You all may be aware that the service industry has the lowest paid jobs...with all the emphasis being placed on Press Gainey scores and customer service, I fear we are migrating to that end of the career spectrum.
We all like to think of ourselves as professionals and having a license seems to validate that, but if employers stop thinking of nursing in that light and instead see more of a service line, would you still be happy being a nurse?
How would/do you feel being considered in the same occupational class as housekeeper and waitress?
I think that's what a lot of dissatisfaction is coming from, only we haven't quite identified it as such.
I think LPNs would become the primary caregiver in hospitals and the number of RN-BSNs/unit would drop.
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Many hospitals in my area do not even hire LPNs anymore. Besides, grandfathered LPNs are not allowed entrance into specialties (like critical care, OB etc.) I read on this forum there are hospitals up north that hire only RNs with BSN. Current trend IS toward increasing educational requirement. Only if nurses themselves would support it, transition would be much quicker.
Yes, they will look overseas for nurses. But a significant number of those overseas nurses have bachelor degrees as their minimum requirement for entry into nursing practise.
If nursing wasn't a female dominated profession then my guess is that the BSN and ADN educational requirements for entry into practise, first put out by the ANA over forty years ago, would have been enacted.
It isn't neccessarily all about increasing the money nurses receive but the educational foundation that a lot of new nurses will need over the next forty years of their working career. And remember the trend in nursing is away from the hospital as more patients are treated outside of the hospital setting.
I have been in patient care at various levels since the mid 1960's and agree with Lindarn's POV completely.
Specializes in Diabetes ED, (CDE), CCU, Pulmonary/HIV.
A hospital is not now, nor will it ever be, a hotel. (No matter how many doctors order "room with bay view" for their pts coming to our hospital on Biscayne Bay.)
Priorities of hotel service and hospital nursing care are not the same. Press Ganey and hospital administration may think they can equate "How quickly did you receive your room service order?" with "How quickly did you receive your pain medication?" Normally, for me, medicating a pt for pain is very high priority. But that can change quickly if one pt is coding, and another just fell on the way to the BR and is screaming "Help, I think I broke my hip."
From what I've seen of the last year of work toward BSN, I don't see it as that valuable for a bedside nurse. In the 4-year BSN program that was operated in the college where I received a BA in English & secondary ed., A nursing student could stop at the end of the 3rd year and sit for NCLEX, or could continue through the 4th year for the BSN. The last year had more courses related to public health issues, conducting research, statistics, etc. that are more useful in mgmt or in nursing academia, or military nursing. Even though many look at ADN as a two-year program, it usually works out to 3 years. Having a BSN does not make a person a better nurse. Nor does it increase pass rates on NCLEX.
One thing that has served to increase earnings for nurses is the increased numbers of men in the profession.
What makes me feel more like a blue collar worker? Punching a time clock and being paid by the hour--but I'll bet no one is ready to give up overtime.
From what I've seen of the last year of work toward BSN, I don't see it as that valuable for a bedside nurse.
I'd agree that BSN coursework as it stands doesn't make a better bedside nurse. It seems that MOST (not all) programs these days don't/can't prepare their students enough regardless to work bedside. I don't know if its cost and resource limitations or simply the fact that bedside nursing keeps getting more complex and the average hospital patient is sicker.
Most new nurses are finding that the first year feels like sink or swim. That 2-3 years of nursing school provides "the foundation" but that you're expected to be a stable house within just a few months. The reality is that it takes practically a whole other year to "get" it and meanwhile you've got full responsibility with people constantly warning you that "your license is on the line." How can you seriously use "your nursing judgement" when you're just 3 or 4 months out of school? At the beginning, you're best sticking with ABCs to prioritize and to get help when you don't know what to do. That doesn't take 2-3 years of school to figure out. If someone's struggling to breathe, if they're very pale and clammy, if they're burning up with fever... these basics can be taught pretty quickly. Like EMT training.
Did they teach this basic assessment stuff first off in my program? No. We learned bedmaking and bedbaths first. We did take a thorough physical assessment course. Head to toe, knee reflexes, breast exams... this isn't the kind of assessment the average bedside nurse does! Good to know what a full exam entails, but shouldn't we learn a fast, basic assessment first? Did we take a course on learning to read lab values? No. As we studied each of a zillion various illnesses, we'd get a list of relevant lab values for that condition and a two sentence explanation of the pathophys behind the abnormals.
So yes, nursing education needs to change somehow to reflect the realities of nursing practice.
Did they teach this basic assessment stuff first off in my program? No. We learned bedmaking and bedbaths first. We did take a thorough physical assessment course. Head to toe, knee reflexes, breast exams... this isn't the kind of assessment the average bedside nurse does! Good to know what a full exam entails, but shouldn't we learn a fast, basic assessment first? Did we take a course on learning to read lab values? No. As we studied each of a zillion various illnesses, we'd get a list of relevant lab values for that condition and a two sentence explanation of the pathophys behind the abnormals.
So yes, nursing education needs to change somehow to reflect the realities of nursing practice.( not trying to hijack the thread)
EXACTLY!! In my BSN course I spent hours and hours practicing the head to toe, all inclusive with ROM and 12 cranial nerves..... this really endeared me to the experienced nurses who could not understand why the thought of a 5 minute assessment freaked me out when I hit the floor. Either the schools need to teach more realistic skill sets or hospitals need to provide decent orientations.
Specializes in Diabetes ED, (CDE), CCU, Pulmonary/HIV.
Regardless of whatever educational program you follow, your learning experience will comprise the program plus what you bring to the program. There might not be a class in interpreting lab values, but that knowledge is essential to understanding pathosphysiology, developing a plan of care, and providing care to a patient in a clinical. So you get a lab book, and you teach yourself.
It's also not a matter of memorizing everything the instructor says or what you read in the texts so that it can all be regurgitated at exam time. It doesn't mean taking everything an instructor says as gospel. And the same goes for what you read in your textbooks. Everything that is presented in an educational program should be filtered through your already considerable knowledge base. If it goes against something "you already know," question it. By questioning, we improve the program and what we get out of it.
When you do a clinical rotation, you see what the floor nurses do and how frantic the pace can be with a full pt. load. The reality might not sink in until you're actually faced with the responsibility yourself, but it shouldn't be a totally foreign concept.
We need to dispense with the bedbaths and bedmaking. Delegate those responsibilities to the CNAs and PCTs, and get on with the complicated profession of providing quality nursing care.
"The reason nursing is underpaid and disrespected is that we, as nurses, permit it to continue - by accepting substandard wages and conditions."
The thing is that many nurses AREN'T accepting it. They either work agency or get out of bedside nursing altogether. Do hospitals/nursing homes improve the conditions? No. Positions remain perpetually unfilled and/or they hire overseas nurses to fill in.
Where I am the pay isn't substandard. It's quite good. But with the conditions, I'd rather take a pay cut and do something else where I'm not being asked to do the impossible and am forced to take questionable short cuts if I want to keep the job.
Yes, your pay may be, "quite good," but I would respectfully ask for a definition of quite good?
Remember, it must be based upon the awesome responsibilities that bedside nurses incur, plus the daily risk to their very lives.
I would argue that out pay may be quite good, say compared to an assembly-line worker or a retail-sales associate.
But it is not-at-all good when rationally based upon responsibility. I mean, isn't that how the CEOs justify base their tremendous salaries?
Why should there be this double standard or movable definition?
Why, because that is the only way to dampen or suppress the irrationality of it all.
We are well underpaid and we have not had a pay increase in 15 years when you figure in inflation and the, "volatile food and energy sector,"
let alone health-care premiums.
I put that in quotes because that, my friends, is incredibly never incorporated or calculated into inflation figures, and that is how they report the figures.
Don't believe me...check it out yourself. The middle class has not had a raise in nearly 2 decades.
I agree that nurses have a lot more responsibility than most people are aware of. I agree that those with that high degree of responsibility should be paid more. I also think nursing education should train nurses to deal with the realities of bedside care or else nurse residencies should be instituted.
However, so far, when nurses have refused to accept current wages and conditions, facilities simply leave positions unfilled claiming they can't find qualified applicants - as opposed to sweetening the pot and improving work conditions. Some places do offer big bonuses and the like but the conditions are still miserable and they can't find and retain quality staff.
Many nurses find working agency to be a better deal than working for a hospital. Surely, the hospitals should be able lure agency staff to their facility by offering better pay with good working conditions and scheduling flexibility.
ZootRN
388 Posts
I think LPNs would become the primary caregiver in hospitals and the number of RN-BSNs/unit would drop.
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Many hospitals in my area do not even hire LPNs anymore. Besides, grandfathered LPNs are not allowed entrance into specialties (like critical care, OB etc.) I read on this forum there are hospitals up north that hire only RNs with BSN. Current trend IS toward increasing educational requirement. Only if nurses themselves would support it, transition would be much quicker.