Residencies: doctors have it figured out - page 6

by Amistad 9,079 Views | 77 Comments

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 process of being matched to a... Read More


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    Quote from KatieMI

    Double the number of clinical hours required. Make it mandatory for the program to keep accreditation to give students hospital-based clinical hours. Make externship/internship mandatory.
    Then you have to cut the number of nursing school admission slots by more than 50%. The hospitals are saturated. Even good schools are fighting tooth and nail for acute care placements for their expanding cohorts of students. The less competitive schools already send their students to doctors offices.

    Doubling the clinical hours and adding an externship would lengthen school by 8-12 months. At that point, the easiest way to eliminate 50%+ of nursing student seats would be to eliminate all ADN programs; and who would go to a 4 year ADN program anyway? Students would get that debt. I guess that would cut down the demand to get in to nursing school.

    Schools are overproducing new grads of less desirable preparedness, but not at 200+% of market demand. Implementing your changes would make a huge nursing shortage in short order to the point where it would make hospitals hire more UAPs and then it would be nursings fault when RNs went the way of the LPN. The system would carry on, just differently. They wouldn't pay $35/hr for the new grad RNs to wipe butts and take vitals because it is cheaper to pay the 14/hr CNA; that is kinda happening already.
    Last edit by SummitRN on Mar 17, '13
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    Quote from SummitRN
    Doubling the clinical hours and adding an externship would lengthen school by 8-12 months. At that point, the easiest way to eliminate 50%+ of nursing student seats would be to eliminate all ADN programs; and who would go to a 4 year ADN program anyway? Students would get that debt. I guess that would cut down the demand to get in to nursing school.
    *** I believe cutting the ADN programs would be a disaster for us. Here's why. The bright high school grad who leaves home to pursue her BSN at State University and graduates in her early 20's and takes her first nursing job (first job ever maybe) brings a certain, and welcome, perspective to nursing. The 33 year old stay at home mom who decides to go back to school when her kids get a little older, or the laid off factory worker, the returning veteran or the downsized, college educated, second career person who seeks a low cost nursing education local to their home in a community college also bring valuable and welcome perspective to nursing. We need both. I would hate to see all nurses be the same kind of people who become physicians. Those of us with years of bedside experience know that it takes a variety of perspectives and life experience to relate to our patients. Perspective and life experience lacking by many in the physician side cause of the uniformity of their applicant pool.
    In short I am a big believer in the value of diversity and think we are stonger as a result of our diversity. I would hate to lose that.
    JeanettePNP likes this.
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    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.
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    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.
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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.
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    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.
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    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
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    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.
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    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.
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    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.


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