How would you improve the nursing profession? (beyond better staffing, higher pay, etc)

[labordude]

TL;Dr: Nursing needs some help. What do you think will help improve the profession?

Nursing as a profession is in definite need of improvement as we go forward into the future. Many additional tasks are thrown at us, sicker patients are assigned to us, and we’re always asked to do more with less and do it faster. There has been a palpable push toward tasks over people, a decidedly different path than historically and from what is taught as nursing in schools.

Based on your experience, what would you change or do to improve the profession?

I’m going to preempt some answers here and say go beyond better staffing/ratios, higher pay, ancillary staff, unionizing, etc. Think about the profession itself and how you think nursing fits within healthcare as a whole now and five years from now.

[Tomascz, ASN, RN]

I don't know where to start. First off, I haven't heard the phrase "LPN" mentioned once here. Did they become illegal? Anyway.
The whole field is a compromised mess as far as certification, academic requirements,professional stratification, innate personality traits required to make good working NURSES, etc. etc.
Entitlement doesn't make for good nursing. Neither do martyr complexes. If you don't think being armpit deep in some poor suffering human beings fecal matter is a valuable learning experience, you're already on your way out.

Why do combat medics make better nurses than snot nosed high school kids?
Because they already know what they want to do and are pretty damn sure they want to do it. They aren't trying this on for size.

The comments about academia.... yeah.

How about we just have a national BON made out of 30 year bedside Nurses design us a new paradigm and academia and the suits and the HR bots can get in line or take a walk.

And, I think Nurses need to own and design and run the hospitals. I like Docs well enough but they're not nurses. They need to work for us and our patients.

[Jeckrn1, ADN, BSN]

19 hours ago, kbrn2002 said:

I'm sure it's already been said but here's my $.02 for what it's worth. Nurses are not maids nor are we waitresses, plumbers, electricians, cable or computer repair etc. Patients are not customers.

I blame the powers that be who came up with the brilliant idea to tie repayment of medical services to a customer satisfaction survey. I'd love to try that concept with my bills. There wasn't anything good on cable TV this month, I'll give them a bad survey so I don't have to pay as much. Now doesn't that sound ridiculous? Yet that is exactly what health care has become.

I know this is off the subject but this is one reason why we have a opioid problem now. No one wants to talk about this but blaming the drug manufactures is easier.

[TheDudeWithTheBigDog, ADN, RN]

16 hours ago, Tomascz said:

If you don't think being armpit deep in some poor suffering human beings fecal matter is a valuable learning experience, you're already on your way out.

Then get in there with me and teach me. Get involved. Every parent in the world can change a diaper, and adults are the same thing, just bigger. If there's something to learn, get in there and teach. But don't forget, assessing what came out is an aide level job. So you better have a really good idea of what to actually teach these students since by now they've seen enough and have enough experience themselves with taking the browns to the superbowl every day of their lives that they know "something isn't right." They know going 5 times in one day isn't normal. They know know that it's not supposed to look like brown water. They know that it isn't supposed to be black. Every aide in the world can smell blood in it. Occult blood is something suspected at the MD level. Every aide can smell potential C-diff. As a nurse, you're not diagnosing anything. All you're doing is knowing that you should probably make sure the doctor knows about all these abnormal symptoms, so that the doctor can get involved. Which is exactly what the aide did when they told you about all those symptoms or called you in to look at what they found since most states don't let them notify the doctor on their own.

First clinical semester, you have a point, everyone needs to learn the basics. About to graduate, pulling students away from a nurse to clean that up is just wasting their time and wasting REAL education opportunities. Students aren't there to work, they're there to learn. If cleaning up someone's explosion is a learning opportunity, then shouldn't a teacher or RN be in there with the student teaching them?

[CaliGrlOncNP]

Many nursing schools need some serious updating of their curriculum. My FNP program left me feeling significantly under-prepared for the job, and I went to a highly regarding state school in California. When my class tried to request additional preparation in certain topics, the director of the program did everything in her power to quiet us. Schools need to do MUCH better or matching the curriculum to the job.

[Wuzzie]

On 3/1/2020 at 10:48 AM, tonyl1234 said:

If cleaning up someone's explosion is a learning opportunity, then shouldn't a teacher or RN be in there with the student teaching them?

On this we agree.

[Hoosier_RN, MSN]

On 2/25/2020 at 8:50 PM, Kitiger said:

As students, we did primary care on our patients. Bed baths helped us observe the work of breathing, and how they completed their ADLs. We did a complete skin assessment, looking for edema and for signs of poor circulation, among other things. We did informal teaching as we helped them with their ADLs. We had to be able to tell our instructor why our patient was on a certain diet, we had to know every med our patient was taking (class, side effects, interactions, etc.). We had to understand why the med was ordered, and whether it was likely to be long-term or not. We assessed out patient's knowledge and did more formal teaching.

We never worked simply as aides unless it was a weekend shift as a part time worker who earned a wage.

We started out with one or two patients the first year. Even then, we read the charts, looked up the labs, did dressing changes, monitored IVs, and called the doctors with our concerns. By the third year, we were team leading with a full load. By team leading, I mean we no longer did mostly hands-on care. We took one or two patients and had others that the aides working under us (and our preceptor) did. We were overseeing the care. We still did all the dressing changes, preps, handled the IVs, etc..

When we graduated, we worked as GNs (Graduate Nurses) until we took the boards, then we became RNs. But even as GNs we took a full load. Orientation usually meant learning the unit's routine, and where to find supplies. We didn't have long internships to teach us how to work as floor nurses. We knew how to do that.

If you don't have the time management skills to do the bed baths, dressing changes, etc., while also doing the rest, then you are not ready to work in the hospital. And that's why so many new grads are so stressed.

Maybe it needs to be a 5 year program.

20 years ago, it was still like this, we didn't have a long internship, just a couple of weeks for computer charting classes and supply location etc. Miss those days. Now they teach to pass NCLEX, and not much beyond