On this week's episode of 'People Offending the Entire Profession of Nursing'...

[adventure_rn, MSN, NP]

Apparently a UK nurse was denied a Guinness World Record for running a marathon dressed as a nurse because she wore her work scrubs.

Although the category itself sounds kind of silly (are there marathons specifically for people dressed as nurses?) this line, courtesy of CNN, had my eyes rolling all the way out of my head and onto the floor.

Quote

Full-body scrubs are too close to the organization's definition of a doctor's costume, officials added.

To demonstrate the point, here are some photos courtesy of Runners World:

Actual nurse, wearing her actual work scrubs: "Too doctor-y."

This guy, 'eligible participant' in the marathon: "Definitely a nurse."

I hate to pull the sexism card, but seriously???

Fortunately, BBC reports that rules are under revision, thanks in part to awareness by the runner herself, Jess Anderson. Hats off to Ms. Anderson for her big accomplishment!

[Jedrnurse, BSN, RN]

Yeah, this category needs to go into the Guinness book for "most stupid idea ever"...

[Forest2]

I wonder what kind of craziness I will read about tomorrow?

[llg, PhD, RN]

On the opposite end of the spectrum .... I was listening to a history lecture on CSPAN recently that was talking about people working as nurses in American Civil War hospitals. The historian said something about how it was nothing like what we know as nursing today (which requires significant education to be able to provide a high level of care) ... but rather involved the provision of some basic hygiene and comfort measures that required minimal training.

Those weren't her exact words, but that is essentially what she said. I thought "Good for her. She's showing some respect for nurses -- both from the past and those of us in the present."

[Susie2310]

7 hours ago, llg said:

On the opposite end of the spectrum .... I was listening to a history lecture on CSPAN recently that was talking about people working as nurses in American Civil War hospitals. The historian said something about how it was nothing like what we know as nursing today (which requires significant education to be able to provide a high level of care) ... but rather involved the provision of some basic hygiene and comfort measures that required minimal training.

Those weren't her exact words, but that is essentially what she said. I thought "Good for her. She's showing some respect for nurses -- both from the past and those of us in the present."

With respect, at least, back in those days, nurses knew how to provide bedside care (i.e. they knew how to perform nurses' fundamental duties taking care of patients) with far fewer of the resources that we take for granted today.

In my opinion, the problem today (that has existed for a few decades) is that while training to be a nurse requires a significant investment of time, money, effort, and family support, all the "higher level thinking" is redundant when new graduates haven't experienced providing much in the way of hands on bedside nursing care during their student clinical training (bedside nursing care/direct care being the type of care that the majority of nurses provide), and they start jobs as bedside nurses very unprepared to do the work of bedside nurses.

Also, bedside nurses today still need to know how to provide basic hygiene and comfort measures such as toileting patients and cleaning incontinence, and while providing this basic care does not require advanced education it requires knowledge of how to move and re-position patients safely, how to assess for skin breakdown, etc., and this utilizes critical thinking unless one just performs these activities rotely.

[HarleyvQuinn, MSN, RN, NP]

16 hours ago, Susie2310 said:

With respect, at least, back in those days, nurses knew how to provide bedside care (i.e. they knew how to perform nurses' fundamental duties taking care of patients) with far fewer of the resources that we take for granted today.

In my opinion, the problem today (that has existed for a few decades) is that while training to be a nurse requires a significant investment of time, money, effort, and family support, all the "higher level thinking" is redundant when new graduates haven't experienced providing much in the way of hands on bedside nursing care during their student clinical training (bedside nursing care/direct care being the type of care that the majority of nurses provide), and they start jobs as bedside nurses very unprepared to do the work of bedside nurses.

Also, bedside nurses today still need to know how to provide basic hygiene and comfort measures such as toileting patients and cleaning incontinence, and while providing this basic care does not require advanced education it requires knowledge of how to move and re-position patients safely, how to assess for skin breakdown, etc., and this utilizes critical thinking unless one just performs these activities rotely.

Part of the problem we're running into is that we're finding, especially as our society is getting heavier, there is no way for the human body to safely move and reposition human beings that are excessively obese. The spine and skeletal system just isn't capable of handling the weight we're trying to move and reposition, regardless of "proper body mechanics." Avoiding manual lifting is necessary and utilization of mechanical lift assist devices is needed to avoid injury to staff and patient.

With all the responsibilities assigned to nursing, the education is absolutely necessary. We're expected to be the catch-all for mistakes made by Pharmacy, Medicine, dietary, etc. We need to have sufficient staff working to do everything that needs to be done. Support staff are necessary and are going to have to be relied upon to do some of the tasks that don't require licensed staff to perform. That's how the professions have evolved. Nurses do so much more now than they did back then.

Schools will never be able to produce graduates who are able to hit the ground as fully functional nurses. That's not possible. That's not how medical school works, either. New graduates will always require orientation. They will always require mentorship and it is a failing of our profession if we are unable or unwilling to provide this. The four year BSN is already a challenging degree that many have difficulty completing in four years, and leaves many graduates with debt. When I was in school, I carried far more than the required full time number of credit hours (12) in order to complete in four years for my BSN. I averaged 17 and one semester I carried 20. This only increased the amount of tuition I had to pay, as well as the amount of stress. With that heavy a load already on students, I'm not sure how much more you want to add on by demanding they increase to satisfy the employer's want for nurses who are more "floor ready" upon graduation. Keep in mind I graduated in 2003.

One thing I've seen are orientations that are horribly lacking. There are either lackluster programs or no programs at all. New graduates are bounced between preceptors, preceptors lack training in preparing new employees, preceptors aren't interested in training, and understaffing make for bad training environments. The department educator should have an organized orientation program with class time scheduled with new graduates specific to the specialty/unit and an assigned preceptor who is trained and actually interested in orienting new employees. This should not be someone within their first year of nursing themselves. Mentoring new nurses should be encouraged and part of the culture of the unit. Even beyond orientation. New nurse residencies are a plus.

[nrsang97, BSN, RN]

I just saw that they changed their mind and gave her the award. The Guardian just posted this on Facebook.

[Ruby Vee, BSN]

On 5/7/2019 at 5:36 PM, HarleyvQuinn said:

Schools will never be able to produce graduates who are able to hit the ground as fully functional nurses. That's not possible.

Sure it's possible. Diploma programs produced graduates who were able to hit the ground running as fully functional nurses. I've worked with them; I've precepted them as senior students. I went through orientation with them in my first and second jobs, and they were awesome! Bring that back, standardize the requirements and give them a degree of some sort. They had to take college level courses as pre-requisites. Make it possible for them to easily get their BSN.

Orientation programs will forever be inadequate until preceptors are trained as preceptors and rewarded for doing the extra work. And allowing a preceptor to opt out for one round of new hires once a year or so would be a nice perk, too.

[cleback]

On 5/6/2019 at 4:09 PM, llg said:

On the opposite end of the spectrum .... I was listening to a history lecture on CSPAN recently that was talking about people working as nurses in American Civil War hospitals. The historian said something about how it was nothing like what we know as nursing today (which requires significant education to be able to provide a high level of care) ... but rather involved the provision of some basic hygiene and comfort measures that required minimal training.

Those weren't her exact words, but that is essentially what she said. I thought "Good for her. She's showing some respect for nurses -- both from the past and those of us in the present."

Overall I agree except that basic hygiene was pretty cutting edge back then... we're talking about an era doctors were literally killing mothers and newborns because they went from autopsy to delivery without washing... and when a doctor realized it, the profession basically ostracized him for his revelation of the importance of getting corpse juice off before providing invasive patient care.

Wild times, I tell you.

[HarleyvQuinn, MSN, RN, NP]

1 hour ago, Ruby Vee said:

Sure it's possible. Diploma programs produced graduates who were able to hit the ground running as fully functional nurses. I've worked with them; I've precepted them as senior students. I went through orientation with them in my first and second jobs, and they were awesome! Bring that back, standardize the requirements and give them a degree of some sort. They had to take college level courses as pre-requisites. Make it possible for them to easily get their BSN.

Orientation programs will forever be inadequate until preceptors are trained as preceptors and rewarded for doing the extra work. And allowing a preceptor to opt out for one round of new hires once a year or so would be a nice perk, too.

You got me there. To be fair, the diploma programs were run by the hospitals themselves and third-party schools are running the BSN programs now and just have contracts with the hospitals for clinical hours/space. Not to mention the shortage of nursing professors. Hospitals can't get staffing, patient safety, or orientation programs right now that they've been taken over by corporate interests. Do you think the new Corp Med can do diploma programs right and train RNs that are able to meet all the expectations of the modern days?

[Tomascz, ASN, RN]

On 5/6/2019 at 9:36 PM, Susie2310 said:

With respect, at least, back in those days, nurses knew how to provide bedside care (i.e. they knew how to perform nurses' fundamental duties taking care of patients) with far fewer of the resources that we take for granted today.

In my opinion, the problem today (that has existed for a few decades) is that while training to be a nurse requires a significant investment of time, money, effort, and family support, all the "higher level thinking" is redundant when new graduates haven't experienced providing much in the way of hands on bedside nursing care during their student clinical training (bedside nursing care/direct care being the type of care that the majority of nurses provide), and they start jobs as bedside nurses very unprepared to do the work of bedside nurses.

Also, bedside nurses today still need to know how to provide basic hygiene and comfort measures such as toileting patients and cleaning incontinence, and while providing this basic care does not require advanced education it requires knowledge of how to move and re-position patients safely, how to assess for skin breakdown, etc., and this utilizes critical thinking unless one just performs these activities rotely.

As I opened this issue of Allnurses I saw an article titled in the sidebar to the effect of "New Grad (BSN no doubt) RN, absolutely hate nursing". How many times have I seen similar sentiments here? That quoted above is, in my opinion, the exact crux of the issue.
You CAN NOT turn a person into a nurse by educating them. Sorry academia. A nurse with a top notch education is a powerful tool in medicine, but you have to "be" a nurse from the heart to start with. You have got to have it in you.
I used to disparage people (silently) who told me "I could never do what you do". I was selling their self awareness short. I was failing to listen.
I don't know where I got this; or why it took me so many years to get here, but I do have it, and I did not learn it in class. I just learned how to apply it to best effect for my patients there.

[ruthogden, ASN, BSN, MSN, PhD]

Honestly,

Granted, I quit nursing about 9 years ago, but it seems the emphasis in BSN programs is 1. to encourage advancement to Masters or Nurse Practitioner 2. Research and 3. Administration and paperwork.

Somewhere along the way, nursing education has gone far astray from bedside care as a priority. So many of the new grads I have worked with over the years have no clue what is involved in bedside care.

This being said, many of the administrators today have NEVER done bedside care and are making decisions based on statistics and written reports. So the rules handed down to the actual bedside nurses are often unreasonable and unattainable.