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

[Guttercat]

(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.

[Guttercat, ASN, RN]

There have been very thoughtful replies in this thread looking at the picture from different angles and I very much appreciate everyone's input.

What's driving me nuts is the obtuse nature of the the subject I started.

I wish to quantify it; project with some accuracy where we are headed as a profession, but the barriers to doing so are the yet unkowns in healthcare reform. The ACA kicked the can down the road and we are just beginning to see where it's going. We know our current system is unsustainable, but while Exchanges and ACO's are scrambling to organize, are we as a body of "professionals" content to tag along for the ride?

I see RN's increasingly bought and sold, traded or downgraded or kicked off the game board altogether like pawns.

The shenanigans going on at the corporate level by buying and selling alliances with politicians, and "working" the system is nothing short of apalling to my sense of integrity.

Anecdotally, one our our hospital's NP's (Employee Health Nurse) was fired and replaced with an RN... no one is "safe."

Someone here posted about a work called "Code Green." I'd like to read that.

I've narrowed my long range goals to include obtaining an MBA...but not even that is a sure-fire. MBA's are a dime a dozen.

I've long admired law and thought about Business/Corporate law in the healthcare context, but from what I understand, there are as many newly-minted lawyers without jobs as there are RN's.

Anyway, I'm rambling. :)

[Guttercat, ASN, RN]

This is extremely depressing to hear when you're about to be a new grad in a few months and you've poured all your heart and soul into becoming a nurse

lelafin,

Your education is not in vain. You will have opportunities you did not have before your degree. You can build on it.

If I had it to do over again, I would have started a different (though perhaps tangential) path some time ago. So go in with your eyes wide open and plan accordingly sooner rather than later.

[Guttercat, ASN, RN]

LOL, hello again.

I've done my research as a pre-nursing student and while I am aware of the pitfalls many are experiencing it will not prevent me (and others) from pursuing the many avenues that exist within the profession. The constant "woe is the profession that I abhor" rhetoric of members on Allnurses is a sample and shall be treated as such. Seldom do I hear the same complaints from advanced practitioners, nurse professors, et al, many of whom are thrilled and love waking up every day to do what they do. While I am tickled by the attempt of others to dissuade the pursuit of entering the profession, it won't stop me from going full speed with my plans, especially as a prospective nurse of color who wishes to obtain an MSN and/or Doctorate in the near future. More racial diversity are needed at these levels.

Because perhaps you're not working with them?

:)

Nonetheless, I admire your spirit and moxee. You'll go far with that attitude. Thumbs up!

[Altra, BSN, RN]

You just did. I love my job and my profession. I never regret going to work. I did suffer from burn out, but I worked at a crap hospital. Three years at my 'new' facility and I could not be happier. I even like managment.

Raising my hand as well ...

Did a complete 180 degree flip to nursing in my mid-30s ... and I'm glad I did so. No regrets here.

[traumarnrodney]

We joke in the ER that eventually administration will just put in a drive-through window with a card reader and a touch screen so patients can get what they want when they want it. The problem with healthcare reform is when providers get reimbursed according to their patient satisfaction scores of course they are going to get any testing performed that they request because it is too much of a hassle if they complain. I plan to complete my MSN in December after 14 years at the bedside and become a Family Nurse Practitioner. Am I worried about finding a job? NO. I've already received offers contingent on my successfully completing my education from my full-time ER job, my part-time ER job, and the site where I'm doing my clinicals which is primary and palliative care. Those that say that there aren't any jobs out there need to lower their standards a little. It's much easier to get a job if you already have one. Sorry for getting off topic. In the future I see a low quality single payer system for the masses with premium services available to the affluent who can afford to pay for them. Not saying that I agree with it, but so many abuse the system that it is unsustainable.

[cdsga]

I just worry about the widening river of nursing administrators and the bedside nurse. While there has always been a bit of a distance-I'm starting to see an increasing elitism that is creeping in once a nurse leaves the bedside. Nursing is cyclical, but is going to suffer the brunt of the Healthcare reform because we can't come together and agree on anything. It's becoming much like the game "Survivor" where nurses form alliances with those who can benefit them and step on those who are really advocating for the patient. I agree there is a smell out there, everyone clamoring to get advanced degrees, and leave the inexperienced nurse out there to dangle with no support. I am filled with a feeling of uncertainty, and a CYA attitude to preserve my job. Don't know about the rest of you but I worry and I didn't used to feel this way.

[Purple_Scrubs, BSN, RN]

If I had it to do over again, I would have started a different (though perhaps tangential) path some time ago. So go in with your eyes wide open and plan accordingly sooner rather than later.

Sadly, I would have done it differently as well. As far as my own future plans, I am hopeful that stay at home mom is in the near future. Once I am ready to return to work, I will be strongly considering alternatives other than nursing (PA, social work, law, etc). I have interests in many areas which is a blessing and a curse. Luckily I will have a few years to sort it out.

Who knows, maybe I will miss nursing enough to return. It is better for me since I am in a non-hospital environment, althouth I wonder if the economic crunch will lead districts to eliminate RNs from schools. If that is the case, my decision will be made for me because I refuse to step foot in a hospital as an employee unless it is that or fail to feed my family!

[Chaya, ASN, RN]

Nursing is whatever the bean-counters decide will suit their purpose-du-jour. Depending on supply and demand the scope of practice seems to be re-defined every few years.

[cdsga]

I find it disconcerting that I have not heard from nurse execs or educators on this topic. Are any even listening?

[Piglet08]

Well, I don't think I'll ever retire, but I can't see doing this when I'm in my 60's. Once the college bills and mortgage are done - not too many years away - I can stop having to pursue the highest pay I can get. What I'd really like to do is Energy Medicine, but I can't see a way to do that as an RN under the law as it is these days. Even as an NP, I would need an MD to work under, and try finding an MD who buys into that whole mind-body-spirit thing. I'm thinking becoming a therapist would allow me some independence, and I can go into Energy Psychology. Either that, or I'll get myself some bodacious costumes and become a traveling Renaissance Festival tavern wench. Or maybe open a gelato shop on the beach.

[Dangerous]

A bedside RN, later an R.N., B.S.N., I remained on the front lines as a care giver almost my entire career. (I did try home care and also hospital nursing unit shift management, but my personal & nursing personalities fit best w/ bedside nursing). I was very frustrated w/ expectations of administration, day nurses waltzing in after 7 AM and then socializing before and during report, understaffing, and being forced to double from nights to days (though that only happened once--I voted with my feet after that episode). In addition, just prior to doubling episode, a former colleague in her late 40s died suddenly. Life was too short to put up w/ any further nonsense. Have been retired over 3 years.

From the tone of the 1st few pages of comments, it seems like it's getting worse. Years ago, I read that if nurses were not hospital employees, it would be a different world (positives for the nurses). As a potential client or family member, would you suggest I do informal (on my own) C.E. to keep on top of stuff?? I guess it's always a good guide to keep current, even if retired AND unlicensed, so I answered my own question.

What can I say? You nurses have my empathy and my sympathy. Hang in there while you can. But always remember, your life is more important than any job. Take a break. Get help if you need it.

[theantichick]

I don't graduate until December, so it'll be next year before I'm even working as an RN.

I'm a mid-life career changer, too. I want to work ER (I was a paramedic in my early 20's) while I get my BSN, and then I'll move into whatever the level of training for FNP is. I want to work in a rural underserved area, so I don't anticipate having problems getting a job then, and I plan to do that until I drop.

I also have a backup plan, in that my particular IT experience dovetails perfectly with Medical Informatics, so at the point I'm choosing my advanced degree plan, I can always switch back into IT, just on the medical side of it, and get out of patient care altogether.