dareese

Sure. I believe that there are LPN to RN programs. I enjoyed working with LPNs at the beginning of my nursing career. I was the charge nurse and the LPNs worked under me. I did not have to spend time directly supervising them as they were competent and had their own duties. We each had divided tasks among us and the system worked well. Fast-forward to now and my last inpatient employer did not hire LPN's. I enjoyed taking care of my own patients but it was not in entirety as I still had CNA's working on my team. However, there were times that I felt like I was drowning in nursing responsibility with nobody to help me. Especially regarding phone triage as our phones rang continuously and the CNAs could not answer any of the calls or questions from family members, etc. Between charting and answering the phone, my time was pretty well taken up with these tasks. It was discouraging and frustrating. If I could have shared nurisng duties, it would have taken the pressure off of my shoulders somewhat.

Appreciate your weighing in from an educational perspective. Excellent points!

Wow-what a shame! Hospitals are missing out on great nurses if this is a trend nationwide. Are other hospitals across the country similar in this practice?

I just read an article called "Medicare Support for NP Training Addresses Nursing Shortage" https://www.medscape.com/viewarticle/966228 where Medicare is considering support for clinical training for NPs. Although the title is deceiving (support is for NPs and not nurses), maybe they are starting to think on the right track.

I see that some nursing homes are starting to think outside of the box like the one mentioned in this article. https://www.mprnews.org/story/2022/01/10/nursing-home-worker-shortage-ripples-through-communities Maybe it is a start...

I agree about utilizing home care more. I still can't understand why insurance is willing to pay for hospital services but home care reimbursement is very limited. It seems to be a win-win to be in the comfort of your own home when ill especially for an elderly patient. It has to be cheaper for the insurance companies and medicare than hospitalization. We are dealing with this issue right now with 2 of our parents.

Our local hospital has a 1-year new grad intern program which seemed to be a little long in my opinion but apparently, it is necessary by the comments on this thread. These newbies are eased into nursing responsibilities very slowly and I would imagine trained well and retained longer than in other "trial by fire" hospitals (which is like the one that I started in). Perhaps hospitals need to adopt this type of model in order to safely train new nurses into the profession.

Well, that's a shame if hospitals are not hiring new grads or utilizing LPNs as they should. I am starting to see a common thread here....

Well, that's a shame!

This is a very interesting thread regarding the downfall of healthcare in the 70s which I was unaware of. Who would have ever thought that it would come to this, our current state of affairs.

I'm not sure if I was unclear. No, I am not saying that these practical nurses would get their BSN immediately. It would be more like a practical nurse program for an LPN with additional training over time to build on their education. The goal would be to get a BSN EVENTUALLY if so desired. Also to get trained practical nurses in place quickly to help fill slots in the nursing homes and inpatient area. Maybe some current RNs are too young to remember the hierarchy of nurses in these areas. BSN nurses at the top with the more complex responsibilities, then AD nurses, with LPN's under the college-educated RNs. This spread out and alleviated some of the responsibilities for the BSN nurses.

This hierarchy of nursing roles had worked for decades. Smart administration! And I bet that the RNs appreciate the help.

I am actually surprised to hear that many nurses do not feel that there is a shortage of nurses in hospitals and nursing homes. Is it just in my neck of the woods? We were always operating short prior to covid with open positions. It seems that if there was a set number of nurses for all nursing positions and some left the profession or retired early due to burn-out from the current environment, others were forced to leave due to vaccine mandates, and many shifted to become travel nurses or work in non-inpatient positions, that indeed there is a nursing shortage in our inpatient facilities? Am I wrong about this?

Great ideas! I would love to figure out a way to consolidate all of our collaboration and somehow get it to land on the desks of those who make decisions regarding our hospital systems. Are there any administrators or nurse recruiters out there who can lend their knowledge regarding actual nursing shortages and solutions (especially for long-term care facilities and inpatient hospitals systems)?

I agree that a shorter education may be a problem. But what other options are there? Maybe it can be a stepped approach like LPN where the responsibility is less. Certainly, a BSN nurse would have more responsibility. Yes, I think it will take buy-in and a concerted effort for all parties to get this idea up and running. Including incentives for nurse educators and schools. Thanks for the input. I just hope that everyone does not drag their feet which could lead to more staffing issues.

Our lifeblood has been drained and nursing shortages have reached critical levels. We must act now to fight for our survival as nurses before it's too late. We need to come up with swift and creative alternatives to our present broken healthcare system. Read on to find out my solution to combat and win back our precious careers and livelihoods. For the first time in almost 2 years, I am starting to feel hopeful about the Covid Pandemic. Although we have not beaten the virus and hospitals are overflowing with Covid patients, we are finally getting the tools and treatments necessary to control it. The 4 significant Covid developments that have made me feel optimistic are: Rapid home tests Antibody infusions to help give the sick a fighting chance Anti-viral medications (to be given to those who are mildly ill in the first 5 days of symptoms) from Pfizer and Merck (so far) Non-vaccine options for those who can't get the vaccine (due to allergies to ingredients, prior adverse reactions to the vaccine or those on high-dose immunosuppressants). So far, these non-vaccine alternatives are monoclonal infusion (for protection) and other new prophylactic drugs just coming on the market. On Dec. 9, 2021, the news outlets, including CNet informed readers that "The drug, called Evusheld (AstraZeneca) is given via two injections to eligible people age 12 and up who aren't sick with COVID-19 and who haven't been recently exposed to the virus. According to the FDA, it may be effective for six months". I followed each of these treatments and tests way before they were approved and am cheering when they have become available to the public. Every development helps to turn the tide on the pandemic. I am happy to see the weakening virus trend (so far). With the above points and the Omicron variant resembling a common cold (for those who have been fully vaccinated), I am heartened that the burden on our nurses may start to ease up soon. However, it is a little too late for our healthcare system as another crisis is upon us. This is one emergency that most staff in the medical world and I saw coming. Staffing Shortage Crisis This current calamity is our nursing and provider shortage. Our medical (mainly hospital and nursing home) staffing is in critical shape and will likely worsen in the next year. We require "fresh troops,” and we need them fast. The usual remedy of throwing more money at nurses is not working. Although generous pay is beneficial, what we really need is more time off, lower nurse-to-patient ratios, and less overcrowding in our hospitals. In essence, nurses are being worked to death. Currently, nurses leave the profession altogether or trade jobs to non-clinical environments to lower their stress levels. Hospitals are left without adequate nursing staff. I, for one, would not want to be a patient in a hospital at present. For the most part, it is an unsafe environment. Even though nurses are doing the best they can, most are already burnt-out and exhausted from overwork. The ER, in particular, reminds me of the state of medical care in an underdeveloped country. Long waits in the ER are now up to days to get seen or admitted to a hospital. Patients who are too sick to sit up in chairs in the waiting area, lie on the floors. Covid patients mix with the most medically fragile in close quarters for too long. Only 2 years ago, we could care for the sick in our community in an organized and efficient manner, and now our medical system has been reduced to inhumane conditions. In essence, the pandemic has dragged on too long and the already fragile camel's back has broken beyond repair. Our hospital systems are aware that our healthcare staffing is a wreck. Many "acknowledge that there is a problem" but are grappling with solutions. So far, I have not seen a whole lot of viable remedies being introduced. Is our government working on helping out in this nursing shortage war? Truthfully, there appears to be a lack of ideas about how to help our hospitals and nurses get back on their feet. Just talking about and telling us there is a problem won't help. We have to fight back right now and fast in this battle for our nurses. There is no time for ponderance when the attack is ongoing and currently waging. We need ACTION now! This whole healthcare crisis started to make me think about the nurses' training from past generations. Revisiting the Past for Ideas for Survival Many of you may not remember the days of "practical nurse training". Much of this LPN and RN education was "on the job". Due to this "immersion" experience, we could churn out practical nurses quickly. As a BSN student, I remember boarding temporarily at one such "teaching" hospital for my critical care rotation. The practical nurse's school had closed long ago, but the "housing" was still in place. The student nurse accommodations was located on the entire hospital's top floor (attic). This large, mainly abandoned area that now only housed outdated supplies and furniture was one scary place for 3 young nursing students to reside all by themselves. The dorm hall was the length of a football field with endless doors and dark corridors atop the hospital. We BSN candidates huddled together in one room for comfort to sleep each night, hoping to ward off what surely could be many ghosts of the dead in this 200-year-old facility. Aside from the creepy accommodations, I am sure that there were many, many nursing students who graduated from this practical nurses program of old and became excellent nurses. As I think back, I am wondering if we currently could revisit this practical nurse education model temporarily to help ease our nursing shortage quickly. I know that nursing has come a long way from those "old" days and the ideal for higher educated BSN nurses has taken over. But once again, we are in crisis, so we may need to think outside of the lines for now. I began to ponder about WWI and WWII medical staffing. How did we ramp up our nursing "troops" quickly? A little research showed that we could meet the nursing needs of our army well. How did they rapidly accomplish this daunting task? I found that the US government hired student nurses to start "nursing" almost right off the bat. After a brief orientation, nurse "cadets" began pitching in as nurses, obtaining nursing skills on the job. This is a similar model to our practical nursing programs, albeit possibly in a more condensed time frame. This blog that I found on the WWII army cadet nursing program is very interesting. Read here if you want to learn more about the process of nursing education for our war nurses. I decided to put into words what I was thinking as a possible solution to our war on nursing. Here is my proposal to give our current warrior nurses some hope for the future along with a well-needed break by bolstering the nursing ranks quickly. 1. The current US administration should pay for "rapid" nursing education programs to get nurses quickly into the field. Their wages should start right from the onset of their education. I'm sure many men and women would love to become nurses but can not afford to give up their current jobs and go without pay as they receive their nursing education. We have many loan "payback" programs currently but this option would be in effect at the institution of the nursing program. 2. Free child-care for nursing students. 3. Institute ideas and incentives to employ additional nurse educators for these rapid grad nursing programs. 4. Continue paying for nursing education once our ranks are replenished to eventually obtain a BSN degree for those who desire to do so. 5. Encourage our current MAs and CNAs to fast-track into one of these programs 6. Hire more "assistants" for the nurses. This article from MSNBC nicely illustrates how "helpers" for nurses free up RNs to perform adequate assessment and care for their patients. We will need government buy-in, of course, for the free training. But we nurses, as one inventive and determined entity, can rise up to meet our current battle with a crusade of our own. If we just complain, quit and wait for others to find a solution, we, along with our sick loved ones will be the casualties. I have seen how quickly telemedicine has developed in the past year. I hope that solutions for the nursing shortage will fall into place just as quickly. If we can come together as a group to tackle our current war on staffing inadequacy, I am confident that we can overcome this crisis on our own terms. So, nurse educators, nurses with political influence, administrators, nurses on the front lines and those in the background supporting our troops, let's put our heads together and beat our common enemy. I know that we will have to get past what we are accustomed to regarding our current comprehensive BSN model nursing education. The outcome of my proposition will hopefully produce a similar result eventually. However, the training process is a new (yet old) concept. I hope this idea could entice interested potential nurses to enroll and train quickly to fill the immediate gaps before more of our current "soldiers" fall. What Next? If this concept is feasible, how can we run this idea "up the pole,” so to speak and get a groundswell going? I would love for our current government administration to quickly get on board if this proposal is attainable. As nurses and nurse educators, we have the best insight into this idea. Can it work? I would love to hear other nurses' opinions on this and their ideas.

I have worked as a camp nurse for many different types of camp. However, I have been less than impressed with my experience each time. I was wondering if it is just me and that I am not cut out for camp nursing or if in general, this type of nursing is not overly attractive for nurses. I actually LOVE camping so it is not the great outdoors and insects that turned me off. I found it to be lonely and at one camp with many medically fragile children, to be overwhelming and very understaffed. I barely slept! I have a friend who worked day camp and LOVED it but I am talking about sleepover camp. What kind of experiences did you have as a camp nurse?

WOW! My heart goes out to you for all that you have gone through this past year. I am so saddened by what happened to the residents of long-term care facilities, some necessary and some not so much. To say it was an awful time for them is saying it too lightly. It indeed was a discouraging time for nursing! I pray that the profession can dust itself off and carry on. Thank you for this insightful and heartfelt post!

Well done going back to the bedside to help out the cause!! Too bad it was a horrendous experience. I, too, was the new nurse at a hospital during covid, and it was pretty awful, although I kept it to myself. Some of the nurses and aides were very mean to me also ? . I am a nurse practitioner also, so I wish you the best in your new career. I now write articles about nurse practitioners! Here are a few of my articles that may help you in this transition! https://www.nursingprocess.org/attend-NP-school-while-working-full-time.html https://www.nursingprocess.org/unique-nurse-practitioner-jobs.html https://www.nursingprocess.org/least-stressful-nurse-practitioner-jobs.html https://www.nursingprocess.org/MSN-is-worth-it.html Wishing you the best!!

Congratulations. Good luck in the new position!

Wow! Are you considering changing positions? There are loads of nursing jobs out there right now.

I can see how that would happen! There is nothing worse than being a displaced nurse in a chaotic and stressful situation. I feel your pain!

Hopefully, with the worst of COVID behind us, nurses traumatized by the havoc and devastation of the pandemic can start to debrief and heal. For many nurses, COVID brought double hardship. Dealing with all the changes that occurred to our everyday lives and the fear or trial of getting coronavirus was enough to make anyone uptight and anxious. Pile on the duties of a nurse dealing with an unknown, deadly virus in an ever-changing and exhausting medical environment, and it is a wonder that we nurses survived the unprecedented situation. As a nurse writer, along with working on a COVID wing during the first half of the pandemic, my peaceful place during this tumultuous time was to document my COVID experiences through journaling. After all, we were living in historical times, and capturing actual life events as they happened made sense to me and helped me keep it all in perspective. Despite my writing, I could barely keep my life together due to developing a chronic painful autoimmune disease and nursing my father through the end stages of his cancer. But then we all had problems this past year, didn't we? Trying to figure out how to care for our children who were being schooled at home, having senior loved ones confined in nursing homes with no visitation privileges, and the inability to visit family and friends was difficult at best. In addition, for some, the loss of income and climbing the walls inside our quarantined homes was not easy. During the debut of the pandemic, I was employed as a float school nurse at a large private boarding school for children ages 4-18. These children primarily came from challenging homes, with some being in foster care placement at the school. As a float nurse at this unique school, I rotated through the elementary and 2 secondary school health clinics and occasionally worked in the triage area. Since the children lived there year-round, the campus also included a 3-wing inpatient hospital for illness, surgery, and psychiatric issues when needed for the students. As a school nurse, I worked pretty regular 8 to 4 hours in the clinics except for my mandatory every 3-week required weekend shift at the hospital. When the schools closed down due to the pandemic, our students remained on campus since, for many, it was their home. All school-based nurses needed to be flexible to cover new shifts and step away from the schools to staff the new COVID wing established to house those in quarantine or suffering from the coronavirus. For me, this translated into being a hospital nurse working all 3 shifts and extra weekends. At this time, I was in my 50's and had not done hospital shift work for quite some time. Struggling with physical stiffness and pain and attending to my father added to my struggle. As the nurses who worked during the pandemic know, policies changed daily to keep up with the newest CDC guidelines, and nurse frustration was at an all-time high. The most current procedures needed to be developed, and new skills quickly learned. Communication was disappointing at best during this time, and tempers were thin. At our little hospital, we needed to swiftly adapt our psychiatric wing to a COVID unit, establishing negative pressure rooms. We also needed to add door alarms for the patient rooms as the youngest children would not stay in their rooms while in isolation. My heart went out to these little ones who did not understand why they were in quarters all by themselves, with only nurses visiting them hourly wearing space suit-like isolation gear. Being one of the newer nurses, I was assigned primarily to the COVID wing. I loved it there as I did not feel like the "new" nurse anymore as we all were navigating the particulars of this novel virus for the first time. I helped to establish the isolation protocol and order the supplies needed for the newly designated COVID rooms. Since the unit had to be set up at a moment's notice, I struggled for the first few weeks with limited supplies. I had the cumbersome but necessary task of cleaning and disinfecting much of the equipment after each use as we had to share blood pressure cuffs, stethoscopes, and thermometers between rooms. Working with children is different than adults as the younger ones would not wait for me to come to their rooms for my rounds for medication, treatments, and assessment. Instead, they would hit the call bell repeatedly with problems such as their computer was not working or they did not understand how to work the television. After a shift of repeatedly doffing and donning isolation gear and cleaning supplies between patients, I was exhausted. However, I empathized with these young patients and inserted my grandsons into the scenario for perspective. I knew that these children needed all of the love and attention that I could give during a stressful hospitalization, so I gave it my all. When Summer came around, my rheumatic condition had progressed, and my father did not have much time left, and my family needed me more. I took a leave of absence from work. Although I was grateful that I had the opportunity to spend time with my father during his last few weeks, I felt like I was abandoning ship in the midst of the storm, leaving my fellow nurses to the elements. Once I began to feel a little better and healed somewhat from my father's death, I decided to support my fellow nurses in a unique fashion. I established a BLOG called "Nurses Need Care Too" to inspire and show my appreciation for my fellow nurses. If I could not physically help out the cause, I would bolster nurses through my writing. When I look back on where I was 1 year ago to now, my life and nursing career have changed a lot due to COVID. I would love to hear YOUR stories about how COVID has changed your job as a nurse. I am sure there are inspiring as well as tragic stories from so many of you. (If you want to learn more about the Nurses Need Care Too BLOG, go to http://nursedonnareese.com/blogs/nurses-need-care-too). I want to thank all of the nurses on the front lines during the pandemic. You truly are HEROES!!

I love this comment! What a wonderful daughter you are. Lovely sentiment!

Wow!