Time to call a duck a duck? - page 5

by eriksoln | 88,791 Views | 547 Comments

I remember having this debate with other students while I was in school. I have seen nothing during my time practicing nursing to change my mind about the issue. Now, with the recession bringing out the true colors of nurses... Read More


  1. 5
    Eriksoln.......
    You "hit the nail on the head" with this thread......
    You are so right........
    This IS why Nursing is not a Profession........
    Mom To 4, Chin up, quezen, and 2 others like this.
  2. 3
    Quote from pedicurn
    However ....Why is theory such as Maslow's considered part of our 'academic core' ? Maslow is very basic ...it's so easy one could learn it in high school.
    Why is the nursing process considered so highly? Again so very basic (and obvious) it's embarrassing. It's a basic problem solving process that any intelligent person uses.
    A smart senior high school student could handle this 'professional' stuff.
    I agree. Yes, the nursing process IS important... AND it's a basic problem-solving process that any intelligent person uses. Does that mean that nursing is "just" basic problem solving that doesn't require any special skills or knowledge? No! It's the knowledge and skill base that can make a nurse out of any intelligent person.

    Quote from pedicurn
    Hospitals realize this....that's why they value those nurses who have learnt 'a bunch of technical skills' JUST AS HIGHLY as those who have these plus the broader picture. ...........

    Which then leads us to the big point. Why do so many areas perform well with so many of those nurses with 'a bunch of technical skills' leading the pack? They are good at performing skills quickly and moving patients through ...conveyer belt nursing. Not much else gets considered ...nothing collapses.
    Very good point! The reality is that task-oriented nurses do thrive in many environments. Many nursing functions ARE task-oreinted. Being task-oriented isn't inherently a bad thing. One can be task-oriented without being oblivious to the bigger picture. ANY good worker will not be so focused getting tasks done that they let bad things happen. If task-oriented nursing didn't work, why is it that we see so many task-oriented nurses surviving for decades in the field?
    Chin up, oliviajolie, and eriksoln like this.
  3. 11
    Quote from pedicurn
    Which then leads us to the big point. Why do so many areas perform well with so many of those nurses with 'a bunch of technical skills' leading the pack? They are good at performing skills quickly and moving patients through ...conveyer belt nursing. Not much else gets considered ...nothing collapses.
    Well, nothing collapses because there's the occasional "thinking" nurse that comes in here and there. Like the lady getting fluids practically straight into her lungs. If she'd had another "follow the directions" kind of nurse, she'd have called the doctor, the doctor would have come, eventually, hopefully before she codes. If nothing else, the code team would show up and give her some lasix.
    How many nurses do you know who seem to have a few more patients go bad than average? More that code, more that have to be transferred to ICU? Or how many nurses on the shift opposite the one you work do you notice giving report on patients that go bad more than average? (This is not a "bad nurses on night shift" thing, I'm talking either shift.) How often do you have to "fix" things at shift change? That's a result of the blindly doing without really thinking kind of nurses.
    The patients don't usually crash on them. They crash on the next shift if it's not picked up really quick. "Failure to rescue" is the closest data you can get on it. But I think it's even more subtle than that. Failure to fix things 24 hours before they went really bad. And then failed to fix them 12 hours before. Then failed 6 hours before. Then they crash. Woops.
    So the bean counters see the bottom line. And they do what they did at my last job. Run off the experienced nurses. Hire new grad LPNs in their place. From a crummy LPN school. Because they're cheaper. They don't get that without someone coming along and taking that patient now and then that can see the bigger picture and fix them, they've got longer length of stays. They've got more "never" events. (This is not a slam against LPNs, but a new grad LPN from a crummy LPN school isn't going to see the big picture until they've had some experience thrown at them.)
    Nursing is more than tasks. And you can survive as a nurse just doing the tasks. But your patients, if they have too many task-oriented folks in a row, they may not survive.
    Chin up, VanLpn, RNJill, and 8 others like this.
  4. 3
    Quote from jjjoy
    I agree. Yes, the nursing process IS important... AND it's a basic problem-solving process that any intelligent person uses. Does that mean that nursing is "just" basic problem solving that doesn't require any special skills or knowledge? No! It's the knowledge and skill base that can make a nurse out of any intelligent person.



    Very good point! The reality is that task-oriented nurses do thrive in many environments. Many nursing functions ARE task-oreinted. Being task-oriented isn't inherently a bad thing. One can be task-oriented without being oblivious to the bigger picture. ANY good worker will not be so focused getting tasks done that they let bad things happen. If task-oriented nursing didn't work, why is it that we see so many task-oriented nurses surviving for decades in the field?
    Re the nursing process ... It's the fact that it is formalized as a key nursing skill that is so embarrassing.
    No other profession does that. It is a 'given' in other professions....no need to formalize something so obvious.

    Yes many task orientated nurses do thrive....however I was making another point.
    Why is their contribution to nursing considered equal (or even superior) to other nurses who have the same practical skills PLUS the other skills?
    One can see the relative lack of value of these higher skills at management level.
    Where I work, diploma nurses have the management jobs and they are firmly cemented into them. However I do not see a lot of skill with process improvement, for example...or many creative solutions re retention. These problems occur because of their relative lack of education. Hospitals prefer to utilize consultants to handle this stuff rather than demand these skills from their senior nurses.
    Middle-management in other industries are expected to come up with this stuff by themselves.
    I agree a lot of nursing is task-oriented ....however when REAL professional skill is not valued in nursing...then we have a problem.
    Perhaps it is time to call a duck a duck
    trixie333, wooh, and SuesquatchRN like this.
  5. 7
    Quote from pedicurn
    However I do not see a lot of skill with process improvement, for example...or many creative solutions re retention. These problems occur because of their relative lack of education.
    I disagree that is based in education specifically. One of the reasons that I am valuable in nursing management is that I have decades of corporate experience and can organize stuff. I can also divorce sentiment from fiscal reality while being able to see a few quarters beyond bonus time and can also see the bigger picture, such as how a larger expenditure on X will save Y dollars down the road. A lot of nursing management seems tied to never increasing expenditures ever, with nary a thought given that it could actually end up saving money.
    trixie333, oliviajolie, SandraCVRN, and 4 others like this.
  6. 24
    am i the only one that wants to come in here and just post:

    goose!


    just me? carry on...
    Chin up, gentlegiver, ohioSICUrn, and 21 others like this.
  7. 5
    Quote from wooh
    Well, nothing collapses because there's the occasional "thinking" nurse that comes in here and there. Like the lady getting fluids practically straight into her lungs. If she'd had another "follow the directions" kind of nurse, she'd have called the doctor, the doctor would have come, eventually, hopefully before she codes. If nothing else, the code team would show up and give her some lasix.
    How many nurses do you know who seem to have a few more patients go bad than average? More that code, more that have to be transferred to ICU? Or how many nurses on the shift opposite the one you work do you notice giving report on patients that go bad more than average? (This is not a "bad nurses on night shift" thing, I'm talking either shift.) How often do you have to "fix" things at shift change? That's a result of the blindly doing without really thinking kind of nurses.
    The patients don't usually crash on them. They crash on the next shift if it's not picked up really quick. "Failure to rescue" is the closest data you can get on it. But I think it's even more subtle than that. Failure to fix things 24 hours before they went really bad. And then failed to fix them 12 hours before. Then failed 6 hours before. Then they crash. Woops.
    So the bean counters see the bottom line. And they do what they did at my last job. Run off the experienced nurses. Hire new grad LPNs in their place. From a crummy LPN school. Because they're cheaper. They don't get that without someone coming along and taking that patient now and then that can see the bigger picture and fix them, they've got longer length of stays. They've got more "never" events. (This is not a slam against LPNs, but a new grad LPN from a crummy LPN school isn't going to see the big picture until they've had some experience thrown at them.)
    Nursing is more than tasks. And you can survive as a nurse just doing the tasks. But your patients, if they have too many task-oriented folks in a row, they may not survive.
    My ED is full of experienced task-orientated nurses who have NEVER believed nursing is a profession. Some of them don't know 'their' from 'there'.....or 'too' from 'to'.
    Some of them even do charge. It is a absolute paradox to me how they can run a large, busy Level 1 trauma ED ...yet not be the broad thinking types.....in fact many of them are gobsmackingly narrow.... I spend hours pondering this.
    But they are all observant and they are all sharp. None of them miss an overloaded patient. None of their patients sit around for hours before they crash. Cripes even our aides notice there is something different about an overloaded patient.
    A lot of this is not rocket science
    Last edit by pedicurn on Jul 16, '10
    ohioSICUrn, CCL RN, eriksoln, and 2 others like this.
  8. 4
    I'm with the OP. I tell my family frequently, nursing is a service job.
    Chin up, trixie333, quezen, and 1 other like this.
  9. 8
    Another thing that I ponder....
    Why can a PA walk into healthcare with an unrelated bachelors...only have two years of medical education and then be writing orders for nurses????
    Totally wrong, wrong, wrong
    Chin up, trixie333, oliviajolie, and 5 others like this.
  10. 7
    Also .....
    Still no CONTROL= still not a profession
    Chin up, oliviajolie, eriksoln, and 4 others like this.


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