WillRegNurse

It doesn't matter zenman. Yale university does not control hiring within Yale New Haven Hospital or the Hospital of Saint Raphael, which are its two teaching hospitals.

I work for a teaching hospital of Yale school of medicine and online NPs wouldn't be hired. Instead, they would be derided by the Yale residents.

I respect young people just starting out in nursing, who are working for the floor and giving it their all. The ones who aren't jaded, weary, and constantly using dark humor in order to cope. They are cheerful, vibrant, and dynamic in their attitude and youthful demeanor. Let's face the fact that most RNs who have been on the floor for more than 20 years are not doing so because they "choose" to stay on the floor. They probably don't want to go back to school to get their BSN, they lack the drive and ambition, or they don't have good enough standing in their facility to be promoted. The kind of people I'm talking about don't "choose to stay on the floor." They *have* to because they are bridge burners. It needed to be said.

The term I thought was apt. One of the characteristics that unites people with this mentality is that they have very low ambition. They are content working as a floor nurse, because it lets them feel above LPNs and CNAs, which is all that is important to them. Becoming an RN is about status to them. And I don't agree that low class ignorant behavior is as pervasive in other professions. When was the last time you saw two pharmacists shouting at each other in the hallway, writing each other up, or trying to humiliate one another in other ways? The same with physical therapists, speech therapists, social workers, and so forth. I just don't see it happening where I work. In nursing, I see it all the time. It is my belief that the raw stock of people that nursing draws from is cut from a different cloth than these other professions, and unfortunately that cloth is poor. And even more unfortunately, I believe that this hurts our profession and holds nurses back from attaining the respect that we deserve from other professionals and our employers.

There's often a little more to it than that, such as their reasons for quitting school. Writing off "whatever reason" as something unrelated to the identity of a high school dropout is flawed.High school dropouts are often marred by behavioral issues, drug use, lack of work ethic, low socioeconomic background, abusive homelives, lack of interest in education, lack of motivation. High school dropouts exhibit these characteristics way more than high school graduates, and WAY WAY more than high school graduates who go on to obtain a bachelors degree. High school dropout mentality encompasses the attitudes that lead to the behavior I described above. Do you want that in nursing? Even if someone reforms by stopping the bad behavior, the underlying attitudes are still there, veiled underneath the mask of a professional title. I honestly believe that that is why so many low class people who become nurses end up like such jerks. They come from nothing and are then exposed to "professional status" without having the manners and tact that goes along with it. And then they become "drunk" on their new title and perceived authority. No, I don't consider such a person anywhere near the brightest. I consider Yale school of nursing graduates among the brightest. Or, I just don't make a mountain out of a molehill.

This thread might draw ire, but I feel that it has to be said. In my carefully considered opinion, one of the biggest things that holds nursing back as a profession is what I view as a high school dropout mentality. Those who have this mentality act as if being an RN gives you the right to bully others. It takes its shape in unprofessional behavior of all kinds, including publicly "calling out" other nurses on the floor, yelling at other nurses in front of patients, lecturing new people about their many years of experience on the floor, and constantly complaining about the facility, the people in it, and gossiping and backstabbing people. You all know people who fit this description to a T at work. Here is what I discovered through my dealings with these types. Certain groups tend to have high numbers of individuals with this mentality, and they include nurses who were adult learners, community college students, former LPNs, former CNAs, and people who actually did drop out of high school in their teens. Meanwhile, BSN students and second degree nursing students tend to not have this high school dropout mentality. Is that because BSN and second degree students are just less likely to actually have dropped out of high school than the groups I listed above? Maybe. "Getting my RN" and becoming a floor nurse is seen as the biggest accomplishment in the world by these groups. Becoming an RN is a worthy accomplishment to be sure, but acting like it's the highest honor in the world is rather pretentious. I am not bashing associate degree nurses. I myself graduated with an associate degree in nursing and am pursuing a BSN while working. Before anyone says it, I realize that most people within these groups are normal, everyday people trying to make a living. But isn't that part of what holds nursing back? I want nursing to attract the best and the brightest. I want people who see it as more than a paycheck. I want people who are interested in professional advancement, education, and research, not people who are content with being a ratty, shat-on-her-scrubs floor nurse in a nursing home for twenty years in order to support three adult children who are on welfare. The kind of nurse who long ago forgot if your appendix is on your left or right side of your body. The kind who doesn't care about the science. Does anyone want to weigh in? Use this thread to discuss your thoughts and feelings about the high school dropout mentality in nursing. Do you believe it exists? Or do you believe it is imagined? Use this thread to discuss ways in which we can raise the standards of the everyday nurse and stop low class, ignorant behavior.

I've begun the PSU program and it's excellent. I'm so glad I found out about Penn State's RN BSN program.

I'm not intimately familiar with Martha Rogers' views on nurses transitioning into medicine, but if she and I are of one stance on this, then she sounds like an intriguing individual whose views might be worth researching. The role of "filling in" for the role that the unavailable, thinly stretched primary care physician is transitioning out of seems flawed. While filling a social need is an admirable role, I believe that the "second string" reputation of NPs that it perpetuates only hurts the profession. It makes them seem less like independent practitioners, not more so. In my carefully considered opinion, the future of nursing lies in bedside care, case management, consulting with social services, end of life issues, ethical decisions. I would sooner see financing for more medical school seats in order to increase our pool of physicians, so that nurses can unify and focus efforts into causes which are (in my estimation) more worthwhile than opening more NP schools.

I may be a new as a nurse, but if you are gloating about how, as if it were supposed to be a "news flash," that a lot of people are disagreeing with me, then I think you need experience more badly than I do. It signifies that you need to grow up. The purpose of this thread was not to "focus angst into getting people to agree with me." The purpose of this thread was to gather other people's *substantiated* opinions on a discussion that I thought was interesting and worthwhile. Several people in this thread have thanked me for the thought-provoking discussion and posted some legitimate rationales in disagreement, and I thank those people for being respectful, intelligent, and being able to see the larger picture. The rest of the people in this thread seem to be NPs, NP students, or NP-lovers who got offended by the discussion, attacked me personally, posted faerie-tale stories about some prodigal NP they know, all in an effort to feel that their role is validated. That sort of coping mechanism was expected. However, I don't feel that "filling the gap of PCPs" and "shortening wait times" and "being less costly" is a sustainable or respectable role. It resounds of settling for someone less educated and less trained due to convenience. By contrast, the bedside nurse has a real identity and a rather irreplaceable role. The NP is there to sub in for someone else's role. That is why I think the concept of NPs is flawed. They have no identity and unlike MDs, are forced into specializing in treating only a certain demographic or age group of patients. Truly, I see regular RNs as being more useful than them. My feelings toward NPs are "what's the point... just be an MD."

My last physical exam was with an NP for employee health at my new job. I have never seen so rushed an exam in my life. Definitely gave the "I've done this already 10x today" impression. Have any other anecdotal evidence which does not impress? Because I sure do, and it's all real.

In the end, it's the appendectomy that saves the patient with appendicitis. Not the NP's "holistic" spew. No disrespect to the NPs out there, or their training, but I see the bedside nurses as more important to the patient's care than the NP's visits that usually just reinforce the MD's diagnosis and plan of care. I truly see bedside RNs as more integral to the healthcare team and more vital to the patient's wellbeing than anything an NP could ever do (write limited, crappy scripts). "Treat the disease not the person" is a silly little overused catchphrase. Please don't repeat it in this thread. This is not an alternative medicine thread. Do you have any evidence that shows that an NP's "attitude" is better than an MD's? Is there a poll? May I see it? Well..?

People are commending NPs without any actual reasoning here, it seems. I think this is due to loyalty to the profession rather than actual logic. You guys are just giving anecdotal "crappola" testimony rather than showing any data that warrants the notion that FNP's provide equal to or better care than medical doctors. That just does not fly in an academic setting. I remember one time I was seen by an NP at my university infirmary, she just immediately had the MD see me after suggesting some weird diagnosis, which was contradicted by the MD's true diagnosis minutes later. Then the NP said "Yes, I agree. That's what I thought too." If people want to give an actual reason for why visiting an NP trumps an MD, I'm all ears. If people instead just want to toot their own horns, then I won't be as receptive to that. That kind of ignorant chest-beating is not intelligent. My family practice MD would have an appointment ready for me within a week. If FNPs are there just to shorten appointment times, or to "fill a gap," then I think they need to reconsider their role badly! The FNPs that I have seen seem more interested in "proving themselves" rather than following up on care.

Hi all. I am a new graduate RN who is enjoying his first job as a med-surg nurse. I don't know about everyone else, but I am so tired of the nurse practitioner craze that seems to be overtaking the newest wave of graduate RNs. Half the people I know at my new job are part-timers in grad school for a master's degree as a family nurse practitioner or a psychiatric nurse practitioner. Good on them, but does anyone else think the idea of a mid-level practitioner has been taken a bit too far? I don't know about all of you, but if I had a medical issue, I wouldn't bother seeing an NP. I'd go straight to an MD. The idea of an NP seems folly to me. Either you are a nurse or you aren't one. Or, either you practice medicine or you don't. A nurse practicing some form of low-level to mid-level medicine seems absurd. The position also seems discredited by the variance in the scope of practice among different states and the fact that NPs can never do surgery. If NPs had limitless prescription power, and could be trained for some surgeries, we'd be looking at something real. But the NP's that I have seen "practicing" at my hospital just seem to be adjunct to the MDs who see their patients. The patients don't take the NPs seriously for just that reason. They seem roleless. I feel like the hospital hires them just as tokens. I don't see NP's as the future of nursing -- AT ALL. There is this one lady nurse practitioner at my hospital who goes into the patients' room and says "Hi, my name is Kristen and I'm the nurse practitioner," and begins some interview while I as the bedside nurse think to myself "You know that patient doesn't care right? You know they will just forget about you once they are seen by the actual MD?" Of course I never say that. But that's what is in my mind. I see no point in them. I see pure bedside nursing as our future. Nursing education. Stuff more involved in social services. I think NPs are suffering from an identity crisis. Let me know your thoughts too.

What do you mean they are not used anymore..? They are used all the time in rehab. Ideally, everyone is transferred using a gait belt. Unfortunately that is a reality in few facilities. I can't imagine why a gait belt would be restrictive. They are not supposed to be fastened tightly. They are there for you to have something to grab on to if the patient begins falling, so that you can ease them downward along your leg. Lifting people under their arms is not recommended as that can injure them, but it's how most of us transfer people. In some facilities, especially LTC and subacute rehab, you can be automatically disciplined if someone sees you transferring someone without a gait belt. They are kept in every single room, in those places.

Uncooperative patients are supposed to transferred using a lift. They should not be handled directly if it can be avoided, and they shouldn't be forcefully ushered into standing, sitting, or walking. SOURCE: Perry and Potter. "Use mechanical lift and full body sling to transfer uncooperative client who can bear partial weight or client who cannot bear weigh and is either uncooperative or does not have upper body strength into chair." The chances of nurses being injured is reduced almost to nothing if he is hanging in the air on the lift rather than standing up and unsteadily teetering backwards and forwards, while we surround him and try to bear his weight upon our own bodies. If you use your head to imagine that, then you will realize that that is just an unsafe situation for everybody involved. Using the lift, his chance of injury may not be lessened, but ours is. I can't picture someone falling out of a lift sling unless it was applied wrong.

Yeah, I'm not that big of a guy either. I am 6 feet tall and weigh 155 lbs. That is pretty skinny, and half of the female nurses I work with surely weigh more than me, from the looks of some of them. Maybe they ought to recruit themselves to lift these huge people!

At my new job on a med-surg floor, we have only two pieces of lifting equipment: a sit-to-stand machine and a hoyer lift. When you want to use them, they never seem to be around. They are shared with other floors and are underused because the experienced nurses see it as a big to-do to scour the floor for them and get the patient into the harness. For that reason, most of the experienced nurses never want to bother using them. They see it as more convenient and efficient to just recruit a bunch of personnel from the hall, including as many male nurses as are around, and utilize these 4 to 6 people to, in my opinion, unsafely transfer patients who are as heavy as 250 lbs, have dementia, and hit people. Just the other day, my preceptor asked me to "get in front of this guy" who was 71 years old, 300 lbs, demented, and combative. He also had sprained something in his leg from falling a while back and was unwilling to stand. So 4 other people and me had to reach under his arms and bear all his weight onto our backs to try and shuffle him from the bed to the wheelchair so that he could be discharged. We did get him into the wheelchair but he was about to fall forward at one point and so my preceptor had to charge forward into his gut and ram him with her head in order to stop his fall forward and send him backwards into the wheelchair instead. It was one of the most absurd things I have ever taken part in. I made a point to say it would be a better idea to take time to use the lifting equipment on a patient like that next time and she agreed, but I believe that when transferring heavy patients, many nurses feel that it is quicker to just get a whole lot of people and get it done without the use of equipment, regardless of how much it hurts our backs. What I resent is that the next time this happens, and I refuse to transfer a heavy patient that should really be transferred via equipment, that I will be seen as unskilled, lazy, or a weakling for not wanting to have a work related injury during my first year out of nursing school. I especially despise comments from nurses who say "it is nice to sometimes have a male nurse help move the patients" as if being a man and having more upper body strength does jack for saving your back when you got some huge person falling down onto you! What does everyone else make of this?

Hi everybody, I am a registered nurse who graduated this past May of 2011, and I have observed a very disturbing phenomenon that is taking place. About two weeks ago, I began orienting on a medical-surgical floor at a hospital in a new town about 3 hours from where I lived previously. I was interviewed over the phone and relocated for this position. The hospital itself is in a small little town about 40 minutes from where I am renting my apartment, which is in a larger suburb of a nearby city. After a few days on the floor, I have noticed things. (1) The hospital has recently gone on a hiring binge to replace people who have left. Many, many new graduate nurses have recently been hired at this small-medium sized hospital. (2) I have heard staff complaining about high turnover and "people leaving after a year." I overheard a male LPN in the cafeteria ruminating over people who leave and treat the hospital as a "proving ground" before moving on to greener pastures, as it were. (3) The new graduate nurses from the local two-year school here are treated favorably by the other staff, who also were trained at that school. These are people who were born and raised in this town and tend to resent outsiders. People who relocated to the hospital, like myself, are viewed with high suspicion. I have already been questioned by LPNs and to a lesser extent, RNs, about why I would move from my perceived-to-be nicer area (a wealthy, cosmopolitan area) to this tired, old factory town to work. "Could you just not get a job back where you were?" Or, "Do you plan to go back there?" And, "Why did you choose here?" And also, "Are you one of the people who moved here?" People have probed me for information, asking dodgy questions in the hope that I will "out" the fact that I intend to leave after a year. It is true that I moved here for a job, and that the area isn't the ideal for me, but that doesn't mean I will leave right away. I don't know about all of you, but I think it is rude to assume that new graduate nurses who relocate to find jobs have secret intentions to leave the area after exploiting the facility for its experience. That may be true for many, many people. However, generalizing an entire category of people based on prior negative experiences that happen more than is common flies against what nursing philosophy. That is discrimination. Imagine if I started asking a black person "Do you plan to commit a crime here? I've seen a lot of people like you commit crimes, so I just figured that's what your intentions were too." People would be outraged, and rightly so. Well, if it is wrong in one situation, then it is wrong in ALL situations. I am an employee of the facility I was hired at, just like everybody else, whether I relocated and they didn't, and I do not deserve to be labeled based on a category I belong to. I don't need it and I don't deserve it. Who agrees?