Michele1377

I don't think that you should have to do anything further either! No one should have to. I decided to get my BSN in 2007 - (finished my ADN program in 1992 and have been continuously employed as an RN since) Well,I dropped out of my BSN program in 2011 with 10 credits left to go, Why??? Because I thought my 18 years of acute care experience and my national certification in my specialty were worth more than the letters B, S and N. (and I didn't want to finish 3 liberal arts credits so that I could take my last nursing class and graduate!) The sad truth is that all of the experience and certifications you hold are worthless in today's market if you live in an area that is trending toward BSN preference and riddled with Magnet hospitals. You quickly come to realize that education is what sets you apart from other nurses applying for the job you want. I never felt that anything I learned in my BSN program was not necessary, and honestly - EVERYTHING I have learned has helped me (in some way or another) to be a better nurse. Those who say they have received an equivalent education in an ADN program are myopic - and can not make that statement truthfully as they have not completed a BSN program and have no way of comparing the two. I "caved" in January and CLEP'ed a sociology course and am now enrolled in my final nursing course and will have my BSN at the end of this semester. And I guess someone must has slipped me some kool-aid as well - when I re-enrolled in January I entered as an RN-MSN student and will stay put until I have completed that degree as well! The bottom line is - if you do not want to go back to school - don't, especially if you are content and secure in the job you hold now and plan on staying there until you retire. But in the same regard please realize that you can not expect that nursing is any different than any other career - if the normal and expected education for the job you hold changes and you don't change with it - you will be left behind. All if us with the initials RN after our names have passed the NCLEX exam - no one can ever take that away from you - but we live in a free market society and no one HAS to employ you if they desire a candidate with more education.

I can't speak for other people but in my BSN program I didn't take world music, history or politics - I took thanatology, world religions, childhood development and interpersonal communication - all courses that would benefit and enrich my practice as a nurse. And you are wrong - having more education is ALWAYS beneficial to your patients - multiple studies have shown improved patient outcomes for patients cared for by BSN prepared nurses.

HouTx - thank you so much for your response! I agree, being more involved in my SNA makes a lot of sense, and I am working on finding a committee to join there - the ENA involvement is more from a level of personal interest - I want to remain current on issues and research related to emergency nursing. I had never even thought about opportunites within my state hospital's association - I will certainly begin investigating that pathway as well. As for MPH school - there is one here in NJ that is accredited by the Council on Education for Public Health (CEPH), which is very important to me - I have heard that if your MPH is from a non CEPH accredited school it does not hold the same weight (job market wise) as a CEPH accredited one does. There is one CEPH accredited program here in NJ (a joint venture between Rutgers University and The University of Medicine and Dentistry) that I have inquired about - I can begin as soon as my BSN requirements are completed this summer. The joint program was basically two degrees done simultaneously, so there is really no need for me to switch MSN programs that I can see. I really appreciate your thoughtful response :)

Thanks in advance for any input! I originally posted this in another forum related to Health Policy/Government Affairs, but I am not sure if that was the best place for the feedback I am seeking. After 20 years of direct care nursing (18+ as and ER nurse and 1 ½ years in peri-op) I have decided what I want to do for the rest of my career - I would like to enter the arena of health policy/advocacy and government affairs. I am so excited to have come to this realization, and I am hoping that some of you might be able to provide me with guidance. In 2008 I had returned to school. I dropped out in 2011, 10 credits shy of BSN completion mostly because I lost my motivation as Ididn't know what I wanted to do in the future (I was in a RN/MSN program). In December I re-enrolled with the intention of completing my MSN (Nurse Educator specialty), and then enrolling in a MPH program. I figured I might work one or two days a week teaching clinical at a community college while completing my MPH. I became aware of a joint MSN/MPH program that is located in the state where I reside, and I am now wondering if maybe it would be better to finish my BSN (I will be done this summer) and sacrifice the 9 graduate credits I have taken at my current school and enter the joint program. My dream job would be to become the Director of Government Affairs for the ANA - but I realize that even if I were to be eligible for that role someday, it would be way, way, way in the future. In the interest of becoming more involved in health policy and government affairs now, I have joined the ANA and my state nurses association. I have also become involved with my local chapter of the Emergency Nurses Association (I had been a member of the ENA for a while, but never became involved) and I have joined one of their committees So I would appreciate any input as to whether or not my educational objectives are appropriate for the type of career I would like to pursue - positions that come to mind would include lobbyist, legislative committee aide, nurse activist for a public or private organization, health policy advisor (or any similar positions that you might work in). Also, I would appreciate any information as to how you arrived at your career destination if you are currently working in these types of settings. And finally, if you have any ideas how I might be better prepared for a career in health policy or government affairs, I would love to hear them!

Thanks in advance for any input! After 20 years of direct care nursing (18+ as and ER nurse and 1 ½ years in peri-op) I have decided what I want to do for the rest of my career - I would like to enter the arena of health policy/advocacy and government affairs. I am so excited to have come to this realization, and I am hoping that some of you might be able to provide me with guidance. In 2008 I had returned to school. I dropped out in 2011, 10 credits shy of BSN completion mostly because I lost my motivation as Ididn't know what I wanted to do in the future (I was in a RN/MSN program). In December I re-enrolled with the intention of completing my MSN (Nurse Educator specialty), and then enrolling in a MPH program. I figured I might work one or two days a week teaching clinical at a community college while completing my MPH. I became aware of a joint MSN/MPH program that is located in the state where I reside, and I am now wondering if maybe it would be better to finish my BSN (I will be done this summer) and sacrifice the 9 graduate credits I have taken at my current school and enter the joint program. My dream job would be to become the Director of Government Affairs for the ANA - but I realize that even if I were to be eligible for that role someday, it would be way, way, way in the future. In the interest of becoming more involved in health policy and government affairs now, I have joined the ANA and my state nurses association. I have also become involved with my local chapter of the Emergency Nurses Association (I had been a member of the ENA for a while, but never became involved) and I have joined one of their committees So I would appreciate any input as to whether or not my educational objectives are appropriate for the type of career I would like to pursue - positions that come to mind would include lobbyist, legislative committee aide, nurse activist for a public or private organization, health policy advisor (or any similar positions that you might work in). Also, I would appreciate any information as to how you arrived at your career destination if you are currently working in these types of settings. And finally, if you have any ideas how I might be better prepared for a career in health policy or government affairs, I would love to hear them! Michele

Rabbi shot Person needed 2nd rabies shot - My friend who was in triage came into the treatment area hysterical laughing telling me that she did check the waiting room just in case it was legit :)

OMG haven't heard it called the penalty box since a nurse I worked with left a few years ago! Brought back memories, thanks :)

I just did that - left my position after 18 years to take a PRN postion and a facility I wanted to "try on". In the end, if it feels right, I will certainly consider a staff postion, but I will never again allow myself to work for a toxic manager! (Still shaking my head that I dealt with it for 18 yrs!)

I hear ya! I have been an ER nurse for 18 years and I have seen nursing (in my dept) be reduced to the task monkey environment that you quote. Don't have an answer for you, personally I think it is pitiful, and I am just about ready to throw in the towel myself! Michele

I think it is a great idea - I am in NJ too - I am sure it is needed for many people - I could have used it when my kids were younger :)

I know that this thread is old, but unfortunately this concept has just reached our ER very recently - So I am backtracking and trying to become as educated as I can about this process. In your institution, who exactly is walking the patients back and giving them to a nurse? I believe the core concepts of these initiatives, but I can't find anything on how to implement this. I would love to PM you to discuss this further so as not to keep commenting on older threads Thanks, Michele

I guess it is just something that is inherent to the position - part of the reason I never sought any type of position like that - would have felt the need to compromise my principles for the sake of my job - something that (even after 18 yrs of working in the same department) I am still unwilling to do. Michele

As for the ENA, I have a membership - am I'm even certified, LOL - I know that they have a position on triage - what I am seeking is guidance as to when triage should occur. If we have non medical people walking patients into the treatment area and placing patients into beds without any prior assessment other than chief complaint - who is responsbile for the patient prior to them being triaged? The nurse assigned to that bed? Who's responsibility is it to tell that nurse that there is a patient in her area? And how does that nurse how to prioritize her work if she has nothing to go on beyond a chief complaint? For example spontaneous headache is not the same as a spontaneous headache with a BP of 234/122 or a headache after falling down a flight of stairs - you know? I really need some sort of help with this issue - the ER nurses at my hospital were invited to go to the next labor/managment meeting to bring our concerns forward - we would like to do it with some sort of evidence on best practices - not merely our own opinions, (which have been easily disqualified by management as us having been resistant to change) Thanks, Michele

I really would like to see some sort of position paper or statement or recommendation from the ENA regarding this practice. I do not see how you can have a lay person in the waiting room taking chief complaint statements from people makes for good practice when the person getting inside may indeed be far sicker than origianlly thought or les sick and just tying up hours that would be better used taking care of someone who needed immediate attention. Personally, I just think it has been an issue of faulty implementation in the case of the ER I work in, but I would like to attempt to make things better for all of the patients and the nurses through discussion with management. I just want to make a solid argument as to why it is better to have a triage nurse (or any type of screening assessment) by someone with some sort of knowledge base.

We have gone from a traditional triage system (patients signed in on paper slips, then were called into triage, then registered, then called to tx area based on acuity and bed availability) to a modified triage system (pt's quick reg'd, then called to triage for basic screening, ie vital signs, chief compliant, "eyeballing", then directly escorted to an avaiable treatment space) to a triage bypass system (patient greeted by non medical "greeter" walked directly into department, swing by charge nurse to tell them you are putting ABC patient in XYZ bed and assigned to a nurse based upon the bed they land in and someone is supposed to get over to the patient to do a full assessment and triage in a "timely" fashion) IT BLOWS that said - they have essentially taken the nurse out of the processs of having the ability to assign patients based on nurse/patient acuity mix, nurse ability, patient needs, etc. Also, they have tied the nurses to being assigned to beds and not patients (something we have been dealing with and trying to adapt to for months now). This combined with the loss of the benefit of having the patient screened before you are assigned to them, (no less not even knowing you are assigned to them util you notice that the greeter even put the patient in your bed) has made for some really scary scenerios. I just am trying to ascertain if anywhere else is doing this or if our hospital has morphed a solid principle into their own convoluted and inexplicable brand of chaos? (wanted to say a word that rhymed with buster and truck but thought the better of it )