I have been a Medical Assistant for the past 24 years. Since graduation, I have worked primarily in Pediatrics.
At this point in my life (41 years old) my husband is ill and currently undergoing Chemo. If he survives this or if he doesn't, I am going to have to take on the role of primary wage earner.
That said, I have decided to return to school to further my career. For many years now I have worked closely with diabetic children. So I have decided that I would like to become a Diabetes Educator. This requires me to get a masters in either nursing or some other health related discipline.
I know I could breeze through the RN program. My problem is....I just don't look forward to clinicals. I am beyond the "hands on" desire I once had in my younger years. Being brutally honest here, I am very anxious about having to clean up bodily fluids and do catheters and phleb etc. It not something I am interested in anymore.
So without sounding haughty, since my goal is to go beyond physical nursing....how involved must I get in clinicals? Is there any way to bypass this? Are there programs that will allow me to get my RN from an administrative viewpoint?
If not....what exactly should I expect from clinicals? How much "hands on" does it require? Can I be a quiet observer rather than actually performing?
Why in God's name are you providing her and every other nurse wanta bes with that information that it is OK to go to a substandard nursing school and skirt by on clinical time?
Where is your loyalty to our profession?
My "loyalty to the profession" is right out in front and very strong. If you have read my other numerous posts on allnurses, you'll see that I am against the lowering of standards that has occurred in nursing education over the past few years in the name of the "nursing shortage."
However ... I also believe in telling the truth -- and in not hiding behind misinformation or a lack of information. We need to speak openly of the differences in nursing education programs if we are to address issues arising from those differences. We can't pretend that all nursing programs are the same. Some schools emphasize bedside technical skills. Other skills emphasize academics. Some schools aim to produce nurses with a well-rounded perspective of life based on a foundation of liberal arts education. Some schools treat nursing education more like vocation training. There is no concensus on what exactly an entry-level program should be. Until that day (which may never come), we need to acknowledge that there are differences -- and the OP is entitled to know that so that she can seek the program that best suits her needs.
Isn't that the mantra here on allnurses? "Seek the program that best suits your needs." Isn't that the culture of our profession? "There is no one right path to becoming an RN. We should embrace multiple pathways?" Isn't that what always get said when the issues of ADN vs BSN as a starting point come? Isn't that what we say whenever distance education is discussed? All I did was apply that same principle to this thread. I said essentially, "Check all the programs available and find the one that best suits your needs." Why is this case so different than the other cases when people advise others to seek programs that best suit their needs -- even if other people feel those programs are inferior?
I expected my post to yield some controversy, but I expected it to come from the folks who support Excelsior and who support the "for-profit, former vocational" schools. I expected them to be angry that I was suggesting their schools were inferior.
Thinking more about it ... maybe we should have schools that don't include much clinical. People who want to focus on other types of nursing are not necessarily bad people or bad nurses. Maybe it should be up to the employer to investigate the various competences possessed by a job applicant to decide whether or not that particular person has the skills necessary to do the job. Hmmm.... that's something to think about. Which skills and what knowledge are essential to be an RN -- and every RN should graduate with -- and what knowledge and which skills are not essential for everybody?
You are right llg there are different skills required for different jobs, and not that the nln has the best plan in place but they do provide a guide for basic nursing education. For example, at times I find my self frustrated with my current MSN education because of the emphasis on nursing research...yes I can see a certain value in it but what I really want as a soon to be FNP is advanced diagnostics, advanced A & P classes (we do have a patho class), instead of some of the less tangible classes of nursing theory and research.
That said, for any nurse that enters a mid management or educator position I think having a strong basic nursing knowledge is a critical building block. And actually I would like to argue that our current BSN programs (even the local ones) are often weak on the clinical side of things, but for the OP this will not be a quick solution.
Over the years I have defined what I consider the three essential C's of nursing:
1. A Caring attitude (in an emphatic way).
2. technical Competency
3. Critical thinking
As you can see these are pretty wide open as far as defining what skills and knowledge are essential as a nurse.
I have been a Medical Assistant for the past 24 years. Since graduation, I have worked primarily in Pediatrics.
At this point in my life (41 years old) my husband is ill and currently undergoing Chemo. If he survives this or if he doesn't, I am going to have to take on the role of primary wage earner.
That said, I have decided to return to school to further my career. For many years now I have worked closely with diabetic children. So I have decided that I would like to become a Diabetes Educator. This requires me to get a masters in either nursing or some other health related discipline.
I know I could breeze through the RN program. My problem is....I just don't look forward to clinicals. I am beyond the "hands on" desire I once had in my younger years. Being brutally honest here, I am very anxious about having to clean up bodily fluids and do catheters and phleb etc. It not something I am interested in anymore.
So without sounding haughty, since my goal is to go beyond physical nursing....how involved must I get in clinicals? Is there any way to bypass this? Are there programs that will allow me to get my RN from an administrative viewpoint?
If not....what exactly should I expect from clinicals? How much "hands on" does it require? Can I be a quiet observer rather than actually performing?
Thank you for your responses.
Since you have experience working with patients, you already have a good sense of what you want to do with your professional career (Diabetes teaching)--that's a great goal. While there may be other routes to becoming a diabetes educator, I am of the opinion that nursing is a good solid way to get there (albeit a biased opinion since I'm a nurse :) You sound like an academically minded person, and I'm assuming that your comment about "breezing through" nursing school is more a reflection of a person who relishes the classroom experience than a person who thinks she's smarter than anyone else. I did not read your post and assume that you thought being an MA was the same as being an RN, and I'm not sure where everyone is getting that from, but what can you do?
Anyway, I would recommend going into nursing with your goals in mind. Clinicals can offer you information about health and disease states as well as give you the experience you need to feel confident as you progress in your knowledge. You will learn a lot about diabetes when you are caring for patients who are hospitalized from complications of the disease. You will also learn a lot about how patients and their families understand the disease process, how they cope with stressful situations, and how they learn best. When you take care of non-diabetic patients you still can learn all of those things about patient care and develop your own teaching style.
I didn't want to do clinicals either. I made it through, learned a lot, now a nurse and soon to work as an NP. "Caring" for people as a nurse, nurse educator, NP, doctor, etc does not equal "skills"--you care for patients because you care ABOUT them. If you happen to have to learn how to put a foley catheter in a patient as you care for them, you will find that your anxiety is about your own technical ability, not about how you are relating to your patient as their primary nurse and all of the professional expertise that goes with that responsibility.
I wish you the best of luck, and whatever you decide I hope you have an emotionally enriching and intellectually satisfying career ahead of you.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
It seems as though the definition of "nurse" is becoming sort of fluid these days, otherwise these posts about how can I get through nursing school in order to be a ------- , when I really don't care to put my hands on people wouldn't pass the logic test.
Even MDs who decide to go into research go through the same med school and residency hoops the eventual Internal Medicine docs, dermatologists and radiologists do. Public perception of "nurse" will have to be changed, too. I'm pretty sure they assume that if someone has "nurse" in their title they could be called upon to be effective in a situation where the traditional role of a nurse is required and had at least some experience actually doing the job.
I just can't see the point in someone slogging through 2-4 years of training doing something they find distasteful. That goes x100 when time is more precious because of an illness with an uncertain outcome.
I don't agree that "caring for people doesn't involve skills-- it means caring ABOUT them"--
I don't agree that "caring for people doesn't involve skills-- it means caring ABOUT them"--
That is not what I said. If you are going to go to the trouble to use the quotation marks, please quote the exact words, not just your interpretation of the words. What I said was caring does not EQUAL skills (not involve)--that means you don't have to LIKE performing the necessary skills of nursing in order to care for your patient. I do not LIKE cleaning poop, but that has no bearing on how I LIKE caring for my patient. I will help clean an incontinent patient because I care that his skin remains intact, that he doesn't get an infection, that he doesn't have to suffer the indignity of lying in his own waste, inhaling the odor, worried that a loved one might come by and see him in such a state. I perform nursing skills so that I am able to provide the care that a patient NEEDS. I will not always work in a setting where cleaning body fluids will be one of the essential needs my patients have of me. Setting sights on a specialty is one of the bonuses to working in health care--finding a match between patient need and provider interest is a great way to advance a career, avoid burnout, and provide inspired care.
I just think that if the OP recognizes the value of clinical experience, she might feel differently about nursing school. I don't understand why someone who expresses hesitation about working closely with some of the grosser bodily functions should be criticized about her desire to go into nursing. I always hesitate before I tackle a code brown. I think that just means I'm sane.
I just can't see the point in someone slogging through 2-4 years of training doing something they find distasteful. That goes x100 when time is more precious because of an illness with an uncertain outcome.
You don't have to spend 2-4 years anymore. You can spend 15 months doing mostly book work, simulation labs, and clinical observations and get an ADN these days (if you go to certain schools). There may be a little "dirty work," but not nearly as much as you find in some schools. Nowhere near 2-4 years.
Then you go to an RN-BSN program online that requires projects and papers (no "patient care" clinicals because you are already a nurse) ... and then a Master's that involves no contact with body fluids either. ... and ... BINGO ... you have an MSn without getting your hands dirty. It's very possible if you know which schools to go to and get lucky finding that first entry-level job in an area that appeals to you.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
Kanzi monkey-
"Caring" for people as a nurse, nurse educator, NP, doctor, etc does not equal "skills"--you care for patients because you care ABOUT them.
means
What I said was caring does not EQUAL skills (not involve)--that means you don't have to LIKE performing the necessary skills of nursing in order to care for your patient. I do not LIKE cleaning poop, but that has no bearing on how I LIKE caring for my patient.
?
I'm sorry if I misinterpreted your meaning in the above quote, but I still don't think it was worded clearly. Probably a combination of the interchangeability of "caring" as in concern, and "caring for" associated with traditional nursing care, or your including of doctors, educators, etc., in your group of those who "'Care' for" people, as there is at least one in that group that rarely touches a patient at all. Either way, it's my problem and I'm not going to quibble with your intent. I only hope I got all the quotation marks in the right place. :)
I admire you and Ilg for attempting to provide some balance to the OP's replies. I don't like to see post after post basically piling on the same point like the cave lady in the comic BC pounding on that poor snake. (Don't flame me you guys, please!!) I agree with most of it and I was po-ed, too. . . about the "breeze through" remark. Now I am pondering it and I think it was likely an unfortunate choice of words, and perhaps she was talking about her "health care" knowledge in a theoretical sense, not really well-versed on the rigors of nursing school. She certainly has a heck of a lot more on her mind right now, anyway. Sadly, I fear we willl never hear from her again, but if she does come back she will at least see that the two of you attempted to set the emotions aside, which in this case, wasn't very easy to do.
Firstly, I would like to apologise for any insult by my "breeze through" comment. It was clearly a poor choice of words. In actuality, I was referring to classroom only when I said that. I neglected to add that I am also a Med Term and Anatomy instructor. So class work does not intimidate me.
That said, I in no way think that actual patient work will be easy. Which is partly why I expressed my dislike of doing clinicals. I have a true appreciation for what actual nurses do on a daily basis. As for my skills, yes they are limited to the office setting. No, I do not fancy myself a nurse. I am a but an MA. While I have many years of experience with office basics like phleb, minor triage, sutures, labs, IV's, caths, EKG etc....I know there is so much more to learn.
Yes I am wary of the "yuck" factor. I do not desire to be bedside...at any point in my career. I simply want to get from point A to point B to point C. In the end being a Diabetes Educator. While this job will require minimal hands on care, it is mostly administrative.
I do see and respect the concept of working my way up. Of putting my time in. But if I were to choose another route to this end, say getting a Dietician degree instead, (another valid means to this end) would you think me less competent to perform my job? I personally want to go the nursing route because I feel it does offer a better education as far as patient care goes. Of learning those nuances and gaining that compassion for the person. Plus, above all, it is a much more honorable title.
My goal here is to work in a capacity that I feel is important and enjoyable. Diabetic care is what interests me. If bedside nursing interests you, I would not condemn you for it. I would not think you lesser than I because we chose different careers.
When all is said and done, aren't we all seeking the same thing? To help others?
I have read and am greatful for all of your responses. They have given me alot to think about. I am still on the fence with this. But I feel much more enlightened to the realities of the job in question. Thank you for taking the time to express your heartfelt opinions.
I just graduated from an RN program. In the beginning, I was afraid of going to clinicals and seeing someone else vomit (didn't want to puke when I saw someone else doing the same) and just how on earth to give a bed bath. (It truly is an art.) Instructors in school readily admit they have "something" that grosses them out.
I was really worried for nothing. In fact, myself and others felt that we did not get enough hands on training in school. Fortunately, it was not half as bad as the complaints of others report.
In nursing school, clinicals are usually only one day per week and you are only there for a few hours in that day. It really adds up to only about 6 hours per week, which isn't that much.
I don't know if this was responded to, my apologies if it was, but....six hours a week??
When I was a student, and now when we have students on the floor, it's two days a week, full 8 hour shifts (one of the days includes a 2 hour post conference, but all the rest of the time is on the floor). The final semester requires a 96 or 112 hour extended clinical experience (you're working literally 3 weeks hands-on with a nurse at a specific site). I have never heard of such a slight requirement of hours, as you mention...
I do realize that their are programs that are out there that I am not familiar with. I guess this just suprises me. Without putting in much clinical time, a graduating nurse would be woefully unprepared, IMO.
Firstly, I would like to apologise for any insult by my "breeze through" comment. It was clearly a poor choice of words. In actuality, I was referring to classroom only when I said that. I neglected to add that I am also a Med Term and Anatomy instructor. So class work does not intimidate me.
That said, I in no way think that actual patient work will be easy. Which is partly why I expressed my dislike of doing clinicals. I have a true appreciation for what actual nurses do on a daily basis. As for my skills, yes they are limited to the office setting. No, I do not fancy myself a nurse. I am a but an MA. While I have many years of experience with office basics like phleb, minor triage, sutures, labs, IV's, caths, EKG etc....I know there is so much more to learn.
Yes I am wary of the "yuck" factor. I do not desire to be bedside...at any point in my career. I simply want to get from point A to point B to point C. In the end being a Diabetes Educator. While this job will require minimal hands on care, it is mostly administrative.
I do see and respect the concept of working my way up. Of putting my time in. But if I were to choose another route to this end, say getting a Dietician degree instead, (another valid means to this end) would you think me less competent to perform my job? I personally want to go the nursing route because I feel it does offer a better education as far as patient care goes. Of learning those nuances and gaining that compassion for the person. Plus, above all, it is a much more honorable title.
My goal here is to work in a capacity that I feel is important and enjoyable. Diabetic care is what interests me. If bedside nursing interests you, I would not condemn you for it. I would not think you lesser than I because we chose different careers.
When all is said and done, aren't we all seeking the same thing? To help others?
I have read and am greatful for all of your responses. They have given me alot to think about. I am still on the fence with this. But I feel much more enlightened to the realities of the job in question. Thank you for taking the time to express your heartfelt opinions.
First off, let me say that I am deeply sorry for your husband's condition, and hope for the best possible outcome for him, and you.
On to the other topic at hand....
This second post you made doesn't clarify or amend much from the original one, for me. Not being intimidated by classwork isn't the same as being able to "breeze through it," so I don't see how that statement further explains the first. Honestly, I don't see being a Med Term and Anatomy instructor will help THAT much...those types of classes are basic pre reqs for nursing. The actual coursework in nursing theory classes is very different from that. Not being intimidated doesn't mean that they'll be easy, which is what I think you're really saying. Will they help some? Sure. I had a good knowledge of medical terminology before going in to nursing school (and that's one thing that came easy for me all along, it's one of my strengths) and it helped, but it's a small part. Same with anatomy. Knowing structures is just a small building block of what you'll have to learn and know as you progress through a nursing program.
Having the "honorable title" of RN doesn't mean much, if your goal is so specific in what you want to eventually do. Part of the reason it IS honorable is because of all it encompasses, and that doesn't interest you, so I'm seeing a direct contradiction in your statements. Hands-on care is a HUGE facet of nursing, no matter what position a nurse eventually finds him or herself in. I'm not understanding your concern of appearing "less competent" doesn't make sense to me. A Diabetic educator is a diabetic educator, RN or not. From your statements, you don't WANT be competent in anything else, so is it just that you want to "appear" that way, by having the title of RN? Unfortunately, it doesn't work that way.
There is no such thing as a "quiet observer" vs an active participant when it comes to clinicals (or skills lab, for that matter). You must prove yourself competent in a myriad of skills in order to successfully complete a nursing program, and that means hands-on.
And, consider this: while I applaud anyone that has such a clear goal of what they want to do with their careers, I'm afraid you're pigeon-holing yourself. What happens if you could not find work as a CDE when that time comes, what good would it do had you not completed clinical skills? A bedside nursing position, while not what you WANT to do, may be your only option when you graduate. I work with a gal who just graduated as an RN (and just passed her boards), she was a CNA/HUC on my unit prior to that. The only job she could find was in a nursing home. Not her first choice by a long shot, but it was better than NO job, which is a position more and more new grads find themselves in. Sure, you could probably continue to work as an MA if you can't find your desired employment, but then what was the point of going back to school in the first place? Also, in some states, I know you can't work below your license level in terms of nursing (ie, you can't work as a CNA if you're an RN, even if that's your only option) so you may not be able to work as an MA once you're an RN, either (can't say as that I know that for sure, though).
To add further weight to the above...the hospital I work in, which is the largest in my region (we get patients from pretty far away cities, and even the next state, due to the services we offer), recently closed our Outpatient Diabetes Clinic. The reason was the economy, and it was suffering not just a loss in revenue, but was costing tens of thousands of dollars more to run than what was coming in. That's where our CDE's all worked. The outpatient clinic CDE's were the ones who also worked with our inpatients. Every one of them suffered one of two fates: severely reduced hours or elimination of their positions. We are now down to 2, who work very part time when they work at all. The ones whose positions were eliminated were displaced in to staff nurse positions within the hospital if they chose (in places like the rehab floor, the surgical IMCU, etc), or otherwise simply found themselves unemployed, with no similar positions to be found anywhere (most took the staff nurse jobs, which then further decreased positions available to new grads, it's a cycle). The inpatient diabetic teaching is now done by US, the staff/bedside RN's.
I doubt mine is the only hospital to have suffered such a fate, either. It's just something for you to think about.
llg, PhD, RN
13,469 Posts
My "loyalty to the profession" is right out in front and very strong. If you have read my other numerous posts on allnurses, you'll see that I am against the lowering of standards that has occurred in nursing education over the past few years in the name of the "nursing shortage."
However ... I also believe in telling the truth -- and in not hiding behind misinformation or a lack of information. We need to speak openly of the differences in nursing education programs if we are to address issues arising from those differences. We can't pretend that all nursing programs are the same. Some schools emphasize bedside technical skills. Other skills emphasize academics. Some schools aim to produce nurses with a well-rounded perspective of life based on a foundation of liberal arts education. Some schools treat nursing education more like vocation training. There is no concensus on what exactly an entry-level program should be. Until that day (which may never come), we need to acknowledge that there are differences -- and the OP is entitled to know that so that she can seek the program that best suits her needs.
Isn't that the mantra here on allnurses? "Seek the program that best suits your needs." Isn't that the culture of our profession? "There is no one right path to becoming an RN. We should embrace multiple pathways?" Isn't that what always get said when the issues of ADN vs BSN as a starting point come? Isn't that what we say whenever distance education is discussed? All I did was apply that same principle to this thread. I said essentially, "Check all the programs available and find the one that best suits your needs." Why is this case so different than the other cases when people advise others to seek programs that best suit their needs -- even if other people feel those programs are inferior?
I expected my post to yield some controversy, but I expected it to come from the folks who support Excelsior and who support the "for-profit, former vocational" schools. I expected them to be angry that I was suggesting their schools were inferior.
Thinking more about it ... maybe we should have schools that don't include much clinical. People who want to focus on other types of nursing are not necessarily bad people or bad nurses. Maybe it should be up to the employer to investigate the various competences possessed by a job applicant to decide whether or not that particular person has the skills necessary to do the job. Hmmm.... that's something to think about. Which skills and what knowledge are essential to be an RN -- and every RN should graduate with -- and what knowledge and which skills are not essential for everybody?
llg, PhD, RN