Baviary

I believe that there are major problems that nursing will never (?) solve - and some of these are the infighting and 'digging in heels' when discussing change. RN's who have been practicing for many years believe that THEIR way is the ONLY way and that anyone who says different is WRONG. Change 'for many years' to 'just a few' and you have the SAME ARGUMENT!!! We look at other RN's with different training and say he/she can NOT be as good as WE are. WE know what is best and NO ONE will change that. 'WE' can be ANY RN with ANY background, training, experience, etc. As a profession - we need to get OVER ourselves and stop behaving like a bunch of high school children. Change is needed. Period. What should the change be? Standardization of education across ALL schools. Since the research - yes, the research, indicates better mortality and morbidity rates from bachelor's prepared RN's, then the entry level should be bachelor's prepared. Now here's when people want to lynch me....I NEVER SAID that I BELIEVE that RN's with ANY OTHER DEGREE are LESS THAN or WORSE, etc. It is the RESEARCH. Again, let's get over ourselves and move on, shall we? As far as APNs are concerned, I only have personal opinion to go on as I have not read any research on this. People who want to be APN's should be held at a higher level academically - be able to write well, etc. There should be rigorous training in the sciences and prepare the NP for a generalized role (kind of like the PA). There should be clincal work - just like when getting one's RN with rotation in various specialties. When the NP chooses a specialty, there should be additional training and clincial work. I believe we should have a residency program as well. Maybe 2 years working in your field of choice with either an NP with 5 - 10 years experience or an MD. Similar to PAs and MDs this would be a paid position where you would basically do the job but with close supervision. DNP's? Not useful in the clinical world and created because the ivory tower people want to advance the prestige of the profession. I started a DNP program and dropped out after 1 semester. Why? the classes and the project that we were to do were EXACTLY what I did in grad school. Waste of my time. AND we had to write a 1 page paper 'to see if we could write'. Sorry but while this was quite a prestigious program, it is obviously not very discriminating if they'll take people who can't even write a decent paper...and they DON'T KNOW IT already! Makes me crazy. Anyway. None of what I or anyone here says, believes, etc. will do anything to assure that changes will be made. The people in charge don't want to hear it as THEY fit into the same catagory as what I said earlier in my little diatribe. Sad but true. Everyone wants it their way and refuses to change. Everyone wants the power. Sounds like our government right now. Again, sad but true.

I am a Psychiatric Mental Health Nurse Practitioner in Massachusetts. I make quite a bit more than what it says here. Oh well!!! LOL!

There is NOTHING wrong with not liking your job as a PCT (in my area we call them nursing assistants, CNA's, etc). There are MANY units who will NOT hire a person who has worked in this job or as an LPN. It may help you within the facility but may NOT in a unit where you are actually working. BTW - for those who will say I'm wrong, the THREE hospitals I've worked in, as well as according to managers at two other hospitals have said this. All are located in either Albany, NY or Massachusetts. I never worked as a CNA - never wanted to...personal choice. EVERY nurse has her/his opinion and all are valid - unless they are critical of others. Should you push through for another 10 months? ONLY if you have to keep the job! If you don't like it - I'd leave and find something else better suited.

I've been in this situation before. I worked 11p - 7a. I made sure EVERYTHING was neat, clean, etc before the next shift came through so that when giving report (we did bedside reports), the next shift would see things were neat, etc. One day during report a patient we had not seen yet had a problem and the bed was a mess. Mind you I had just cleaned her up about 1/2 hour prior. Anyway, when we went into the room the RN to whom I was giving report pointed it out (I saw it the same time she did) and walked out saying she'd be back when I cleaned things up. I was not new. I NEVER left my patients in a bad situation or left things for ANYONE to clean up after me. The AM RNs ALWAYS thought we 'night nurses' left 'everything' for them and that we were lazy, etc. THIS is the problem I saw when an RN on the floor.

In reference to the 'hop between mental health and other areas', it is true that NPs can NOT. I am a Psychiatric NP and ONLY do mental health. FNPs and others do NOT have the training that I and others do unless they go back to school and take the various courses that concern psychiatric care. There ARE NPs who prescribe psychiatric medications but laws are changing so that they will not be able to continue. I for one believe that unless an NP has received the training in mental health - specifically psychiatric diagnosing, co-morbidities and psychiatric medications, they should refer to another provider. This also is what I believe about my practice - I refer patients to their PCP for EVERYTHING other than mental health. I did NOT receive the training and therefore do not feel I am as qualifited.

I've met RN's who are rude and think they're better than everyone else..AND have met NP's who are the same. That being said...I am a Psychiatric NP, work outpatient. I make my own hours and see 3 patients an hour. I make 4X what I made at my best paying RN position. For me the ability to work closely with my patients, not have to work weekends/holidays and being respected by not only my patients but also those in collaborative roles makes my position , well GREAT! I LOVE what I do.

Having worked on a med/surg floor I get what the writer is saying. I also challenge each and every person to re-evaluate the negative thoughts around these patients. If I took all your dignity away, called you a liar (not directly of course but with tone of voice, attitude, body language), treated you like a child (TELLING you what you should be doing/taking, etc)...what would YOU do? Don't start the 'well, patients ARE in the hospital for a reason and they should be doing what I/the MDs tell them' etc). If you studied psychology (NOT the diseases/disorders but NORMAL psychology) you would understand that these people are scared. They are doing everything in their power to feel normal, take control back (you DO take control of EVERYTHING while they are there!). Does it make sense and it is polite, etc? Nope. Is it a pain in you a&* that they behave this way? Yup. You can moan and groan all you want and it will NEVER change until YOU change. Yes, you heard me. When the patient I had threw his meds at me, I didn't complain. I also didn't do what many nurses do - storm out, give a nasty look (trust me, many do!). I came back when he was resting but very awake and asked him about his life, his family. Over a few days we developed a great relationship because I MADE THE EFFORT to gain his trust by giving him (or at least he THOUGHT I gave him) the power back. I gave him the respect he needed. Or how about the patient who told the surgeon (and everyone else, for that matter) to f-off and threw things at them?! It took me MAYBE 3 minutes (yes, true) to get him to be on my 'team' so we could work together to get him better. Yes, I work in psychiatry. I am a Psych NP now and love it. BTW - the family stuff...different kettle of fish LOL! But as far as the patients are concerned...it's easy to stop these behaviors with the right manner, words, etc.

I also worked overnight and found that many nurses thought like you. This means that the responsibility of covering falls on US! We have to work as a team. Maybe if you took a shift once in a while this wouldn't have happened to you. Sorry but refusing to do ANY call is selfish.