Enough is enough- taking back our profession - page 3

by forrester 4,870 Views | 29 Comments

the nursing declaration of independence the unanimous declaration of the 3.1 million nurses in the united states of america when in the course of human events, it becomes necessary for one people to dissolve the political... Read More


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    Yes, there would need to be a Valley Forge ... and probably a Civil War, too. "Unions" don't fight battles -- their members do. And when unions flex their muscles, people get hurt. Unions need their members to hold fast when the going gets tough -- not just their money.

    I'm not saying that collective action and personal sacrifice is always wrong: sometimes suffering and personal sacrifice is necessary to accomplish goals. What I am saying is that I don't think many people are willing to make those personal sacrifices at the moment. We are not sufficiently unified around a common cause that we believe in strongly enough to suffer for.

    The Founding Fathers were. They were able to set aside their differences -- and pledge "their lives, their fortunes, and their sacred honor" for independence. I doubt even you, forrester, are willing to do that.
    anniv91106 likes this.
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    Quote from ALavallee
    HA! Pure Awesome!
    Too bad the OP wasn't trying to be funny.
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    Actually llg, I have.
    Been fired twice for things not related to job performance.
    Once for publishing an article, once for going on national radio. Both times trying to get nurses more engaged in the political process by understanding that we don't just have to take it, and that there is a very real connection between securing our independence in both the facilities we work in AND the advanced practice we can do.

    Gave up what could have been a lucrative (as far as nursing goes) administrative career with a major corporation.
    We can become what we should be.
    libbyliberal likes this.
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    The NNU is ONLY about bedside nursing issues. They felt the same way when they took over their state association, quit wasting time and money with the vagurries coming out of the ANA, and took their own path to self actualization.

    Pennsylvania, Maine, and Massachusetts have joined them.
    Maybe something we should all consider. And that's part of the gist of the Declaration I submitted- What part of the nursing process do we not apply to ourselves?

    Things chnage when we make them change.
    kalevra likes this.
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    Sorry to play the devil's advocate and be "that guy" but not until NP education steps up it's game in teaching and coursework (I'm looking at you DNP degree which IMO is nothing but a MBA for nurses), NP autonomy should not be boosted.

    For every feelgood story about how great someone's NP was, I've seen personally or heard some way that they botched a dx or tx for a patient. When practioners of any walk of life cannot identify key anatomical structures, basic metabolical pathways, or poor diagnostic criteria that is when it stop's being an issue about professional progression and more about patient safety. Holism and therapeutic communication are all fine and dandy provided that you can actually get the right treatments on board and establish that based on a solid foundation of wisdom and experience not algorithms.

    Square away and standardized the education across the board and drop the filler and add some substance to the education then we can move forward from there. I also have some sentiments with the other poster who noted that the NP profession is very much dissociating with nursing and their wishes do not necessarily represent that of the nursing community - call it advanced nursing or whatever you'd like - it's still medicine.

    Again, not trying to come off as hostile or dismissive, just saying the other side of the coin that perhaps a not so vocal population would voice. I just feel that we have to fix things in our own camp first before we expand our practice and independence.
    Aggie RN, zoidberg, and kalevra like this.
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    I am not an NP nor is my purpose to be argumentative. Botched dx or tx is not exclusive of NP's. I think that physican's have far more well know cases in that dept. and long before the NP role came about or rose to the forefront it is today.

    I am in agreement that nursing ( all levels- bedside and NP's) MUST unify and become one powerful voice. We nurses have the numbers, We have the machine - the NNU which needs to broaden it's membership to include NP's, APN's. We have the political and government backed ground work and support for it. This ground work was laid down by the Dept of Human Services- with it's policy and agenda last winter(Feb 2010) of a shift in the national focus in healthcare practice from an acute care model of healthcare to one of primary and preventative care model. Secretary Seblius put forth this ground work at the congressional hearings last winter, during the hearings on Healthcare Reform.

    The federal government gave $122 million to the community health clinics to this country last April(2010). The hospitals got zip. I think that says a whole lot about which side of the politicial arena the federal governement sits on. "No soup for you Mr hospital CEO . You have done enough in this country's healthcare disaster- financial and practice". Multi million dollar salaries, perks, bonuses, continued skyrocking helthcare costs, no improvement in the general overal health level of this country's population but the adding to the poverty level( the gover't had to RAISE the poverty level thresholds this past yr to include the once middle class, poor health habits( not seeking care until the condition is so far out of control it requires admits to ICU's), cheap destructive nutritional status( buying groceries in walmarts and dollar stores and the choices of which are high in carbs and fat to fill stomachs on a unemployment check budget)', acutely ill complex health level of the people in this country, by laying off nurses and doctors adding to the unemployment rates and over burdening of those that are still employed in your wonderfully expensive poop spas. Spending millions on advertizing"My hospital is better than yours" on billboards, radio and TV, excuse me, HDTV.

    Not alot of medical students are flocking to the Family Practioner track of their programs. They want the "specialities" of cardiology, neuology, GI, surgery etc. Why. These specialities do alot of proceedures and therefore bring in lots of money to the practioners in them. The AMA is doing what? to discourage this trend and how long has this been going on??? I think nothing!!

    Where does this leave the 30 Million uninsured- by reasons of unemployement, 18- 26 yr old age group( which has lessening the uninsured rate- from $45 million to $30 million: They are able to continue on their parents insurance until age 26) the elderly( medicare only covers so much, and if they live on social security, that extra cost for meds and services wipes them out. the average income of a person living on social security is $12,700/yr. That was another congressional hearing- Hearings on Aging; headed by Sen. Bernie Sanders-Vt., this fall)

    Nursing can certainly jump on board with this. Primary care is perfect for nursing. I'm not real sure why the nursing powers that be want the NP's to now have their DNP- I don't see how that is going to change their role or scope of practice any to continue to participate in the independent practioner role. Unless it is what an OP posted- DNP is the focusing on the MBA- which kind of shows us who is behind the push to the DNP- the CEO's, AMA and the lame duck ANA- which is afraid of it's own shadow and doesn't want to stand up to the healthcare aristocricy.


    I already think there is a civil war going on in this country- it's casualities are the patients and remaining licensed health care workers who are subjected to this "Greed is Good" philosphy and practice of those who control the health care facilites purse strings, there fore ration out jobs, health insurance( or even the ability to purchance on their own with decent wages to afford) and jeapordize a person's life( premature discharge with inadequate staffing levels for licensed healthcare workers to competenly, safely and ethically do their jobs) with the stoke of their greedy pen,because profits are down because admits are down, because reimbursements are down but still want no cutting into their mega buck incomes of which, if there was ever another larger scale national disaster- like another 9/11 attack, they are useless, unskilled, uneducated and grossely in the way of those who are. These creeps probably couldn't even boil water on a barbaque grill. Useless. JMHO
    Last edit by kcmylorn on Jan 7, '12
    PintheD, IowaKaren, and tiredbeatupRN like this.
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    How about we focus on taking back nursing from ourselves? Many of our problems are iatrogenic.
    Woodenpug and barbyann like this.
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    Interesting discussion. Thanks OP. I'm going to check out the NNU.

    Coolhand - "I have my pitchfork and my torch, where we headed?" Can't get the visual out of my head, nor can I stop laughing!

    kcmylorn - "poop spas" !!! So so funny, yet oddly accurate! Also, great post.
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    just to keep this rolling... in the current state of things, NP education is inadequate. Np's should not be set free to practice independently because they will attempt to practice medicine, not nursing. NP's education is inferior to PA education, yet they somehow think they are entitled to independence to practice "nursing" while they actually intend to diagnose and prescribe. NP's would function best and most safely as a PA does: a physician extender. If an NP thinks they can be a person's primary care provider after 1 pathophys and 1 pharmacology course with under 1000 clinical hours, they are delusional and dangerous. They will miss something and someone will die. While I plan on becoming an NP, I will work with an MD because
    i want someone who spent a decade learning about the human body and what affects it. I know some may say this is anti-nursing, but it it pro-nursing. If NP's stopped trying to gain complete independence, maybe the focus could shift to helping nursing reach its goals for nurse practice and patient care, not NP practice, which IMO should be managed separately.
    Aggie RN likes this.
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    Yeah, I agree fully with benm93. I have the utmost respect for NP's, because it's not "easy" to become an NP. It's just not as difficult to become an NP as it is an MD. That being said, there's a reason why it's harder to become an MD: education. I think there are a lot of good NP's out there that have had enough clinical experience to be good independent practitioners (heck, I work with an RN that has been around long enough he could be an independent practitioner), but I think that's more the exception than the rule. NP's and MD's should figure out a better way to collaborate, not fight to see if they can even coexist.


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