursing residencies or whatever. And for more than a decade, Medicare funding for residency spots has essentially flat-lined.
- Jul 21, '12 by dudette10Quote from nursel56Very true! Medicine and the military have a long history of hazing behavior. Nursing also does, to a certain extent.Medical education is so completely different. The strict pecking order involved there would have the "nursing eats it's young" people immobile with apoplexy.
I think a modern nursing model similar to the traditional medical model could be created without the expectation of hazing behavior.