Ch, ch, ch, ch... changes. What are your long term goals?

[Guttercat, ASN, RN]

(thanks Mr. Bowie for the thread title).

Those of us in the nursing field for twenty or more years have seen many changes to our profession, not in knowledge or scope of practice per se, but in the actual process of delivering care. We have rolled with it and adapted.

Until now. Somehow, this time it is different.

There is a distant whiff of change in the air, an ominous yet unseen brewing storm on the horizon that we can smell, and we instinctually know this is not just another policy revision; not just another economic dip.

There is a growing sense that nursing is being redefined as cheap, blue-collar labor, yes-men, and trained monkeydom. Especially floor nurses on the front lines.

Even my latest issue of "The American Nurse" is greatly devoted to the future of nursing and nurses who have or are furthering their education in the (hinted- at undercurrent) context of Health Care Reform, ACO's and Bundling.

Is education advancement enough? I listened to a flustered and overwhelmed hospitalist vent to me a few days ago, that they'd taken away half of the PA's effectively doubling her workload.

I see MSN's working the floor.

I see BSN's unable to find employment as a floor RN.

I see my own department ripped to pieces and sold to the highest bidder.

So, how many of you are rethinking your career path? If I was an Appliance RN (RN married to a high-earner and only needs a little income to buy the latest Cuisinart or a gym membership) I probably wouldn't bother.

But as it is...I'm about to bother.

[MN-Nurse, ASN, RN]

If I was an Appliance RN (RN married to a high-earner and only needs a little income to buy the latest Cuisinart or a gym membership)

Love "Appliance RN"!!!!

[mrr5745]

Just this morning I was thinking the entire healthcare system in the US is seriously in trouble. Having private business in healthcare is now causing massive drug shortages, unsafe staffing level (while laying nurses off), and continuing to drive the cost of care sky high so the CEOs can further pad their wallets.

It all feels like one big experiment that has gone bad. Do I think government run healthcare is the best option? Probably not. But, when we as healthcare providers can no longer provide adequate care or give or pts the life saving meds they need, it's time for something to change. Also agreed it feels like something major is on the way, but I guess only time will tell!

[Been there,done that, ASN, RN]

Cheap ,blue collar labor?

I wish.

I am a beast of burden.

My goal is to last 5 more years.. try not to be too bitter about 30 years of brutal working conditions ..and think about SOMEWAY I can improve the picture for fellow nurses.

[Old.Timer]

Yes, Guttercat, it is very different this time. Nursing is on a downward spiral and in the process of being redefined forever. It is quickly becoming unrecognizable. I would not recommend the field of nursing to anyone I know or care about.

[cayenne06, MSN, CNM]

Even as a a brand spanking new RN, I agree. There is basically nothing that an RN can do that no one else can- hell, there are even med techs to pass our meds! Yes, theoretically only RNs (or above) can "assess," but really- that's kind of semantics. I definitely think nursing has lost its niche and I am interested (and a little scared) to see how things pan out. I went into nursing to become a CNM (I am a CPM by trade, but the on call hours of a home birth midwife became too much for me), so this whole discussion is very important to me.

Obviously I am oversimplifying, and I can't fathom a time when RNs won't be critical in an acute care setting, but yeah, I agree that nursing is undergoing some fundamental changes. HOPEFULLY for the better.

[Thomas_Spence]

Oh, I had no idea things were so bad....

I really hope nothing change's, for the worst at least, I'm no where near being a nurse yet, but just the other day I was thinking something like this, well not exactly, but I thought, what if I go through all the school, all the payments and all the trouble to become a nurse and.... I can't even be one! I mean, medicine and science is improving everyday, which is a good things, but I can't help but think, will actual healthcare professionals, become obsolete? I know this sounds far fetched, but what if they bring in robots or something? I mean, I don't quite know the cost of making a robot, but they wouldn't have to pay nurses anymore, I'm certain that somewhere along the line something like that could possibly happen, people are always looking for ways to save money....

[VICEDRN, BSN, RN]

So...been a nurse about two years and since you are asking, my preference is to start down the path for an MD. I work in the ER and I find the scope of practice too limited for an NP for the amount of time and money that one invests in grad school. I also see that they are expecting ever more education for a more ugh, defined, scope of practice. (read" limited)

the hubby started in nursing school to become a CRNA and I am trying to convince him that its obvious this job is not a keeper and he should go to grad school but he hasn't gotten there yet...

[NayRN]

I've been a floor nurse for just over 3 years now, and I look at it as experience towards my future profession. I try to be active in committees and process improvements, etc. and for the moment, I am happy with my small victories, and I have actually been able to change some things because of my involvement. I think that because of everything that is going on in healthcare these days, the legal aspect is the way to go, and I hope to go on to a law or ethics based masters program next year. Be a big picture advocate, you know.

[mama_d, BSN, RN]

Current long-range dream:

Open up a practice as a DNP with a friend of mine in a rural area nearby. Have it open at hours accessible to all. Also have in same building diabetic educators, PTs, OTs, hospice, as well as collaboration with alternate practioners (think equine therapy and massage). And referrals to physicians we know and trust to take good care of them when specialists are needed.

Basically a one-stop, holistic based, medical enterprise.

[zorabanks]

What I hate is having to be responsible for what unlicense personnel are allowed to do under my license just because I am an RN!!!! If you are going to hire a med tech because it "cost effective", then that person should be held responsible for what they do or fail to do.

[jwkwildland]

dang it.