Future Shortage in Bedside Nurses

[westieluv]

I have been an RN for 22 years. In recent years, we all know that the trend has been for acute inpatient facilities to try to hire BSN nurses as much as possible. However, another trend that I am seeing, both here on these forums and in the places where I have worked, is that most of the young BSN nurses have no desire to do bedside nursing any longer than they have to. All I seem to hear is that they all want to either move into a management position or go back to school to become an NP or CRNA. Even the ones who haven't voiced those goals have expressed a great contempt for bedside Med/Surg nursing and want to work in specialty areas such as OB. The thought process seems to be that they didn't go to school for four years "just to" care for sick people at the bedside. If this continues, it seems that there is going to be a great shortage of bedside nurses in the near future as more and more of the "old school" nurses retire.

Does anyone else see this where you work? What happens to the army when everyone wants to be a general and no one wants to be a foot soldier? I'm just curious. I have over 100 undergrad college credits that I could apply towards a BSN, but at this point in my career, I just want to finish out my years as a nurse taking care of people who need help. Never had any desire to climb the ladder whatsoever. Are any of you new grads in the same boat, where you would be contented to do bedside nursing for the foreseeable future, or is being a bedside nurse becoming passe'?

[dirtyhippiegirl, BSN, RN]

ALL of those on my floor with more than 20 years of experience have done something outside of bedside, I believe. I dunno who can handle it for 20-30 years either. I notice that the whole staff is about 0-7 years in experience and then a few with over 20years. Where do those in the middle go? interesting.

Our ICU nocs float pool averages about 15 years of experience per nurse. I can think of at least one who has been doing ICU noc nursing exclusively for 27 years. I just can't fathom doing direct patient care for that long.

[Ruby Vee, BSN]

I've noticed that some people seem to criticize others for wanting a higher degree, and/ or to leave bedside nursing. Please keep in mind that professional development is a personal choice. As I mentioned in an earlier post, more nurses would willingly stay on acute/ med surg floors if the working conditions were better. Sure, it's very noble to care for others....but not at the expense of your own health.

I don't think anyone is ever criticized for wanting to learn more, understand better or grow. The people I've seen criticized for wanting to leave bedside nursing are those who have made the following comments:

"I'm only here to get my one year of experience so I can go to anesthesia school and make lots of money." (At lunch, halfway through her orientation to the ICU)

"I didn't get a degree to wipe butts. How soon can I get an office job?" (On her first or second day in hospital-wide orientation).

"I'm the RN, I don't have to wipe butts. That's for the techs." (On her first day in the ICU)

"I'm going to be an NP, so I don't have to learn that." (About anything that involved getting her hands dirty.)

"Bedside nursing is for lazy people who lack ambition." (As she sat at the desk and did her nails, relying upon her orientee to do any and all patient care -- without guidance.)

I've noticed that too many people who seek higher degrees lack respect for those nurses who don't seek higher degrees and/or are happy at the bedside.

I enjoyed graduate school -- it was far more fun than anything else I could do with the time or the money at that point in my life. But I have the utmost respect for those nurses who, for whatever reason, have chosen to continue at the bedside without additional education. In fact lately, I have MORE respect for nurses willing to stay at the bedside despite the fact that the job is getting more and more difficult.

[itsnowornever, BSN, RN]

The question is.....are you willing to add to your knowlege base at the same pay.

Of course. The knowledge I am wanting to gain is for my personal benefit as well as for my patients and as an insipration to my kids---I dont expect any hospital to pay me more because I wanted to show my children that even though I had them young and was kinda lost on the "what I wanna be when I grow up" path. The extra letters and extra schooling are because I want it, not because I want more money for it.

[itsnowornever, BSN, RN]

Great post! I have been an RN for 22 years, and some of the best and most skilled nurses I have ever worked with were the career LPNs of yesteryear who put everything they had into their jobs and weren't afraid to work. I would give anything to have some of them back on the inpatient units as opposed to new grads who are already looking to escape hands on care, and I would have trusted many of them with my life. There's something to be said for learning that was obtained from working in the trenches and sticking with it for years.

I hate when all new grads get lumped together. Kinda like when the more experienced nurses hate when they all get lumped together as the "grouchy mean catty lot".

[bardone]

Seems like a similar feeling about AP nurses (NPs, at least) extends to MDs, too. This is from the comments section of the NYT article referenced earlier:

"Perhaps what we're seeing here is the dumbing down of America now extending to medical school applicants. Everyone wants to be experts without having to go through the rigors. Just look at the explosion of Nurse Practitioners."

Zing!

[cdsga]

Seeking career advancement in nursing is always a plus. Management is tough especially when you become distanced from the actual work at the bedside. The balancing act of a nurse manager is to be able to relate and support the bedside "foot soldier" who in the trenches is the best evaluator of process improvement and work flow issues. There will always be a need for the bedside nurse, though the nursing schools need to do a better job of preparing the student for reality. There is sacrifice involved and there's not always another job down the street. The staffing situations in hospitals now does not adequately provide nor should be 100% responsible for the continuing education for the novice nurse. Especially in areas outside of big city institutions. There is a big disconnect that should be addressed immediately to enable the experienced nurses to be able to adequately and productively precept new nurses.

[TheCommuter, BSN, RN]

I can't think of a single nurse with their MSN who works on the floor either

One of my coworkers is a floor nurse with a MSN degree. She has never worked in management, has spent an entire career as a floor nurse, and is honestly not managerial material due to her lack of leadership qualities. However, she is a darned good nurse who can rock it on the floor.

One of our frequently-posting members (♪♫ in my ♥) is a second career nurse with a MSN degree who works in a bedside position.

[neverbethesame]

A couple of comments:

I went back to school for my RN in my early 40's after working in another field where a BS and a license is needed so I have some life experiences behind me. It was "interesting" to hear the very young girls talk about the kind of RN they wanted to be while still in school. They had definite opinions of a hierarchy in which certain kinds of nursing were "lesser" in their mind. They never stopped to think that nurses in every aspect of nursing are (hopefully) there because it is where their gifts and talents are, it is where their ability to care and apply their clinical skills are best utilized. If I recall one conversation correctly, they were looking down their nose at nurses who work in GI-related fields and I remember thinking, "If I had a loved one with GI issues I would sure would want an RN who wanted to be in that field and was good at his/her job." I sure as hell wouldn't look down my nose at that RN feeling sorry for them that they are not a critical care nurse.

I don't believe that there are "better" than others in realm of healthcare. I was watching one of the Sunday morning shows where they were talking about the shortage of PCP's coming up and lamenting MD's going into more specialized and higher paying fields rather than become a PCP. While there is a med school price tag vs. income levels of these MD's which is a completely other issue, in terms using gifts and talents where they are best utilized is key to good care, happier MD's, more satisfied patients, and of course, the almighty higher Press Ganey scores.

[nursel56]

It's disheartening to hear that kind of value judgement coming from people who've yet to set foot in a room with a real patient in it. I can only hope experience and maturity will have them someday cringe at how they viewed their fellow nurses.

One thing the Institute of Medicine of 2010 report repeatedly pointed out was the trend toward a patient population that lives longer and thus spends potentially many years of living with chronic conditions like diabetes, arthritis, CHD, etc., and the trend toward community based and outpatient surgery centers. It's probably best to make up your mind that you will learn something unique and valuable with every job you take. Sometimes finances and job availability will dictate that you don't end up with a lot of choices in that regard.

[Toni82]

I had to take organic chem for my BSN program. Actually all the schools in my area(San Diego) require it.

[cdsga]

It takes time for people to find their niche in nursing. Thank goodness not everyone likes the same type of nursing care. I know I'm not "cut out" for certain types of nursing, not that I can't do it, just that I'm not attracted to it. If I got a good job offer in a field that was not my first choice would I take it if I needed the job???? You bet. There is something that can be gained from doing, observing, putting yourself in areas that are a bit uncomfortable to you-you learn quite a bit about the area of work, and about yourself, not to mention gain confidence. Each step you take is a building block for a more gratifying role in nursing. You just have to try, and in this profession, we sometimes have the opportunity to branch out and do different things. That's one of the attractive characteristics of the nursing profession. Surprise surprise, you just might like something you thought you might not. To paraphrase Abe Lincoln, "People are about as happy as they set their mind to be".

[Guttercat, ASN, RN]

I don't think anyone is ever criticized for wanting to learn more, understand better or grow. The people I've seen criticized for wanting to leave bedside nursing are those who have made the following comments:

"I'm only here to get my one year of experience so I can go to anesthesia school and make lots of money." (At lunch, halfway through her orientation to the ICU)

"I didn't get a degree to wipe butts. How soon can I get an office job?" (On her first or second day in hospital-wide orientation).

"I'm the RN, I don't have to wipe butts. That's for the techs." (On her first day in the ICU)

"I'm going to be an NP, so I don't have to learn that." (About anything that involved getting her hands dirty.)

"Bedside nursing is for lazy people who lack ambition." (As she sat at the desk and did her nails, relying upon her orientee to do any and all patient care -- without guidance.)

I've noticed that too many people who seek higher degrees lack respect for those nurses who don't seek higher degrees and/or are happy at the bedside.

I enjoyed graduate school -- it was far more fun than anything else I could do with the time or the money at that point in my life. But I have the utmost respect for those nurses who, for whatever reason, have chosen to continue at the bedside without additional education. In fact lately, I have MORE respect for nurses willing to stay at the bedside despite the fact that the job is getting more and more difficult.

I think you've hit the nail on the head right there.

My choice to go back to school is that after twenty years in direct patient care, I'm ready for a new challenge as I head into my later working-life, and to serve my patients in a different role.

That, and I love the whole process of learning in a college environment.