Think about it: The bedside nurse (aka, the staff nurse, the direct caregiver), is what this whole thing called nursing is all about. All other aspects of nursing serve only one purpose: to support the bedside nurse, because he or she is the single most important element in healthcare along with the physician.
Nursing school instructors serve to produce bedside nurses. Managers manage so the bedside nurse can more efficiently do their job. Researchers with DNS and PhDs only exist to provide information that ultimately can be used by the bedside nurse. The nursing shortage is all about the bedside nurse. Think about it: almost all functions in a hospital revolve around the bedside nurse and the physician. Even the cook in the kitchen is only there so the patient's nurse doesn't have to go and cook the meals.
Of course, "bedside" includes any bedside, not just a hospital bed (hospice, home health, LTC, etc.,). The point is, the apex of nursing practice is the bedside nurse. It is ironic that the lowest status in nursing is also had by the bedside nurse.
I wonder why that is? Whatever the case, who can deny that the whole of the nursing profession rotates around the bedside nurse? Why would anyone ever want to be anything else?
It is ironic that the lowest status in nursing is also had by the bedside nurse
Are you sure about that?
Why would anyone ever want to be anything else?
Of course bedside nursing is the foundation of all nursing practice. There are, however, reasons to be involved in other aspects of nursing.
What about nurses who aren't physically capable of sustaining the energy/strength to manage the physical and mental stresses of understaffed 12 hour shifts of bedside nursing?
What about nurse lawyers or SANE advocates who go to court to send rapists to jail?
Or nurse practitioners who get better compliance than doctors because they know how to treat a patient with respect?
FYI I plan on being an ER bedside nurse for the entirety of my nursing career.
Whatever the case, who can deny that the whole of the nursing profession rotates around the bedside nurse?
I just do not look at it the same way. Nursing is centered around the patient. It doesn't matter whether it is direct or indirect care. YES, even the nurse manager's ULTIMATE function is to ensure that PATIENTS get the care they need.
The concept of teamwork is critical in the nursing profession, so I find it counterproductive to make statements conveying the idea that all other areas of nursing support the bed-side nurse. It seems to me that you are missing an important concept. All areas of nursing support the PATIENT.
Your definition of the "bed-side" nurse as being one that provides DIRECT patient care no matter the setting, is so braod that it encompasses just about ALL areas of nursing. Were you intending to exclude only management and administration? If so, it would have been better to be more concise and just say so.
When we wrote our own career structure we wanted to make bedside nursing MORE important to get rid of some of the old "status" issues and to re-empower the bedside nurse. So to that end the career structure was "flattened" with an extra level created at the bedside - known as the "clinical nurse" as opposed to the registered nurse. Clinical nurses are paid more but they also carry a heavier load which could be responsibility for quality assurance within the unit or infection control or workplace health and safety. One of our clinical nurses just carried out an audit on the accuracy of the patient - nurse dependency system we use to calculate nursing patient ratios.
Clinical nurses although thier base rate was not as high as the nurse managers shift work allowance usually pushes the pay up past that level.
Of course bedside nursing is the foundation of all nursing practice. There are, however, reasons to be involved in other aspects of nursing.
What about nurses who aren't physically capable of sustaining the energy/strength to manage the physical and mental stresses of understaffed 12 hour shifts of bedside nursing?
What about nurse lawyers or SANE advocates who go to court to send rapists to jail?
Or nurse practitioners who get better compliance than doctors because they know how to treat a patient with respect?
FYI I plan on being an ER bedside nurse for the entirety of my nursing career.
Good points. Actually, I don't have a reply because your first paragraph confirms what I'm trying to say, and the examples you give are valid.
The function of any industry or service area is to allow the workers to do their jobs. For example, in the auto industry management, product development etc. makes it possible for the assembly line workers to do the job of making cars. In the school system, the school board, principals, etc. provide the structure for teachers to teach. It doesn't mean that teachers or auto workers are more important, just perform a different function. If you didn't have management and leadership, you wouldn't have vision or direction in how to do your job. Sadly, I don't think nursing leadership has had much of a vision for nursing and it is making it difficult for nurses at the bedside to do their jobs. Hopefully that is changing.
I wish someone would tell housekeeping, lab, radiology, nurse staffing, management and everyone who gets in the way of me providing care that I am the most important person around!
Specializes in Case Mgmt; Mat/Child, Critical Care.
Originally posted by ADNRN
Think about it: The bedside nurse (aka, the staff nurse, the direct caregiver), is what this whole thing called nursing is all about. All other aspects of nursing serve only one purpose: to support the bedside nurse, because he or she is the single most important element in healthcare along with the physician.
Nursing school instructors serve to produce bedside nurses. Managers manage so the bedside nurse can more efficiently do their job. Researchers with DNS and PhDs only exist to provide information that ultimately can be used by the bedside nurse. The nursing shortage is all about the bedside nurse. Think about it: almost all functions in a hospital revolve around the bedside nurse and the physician. Even the cook in the kitchen is only there so the patient's nurse doesn't have to go and cook the meals.
Of course, "bedside" includes any bedside, not just a hospital bed (hospice, home health, LTC, etc.,). The point is, the apex of nursing practice is the bedside nurse. It is ironic that the lowest status in nursing is also had by the bedside nurse.
I wonder why that is? Whatever the case, who can deny that the whole of the nursing profession rotates around the bedside nurse? Why would anyone ever want to be anything else?
Interesting post, I believe you're a little "off" in your assessments however. But what you state is logical, from a non-nurse perspective. It WOULD seem that all aspects of care revolve around the "bedside" or staff nurse. It would be nice if that WERE the case, unfortuneately, that just isn't true.
For example:
*Nursing instructors help increase the number of nurses in existence,period. Some do have a career as a staff nurse, some never do. Either way, the "production" of nursing students serves the patient, ultimately.
*Managers, sadly, are NOT in their role to "support" the staff nurse. Ever heard the saying "...too many cooks in the kitchen..." or "too many chiefs, not enough Indians..." This is the case w/nursing management. Nursing admin doesn't give a wit for the bedside nurse, many don't have a clue as to the needs of the staff nurse. Hence, the timeless struggle of "them against us"...the animosity for the two opposing groups...staff vs admin/mgmt. Nusing admin supports the overall administration running the facility....haven't you heard....healthcare is now a business, and the "business" is about money.... Doesn't seem right, does it?
*Research supports the patient.
*Nursing shortage ultimately impacts the patient, units and hospitals shut down when there's not enough nurses, this is a bad outcome for the patient.
*All functions in the hospital do not serve the staff nurse...radiology, nuc med, MRI, RT, PT/OT...these all serve the pt...these are separate disciplines w/their own fxn, training and again, focus for that discipline is the patient.
As for ancillary staff...housekeeping, dietary...guess what, they exist because the patients are there. Do you think at 3am, when there is no one in dietary, that I, the RN, am going down there and prepare a meal? Not gonna happen. If no linen is delivered or available, is the RN going to the laundry and do it? And then deliver it, unload it, etc? Nah. Real world...we do without, make do, wait 'til we get what we need etc. Same w/central supply. And guess who suffers? You got it, the PATIENT.
In reality, you wanna know who spports ME, a staff nurse...when I'm on duty, and I need help? My fellow STAFF nurses. We help and support each other. That's what you hope for when you're a staff nurse...that you work w/a great team/crew, that you can depend on, and they, in turn, depend on you!
Nursing has always been about the patient, even if you go back thousands of years. And bedside or direct care nursing is the heart of it. When Florence Nightingale campaigned to reform nursing, her idea was never to make it compete with medicine, but to feel a need and a gap that wasn't addressed by physicians. And that gap was care of the patient, beyond potions, elixirs and surgery.
That said, obviously, someone was going to be needed to train nurses. So nursing instructors came about. There was also a need for a nurse to oversee the nurses who were working. And so nursing grew. Someone came up with the idea to send nurses out into the community, so public health grew as a profession.
As healthcare evolved, nurses were needed to move beyond direct patient care, into fields which indirectly helped both patient and the bedside nurse, ie, infection control, quality assurance.
And so it goes. The heart of nursing remains in direct patient care, but other positions are just as important, as they all add (or at least they should--not getting into any discussions about incompetent and brain-dead managers) to the overall care of the patient.
And everyone on the hospital team is important. Where would nurses be without the pharmacist, or the laundry, or housekeeping? Back to them good 'ol days when nurse was janitor/dieticiian/laundress/nurse. Where would we be without a good unit clerk, to answer the phones, take off orders, and do a million other behind the scene tasks?
It is sad that the lowly workers, such as bedside nurse, housekeeper, techs, are so poorly paid as compared to the suits upstairs. The CEOs multi-million dollar salary and mega-ton Christmas bonus, compared to a nurse earning $18/hour. But that is another issue entirely.
In reality, you wanna know who spports ME, a staff nurse...when I'm on duty, and I need help? My fellow STAFF nurses. We help and support each other. That's what you hope for when you're a staff nurse...that you work w/a great team/crew, that you can depend on, and they, in turn, depend on you!
Excellent point. And I have changed my view. I now think that the entire healthcare system is, in theory, there to treat and care for the patient. Everyone is needed.
But since I can't delete my original post. I suppose I'll just have to bow out of this string and start a different one.
The heart of nursing remains in direct patient care, but other positions are just as important, as they all add (or at least they should--not getting into any discussions about incompetent and brain-dead managers) to the overall care of the patient.
Sad that is has come down to a very strange idea these days.....I hear students say "I'll NEVER be a bedside nurse!!!" and I can't help but wonder what led them to think they would be a good nurse in the first place?? It's the elitist ideas out there....cuz they can get advanced degrees and skip right past 'lowly bedside nursing.' Strange thoughts but its a new day I guess.
Nursing has become a different animal today and I don't know if that is all good, to be honest. While I'm glad we have many options in nursing, it has become a bit strange out there IMHO.
And I know my post will pizz off some nurses here, so be it. The volatile BSN mandate argument has some roots in this...as the higher education nurses are pushing this, while those of us in the trenches wonder why...they are so far removed from the heart of nursing in many cases...'ivory tower nursing' making the decisions for those of us who have stayed in traditional nursing and think it is important.
bluesky, BSN, RN
864 Posts
Are you sure about that?
Of course bedside nursing is the foundation of all nursing practice. There are, however, reasons to be involved in other aspects of nursing.
What about nurses who aren't physically capable of sustaining the energy/strength to manage the physical and mental stresses of understaffed 12 hour shifts of bedside nursing?
What about nurse lawyers or SANE advocates who go to court to send rapists to jail?
Or nurse practitioners who get better compliance than doctors because they know how to treat a patient with respect?
FYI I plan on being an ER bedside nurse for the entirety of my nursing career.