Most Pressing Issues in Nursing Today

pmcgrady · Mar 7, 2018

pncgrady, MSN, You are saying creating a uniform baseline education is a problem, but you believe all nurses should have a BSN?
You think turnover is a problem because we need performance based incentives and bonus structures?
We are from different worlds. I was poor. My single mom could not afford to send her children to school. The eldest paid his own way. The middle child had a football scholarship. I was in a co-op program in high school, working 1/2 days. I was engaged and married straight out of high school. I soon divorced. The reason why would make excellent lyrics for a Country and Western song.
I started as a night student business major. I debated the military or nursing school and started in LVN school. It was a good school and a good match. Upon graduation I thought, "I'm doing the same work as the RN, their pay is better." I worked full-time nights and obtained my ADN. It was available, practical and affordable.
My BSN I got around age 40, my MSN around 50. We've lived in rural areas. There were no incentives or career ladders. My husband is a CRNA. We were never dependent on my income. The salary cut I took when we moved to the mountains of North Carolina from Texas would curl your hair.
We were living in a beautiful part of the world, but high school graduates had a tough job finding work. The furniture factories and textile industries were closed down. There was some tourism, but jobs were scarce unless you worked in fast food, at the prison or for a local feldspar plant.
What would you have the young, less privileged, high school students do? What about the ones like me who weren't ready to travel and may not have been university material? What is your level of respect for community colleges?
I have mixed emotions about requiring a BSN for nurses. You are going to exclude the working poor. I can't address your 4-year degree vs. my hybrid one. It was fairly new and some of it was fluff. One friend said, "If is as if they consider us backward and are trying to civilize us." It was a moneymaker for the college.
Nursing is a respected profession. I applaud our increased autonomy and recognition as more than the the doctor's handmaiden, but if your opinion is based on nurses needing to study nursing theorists, I will have to disagree.

This is the American dream. You worked your way out of poverty. The country song think about getting married right out of high school and divorced is a personal choice though unfortunately. Studies show the having BSN prepared students leads to better outcomes. Which is why my hospital system (in the top 5 in the country) requires a BSN within 5 years of employment

pmcgrady · Mar 7, 2018

x10.
I woke up this morning and wrote out a couple of posts related to this. Still deciding whether to share. I could not agree with you more. I think refusing to play this particular game is more than just common decency at this point, it's a powerful strategic maneuver whose time has come.

Please share!

TriciaJ, RN · Mar 7, 2018

I don't think nurses are quite the modern equivalent of sweatshop workers. In what other profession can you make almost 30 dollars an hour from an associates degree. Oh and also with upward mobility through tuition reimbursement programs. I think it is a pretty good gig. Could be better, which is why I started this post.

What other profession doesn't get to stop long enough to pee? What other profession has so many responsibilities and so little autonomy?

TriciaJ, RN · Mar 7, 2018

This is the American dream. You worked your way out of poverty. The country song think about getting married right out of high school and divorced is a personal choice though unfortunately. Studies show the having BSN prepared students leads to better outcomes. Which is why my hospital system (in the top 5 in the country) requires a BSN within 5 years of employment

Are you talking about the Aiken study where they measured educational background and patient load simultaneously without a corollary study? The one that didn't break down whether the BSN nurses were entry-BSNs or previous ADNs?

And your hospital system is in the Top 5 for what exactly?

pmcgrady · Mar 7, 2018

What other profession doesn't get to stop long enough to pee? What other profession has so many responsibilities and so little autonomy?

Definitely depends where you work. I'm CVICU and we have 1 to 1 or 2 to 1 assignments and a lot of autonomy

pmcgrady · Mar 7, 2018

Are you talking about the Aiken study where they measured educational background and patient load simultaneously without a corollary study? The one that didn't break down whether the BSN nurses were entry-BSNs or previous ADNs?
And your hospital system is in the Top 5 for what exactly?

I'm sure if you looked at the state where I work you could figure it out

LadysSolo · Mar 7, 2018

Probably works at the "house of God" in Cleveland, which (as a fellow Ohioan) I don't think is as wonderful as the worshipers seem to think it is.

Oldmahubbard · Mar 7, 2018

The pressing issues of nursing today are staffing, or lack thereof, and educational preparation.

Get rid of the nursing theory at all levels and give us some meat.

pmcgrady · Mar 7, 2018

The pressing issues of nursing today are staffing, or lack thereof, and educational preparation.
Get rid of the nursing theory at all levels and give us some meat.

My coworker and I were talking about that with regard to NP programs. Less theory, more gross anatomy and pharm

TriciaJ, RN · Mar 7, 2018

Probably works at the "house of God" in Cleveland, which (as a fellow Ohioan) I don't think is as wonderful as the worshipers seem to think it is.

I don't put much credence into any kind of ranking system, any external designations such as "Magnet" or even various awards. Too much tendency for naked emperors. "Autonomy" means whatever anyone says it is. Nurses might actually have autonomy in a given hospital, or they have lots of staff committees that look good on paper and management still calls the shots from the inner sanctum.

OP, if you love your job and place of employment, that's great. But your experience might be very different from the multitudes who post here.

**RosesrReder, BSN, MSN, RN** · Mar 7, 2018

This is the American dream. You worked your way out of poverty. The country song think about getting married right out of high school and divorced is a personal choice though unfortunately. Studies show the having BSN prepared students leads to better outcomes. Which is why my hospital system (in the top 5 in the country) requires a BSN within 5 years of employment

The studies are all full of poo! How many of those BSN's were ADN's or Diploma prepared nurses for a long time before going back for their BSN. All of a sudden the "studies" claim it's because of degree and fail to point out that EXPERIENCE is what truly matters. I have yet to see studies of students who were not nurses prior to obtaining a higher degree. Stop drinking the Koolaid.

dbabz · Mar 7, 2018

The biggest problem in nursing is the focus on patient satisfaction and lack of personal responsibility. We are so scared of bad HCAP scores that we don't hold patient's accountable for their actions. Diabetics eating donuts you say? Must mean that nurse didn't educate them properly not that they are a noncompliant trainwreck....

I was going to ask about this. Just graduated; not yet employed. During my clinical rotations, there was a huge emphasis on keeping the patient "happy." This was the case even when safety was compromised (in my opinion.) I had a patient who was a hoarder and his room became an obstacle course. I asked how we would get the crash cart in if he coded and was given a blank stare. I also suspect that patient satisfaction ratings are behind the whole "pain is subjective" movement. So if a patient is relaxed, watching TV, drinking a soda and talking on the phone and rates his/her pain as a 10, it's a 10. No questions asked. Is this a departure from past protocol or has it always been this way?