jtfreel

I personally find this topic disturbing and wonder where the state Boards of Nursing are or what they are thinking. In Virginia, an acute care medical center was allowed by the Board to use medication technicians to administer everything but IV push drugs. In some instances, these medication techs worked between floors administering medications on 2 separate units. Though the practice has been stopped, it was extremely concerning that the Board of Nursign approved this practice for individuals with no license who had received minimal training. My husband was hospitalized and I recognized our bank teller as his 'medication nurse.'

I am retired military and will vote for Pres. Bush.

The nursing shortage is a global issue. If countries recruit from abroad, does that help with the global shortage? Does this practice address the factors fueling this issue? Does it make nursing education as viable a career option as hospital nursing? Does it attract students to enter nursing? None of the above: it says the country with the most money can buy what it needs even at the expense of others.

First, let me put on my flak jacket. Having been in nursing management and administration for longer than most of you have been born (yup, I earned these gray hairs!), let me share some objective observations if I may: 1. When interviewing candidates of both genders, males were more willing to negotiate salary. Yes there is a starting range for positions, but there is also wiggle room within those ranges. For example, for one position the starting salary range (depending upon experience and education) was $25-29.50/per hour. Two candidates applied and each had the same educational credentials and similar experiences. One asked about the salary and entered into a negotiated range of $28.50 per hour and the other never asked but demanded a starting salary of at least $26.00 per hour. I hired the one for $26.00 per hour because it saved me money for the same quality of employee to fulfill a vacancy. 2. I never had a male request an extended leave of absence for biological reasons. Whatever your feelings, time away from work equates to a lower level of seniority and that impacts longevity salary ranges. 3. When positions became available, it was often difficult to get some excellent, well-qualified female applicants to apply. Males were commonly more willingly to take risk. 4. This same trend was noticed in the high risk specialties of nursing: the percent of male applicants were higher than in many of the lower risk specialties. Again, a higher risk equates to more money. 5. Men tended to understand that the organization was a business and they had a better command of the business world than a lot of women. Women are fast studies and are rapidly catching up but the tendency to blame others for our choice patterns will only serve to undermine accomplishments. We do not need anyone to protect us if we are truly informed and professional. Numerically, we are not a minority though as a profession we chose not to organize. We are not a victim though it is easier to act victimized instead of accepting personal responsibility and being part of a process for change. We have a responsibility to analyze reports such as those cited from an informed view point and realize that everyone has an agenda.

Remember that the work place is not a social club. It is okay to make friends at work, but the primary purpose for being at work is to provide patient care. Always look and act professional. If you look sloppy, the impression you give is that your work is sloppy as well. If you act unprofessional (gossiping, negative attitude, cussing, talking loudly at the nurses station), that too will give others the impression that your care lacks professionalism. Give yourself permission not to have to know everything. No one does. Learning is an ongoing process. Do not join the 'complaining as an art form club.' If you are really unhappy, determine why but avoid complaining: it is unproductive and unprofessional. If there is an issue, address the issue. It is okay to have fun!

My husband and myself are on the low carb diet under a physician's supervision. Results: bad cholesterol down, good CHOL up, better management for hypothyroid, blood pressure down, overall improvement in mood and affect. Lifelong? I will continue to watch simple carbs and will choose wisely. Mike was a lover of bread, rice, pasta, etc. After 3 days, however, he adjusted and (as men do) continues to lose nicely. This diet-or any weight loss diet is better than obesity.

I would like to address not what 'they are doing to us' but what 'we' are doing to ourselves. 1. As a profession, have we elevated complaining to an art form? 2. A sense of 'victimization' appears to be the norm. Are we forgetting that we are willing victims if we routinely fail to confront people or issues. 3. Other professions do not have to attack us-we do a great job of ensuring that nursing does not unify by continuing the age old battles without resolution. Most studies and surveys reflect that 99% of others do not care whether our educational background is ADN, diploma or BSN as long as they are cared for by a competent nurse. We have many in all levels who have a personal agenda and need that secondary gain to keep the fight going. It makes us look immature. 4. We have adopted the practice of initials. Read any nursing articles and see how many initials follow the author's name. We may be attempting to dazzle with credentials in the hopes of earning desired respect. 5. As a profession, we seem to care more about what others think about us than what we think about ourselves. 6. We no longer look clean and neat. 7. Hopefully we do not fit the phrase, 'professional aspirations in a blue collar reality.'

For fast references go to Google.com and type in a search phrase "endotracheal suctioning" and just choose... Good luck.

Nursing will never be accepted as a "true profession" (in my opinion) as long as the health care system needs a practice group to do the dirty work-regardless of the education level of the members of that practice group. Example: Who picks up when the Pharmacy, Respiratory therapy, Phlebotomy, Business Office, Physical Therapy and housekeeping are closed or otherwise unavailable? When this is the practice, who benefits-financially? (Hint: if you want to really see who has the clout, follow the money trail: if one department is doing another's work WITHOUT receiving the financial benefits-you have found the organization's official grunts.) What does all of this have to do with educational levels: plenty. Keep it stirred up and you keep the practice group diverted from the obvious. Recommendation. Follow the medical practice model. Entry level is the general practitioner. A physician who chooses to specialize receives additional educational and training. In study after study, all graduates who pass the NCLEX are licensed to practice in beginning professional roles. Regardless of personal opinions, graduates from all schools are performing as equals on this examination. In some states ADN graduate score averages are slightly higher than BSN, in other states the BSN is slightly higher. In employer surveys, it has been reported time and time again that there is no statistical difference between the performance of these 2 groups from the employers point of veiw. It is time for this to stop. If we do not consider ourselves a profession, no one else ever will. If we do consider ourselves a profession, it makes no difference what anyone else thinks.

Nursing will never be accepted as a "true profession" (in my opinion) as long as the health care system needs a practice group to do the dirty work-regardless of the education level of the members of that practice group. Example: Who picks up when the Pharmacy, Respiratory therapy, Phlebotomy, Business Office, Physical Therapy and housekeeping are closed or otherwise unavailable? When this is the practice, who benefits-financially? (Hint: if you want to really see who has the clout, follow the money trail: if one department is doing another's work WITHOUT receiving the financial benefits-you have found the organization's official grunts.) What does all of this have to do with educational levels: plenty. Keep it stirred up and you keep the practice group diverted from the obvious. Recommendation. Follow the medical practice model. Entry level is the general practitioner. A physician who chooses to specialize receives additional educational and training. In study after study, all graduates who pass the NCLEX are licensed to practice in beginning professional roles. Regardless of personal opinions, graduates from all schools are performing as equals on this examination. In some states ADN graduate score averages are slightly higher than BSN, in other states the BSN is slightly higher. In employer surveys, it has been reported time and time again that there is no statistical difference between the performance of these 2 groups from the employers point of veiw. It is time for this to stop. If we do not consider ourselves a profession, no one else ever will. If we do consider ourselves a profession, it makes no difference what anyone else thinks.

You asked a very good and hard to answer question. For me, it was the realization that nursing has been caught up in the "business" of health care and is still, predominately, controlled by elements outside of the profession. In some for profit organizations, nursing is a cost center not a revenue producing center and the bottom line is sacred. The power brokers were the physicians and elements of administration that could grant or withhold favors. Empowerment? Those who give can take away. My personal choice to leave was to avoid supporting practices that diluted patient care standards (in my opinion). I could not support practices which forced overtime during high census (with the resulting caustic memos from finance) periods and FORCED time off during other times. I watched nurse managers attempting to provide professional care, achieve professional development, implement change and support their patients and staffs only to be ignored by Administration. I watched other units (who had learned the game) provide substandard care (as evidenced by medicattion errors, patient complaints, high nosocomial infection rates, etc.) brown their way to secure administration's and physician support. It really isn't how well you do the job of nursing in some organizations: it is how well you make the power brokers feel you are doing the job regardless of evidence to the contrary.

I know where you are coming from. I not only stepped down, but left nursing management entirely when I could no longer support policies and agendas that continuously and adversely (in my opinion) impacted upon the patients and the nursing department. In this organization, the primary customer was not the patient-it was the physician; the bottom line was the driving force and nurse patient ratios were viewed as a scalable item (adjusted according to profits). Even so, many dedicted individuals gave 100% daily. The personal toll was high for them and for me. I only hope my successor is more successful in achieving the professional goals than I was. I chose to leave because of my love for the profession and for the individuals in the profession-and for the patients. The result? My enthusiam is back, the future is brighter and my hope for the future of the profession is renewed.