Just one persons opinion

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To all "experienced" nurses. Please help me with this issue. I need to know if I'm being overly sensitive or have I once again been slapped in the face by an organization that promotes itself as having my best interest at heart. When I got home yesterday I found the newest edition of The Maryland Nurse in my mailbox. In need of some light reading a bold statement on the front page caught my eye, "You can't take care of your patient if you don't take care of yourself and your profession." I had to read on only now I wish I hadn't. Tim Porter-OGrady, DM EdD, APRN, FAAN is further quoted as saying "experience is not sufficient for competence." "A nurse with years of experience is experienced in an age that we are now leaving behind." He goes on to profess the wonders of Evidence Based Practice. Now I have to tell you I was so mad at reading this seeing as I am a nurse with 27 years experience that my evening was just about ruined. This statement to me is another reason why I would be so disappointed is my daughter ever came to me and said she wanted to be nurse. Because this is such a blanket statement that those of us with experience have nothing new to offer. Anyway before I continue to vent I'd like to hear from others as to whether my anger was indeed out of place.

Specializes in Hospital Education Coordinator.

I have met Tim and he is a well-known nurse and Educator. The finest. Before you get all steamed up again, do a little research on the concepts in his article. It is true that the longer someone does a job the more "rote" it becomes and, in some areas, the harder it is to teach that person new processes. This is true for all professions, not just nursing. However, it may not be true of you. If you are challenging yourself with continuing education you would be the exception and, at the same time, a better nurse for the effort. Example: I had a nurse tell me that since he has nursed >20 years he knows more about CPR than AHA does so he does not think he should have to take the renewal course. AHA spends millions on research for the BEST way to get the BEST patient outcomes. I doubt that 20 years of doing things the same way, with a closed mind, can provide that sort of evidence. Another nurse, same tenure, gets excited about learning and teaching new things. He is a valuable resource to our facility. I pay him a consulting fee because I want his expertise. So, please take Tim's article with a grain of salt and let it encourage you to be the best you can be!

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Well, I'm not so sure that the guy who thinks he knows more about CPR is completely wrong. Having ACLS change from pushing CPR, to pushing defib, to pushing CPR, over and over again through the years- obviously we aren't making a huge enough dent in the death and poor outcome rates or they wouldn't keep changing things. I think that some of those millions of dollars that AHA spends might be used in better ways. People die. Medicine cannot save everyone. And often times it SHOULDN'T save people. The focus of AHA is on often on quantity and not quality of life. We are never going to get the general public to be willing to start CPR at the rates needed to drastically improve survival rates so by the time medical personnel gets there....not always worth it to keep changing the CPR/ACLS rules because it's too late anyway.

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Specializes in Community Health, Med-Surg, Home Health.
Does he think I just slept through the last 28yrs and am stuck in the 80's?

I guess he does suggest that you all were like Rip Van Winkle, and dreamed your way to the new millenium (I say this sarcastically):down:

I still stand on the fact that the more senior nurses are survivors and can show me a great deal. Of course there are those that are so stagnant and crochety that they are scary as well as those that eat their young. But, those that really came from a good crust know that it takes both, experience and keeping up with trends in order to survive.

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i can't comment on the contents of the article since i don't have access to it.

however, i'm going to agree with the quoted statement: experience isnot sufficient for competence.

maybe i'm dense, but i'm not understanding why so many seem to be taking offense to that.

i don't think that statement discounts the value of experience. you would be a fool to take the stand that experience is worthless. nursing school presents us with the absolute minimum of experience; yet you could memorize a med/surg or critical care text, and it wouldn't be worth much without the basic experience you gain during clinicals.

the knowledge a nurse gathers in multiple years of bedside nursing is invaluable. but it isn't enough.

as with any other lesson, what you do with that experience means more than the experience itself.

to me, that statement is more about the necessity of keeping up with current practices than it is about the value of experience. it is about learning from your mistakes and the mistakes others make. it is about accepting that learning does not stop when we graduate from nursing school ... or when you get done with orientation ... or once you've been a nurse for five years ... or fifty years.

a nurse with 20 yrs of experience who refuses to accept new policies, procedures, equipment, and techniques because "that's not how i was taught to do it" may not be competent.

a nurse with 30 yrs of experience who doesn't go to mandatory inservices on new equipment, or look up new drugs before she/he gives them may not be competent.

granted, "best practice" comes and goes. we work in a rapidly evolving field. part of being a competent nurse is accepting that things will change as research is done. we sign up for that when we decide to become nurses.

i freely admit that i don't like some of the changes i see. however, it is part of my obligation as an rn to be aware of the changes, and to work with them.

i agree!!

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Specializes in Med/surg, pediatrics, gi, gu,stepdown un.

What an insult to nurses, who are very competent. I agree that things are proven to be done one way and then changed back to the "old", way because it is safer or more efficient. We are continually learning everyday new procedures or learning how to use new equipment even if we have "years" of experience. I think that we can all work together "new" nurses and " expericenced" nurses and give really excellent care to our patients. We have to be "competent" in all areas of nursing. Like computers, labs, procedures,treatments, diagnosis. What profession do you know who has to be a computer person, phlebotimist, maintainence person,social worker, physical therapist, respiratory therapist, dietitian and pharmacist and a nurse all the time?

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Specializes in Critical Care, Education.

I really can't blame anyone for reacting badly if they feel that Dr O'Grady insulted them. However I am and remain a HUGE fan of his - he is one of our leading voices for nursing.

I haven't read the article in question - but I know that his statement is not a new one. Dr O'Grady - along with everyone involved in the study of comptency or educational practice - acknowledges that you simply can't become an expert without experience. Lets all face it Experience does not automatically equal competence. For instance, would you consider Elizabeth Taylor an expert on marriage? She certainly has had a lot of experience.

I know that I have worked with people who have many years of experience, but - I swear - it seems like they must have been just doing 'year one' over and over again. Some people just do not learn from experience.

Learning from your experience takes effort - you have to analyze what happened and then apply it to your every day decisions. "How can I avoid this?" or "How can I get this to happen again?" That's one of the most wonderful benefits of having a great coach - they can painlessly help you learn from new experiences

Just my :twocents:

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Specializes in Hospital Education Coordinator.

I agree with Michelle126. Nursing is a dynamic profession and we should be constantly willing to learn. I value the mature nurses for their experience. Often they are less likely to go up in smoke (because they have seen it all). We need to retain our experienced nurses.

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Specializes in Home Care, Hospice, OB.
and there you have it - you have to stay current like janey said. which is why i am so irritated that nurses get angry because they are required to take ce for license renewal.

quote]:typing:nurse::typing

except in virginia..but don't get me started!!:argue:

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I'm not sayng experience equals excellence. All I'm saying is that Dr. O'Grady with all his initials could have found a more eloquent way to state his point. Afterall experience has it's place in every profession. And although I wouldn't consider Liz Taylor an expert on successful marriages I certainly would have to listen to her advice regarding the failure of marriage. Besides the so called leaders of nurses need to start getting the AMA to respect our opionions. I can be credentialed and initialed up the ying yang but when it comes to who will have the final word in any decision regarding practice it will unfortunately be the MD. I speak from experience in my time as an IV nurse. I had the INS packing on many of the decisions I made as manager for an outpatient infusion company only to be told multiple times that "it's the doctors decision." Heck I didn't even have the backing of my immediate supervisor even though I could site the paragraph in the INS handbook regarding correct practice of care. I personally do not feel that the ANA represents my best interests within the work place and then when I see a quote like this it confirms my feelings. I would like to see nurses working as a team. I would like to see MD's truly acknowledge what we have to offer. I would like to see a manager tell a nurse to join in the fun we call work rather then surfing the net, playing games on a PDA, reading romance novels, taking 2 hour lunches. If the ANA wants to do something for me how about introducing a little thing I like to refer to as equity. If I'm required to work 8 hours for 8 hours pay then why then was I surrounded by nurses who worked 4 hours for 8 hours of pay. That is my problem with nursing management and people like Dr. O'Grady. Just a question nursing can't even come to term with the basic requirement for entry into the nursing field, why then without that fundamental core to the educative process being answered should I return to school for a hire degree. I am a diploma grad with a BS in business and very proud of it. When I look around at my peers and see how nurses with masters conduct themselves with the public and other nurses I want nothing to do with higher education. I'll stay at the bedside thank you very much.

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Specializes in Critical care, tele, Medical-Surgical.

Dr. O'Grady advocates software rograms that can easily over ride the judgment of an experienced RN.

And waste our time.

He is out of touch enough not to understand that all too many nurses are spending more time learning and troubleshooting technology that caring for patients.

My patients are more important than the computer.

No algorithm can teach how to help a confused, sad, angry, or depressed patient.

No software can assess and intervene with spiritual, psychological, and teaching NEEDS of a sick person dealing with illness. And their families and dear friends.

An experienced human nurse can.

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In response to classicdame. How can someone, anyone stay in nursing and not adapt to new changes and developments. When I think of how medicine has changed since I graduated if I had not stayed up on things I'd be lost. The acuity level of the patient alone has drasticly changed. I remember when doing homecare, asking patients, "If they sent you home who did they actually keep." If Dr. O'Grady wants to improve nursing at the bedside then come up with ways in which nurses, doctors, and assistances can work as a team. Each member of the health care team should be able to promote ideas without being ridiculed. I recognize that a doctor has many more years of education behind his MD however it is very insulting to have your years of experience discounted because you became a nurse in 2 years, 3 years, or 4 years. I witnessed the melt down of many new grads because they are expected to function as excuse the term "experienced nurses" just because they passed boards. There given inadequate orientation periods, there preceptors are counted as staff, they lack the back bone to stand up for the patients rights. Experience assists you in all of these areas. If Dr. O'Grady wants to decrease the mass exodus of younger nurses from the profession then come up with ways to make hospitals mentor new nurses, because as a seasoned nurse I'm a bit tired of picking up the slack. And here I go again bringing up my favorite word equity. With the aging of the nursing profession I think those who believe they are our leaders and representatives should take a little bit more time before making a blanket statement.

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