If you could change NURSING what would you change?

Marie_LPN, RN, LPN, RN · Aug 2, 2004

How could i forget to mention unsafe nurse-patient ratios?

Hellllllo Nurse, BSN, RN · Aug 3, 2004

I think separating from hospitals and working as contractors is a FABULOUS idea. They could try to lessen their needs for "expensive nursing service" but research (and trial and error) has already proven that that crap won't fly. The fewer RNs taking care of patients, the more patients suffer complications and/or die. To not provide RNs just because they are "expensive" is the corporate version of negligence. How about letting "ivory tower" salaries take a hit if they are THAT worried about costs? Why should trimming the budget ALWAYS start with nursing? The hospital would function just fine if the vice president of patient butt-kissing took a pay cut or was eliminated entirely, for that matter. How about cutting back those CEO of insurance company salaries to make health insurance more accessible for all? (If more patients had insurance, hospitals wouldn't be so far in the red to start with). How about breaking up those pharmaceutical company conglomerates to encourage price competition? How about breaking up those hospital chains so health care won't be reduced to "their way or the highway"?
A slight variation to the contracting idea would be to make nursing a "bill for service" profession, just like law or medicine.

Woohoo, RN4NICU!

You've got my vote!

dmp135 · Aug 3, 2004

hello fellow nurses i have studied alot of these posts and i see a lot of pros/cons in our profession and i would like to know if you could change anything about nursing what would you change?

well change itself i think.you know...funny but the same things i recall nurses discussing/debating/caring passionately about when i was a new grad in 1980 are still being discussed as i consider going back after a 5 yr hiatus. the education bsn vs diploma etc debate still being waged 25 yrs later...i recall sitting in classes and hearing professors talk about a shortage around the year 2000...geez that sounded far away and yet here we are. nurses are burnt just as toasty as those talked about in reality shock. i am not seeing the change one would expect 25 yrs later. dedication and passion is there. nobody works harder than a nurse but we seem to be in the same place with the same upsets.

warm and fuzzy tv commercials announcing "i am a nurse" albeit lovely marketing did not fool my daughter, now looking at college, into going into nursing. she knows what it means to be a nurse and how tough a job it is.

she is using her helper gene elsewhere.

i'd have to say patient care ratios and staffing would be at the top of my list.

dorothy

WyomingRN · Aug 3, 2004

I think nurses should totally separate from hospitals....create our own practice groups and contract our services out to hospitals. We can obtain health benefits, et al, through our "group". We could follow the model of legal firms or MD group practices and charge for services independently. The different "groups" will be owned and run by nurses only, of course....maybe even get tax breaks because of the nursing shortage, eh?
...just a thought....

This is already being done by 1000's of nurses across the country. And it is the only real solution to the problems facing nurses and nursing. And the best part is that it is not very hard to do. Since I went independent, I am treated totally differently than I was as a staff nurse. I've had so much work that I had to quit marketing. Have had to hire another RN and two LPN's.

I set my rate to match the agencies in the area; but my service is far more than a warm body. It has to be if I want this to succeed. I save the facilities $$ by not charging for such items as travel or working as charge. On the other hand, I stay away for those facilities with bad reputation on the treatment of nurses. My rate is not the same for every facility. Those with good management and which treat nurses decent get a much better rate. Those that like to play games get rates 15%-25% higher.

NOW PICTURE THIS in your minds eye. 35% of nurses become independent over the next - say year. They will immediate realize that they can't do it all. What if they are injured or sick? Contract fulfillment is still required. So each of those new businesses hire 1-3 nurses (LPN's and RN's). How many does that leave to be employed as staff nurses? And they think there is a nursing shortage now!!!

Many say that facilities will not contract with independents. First, we have found some facilities with that attitude. But there are facilities that had that attitude two years ago that are using independents today. And if the formula set forth in the paragraph above was implemented, facilities would have no choice. This would be especially magnified if nurses in every State would start demanding the passage of patient ratios laws.

It is for these reason that we spend a great deal of our time assisting interested nurses in becoming independent. The problems in nursing will never be solved until nurses take control of their own careers and nurses control nursing.

I have tripled my earnings. And I only work about 60% the hours I use to. I love the extra time off. Even if 1/3 goes to taxes, I have still doubled what I was getting as a staff nurse.

And this is really good for travelers and PRN nursing. In short, you are simply eliminating the middle man and putting the $$ they were making off your hard labor into your own pocket.

momangel29 · Aug 3, 2004

I would definitely want to see change in the way we are treated.I would also like to see lower patient ratios and I would like to see nurses sticking together instead of tearing each other apart.I'm going to try to keep the rose colored glasses on now!

jaramilm · Dec 6, 2005

How do you become an independent nurse?

NickieLea · Dec 7, 2005

How do you become an independent nurse?

I'd love to do this too, but I do not want to leave my family while I travel and do this.

I also live in Montana in an area not very populated. There aren't many opportunites here and my husband won't be able to leave here until 2007.

Simba&NalasMom, LPN · Dec 7, 2005

I would definitely want to see change in the way we are treated.I would also like to see lower patient ratios and I would like to see nurses sticking together instead of tearing each other apart.I'm going to try to keep the rose colored glasses on now!

Well said. As a new grad, it's been pretty dang brutal to see the way some nurses are so catty and out to get each other, not to mention the fact that new grad LPNs in LTC are expected to perform as well as 20-year vets after the first month.

For me, it's a toss-up between nurses treating each other better, better mentorship for new grads, and better staff/pt. ratios.

I've only been doing this a few short months and at the moment I'm finding it difficult to even FIND my rose-colored glasses. :crying2:

Retired R.N. · Dec 7, 2005

hello fellow nurses i have studied alot of these posts and i see a lot of pros/cons in our profession and i would like to know if you could change anything about nursing what would you change?

i would change the entire structure of nursing organization and education to cover everyone from cna through lvn, and all levels of rn.

instead of bickering about the various levels of education, we would have one nursing organization with leaders combining their expertise to optimize education and unlimited step-by-step advancement up through the ranks of nursing, with the cna experience being the mandatory entry level for all nurses.

before i hear all the howls of protest, i would like to remind you of the number of bsn students currently graduated every year without the clinical skills to practice effectively in entry-level positions and the ones who burn out within few short years because nursing is not what they expected it would be. it seems very wasteful of human capital as well as scarce collegiate resources to enroll a student who has not already shown he or she has the educational and personality aptitude to succeed in nursing. in contrast, a system that permits a student to take one level at a time, and be able to earn a decent living after successfully completing any level of nursing should help ease the shortage of nurses actually working in the field.

only when all nurses are able to get their act together and treat everyone on the nursing team as a professional person will the general public get the idea that nursing is not a second-rate job for trained monkeys where people can be poorly paid, used up, and discarded. the big question as i see it is whether the future of nursing will be determined by nurses or by outsiders.

Simba&NalasMom, LPN · Dec 7, 2005

I would change the entire structure of nursing organization and education to cover everyone from CNA through LVN, and all levels of RN.
Instead of bickering about the various levels of education, we would have one nursing organization with leaders combining their expertise to optimize education and unlimited step-by-step advancement up through the ranks of NURSING, with the CNA experience being the mandatory entry level for all nurses.
Before I hear all the howls of protest, I would like to remind you of the number of BSN students currently graduated every year without the clinical skills to practice effectively in entry-level positions and the ones who burn out within few short years because nursing is not what they expected it would be. It seems very wasteful of human capital as well as scarce collegiate resources to enroll a student who has not already shown he or she has the educational and personality aptitude to succeed in nursing. In contrast, a system that permits a student to take one level at a time, and be able to earn a decent living after successfully completing any level of nursing should help ease the shortage of nurses actually working in the field.
Only when all nurses are able to get their act together and treat everyone on the nursing team as a professional person will the general public get the idea that nursing is not a second-rate job for trained monkeys where people can be poorly paid, used up, and discarded. The big question as I see it is whether the future of nursing will be determined by nurses or by outsiders.

Excellent post. Thank you!!! :)

zenman · Dec 8, 2005

1. I would change to one entry level. I would also change the curriculum. One must debate on whether you want nurses to be able to function as experts the minute they graduate...most professions do not. If most of your "clinical" after graduation occurs in the hospital, and in the area you want to work, you will be earning money whereas if you are getting clinical experience in school, you are paying.

2. Drop nursing diagnosis

3. Make training/education a little more in line with the real world. This can't be done totally, nor should it.

4. The fee for service has been tried many years ago and probably will not work since nurses are not in charge of healthcare payers.

5. JACHO should definitely be dropped as they are an added burden and cost.

6. Increase nursing faculty salaries.

7. Vote for me for President.

gauge14iv, MSN, APRN, NP · Dec 8, 2005

Cant EVEN go for the union concept AT ALL but contract groups are a GREAT idea - possibly the wave of the future. All the benfits of a union, without the drawbacks.