Residencies: doctors have it figured out - page 5

After chatting with a fourth year med student today at clinical, it occurred to me how vastly different the physician career-path is from our own. Fourth year medical students are undergoing the... Read More

  1. Visit  PMFB-RN profile page
    0
    Quote from Mijourney
    Yes, PMFB-RN, you are correct on certain levels. But, more and more jobs are being automated and outsourced as we write and those jobs will never come back. Currently, we are faced with the health and medical industry being the predominant industry in terms of jobs. I'm not sure that will change anytime soon in light of the fact the boomer population has not reached its peak. I also believe that as long as we have two year nursing programs that we will always have people who will be looking for the fastest way to decent wages.
    *** Of course, it only makes sence. If you can invest $5K and 2-3 years local to your home to become qualifed for a job that pays (let's say) $25 an hour, why would you invest 4-5 years and $50-$80K and travel to the state capital to become qualified for the same job?
    However we need those community college prepared nurse among us. Without them we would be more like physicians with mostly nerdy, limited life experience types becoming nurses.
  2. Visit  Mijourney profile page
    1
    PMFB-RN, I think that it does not settle well for you to imply that four year nurses are mostly nerdy with limited life experiences. I think what is important is whether the nursing profession is producing well-qualified people for the task at hand which is providing great quality care and services. Patients and their families want the best bang for their buck. They want highly competent, skilled and knowledgeable caregivers who can lead them to optimal health in a caring, compassionate, and cost effective manner. An across the board well-established nurse residency program, in my mind, can lend itself to meet that end whether it be through a two, three, four year or graduate level program. The longevity and effectiveness of these programs are being decided by nurse researchers as we write.
    SummitRN likes this.
  3. Visit  PMFB-RN profile page
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    FB-RN, I think that it does not settle well for you to imply that four year nurses are mostly nerdy with limited life experiences.
    *** I see these bright kids come to the hospital all the time. Very smart, ambitious and mostly from a similar background and life experience. Obviously with some exceptions. Yes mostly with limited life experience. Not nerdy like so many interns.

    I think what is important is whether the nursing profession is producing well-qualified people for the task at hand which is providing great quality care and services. Patients and their families want the best bang for their buck. They want highly competent, skilled and knowledgeable caregivers who can lead them to optimal health in a caring, compassionate, and cost effective manner.
    *** Well I disagree. I don't think that's all thats important. I also think a broad bases of backgrounds and experiences are valuable. It's nice to have people with experience in other field who can instantly know when nursing administration is attempting to screw them., Nice to have nurses with strong self confidence earned in other fields (like for example the battle field) who don't hesitate to stand up to the bully physician. I could go on.

    An across the board well-established nurse residency program, in my mind, can lend itself to meet that end whether it be through a two, three, four year or graduate level program.
    *** Yes of course nuring should have a residency program. I thought we already decided that? I went through a very good residency program as a new grad and it launched my career in the right direction. I highly recomend it for all new nurses.

    T
    he longevity and effectiveness of these programs are being decided by nurse researchers as we write.
    *** I doubt it. I doubt nursing researchers will have much, if any say in deciding the longevity of nursing programs.
  4. Visit  LadyFree28 profile page
    0
    I think people need to keep in mind that there are "candidates" that have life experiences are gong the BSN route as well. I was 30+ when I got my bachelors degree last May...and I am based in reality...in my area, most BSN programs have evened out life experience with new experience for a good skill mix to graduate...it has boosted graduation rates for those schools.

    Most people in my area are new grads that have life mileage underneath them.

    I also point out that most programs in my area the BSN makes sense because of the amount of time it takes, there is an additional semester. Totaling the amount of tuition credit prices, while it is more reasonable to get prereq's at CC, which I did, the financial aid package for my part time program was mid range reasonable for a state run Christian Brother School. The CC in my area has expensive credits...even going full time, if I went to CC, I would've maxed my aid for CC.
    In my area, gone are the days that nursing CC is "reasonable"...yet are closer to a BSN tuition for a state run school.

    Let's stick to the point that nurse residency programs do help put it all together and assist in transitioning nurses, as well as it is up to the nurse as well...they teach us to advocate, nurses must invest in ourselves and each other to make sure we have a healthy team of patient care advocates, regardless of background. What matters is putting all together, and being flexible enough to know that nursing and healthcare is very fluid...our bedside and communities, and we need to be prepared.
  5. Visit  SummitRN profile page
    0
    Quote from PMFB-RN
    I see these bright kids come to the hospital all the time. Very smart, ambitious and mostly from a similar background and life experience. Obviously with some exceptions. Yes mostly with limited life experience. Not nerdy like so many interns.
    So, you get a ton of diverse backgrounds from ABSN more so than you get from ADN programs that are full of the same 20 year olds that you find in BSN traditional programs.

    You and others have repeatedly mentioned nurses and doctors being "nerdy" with a very clear negative implication. What on earth is your problem nerds???? Is this some sort of too-cool-for-high-school attitude that hasn't faded? I honestly want to see nerd tendencies in my medical providers instead of nurses who only took science courses because they had to and are terrified of simple arithmetic.

    It's nice to have people with experience in other field who can instantly know when nursing administration is attempting to screw them., Nice to have nurses with strong self confidence earned in other fields (like for example the battle field) who don't hesitate to stand up to the bully physician. I could go on.
    You seem to think that only old people from non nursing backgrounds can do this... I disagree. I see plenty of 22 year old nurses, bsn and adn, with personalities that allow them to stand up and plenty of second career pushovers, bsn and adn. I tend to see fewer male pushovers so maybe we need more men in nursing?
    Last edit by SummitRN on Mar 17, '13 : Reason: missing word
  6. Visit  Mijourney profile page
    0
    Quote from LadyFree28
    Let's stick to the point that nurse residency programs do help put it all together and assist in transitioning nurses, as well as it is up to the nurse as well...they teach us to advocate, nurses must invest in ourselves and each other to make sure we have a healthy team of patient care advocates, regardless of background. What matters is putting all together, and being flexible enough to know that nursing and healthcare is very fluid...our bedside and communities, and we need to be prepared.
    Couldn't agree more.
  7. Visit  SummitRN profile page
    2
    The main reasons I chose nursing over medicine were the flexibility and ability to transfer specialties, and the ability to go into practice in half the time making twice per hour what physicians make after 4 years (and for 4 years more). Additionally, there wouldn't be call and 80 hour weeks 8 years after the start.

    That said, I have a lot of respect for physicians and won't engage in the physician hate that I've seen from a few people in this thread. Their model makes excellent providers, although it may be oppressive. I don't buy the veiled accusations of physical violence. The accusations of intellectual slavery pale in comparison to the PhD/graduate student model for the sciences.

    I think nurse residencies are great. I am in one. If we have the government underwrite residencies with money like in the physician model, we may see nursing specialties become insular and there won't be cross-specialty portability during a career. Why would an OR nurse manager hire a med surg nurse with 5 years experience and pay to train them when they could instead hire a new grad, pay them 30 or 40K while getting 75K from the government? Maybe they'd enroll that experienced nurse at 30K in the residency program...
    ThePrincessBride and Mijourney like this.
  8. Visit  Mijourney profile page
    1
    You make a good point SummitRN about the training for physicians and the training for nurses. As the scope of nursing practice expands, nurse residencies make good sense. Patient care has become too complex for nurses to simply graduate from a nursing program and be thrown completely to the wolves.
    SummitRN likes this.
  9. Visit  ThePrincessBride profile page
    1
    Quote from Anoetos
    It's probably also worth pointing out that physicians go to school for much longer than we do and bear a larger responsibility with regard to patient outcomes. A slow and diligently managed post-graduate preparation program makes sense.

    Put simply, at entry level, it is probably quite a bit harder for a nurse to kill someone.
    I disagree. One med error could easily kill a patient.
    joanna73 likes this.
  10. Visit  SummitRN profile page
    0
    Quote from ThePrincessBride
    I disagree. One med error could easily kill a patient.
    You seriously think a physician has an equal level of responsibility compared to a RN? Simply comparing the maximum consequence and finding them equal, then concluding there is an equal level of responsibility is a major failure of critical thinking... and logic... and/or a total misunderstanding of the roles of a physician and a RN.
  11. Visit  ThePrincessBride profile page
    0
    Quote from SummitRN
    You seriously think a physician has an equal level of responsibility compared to a RN? Simply comparing the maximum consequence and finding them equal, then concluding there is an equal level of responsibility is a major failure of critical thinking... and logic... and/or a total misunderstanding of the roles of a physician and a RN.
    Back up for a second. Where did I say that the consequences were equal or that doctors and nurses had the same level of responsibility? I didn't. I did state that it is rather easy for an entry-level nurse to kill someone with a simple med error. Case in point: my clinical instructor had a patient suffering from hypercalcemia. The doctor had mistakenly placed an order for medication that treated hypocalcemia. The nurse noticed this and immediately called the pharmacy. Had she given the med, according to the pharmacist, the patient would have died and both the doctor AND the nurse would have been reprimanded / lost their licenses.

    True story. Nurses have a great deal of responsibility. Not only do they have to watch their butts, they also have to cover the doctor's ass as well. You would know this if you had experience in the field...do you?
  12. Visit  FlorenceNtheMachine profile page
    2
    I don't believe that the level of responsibility of nurses are on the same level as a doctor. Are we in dangerous positions as nurses? Yes! Emphatically, yes.

    Staff nurses don't get phone calls on patients at home, when they've reported off to the oncoming nurse. We don't have the same level of obligation as a doctor does. Our obligation is gone when we leave, and starts back up when we come back.

    Does that make sense at all?
    joanna73 and SummitRN like this.
  13. Visit  SummitRN profile page
    0
    Quote from ThePrincessBride
    Back up for a second. Where did I say that the consequences were equal or that doctors and nurses had the same level of responsibility?
    It wasn't clear which part of the quote you were responding to, and I assumed it was the first part, not the second, thus my response. Sorry we had this misunderstanding (apparently I wasn't the only one to read it that way).

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