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.
I know "nurse" is protected,but isn't nurse non specific so to speak?
I thought "Rn" and "Lpn" were protected titles?
That's exactly why it is protected legally. It was very common to find people referring to themselves as "baby nurses" when they were neither a nurse or even a very good babysitter. "Office nurse" is another one: misleads people into believing the person spouting off about something of a medical nature with authority is actually a licensed nurse---when she's really the receptionist.
I believe the reason for the push to make "nurse" a protected title came about because of a newborn's death while in the care of a 'baby nurse"....someone who didn't even know basic cpr, as I remember.
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.
.... 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.
^^^^LIKE LIKE LIKE LIKE^^^^
AND THIS IS AT THE ROOT OF TOO MANY -- maybe all-- OF THE CONTROVERSIES IN NURSING, from the lab "skills" check-off mentality of nursing students to the "we all sit the same NCLEX and do the same job" foolishness to the "I do everything an RN does and don't get no respect" and "my MD's office uses MAs and they give shots just fine so why shouldn't they call themselves 'nurses'?" in this thread to the "nursing diagnosis has no part in my work."
If you think all that nursing is consists of "skills" (tasks), then you are tragically unaware of the unique place registered nurses hold in health care. If you are an RN and think this, then you have squandered your professional birthright (read the original story to get the effect of the allusion). If you cannot (or will not) explain the difference to the public, you do them, your community, and and your country a disservice.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
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.
My question to BFNP and subsequent reply may have given the impression that I didn't understand the distinction. I do understand it. I feel that when an educated person does a "task" it ceases to be a "task". I see that in an effort to distinguish "real nursing" from everything else the emphasis on the cerebral as separate from the actual hands-on delivery of care could lead to a devaluing of the latter, even as an unintended consequence.
My question to BFNP and subsequent reply may have given the impression that I didn't understand the distinction. I do understand it. I feel that when an educated person does a "task" it ceases to be a "task". I see that in an effort to distinguish "real nursing" from everything else the emphasis on the cerebral as separate from the actual hands-on delivery of care could lead to a devaluing of the latter, even as an unintended consequence.
I think the devaluing of the former has more and longer-range adverse consequences.
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.[/quote']
Nurses are wonderful to have in primary care offices, but for small practices it is just not economically feasible as they do not generate any revenue directly, though one could argue that they secondarily generate revenue.
Suggesting that a TSH be checked on a patient based on history and physical findings demonstrates knowledge and critical thinking, but in all honesty, I don't need to pay three times the hourly wage for that as it's not something I am likely to miss. Obviously having two sets of eyes and a pair of brains is better than just one.
Our experienced MAs are actually very good with labs and imaging orders as they see them all the time. In fact, they might even be too good as they sometimes need to be reminded they don't have ordering privileges.
If I had a big office a nurse would likely be a benefit as the nurse could cover multiple providers and the overhead would offset.
Specializes in Nurse Leader specializing in Labor & Delivery.
Nurses are wonderful to have in primary care offices, but for small practices it is just not economically feasible as they do not generate any revenue directly, though one could argue that they secondarily generate revenue.
Suggesting that a TSH be checked on a patient based on history and physical findings demonstrates knowledge and critical thinking, but in all honesty, I don't need to pay three times the hourly wage for that as it's not something I am likely to miss. Obviously having two sets of eyes and a pair of brains is better than just one.
Our experienced MAs are actually very good with labs and imaging orders as they see them all the time. In fact, they might even be too good as they sometimes need to be reminded they don't have ordering privileges.
If I had a big office a nurse would likely be a benefit as the nurse could cover multiple providers and the overhead would offset.
What I can do, though, is take on a lot of the stuff that MAs cannot do, that was previously the domain of the mid-levels/care providers, so that they have more time to do level visits. I'm constantly thinking of ways that I can ease the job of the care providers so they can see their patients on time, maybe even double-book here and there in order to see more patients. When I take over many of the duties that cannot be delegated to MAs, that means the care providers can do more money-making activities. By me taking care of all the labs each day, that means that the care providers have more time to see more patients, see them on time, increase patient satisfaction, which means they will come back to our clinic instead of going elsewhere.
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 know plenty of other people have commented but I had to add. . .
As a former pennycostal (translation pentecostal for non-Southerners) I just about got a blessing and started shoutin' at this! Preach on Bean-town sister (or is it brother?)!!
smartnurse1982
1,775 Posts
I know "nurse" is protected,but isn't nurse non specific so to speak?
I thought "Rn" and "Lpn" were protected titles?