KeyMaster

Our system leadership mandated a minimum BSN requirement and won't accept applications from nurses with an Associate degree. Yet they are willing to moan, groan and complain about the severe nursing shortage that is keeping them from filling the HUGE number of open positions we have in our system. One of our busiest acute care floors only has two actual hospital employees - the rest of the staff is agency or travel nurses. Rather than accept an application from nurses who have graduated from one of the FOUR of the Associate degree programs in our area we are bringing in large numbers of contract nurses from outside the country. The total irony is that many of the temporary and contract nurses don't have a BSN, which is apparently OK because we haven't hired them as permanent employees....meanwhile we have a surplus of RNs who can't find jobs in their own city.

OP: "Definitely thinking about different degree, since experience is the only way to open up other nursing positions, but I am not about to work bedside for 10 years. I would rather go back to school." Oh yes, absolutely! What we really need are more Master's and Doctorate prepared nurses who can't stand the thought of actually touching a patient, much less *gasp* their pee or poop. I am really tired of seeing entry level MSNs who make it painfully clear that hands-on patient care is not what they got their master's for and they are only suffering through bedside care until they can land a management/teaching/informatics/sales position. But I guess I am the delusional one, because the job postings I see nowdays make it clear that initials behind your name are valued over experience.

Don't Panic! Words of wisdom there

The downside in my hospital is that a lot of the MDs simply don't want to put in electronic orders. Many are older and although they may be comfortable with a computer they are not proficient with a keyboard, so order entry is time consuming and frustrating for them. When the docs actually do enter their own orders it does work well. The nurses are not supposed to take verbal orders, but we are not supposed to refuse to either. Rather than hold the docs accountable, much time and effort has gone into devising ways to have the nurses enter orders, while making it look like the MDs do so that we can meet our meaningful use goals. We have lots of "protocol" order groups that RNs can enter and have the docs sign later. Or we take one verbal or phone order to enter a pre-built group of orders so the MD percentages for verbal or phone order entry are lower. All in all it creates more work for the nurse because the unit clerks can't enter orders anymore and there are still a lot of docs who won't - guess who's left to do it.......

I teach electronic perioperative documentation to our newly hired associates. It is obvious that many of the more mature nurses simply don't use the computer in any ongoing capacity. I always encourage them to make sure they have glasses that allow them to see the screen clearly and that they have a good understanding of BASIC windows functionality to navigate through the record. For those that need to improve their mouse or keyboarding skills or to overcome their hesitancy to click and navigate I direct them to All Nurses! From this site they can learn how to search different topics, how to improve typing skills, how to navigate through different screens, how to save, copy & paste, etc. And they get to see that there are plenty of nurses in the same boat. The more practice someone has - in a non-threatening environment - the more successful they will be.

Saw it lots when I worked on a geriatric med-surg floor. Sometimes with dementia (back when we called it organic brain syndrome), sometimes with tardive dyskensia, sometimes just because. To prevent patients from picking sores on themselves or irritating their finger tips (if it was really bad) we would place a square of shearling across their lap for them to pick at.

Any credibility to this argument was lost with the opening sentence.

The entire staff of the hospital should obviously have mandatory education provided on how to knock on a door. Of course someone will have to develop a policy on how loud the knock should be and the duration and frequency of the knocking. This will probably require an extensive search of literature to provide evidence for best practice. Additionally, a study should be drafted as to determine which nursing theory is the most effective model to follow. A suitable consequence should be determined for failure to knock on a closed door, with progressive action for repeated failure to knock. The terms "Knock" and "Closed door" should be clearly defined to enable everyone to follow policy appropriately and avoid misinterpretation of the Knocking On A Closed Door policy. Policy should include proper documentation of knocking or the reason that the knock was not performed. Understanding of the policy will be verified through testing and return demonstration. Repeat testing will be allowed for the first failed attempt, and a transcript placed in each staff member's file. Understanding should be validated on a yearly basis.

Wow. I couldn't even begin to imagine. Makes me even more thankful for the good old Diploma program days. I received a stellar education with tons of hands-on clinical time, passed "boards" with ease (like 99% of my class) and went on to work at the hospital associated with the nursing school. Thanks to their "loan forgiveness" program for every month that I worked part of my school loan was paid. After working full time for a little over three years my loan was repaid in total with no impact to my take home pay. Basically, my nursing education was completely free. I have worked at the same hospital ever since - in fact my office is now in one of the old school of nursing dorm rooms :) A couple of years ago I went through an RN to BSN program that was mostly paid for with a tuition reimbursment program. It really makes me question how the media and the public can buy the story about the "nursing shortage". My education was free because the hospital could justify the cost of educating a nurse who would fill a position - if there was such a dire shortage today how come people are having to pay such an outrageous price for their education?

:yeah:well said!! the total truth in a nutshell. there is no nursing shortage. there never has been and with the number of new grads cranked out every year there will not be a nursing shortage in any forseeable future. do not be fooled into thinking that healthcare is doomed because of a lack of nurses when the information is generated from those who profit from the propaganda.

Sadly a lot of places are interviewing, but still not filling positions. If you have a stong education with a string of degrees behind your name, recruiters want more experience. If you are experienced, they want more education. If you have both you are over-qualified. If you have neither you are disposable. Truth is - it's an employer's market. They have plenty of applicants to pick and choose from, yet somehow still find a reason to not fill vacancies.

This article only PROVES that THERE IS NO NURSING SHORTAGE - and that there never has been. There is simply a shortage of nurses who are willing to work in understaffed, underpaid positions. "hospital employment of registered nurses (RNs) increased by an estimated 243,000 full-time equivalents (FTEs) in 2007 and 2008 — the largest increase during any 2-year period in the past four decades" We are cranking out nurses in record numbers, but there is NO WAY that we have graduated more nurses in a 2-year period than we did in the past four decades. The RN's that filled those 243,000 FTEs already existed - they had just opted out of poor work environments. " an economic downturn may have a particularly large effect, since many RNs who were not working or were working part-time may rejoin the workforce or change to full-time status to bolster their household's economic security." There is NOT a shortage of nurses!! There is a shortage of positions attractive enough to be worth working for. If there were nursing positions that provided competitive pay, flexible hours and job satisfaction (without pointless CYA paperwork) there would be plenty of nurses available and willing to work no matter what the state of the economy is.

I once had a very tired resident order foley to low wall suction and an NGT to bedside drainage :) A quick phone call cleared that up with no problem though.

My RN-BSN program through South University was all online. I did not have any clinicals.

Sadly this is a scenario that will repeat itself as more and more emphasis is placed on the number of letters after your name rather than the number of years of experience you have. I have not worked in LTC, but have lived the same situation in the acute care hospital setting. My facility was working toward Magnet status (what a joke) and we were required to have a certain percentage of nurses with a BSN or higher. So, step 1: close the hospital associated diploma school which had graduated it's first class in 1921 and had supplied knowledgeable, dedicated nurses to all five of the facilities in my system for decades. Step 2: require ALL positions above bedside staff nurse to have a BSN within 3 years or else be fired or demoted. Step 3: After 2 years begin eliminating staff that have not started school yet because they will not make the deadline to graduate with a degree. So, take the manager with 36 years experience as a nurse and 12 years experience in a management role and demote them. Step 4: Hire brand new BSN who just passed NCLEX into manager role, because she is the only one available who meets the current job requirements. Step 5: watch my favorite boss waltz out the door (and take her years of experience with her) because she is now expected to mentor the new BSN and to train her for the position that the old manager is no longer qualified for. That is how a new RN with no nursing experience can be a supervisor. But it looks good on paper!