Hello all. I am a nursing student here in SC and I love this website. It has been very helpful and even though I have never directly participated on here, I have learned a lot from you all. I have decided to finally make a post, but it is not about my studies....
I know someone who works at my child's doctor's office. She refers to herself as "head nurse" there. She claims to have graduated from the school I am attending. She actually went to HS with me, but was a few years older. I noticed she was not pictured in the nursing building for the year she said she graduated as a RN. (Our school displays the pictures of all the RN & LPN graduates in the halls). I asked her about this and she told me she failed out of the RN program early on (I don't think she ever got into the program but can't be for sure), but anyway, she graduated as a surg. tech. This I have verified. She does not refer to herself as a RN and doesn't sign her name that way, but she does give shots, and everything else a nurse would do in pediatrician's office. I have also heard her mention how she's started caths for patients in the office. Does this sound right to any of you? Can surgical techs do that? She told me the Dr. knows she is a ST.
Is this legal? I don't mean to sound...picky, it just seems strange.
Now we are getting somewhere- is it possible the real complaint of OP is that a ST that failed nursing school is performing tasks identified with nurses? And the fact is many people would be aghast at the scope of many MAs, that have had no formal training. The fact is that MA is a strange animal- they can do basically whatever a physician wants them to- with or without formal training, even IV therapy in many states. Even LPNs in most states need additional IV cert courses for that, and in many states they need courses just to draw blood? This is not an easy idea for many nurses to accept, but it just is what it is. That said, why would a physician pay a real nurse, when he can hire somebody 'off the street' to act in the capacity of one, if that's how you want to label it?
That's what this all really boils down to. And in my opinion they should be called out for it. It's a form of fraud, and it endangers the public. All in the name of making an extra buck. My $.02
As stated before, my office utilizes MAs, and they are very good at what they do. I do have to remind them at times that they are not to be doing triage outside of our exclusion policy. They are not to be giving medical advice or education, and they know this. They do great work with skills-based procedures: vitals, EKGs, injections, INRs, minor surgical assisting, etc.
I would love to have a nurse that could triage and do patient education. I don't want to pay 2-3x the amount in hourly wage for it, as tough as that sounds, it's not particularly feasible for a small primary care office.
This also serves as an excellent example of why nursing, as a whole, needs to move away from the skill-based profession if they want to protect their salary.
As stated before, my office utilizes MAs, and they are very good at what they do. I do have to remind them at times that they are not to be doing triage outside of our exclusion policy. They are not to be giving medical advice or education, and they know this. They do great work with skills-based procedures: ......
I would love to have a nurse that could triage and do patient education. I don't want to pay 2-3x the amount in hourly wage for it, as tough as that sounds, it's not particularly feasible ...
No one is saying that they don't do a great job. I am sure they do. But they are being hired because they work cheaper. Sort of like "undocumented aliens" or H1b visa holders. IMO paying proper wages to qualified and trained personnel is just the cost of doing business. And if one cannot afford to cover that cost, maybe a person should consider doing something they can afford, as equally tough as that sounds. Maybe clients will have to pay a bit more for their visits. As much as I personally want to save money, I am willing to pay a bit more knowing that I am being treated by licensed personnel - it's my health we're talking about here. Most people are given the impression that they are being served by an educated, trained, and fully licensed nurse. But as we can all see, they are not. And that's not entirely being straight with people.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
......This also serves as an excellent example of why nursing, as a whole, needs to move away from the skill-based profession if they want to protect their salary.
I'm curious about what you mean by that. What should nursing be doing more of in place of skills and how would it protect our salary?
I'm curious about what you mean by that. What should nursing be doing more of in place of skills and how would it protect our salary?
I wouldn't presume to speak for Boston, but I will offer what I have gleaned when this discussion has come up in the past. The idea is that the more nursing stays focused on tasks (which can be taught with relative ease) instead of knowledge (which must be obtained over time, and in professional settings) the easier it is to become replaced by those who have merely learned how to perform the task alone.
It is pretty simple for someone to learn the rote skills/tasks required in nursing; far less so to have that same person disseminating patient education accurately and effectively.
I'm curious about what you mean by that. What should nursing be doing more of in place of skills and how would it protect our salary?
Off topic, but IMHO:
Nursing needs to position itself so the value of nurses is not in tasks/skills but in critical thinking, patient education, assessment and intervention on individual, community, and population levels as these protect patients safety. You don't need to go to school for 2-4 years to take a blood pressure or give a shot (autocorrect tried to change that to another four letter s-word, which ironically also makes sense) you need to go to school to know what that blood pressure means or why that shot needs to be given or when not to give it. This is nursing's value: educated to assess and intervene. If you remove that then it becomes a skill or task-based job that employers can hire a $10/hr individual with minimal training to do.
What makes nurses worth $30 an hour versus $10 an hour? The education and the ability to assess, plan, intervene, and evaluate that it affords.
I wouldn't presume to speak for Boston but I will offer what I have gleaned when this discussion has come up in the past. The idea is that the more nursing stays focused on tasks (which can be taught with relative ease) instead of knowledge (which must be obtained over time, and in professional settings) the easier it is to become replaced by those who have merely learned how to perform the task alone. It is pretty simple for someone to learn the rote skills/tasks required in nursing; far less so to have that same person disseminating patient education accurately and effectively.[/quote']
Specializes in Peds/outpatient FP,derm,allergy/private duty.
Thanks RNsRWe and BostonFNP...
"Off topic, but IMHO: Nursing needs to position itself so the value of nurses is not in tasks/skills but in critical thinking, patient education, assessment and intervention on individual, community, and population levels as these protect patients safety. "
I thought that may have been your point, and I agree. I agree to the point that critical thinking is so integral to nursing that hiring a nurse solely to fulfill the role specifically excluded (in my state) for MAs, namely assessment and telephone triage deprives a practice in many ways because of the way nurses are taught to think.
I would differ though, that tasks and skills are equivalent. I understand the role of APRN is different from bedside or direct contact, however I think skills and skilled skills are integral to all that thinking and nursing at it's heart is still head and hands. Each informs the other and from a patient standpoint, it matters a whole lot how a nurse starts an IV or pulls a drain, or assessing the general appearance of a patient as he or she is taking a blood pressure on a man with a complaint of indigestion since this morning.
If we continue to cut away at the "hands" part of nursing salaries will be protected but our numbers will drop. Maybe that is inevitable.
" .....you don't need to go to school for 2-4 years to take a blood pressure or give a shot (autocorrect tried to change that to another four letter s-word, which ironically also makes sense)...."
I think we argue the same point in that it is the assessment and intervention part of performing tasks (from answering phone calls to giving injections) that make nurses valuable members of the healthcare team and well-paid members.
Specializes in Cardio-Pulmonary; Med-Surg; Private Duty.
My very first class back in nursing school, my instructor said that the hiring managers of local hospitals told the college, "We don't care if they know how to insert an IV -- we can teach them to do that when we get them to the hospital. What we can't do is teach them to THINK -- please give us new grads who can think."
Specializes in Nurse Leader specializing in Labor & Delivery.
I'm curious about what you mean by that. What should nursing be doing more of in place of skills and how would it protect our salary?
I can tell you what I do in in a primary care clinic as the only RN - triaging patient problems (walk ins and phone calls), evaluating all the labs for the day and figuring out if they're normal or abnormal, ie: using nursing judgment and critical thinking (for example, I've learned a hell of a lot about the significance of a low MCV in the absence of anemia, or what to do when a syphilis antibody comes back positive, but the RPR comes back negative). Basically, using my BRAIN in addition to being able to give IM injections properly or knowing how to dip a urine.
Or, using Boston's example of taking a BP - noticing that the BP and HR are both on the low end of normal, and then after learning that the patient has had difficulty losing weight, putting 2 and 2 together and suggesting to the care provider that maybe we should check a TSH with their other labs. Someone who has gone to MA school probably wouldn't consider that, nor are they trained to. They would see that the vitals are low, but still WNL, and go on with their day.
LPN Guy
44 Posts
That's what this all really boils down to. And in my opinion they should be called out for it. It's a form of fraud, and it endangers the public. All in the name of making an extra buck. My $.02