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

Nurses   (3,648 Views 30 Comments)
by adventure_rn adventure_rn (Member)

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You are reading page 2 of On this week's episode of 'People Offending the Entire Profession of Nursing'.... If you want to start from the beginning Go to First Page.

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7 hours ago, Tomascz said:

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". 

She's Canadian. I believe the entry level RN is a BSN

Maybe the Canadian nurses could speak to the kind of clinical education a BSN candidate receives.

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DowntheRiver has 5 years experience and works as a Registered Nurse.

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Let's bring back diploma programs. My mother is a diploma nurse, graduating in the very early 70's. Her first year was spent learning in the classroom with minimal clinical and her second year she literally worked the floor as a student nurse and that was her clinical experience. A whole year as a student nurse working with senior nurses for guidance AND she got paid, albeit a small amount that covered her tuition. When she graduated, she just transitioned to RN on the same floor she worked on. 

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I was a dipoma grad in 1976, the second week of school we were on the floor, that week we did vitals and baths. By graduation we were working a full staff assignment for a 8 hour shift on the floor under the watchful eye of our instructor and a floor nurse.  We also did a week of 3-11 shifts. I knew how to organize my time and how to do "stuff" when I got my first job.  We had college classes and could go on to finish our BSN if we chose to. Bottom line is we learned how to be a nurse and how to assess and make decisions about our patients, we were on the floors for first two days then three full days each week. You had first just 1 then 2-3 patients depending on the rotation.  You did total care. And if you had 5 minutes, you had better be in that room talking to that patient learning more about them and their needs lol!  But, I learned to assess a patient very quickly and hear what they are saying and what they are not saying.  I have spent time with students who really do not get much clinical time and my heart kind of breaks for them, they do not even know if they like being a nurse before they graduate much less if they can tolerate being around sick people and their families. They know the book answers but that doesn't always get you very far in the real world. 

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Leader25 has 35 years experience.

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

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.

You got that right, one exception :not all preceptors are disinterested.,although I see the struggle to precept someone in the bad enviroment of understaffing.

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On 5/7/2019 at 7:18 PM, Ruby Vee said:

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.

Absolutely true

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CalicoKitty has 6 years experience as a BSN, RN and works as a Med-Surg Nurse.

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I'd still give kudos to that guy that wore the skirt. More if he had the matching heels. :D 

Neither has a stethoscope, though. Is that doctory or nursy?

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HarleyvQuinn has 10 years experience as a BSN and works as a Patient Wrangler.

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3 hours ago, Leader25 said:

You got that right, one exception :not all preceptors are disinterested.,although I see the struggle to precept someone in the bad enviroment of understaffing.

 Not all, but some, especially when they're voluntold into the position. Which, of course, does absolutely nothing to help the new employee or the person training. Understaffing gets even worse when we start stacking responsibilities on the preceptor. Hey, you have a new orientee, plus you're charge and have a full patient load. You two have fun now! :no:

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GrumpyRN has 35 years experience and works as a Retired Emergency Nurse Practitioner.

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6 hours ago, CalicoKitty said:

I'd still give kudos to that guy that wore the skirt. More if he had the matching heels. :D 

Neither has a stethoscope, though. Is that doctory or nursy?

In UK nurses don't routinely use or carry stethoscopes.

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5 hours ago, GrumpyRN said:

In UK nurses don't routinely use or carry stethoscopes.

In what types of situations would nurses use stethoscopes in the UK?  

Are you saying that UK nurses who provide bedside care do not listen to apical pulse, heart sounds, lung sounds, or bowel sounds when they assess patients or give medications that affect these systems?  What if the patient has cardiac, respiratory, renal, neurological, sepsis, G.I., or bleeding  problems?  How do UK nurses take blood pressures and auscultate apical pulse?

Edited by Susie2310

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GrumpyRN has 35 years experience and works as a Retired Emergency Nurse Practitioner.

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1 hour ago, Susie2310 said:

In what types of situations would nurses use stethoscopes in the UK?  

Are you saying that UK nurses who provide bedside care do not listen to apical pulse, heart sounds, lung sounds, or bowel sounds when they assess patients or give medications that affect these systems?  What if the patient has cardiac, respiratory, renal, neurological, sepsis, G.I., or bleeding  problems?  How do UK nurses take blood pressures and auscultate apical pulse?

Nurses in UK don't listen to heart, chest or bowel sounds. They may listen to apical heart if doing apex and radial (rare) but otherwise no. BP is done by machine - can still be done manually but would use ward/departmental stethoscope not their own. As an ENP I would treat chest wall trauma and then I would use the departmental stethoscope to listen for air entry but only the ENP's would do that, the other nurses in the Emergency Department would not use a stethoscope.

"What if the patient has cardiac, respiratory, renal, neurological, sepsis, G.I., or bleeding  problems?"   Simple answer is, they don't. This is a doctors problem not a nurses.

In 35 years in nursing I have only ever used a stethoscope for apex and radial testing (a very long time ago), BP's and as stated, on chest wall trauma that was seeing as an ENP. In fact as I write this I can not remember the last time I took a BP using a stethoscope.

I have used a stethoscope during ALS, TNCC, ATLS courses but have never done it in real life on an actual patient.

 

ETA; doctors are going to listen to these things anyway so why should the nurses do work that is going to be done.

Should add that there may be areas like ICU where nurses use stethoscopes on their patients more but they would still use the department stethoscopes.

Edited by GrumpyRN
To add

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OldDude works as a School Nurse.

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In the US, nurses without a stethoscope around their neck would be like a Shaman with their bearclaw!! It's part of the uniform. Also part of the car interior...hanging on the rearview mirror.😀

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On 5/7/2019 at 10:18 PM, 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.

Not only for new nurses who don't know doo doo, but for knowledgeable nurses who don't know doo doo about your particular hospital or unit.  I know nursing, but the orientation I have had in some places has been atrocious.

I spoke to a nurse this past week who said on her last job, she got the usual orientation for everybody but when it was time to go to the floor, her "preceptor" did not show up and so she was on the floor working with no orientation.  She lasted 3 months.  I am a very very firm believer in good solid onboarding and preceptor programs.

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