First, I do not want to challenge nurses with several years of clinical experience that are ADN or diploma trained nurses or those nurses that graduated recently with a ADN, and I do not want to challenge anyone by saying that there is a difference between the ADN versus the BSN prepared nurse.
There is a push for all nurses to be BSN prepared or for ADNs to achieve their BSN; however, there is no increase in wages for the majority of those with their BSN or those going from an ADN to a BSN. I find that as a workforce, we do not understand our worth. Why do we need the BSN as it costs more and it has no pay benefits. Students that have an ADN from a community college have less student loans, and they make the same a student that has a BSN; however, the BSN student has increased student debt with no increased monetary income to show for their degree.
I challenge the nursing workforce to acknowledge our value as a profession, and demand an increase in pay if we are to have a BSN. The current yearly income of a nurse is based on the costs of an ADN level of education; however, it does not match the cost of a BSN cost of education. If I am required or it is preferred that I have my BSN, I need to be paid accordingly. I do not practice nursing strictly for the income, but I do appreciate putting a dollar value on the work I do.
Nurses are no more an 'appliance' than CNAs, PAs, radiology techs, OT/PT. All members are good and necessary.
I submit that perhaps nursing is looking down its nose at other 'appliances' while aspiring for the status doctors have- which is basically pride and vanity.
I believe we need to value our role, pursue excellence in it and, most importantly, ACCEPT it. It's not that bad and it's not that hard.
(The reference to appliances from DoGood does not refer to nurses as appliances -- back when I was in school (in the Dark Ages), people sometimes referred to individual nurses as "appliance nurses" -- meaning that they didn't work most of the time because they were supported by their husbands; they would get a job when they wanted some extra money for something special and expensive, like a new refrigerator or range, and then quit working again as soon as the item was paid for. Hence, "appliance nurses," and, I'm assuming, DoGood's reference to "appliance ... profession." This ("appliance nurse") was used in a clearly derogatory sense by some instructors at my school to refer to nurses who did not take themselves seriously as nurses and were not interested in a career, and so, had no interest or investment in the larger nursing community -- just maintaining the ability to make some quick extra cash when they felt like it.
I would, however, take issue with DoGood statement that nursing has "mostly always been" an "applicance profession.")
(The reference to appliances from DoGood does not refer to nurses as appliances -- back when I was in school (in the Dark Ages), people sometimes referred to individual nurses as "appliance nurses" -- meaning that they didn't work most of the time because they were supported by their husbands; they would get a job when they wanted some extra money for something special and expensive, like a new refrigerator or range, and then quit working again as soon as the item was paid for. Hence, "appliance nurses," and, I'm assuming, DoGood's reference to "appliance ... profession." This ("appliance nurse") was used in a clearly derogatory sense by some instructors at my school to refer to nurses who did not take themselves seriously as nurses and were not interested in a career, and so, had no interest or investment in the larger nursing community -- just maintaining the ability to make some quick extra cash when they felt like it.
I would, however, take issue with DoGood statement that nursing has "mostly always been" an "applicance profession.")
Even if nurses did it and still do it- who cares!? Everyone is allowed to have their reasons for being a nurse. As long as you do your job well when you do it, no one should care.
Some are too judgmental about people's motivation for being a nurse. Again, as long as they do their job with competence, professionalism and treat clients with respect, it's none of our business. Way too many controlling attitudes when it comes to this issue, I think.
Thanks for educating me on the social jargon- good to know.
OP makes a very sound argument. BTW, this is the same one that is used by physicians - in order to justify paying NPs less for the same services.
But the truth is - there is less money available these days because of shrinking healthcare reimbursement. It isn't even a 'zero-sum' game any more, it is 'less than zero' as organizations are facing an unprecedented decline in volumes at the same time that reimbursement changes are kicking in. The logical outcome - if nursing salaries are forced upward - is that organizations will have to cut the number of RN positions and stretch RN staff with unlicensed 'nurse extenders'. I'm not supporting this - just pointing out the obvious. Approximately 42,000 health care jobs have been lost since January!!! And downsizing continues throughout the nation.
I support BSN entry for acute care. At this time, we don't have sufficient evidence that more BSN staff produce better outcomes in non-acute settings.
Also, as the market becomes more flooded with nurses (of any level of education), there is less incentive to pay more. So much for a nursing shortage. In my area (south central Indiana), there is approx 45% unemployment of nurses out of school
(The reference to appliances from DoGood does not refer to nurses as appliances -- back when I was in school (in the Dark Ages), people sometimes referred to individual nurses as "appliance nurses" -- meaning that they didn't work most of the time because they were supported by their husbands; they would get a job when they wanted some extra money for something special and expensive, like a new refrigerator or range, and then quit working again as soon as the item was paid for. Hence, "appliance nurses," and, I'm assuming, DoGood's reference to "appliance ... profession." This ("appliance nurse") was used in a clearly derogatory sense by some instructors at my school to refer to nurses who did not take themselves seriously as nurses and were not interested in a career, and so, had no interest or investment in the larger nursing community -- just maintaining the ability to make some quick extra cash when they felt like it.
I would, however, take issue with DoGood statement that nursing has "mostly always been" an "applicance profession.")
Will withdraw then "always" since until rather recently (1950's or so) many places did not hire married women and or discharged nurses who did; but aside from that it cannot be ignored that the nursing profession is heavily influenced by economic and other conditions on the ground for females.
Can still remember sitting in class post lecture for Med/SurgI and our instructor going on about how nursing was an excellent profession for young women. By her rationale this was because it could be taken up after college for a few years, then put down when one married and had babies. If money was needed later you could always return to work. This was only back in the 1980's, so not dearly as dark" ages. Dim perhaps or even dusk, but not dark.
Wages and bennies for nurses have never been much to write home about, not to mention the working conditions. In many areas of the country you could make the same money working as a secretary or many other places instead of the bedside. A fact not lost upon no small number of nurses who simply left the profession but made sure to keep their licenses active. What nursing did offer (until recently) was the ability to find work instantly. That is something not every profession or job could match.
So maybe not working for an "appliance" but nurses could be seen as taking the profession as a safe one to put down and take up again should the need arise. Further proof of this has come as the supposed "nursing shortage" vanished literally over night as scores of experienced nurses returned to the bedside during the past recession/economic upheaval.
I agree. The current BSN is useless unless you were an RN first, who then went and finished the degree. If you just started nursing school and got a four year BSN, they teach you virtually no practical skills. What good is an RN who can't start an IV, drop and NG or put in a foley? I just taught an IV class to a group of LTC nurses and one RN told me that she has NEVER put in an IV and NEVER was allowed to do any skills in nursing school, and she went to school in a large school in Minneapolis! I may be biased because I was a paramedic first, and for paramedic training, you had X number of skills you had to do in addition to the 800 hours of clinical time, and if those skills weren't done, it didn't matter if you had 1000 hours of time in, you continued to do clinical time until your skills were complete. We intubated pts in the OR, changed dressings in the burn unit, did hands-on in L&D, did hundreds of hours in the ER, and all before we were allowed to ride on the ambulance. My nursing school clinicals were beyond a waste of time. Nursing school didactic is fine for teaching NCLEX exam skills, but clinical time would be better served doing actual skills, not observations. One bed bath, one turning a pt. Check, on to the next thing, not wasting weeks on end handing out pills. You should follow the wound nurse, or the ostomy nurse, and do rotations where actual skills are performed, like IVs, IMs, drug pushes, CPR, NGs, foleys and the like. Otherwise, you set up the new grads to fail. One of my nursing instructors said this, "I don't know WHY nursing students think they should be able to start IVs and put in foleys when they graduate nursing school!" Um, because that's EXACTLY what they should be expected to know when they graduate! You expect your mechanic to be able to fix your car when HE graduates from school, right? Why is this different?
Also, as the market becomes more flooded with nurses (of any level of education), there is less incentive to pay more. So much for a nursing shortage. In my area (south central Indiana), there is approx 45% unemployment of nurses out of school
Employment market in many areas of the USA are becoming flooded with nurses for another reason as well; facilities closing and or merging along with the push towards less inpatient care.
New York City alone has lost ten or more hospitals in the past decade (have stopped keeping count), and there seems to be more on the horizon.
In the place of these full service hospitals we are getting what NS-LIJ is doing to replace Saint Vincent's and Montefiore to Westchester Square Hospital; full-service emergency department and ambulatory surgery centers.
NS-LIJ and the Rudin family who are developing the former St. Vincent's O'Toole building into such a place promise it will offer 90% of the services of the bankrupt hospital. However am willing to bet it will not have that number of professional nurse jobs.
NYP seems to be investing money and so forth in making it's takeover of Beekman-Downtown work, but if it does not that hospital will go as well.
In short the labour market for nurses is changing but we see little to none of that on the education side. The NYC area has pretty much the same number of programs as it had ten years ago. Indeed the number actually has increased if you add he number of ABSN/second degree programs that have come along.
Something somewhere has to give. It simply is not fair to make all these potential and current nursing students not to mention recent grads invest so much time, effort and finances for an uncertain labor market. Vague promises (warnings?) of a future nursing shortage aren't going to cut it when you are a new grad staring down major student loan debt but cannot find a job.
I agree. The current BSN is useless unless you were an RN first, who then went and finished the degree. If you just started nursing school and got a four year BSN, they teach you virtually no practical skills. What good is an RN who can't start an IV, drop and NG or put in a foley? I just taught an IV class to a group of LTC nurses and one RN told me that she has NEVER put in an IV and NEVER was allowed to do any skills in nursing school, and she went to school in a large school in Minneapolis! I may be biased because I was a paramedic first, and for paramedic training, you had X number of skills you had to do in addition to the 800 hours of clinical time, and if those skills weren't done, it didn't matter if you had 1000 hours of time in, you continued to do clinical time until your skills were complete. We intubated pts in the OR, changed dressings in the burn unit, did hands-on in L&D, did hundreds of hours in the ER, and all before we were allowed to ride on the ambulance. My nursing school clinicals were beyond a waste of time. Nursing school didactic is fine for teaching NCLEX exam skills, but clinical time would be better served doing actual skills, not observations. One bed bath, one turning a pt. Check, on to the next thing, not wasting weeks on end handing out pills. You should follow the wound nurse, or the ostomy nurse, and do rotations where actual skills are performed, like IVs, IMs, drug pushes, CPR, NGs, foleys and the like. Otherwise, you set up the new grads to fail. One of my nursing instructors said this, "I don't know WHY nursing students think they should be able to start IVs and put in foleys when they graduate nursing school!" Um, because that's EXACTLY what they should be expected to know when they graduate! You expect your mechanic to be able to fix your car when HE graduates from school, right? Why is this different?
Don't know when exactly it changed but at least through the 1980's and maybe in some places still clinical time was just what you described. It was where one learned "nursing arts" and practiced skills on live patients.
Somewhere along the line "tasks" and "technical" became dirty words because as *anyone* knows *real* nurses do not do such things; that is what aides and techs are for! *LOL*
I abosolutely agree with BostonFNP. I am currently in school right now working towards my BSN. Most nurses nowadays really focus on money and not on helping people. If you look at people comments, that's all they are talking about, Money,money,money. Money is not a big issue to me,if I didn't have my BSN, I would love to better myself as a Nurse. I mean why not,but your comment made absolutely perfect sense.
Wildboo, I don't know what Nursing School that nurse attend but at my nursing school,we do alot of hands on so I don't know what that nurse talking about.
Will withdraw then "always" since until rather recently (1950's or so) many places did not hire married women and or discharged nurses who did; but aside from that it cannot be ignored that the nursing profession is heavily influenced by economic and other conditions on the ground for females.
Can still remember sitting in class post lecture for Med/SurgI and our instructor going on about how nursing was an excellent profession for young women. By her rationale this was because it could be taken up after college for a few years, then put down when one married and had babies. If money was needed later you could always return to work. This was only back in the 1980's, so not dearly as dark" ages. Dim perhaps or even dusk, but not dark.
Well, that just illustrates the lack of consistency across nursing -- your instructor was touting the "appliance nurse" option to you as a reason why nursing was a good occupational choice for young women at exactly the same time as my instructors were pointing to "appliance nurses" as one of the significant reasons why nursing was not advancing as a profession, and as examples of nurses not taking themselves and nursing seriously.
Somewhere along the line "tasks" and "technical" became dirty words because as *anyone* knows *real* nurses do not do such things; that is what aides and techs are for! *LOL*
No...along the way as reimbursements declined, unless there are much more intense IV therapy needed, most lay people know how to do "tasks" ie, "drop" an NG, urinary catherization, etc...those things do NOT a nurse make. and at the evolutionary point, in nursing it doesn't, at least the work that I do and have done in my 8 years as a nurse, and I was a tech FIRST, totaling out my years to 13 years in healthcare.
Wildboo I don't know what Nursing School that nurse attend but at my nursing school,we do alot of hands on so I don't know what that nurse talking about.[/quote']
THIS...not every nursing school nor BON is the same...discuss your viewpoint from your corner of the world; however, understand that he "task" curve is a small one compared to the nursing knowledge and application curve today...a proficient, competent nurse is one who can think like a nurse FIRST in addition to grasping "technical" skills; one is not going to know ALL the "technical" or see them everyday; but can know what the patient NEEDS beyond the monitor or the tasks; that is FAR more important; I appreciate a knowledgable nurse beyond her tasks, as a patient that had a major medical issue (as a nurse), and as a peer in the trenches.
and at the evolutionary point, in nursing it doesn't, at least the work that I do and have done in my 8 years as a nurse, and I was a tech FIRST, totaling out my years to 13 years in healthcare.
elkpark
14,633 Posts
(The reference to appliances from DoGood does not refer to nurses as appliances -- back when I was in school (in the Dark Ages), people sometimes referred to individual nurses as "appliance nurses" -- meaning that they didn't work most of the time because they were supported by their husbands; they would get a job when they wanted some extra money for something special and expensive, like a new refrigerator or range, and then quit working again as soon as the item was paid for. Hence, "appliance nurses," and, I'm assuming, DoGood's reference to "appliance ... profession." This ("appliance nurse") was used in a clearly derogatory sense by some instructors at my school to refer to nurses who did not take themselves seriously as nurses and were not interested in a career, and so, had no interest or investment in the larger nursing community -- just maintaining the ability to make some quick extra cash when they felt like it.
I would, however, take issue with DoGood statement that nursing has "mostly always been" an "applicance profession.")