Time to call a duck a duck? - page 13

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... Read More

  1. Visit  eriksoln profile page
    2
    Quote from wooh
    In peds we have a new directive to do "Asthma Action Plans" whenever we send home an asthma patient. So we write all their inhalers on there. Now I was being good, telling them to take their albuterol, how many puffs, how often. Then get a note back that we have to write the strength, even though albuterol only comes 90mcg/puff (For other puffers, ok, there are different strengths but albuterol only comes in 90!). So I write that all the time. Then we get a note saying we have to write the route out. Now if I send a patient home, and the family decides that they're going to go for doing their puffs rectally or vaginally instead of by mouth, I think they have bigger problems than just the asthma, and those problems aren't going to be fixed by writing "albuterol 90 mcg/puff 4 puffs BY MOUTH every 4 to 6 hours as needed."
    I hate to say this, but if I were looking at this with a critical eye......................like a "professional nurse", I'd say I fell a little short with this guy. I don't think lack of understanding of how the meds work were his issue.

    Maybe a psych. issue that is being ignored as we rush him through care, maybe a GI problem that makes him want to do this. I wonder if I would not have handled it differently had it been in the middle of the night instead of the end of my day.
    RetRN77 and pedicurn like this.
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  3. Visit  jjjoy profile page
    2
    In regard to professional self-regulation, here's another way nursing as a profession/trade has limited power- it's up to employers, not nursing boards, to decide the minimum qualifications above and beyond an RN license for (and additional formal training/certification, if any) for most RN positions.

    The upside is the relative ease with which a nurse can switch specialties. If a facility is willing to hire someone without proven experience or certification in a particular area, that's their prerogative. On the downside, having no formal requirements beyond RN license for many positions reinforces the incorrect notion that a nurse is an easily replaceable cog doing work that doesn't take much to master.

    Good places will offer strong training and support. But many places take the "sink or swim" approach to on-the-job training. Either way, it's between individual employers and individual nurses what is acceptable; there often isn't an industry-wide standard set by and for nurses.
    carolmaccas66 and eriksoln like this.
  4. Visit  pedicurn profile page
    2
    Quote from nursemike

    So, over the past weekend, I was in our stepdown subunit, and overheard a nurse on days reporting off to one of my coworkers that one of her patients had a Disturbed energy field. She was joking--sort of--but I watched my coworker, an old-school nurse if ever there was one--working magic with this dude, using old-school interventions like maintaining proper body alignment and therapeutic communication. Her "therapeutic touch" wasn't the new age version, it was rubbing his shoulders to help him relax. She demonstrated caring because she's a nurse and that's what she does. I don't know whether the guy had an aura or not, but if he did I think it was probably in better alignment by morning. At least his behavior was more appropriate. And while the problems that put him in a stepdown bed were probably scientific in nature, his most pressing needs from his POV, r/t dealing with a life-altering injury, were ones that called on the art of nursing. It was cool to see him getting both.
    This is not magic .... this is effective rapport+kindness+sales.
    She sold him the idea of improving his behaviour.
    Some nurses are very good at sales (that's why so many of the more successful real estate salespeople are ex-nurses)
    Nursing seems to be good training for this ....a lovely combination of verbal and nonverbal communication/need assessment/empathy/kindness injected at the right moment ......and the p't changes behaviour.
    I am good at this ...my coworkers think I have magic skill ....well no...just sales skill
    However it can't really be taught. One either does this very well or one doesn't ....either got it or haven't
    LPNnowRN and eriksoln like this.
  5. Visit  tewdles profile page
    4
    Quote from eriksoln
    Thats not candy you have in your hand there. Unless denial is chocolate flavored all of a sudden.

    LOL at the state/nurses get to choose who is licensed and who is not. Sooooo.........as they currently are in NY, when the businesses decide they are only hiring BSN................what good does being allowed the ADN license do you? After the business (the non-nurses) set the standard, the BON just follows suit. They don't make any decisions.........they just adjust and cater their "policies" to whatever the non-nurse decision makers are saying.

    And yes, you can technically have your license after an incident but be fired by your employer. In essence, you are not being disciplined by the "nursing" BON. Won't do you a bit of good unless you can relocate to the other side of the country once you've been fired........................for forgetting to empty the trash cans. Again, actually having your license in this case is simply cosmetic. If you have a bad rap with the business suits and get black listed..........well, nuff said.

    Your post kinda reminds me of a lot of the administrative type nurses I knew a few years ago. You know the type............hasn't seen the bedside except through pictures in the hospital news flyer in years, has some special title and area of "expertise" that they are accountable for () and...........for the most part are invisible other than in the lunch room and a few emails they send the nurses. These people walk around the hospital, strutting like they owned the place and had it all figured out. Annoyed the hell outta the bedside nurses more than anything else.

    Well, these were your "I am a professional" nurses. Guess who was excused out the door first when the recession hit. Yep. Most of them were told "You have no practical role to the hospitals functioning and we are relocating your (cough, ahem) duties to other people". It happened overnight almost. One day the hospital is full of em, next day................well. Some even tried to return to bedside nursing but, most were given a nice, political "you are overqualified" pat answer.

    They had the "I am a professional" part of nursing a little too blown up and lost their value because of it. Didn't have the "get down and dirty" part that is necessary for all nurses, even the one's who say nursing is a profession. And they all felt they could be autonomous and had a body of knowledge that was so unique too.
    Eric, you make me laugh...

    I find it amusing that you and I disagree about this and so...in your estimation, I am in denial...LOL...see, made me chuckle right out loud just now typing it.

    Yo are correct...that NY facilities may decide that they will hire only BSNs...okay...does that mean that no other degrees may practice nursing? That decision STILL only determines who they will hire...not what defines a nurse...and until the NY BON changes that there will continue to be nurses with a variety of educational prep. Even if the BON does decide to change the educational requirement it will include "grandfathering" language.

    Seriously Eric, do you think that being fired by an employer is worse than BON discipline? You speak as if you may have experienced a blacklisting. Honestly, unless you work in a rural area with limited access to health care jobs/employers...nurses get fired and get new jobs all the time...even in this economy. It is not easy...but a good and qualified nurse can usually find a job...I have (too many times in the recent past). Yes, you may get blacklisted by a particular company or organization., often wrongly (not emptying trash)..but heck, health care is a profitable for-profit endeavor and there are lots of young companies with growing employment needs. So...if your local ALF, SNF, sub-acute, LTC, etc talks dirt about you...consider taking a break from that area for a few years and learn a new skill set.

    However, when you are disciplined by the BON you do not have the option of seeking employment as a nurse if they say so...period...this will also affect your ability to get licensed in other states. Because you are trained as a nurse, it is difficult for some employers to hire you in a different capacity, so CENA jobs are not necessarily east to come by. Dependent upon the cause of the discipline, the nature of work permitted, once they allow you to resume practice, may be radically different from previous jobs. This is not a process, in my estimation, that should be equated in anyway with being blacklisted by an employer/group/corporation, etc.

    You are correct...I know the "administrator professional nurse" types. I had to deal with them all the time when I was in my 30s, running a very busy regional PICU. I had to deal with them all the time...people who had not actually cared for patients for sometimes 8 or 10 years. Today that gap is often much worse as nurses now prepare themselves early for the advancement, and the ambitious ones will be promoted, quickly. That puts a pretty significant part of the clinical power in the hands of nurses who are not expert at being nurses.

    I caution you, however, to avoid making the mistake of thinking that I am removed from patient care. I provide hands on nursing care daily. I am good at it. By this time in my life I can birth you and take care of your momma, provide all of your neonatal and pediatric nursing care. I can provide for your ongoing primary nursing care and and have done manyy sports and camp physicals. If you need nursing in the ICU, I can be your nurse (with some exceptions of course). When you go home and need home care...I'm your gal. If you need vaccinations to travel overseas or for INS...I can help you. And when you finally get tired of it all and decide that 6 months is all you are going to live...you DEFINITELY want me as your nurse. So...I may sometimes sound like someone who is all "pie in the sky" removed from reality...but I really am just an old professional nurse who really enjoys nursing. My mother was a nurse, my husband is a nurse, my brother married a nurse, 2 of my 4 cousins are nurses.

    Maybe my attitude about nursing as a Profession is a familial defect??? (please don't comment on the genetics of this...it was a joke)
    NocturneRN, pedicurn, eriksoln, and 1 other like this.
  6. Visit  eriksoln profile page
    0
    Quote from tewdles
    Eric, you make me laugh...

    I find it amusing that you and I disagree about this and so...in your estimation, I am in denial...LOL...see, made me chuckle right out loud just now typing it.

    Yo are correct...that NY facilities may decide that they will hire only BSNs...okay...does that mean that no other degrees may practice nursing? That decision STILL only determines who they will hire...not what defines a nurse...and until the NY BON changes that there will continue to be nurses with a variety of educational prep. Even if the BON does decide to change the educational requirement it will include "grandfathering" language.

    Seriously Eric, do you think that being fired by an employer is worse than BON discipline? You speak as if you may have experienced a blacklisting. Honestly, unless you work in a rural area with limited access to health care jobs/employers...nurses get fired and get new jobs all the time...even in this economy. It is not easy...but a good and qualified nurse can usually find a job...I have (too many times in the recent past). Yes, you may get blacklisted by a particular company or organization., often wrongly (not emptying trash)..but heck, health care is a profitable for-profit endeavor and there are lots of young companies with growing employment needs. So...if your local ALF, SNF, sub-acute, LTC, etc talks dirt about you...consider taking a break from that area for a few years and learn a new skill set.

    However, when you are disciplined by the BON you do not have the option of seeking employment as a nurse if they say so...period...this will also affect your ability to get licensed in other states. Because you are trained as a nurse, it is difficult for some employers to hire you in a different capacity, so CENA jobs are not necessarily east to come by. Dependent upon the cause of the discipline, the nature of work permitted, once they allow you to resume practice, may be radically different from previous jobs. This is not a process, in my estimation, that should be equated in anyway with being blacklisted by an employer/group/corporation, etc.

    You are correct...I know the "administrator professional nurse" types. I had to deal with them all the time when I was in my 30s, running a very busy regional PICU. I had to deal with them all the time...people who had not actually cared for patients for sometimes 8 or 10 years. Today that gap is often much worse as nurses now prepare themselves early for the advancement, and the ambitious ones will be promoted, quickly. That puts a pretty significant part of the clinical power in the hands of nurses who are not expert at being nurses.

    I caution you, however, to avoid making the mistake of thinking that I am removed from patient care. I provide hands on nursing care daily. I am good at it. By this time in my life I can birth you and take care of your momma, provide all of your neonatal and pediatric nursing care. I can provide for your ongoing primary nursing care and and have done manyy sports and camp physicals. If you need nursing in the ICU, I can be your nurse (with some exceptions of course). When you go home and need home care...I'm your gal. If you need vaccinations to travel overseas or for INS...I can help you. And when you finally get tired of it all and decide that 6 months is all you are going to live...you DEFINITELY want me as your nurse. So...I may sometimes sound like someone who is all "pie in the sky" removed from reality...but I really am just an old professional nurse who really enjoys nursing. My mother was a nurse, my husband is a nurse, my brother married a nurse, 2 of my 4 cousins are nurses.

    Maybe my attitude about nursing as a Profession is a familial defect??? (please don't comment on the genetics of this...it was a joke)
    I actually was talking to someone about this and they said I had it backwards. That the BON made the decision not the hospitals. Eh, IDK now. There's an article on this site somewhere about it, I'll have to go educate myself.

    Yeah, IDK. Might be residual from travel nursing. Having a strong resume and as many letters of recommendation as possible is important when you do that. One bad review and all of a sudden you can't get hired anywhere except Arkansas or Detroit. No offense to anyone living there, I just didn't want to travel nurse there. And you are right. I do fear blacklisting more than the BON. Just me I guess. Mind you, when I say "fear it more" I mean, I think they are equally bad things but I am afraid of the blacklisting more............I think it happens more often. I rarely hear complaints of the BON being unreasonable. Can't recall a single case where someone has said so and I didn't think to myself "Well, what'd you expect acting the way you did?". Now, on the other hand, hospitals will let you go for all sorts of reason's that have notta to do with how well you perform your job. Politics.

    I've seen GNs, straight outta school and on orientation, acting like being in a pt. room is beneath them. Emptying the trash bins and fetching ginger-ale for people? You must be joking. They are perfect little nurses when..........certain people are around to witness it, otherwise they are much too busy social networking to be bothered with teaching grandma how to us that inhaler she is going to be D/C'd with. Blah. Hate'em. This is one of the types I equate "Professional Nurse" to.

    Somehow I knew you were a bedside nurse. IDK why. I didn't mean I thought you were one of the people I described, just that your insistence that we have autonomy and all this power seems to match them. (...........Don't yell at me though when I tell you, not making fun of you or anything but...........I also thought you were a guy DOH).
  7. Visit  wooh profile page
    5
    Quote from tewdles
    Today that gap is often much worse as nurses now prepare themselves early for the advancement, and the ambitious ones will be promoted, quickly. That puts a pretty significant part of the clinical power in the hands of nurses who are not expert at being nurses.
    I'll never understand the people that go through nursing school, and really have no interest in actually NURSING. They're immediately applying for advancement, to be managers. Why do they go to nursing school? Getting a business degree would have been easier!
    carolmaccas66, pedicurn, tewdles, and 2 others like this.
  8. Visit  tewdles profile page
    0
    you just made me laugh again...of course, just because I have a husband does not necessarily mean that I am a woman...

    and I rarely yell at my peers...
  9. Visit  eriksoln profile page
    4
    Quote from tewdles
    you just made me laugh again...of course, just because I have a husband does not necessarily mean that I am a woman...

    and I rarely yell at my peers...
    Eeek. Don't go there. I got yelled at in another thread for not having compassion for the gay.

    Besides, you said "I'm your gal" that where I go that UR female from.

    I tend to be the "rare" exception a lot when people "rarely yell". IDK. Maybe they think I am a threat cause I am so beautiful ha ha ha ha.
    wooh, Altra, tewdles, and 1 other like this.
  10. Visit  tewdles profile page
    1
    caught me...yup I am a woman and have been for awhile now
    eriksoln likes this.
  11. Visit  eriksoln profile page
    0
    Quote from tewdles
    caught me...yup I am a woman and have been for awhile now
    I KNEW THERE WAS SOMETHING ODD ABOUT YOU LMAO
  12. Visit  NeoPediRN profile page
    5
    If I may ask, does it really matter? Labor or profession, we are all college-educated individuals whose goals remain the same - to give quality patient care. Being a labor vs. a profession does not impact relationships with our patients or change the amount of effort we put into our career. Duck, swan, or Canadian goose, they're all ultimately a bird, no?
    wooh, tewdles, CNL2B, and 2 others like this.
  13. Visit  eriksoln profile page
    1
    Quote from RN4WeeOnes
    If I may ask, does it really matter? Labor or profession, we are all college-educated individuals whose goals remain the same - to give quality patient care. Being a labor vs. a profession does not impact relationships with our patients or change the amount of effort we put into our career. Duck, swan, or Canadian goose, they're all ultimately a bird, no?
    Yes. And No. lol

    Actually, IDK, I kinda thought I was making the point that it doesn't matter so much and that obsessing over "We are a profession" kills us.

    But, somehow, it got turned into me being obsessed with us not being one, and being a trade instead. Which, in the end, if all the "pie in the sky" types settled for that, we'd still be ahead.

    I'm not bantering about if we are or not as much as I am........eh, complaining.........about the time wasted on trying to convince everyone we are.
    wooh likes this.
  14. Visit  paganoid profile page
    4
    This debate is not new. It's been going on in this country since the beginning of nurse education over a century ago. I did a paper on it for Nursing History class. (Yes, I'm a BSN graduate.) The argument of "trade" versus "profession" mirrors the argument of which degree should be the entry level position (ADN vs BSN vs diploma).

    The point I made in my paper is that there is room in nursing for all kinds of nurses. One size need not fit all. If you and your friends want to be "trade" nurses that's awesome. Be the best trade nurses ever. If some high-fallutin' nurse executive wants to spout an opinion about the "profession" of nursing then I say let her. It doesn't affect me because I don't read those magazines they send me.

    All of this is, and IMHO always has been, a tempest in a teapot. We all know that as long as nursing is a "women's profession" then nurses are going to be abused. It will only change when men arrive in significant numbers and refuse to accept the BS that women, taught since childhood to do as they're told and be quiet, have historically accepted as given. But that idea opens a whole new can of worms, doesn't it?
    wooh, fungez, eriksoln, and 1 other like this.


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