Protect your profession...

[markdanurse]

Hello fellow professionals,

May I have your attention please. An allnurses.com user by the name of nursebrandie made a valid point in the emergency nursing subforum that I would like to discuss with all of you. We were discussing the use of paramedics in the ER, and it was mentioned that the two professions were interchangeable. This is alarming to a professional nurse such as myself. We must not give give up our career roles to other specialties. Any of you that do not believe this is an issue, please consider the following:

1. Anesthesia started out being administered by nurses, that's right, nurses...not physicians. Nursing gave this role up to physician anesthesiologists. Yes, we still have the CRNA profession, but now there is a new role out there called the Anesthesiologist Assistant (AA). It is a master's degree program that physicians created to keep the midlevel anesthesia providers under their thumbs. The position pays as well as, if not more than, a nurse anesthetist.

2. Physical Therapy and Occupational Therapy started off as subspecialties of nursing. Yes, PT's and OT's were orginally nurses that received specialty training in the activities of PT and OT. But we gave these positions away too and now the PT has become a clinical doctorate degree and the OT has become a master's degree.

3. Midwives originally birthed babies, not physicians. In fact, the first known male physician to witness a live birth dressed up as a woman to see the event, and when it was discovered, he was burned alive at the stake. Yes, we still have nurse midwifery, but it never should have been given to the male physician group. And also look at what CNM's get paid compared to OB/GYN physicians...for pretty much the same job.

4. RN's used to be able to mix drugs in piggybacks for I.V. administration. Now pharmacists have completely taken over that arena too. Why is this important? Well, just this...did you ever need a drug in an emergency situation, like Mannitol, but had to wait for a pharmacist to mix it and you get it back in 30 minutes when you could have mixed it in 5 minutes flat? Look around you...nursing's skill set is being taken away, but our nursing leaders are demanding us to have more education. Why? Nurses aren"t smart enough to use strict aseptic technique to mix drugs in an emergency situation?

5. Why is it that nurses cannot endotracheally intubate except in an ambulance or flight nurse role? Why is it that a paramedic can put in an EJ IV line, central line, or chest tube but nurses cannot except if employed in a flight nurse or ambulance role? Why is it that are profession seems to want us more educated but we have allowed ourselves to become "dumbed down"?

So yes, the idea of paramedics taking over the ER nurse's role is a real threat, and it should not be taken lightly. Paramedics are great to have in the ER...but paramedics are paramedics and nurses are nurses.

Embrace your skill set, and do not allow others to take anything more away from you! You went to school. You learned the skills. You know how to critically think! Nurses are more than just well educated technicians. I am more than a butt wiping, pill pushing, bed making technician. So are all of you.

Keep this in mind as you move through your career. Nurses need to come together, not grow apart if this profession is ever going to be something more.

Mark

[jjjoy, LPN]

:yeahthat:

[elcue]

one of my biggest beef about being a nurse at the staff nurse level is that we never get reimbursement for our nursing services. .....our salaries are factored in the general overhead of running a healthcare facility - in the same category as porters, housekeepers, and maintenance personnel.

on the other hand, physical and occupational therapists send their paperwork to the insurance companies and the hospital is paid for the services they provided.

bingo!!!

i have said this for years- of course nurses are not respected/recognized for our education, skills, contributions. we are included in the room rate!!! grouped in with the hosekeepers.

we appear nowhere on the bill as providers of care. this both reflects our place in the hospital hierarchy and subtlely shapes peoples' perceptions of us. (invisible) if patients saw how much it cost to provide their nursing care, they might not be so apt to perceive us as people who "wait on" them rather than what we truly do.

[PMFB-RN, RN]

The ER nurse replied "I didn't spend 60 thousand dollars to go to nursing school to put people on the bedpan."

*** That nurse is a moron for two reasons:

1. S/he thinks they are to good to do a little basic patient care.

2. What kind of a moron would spend $60K just to be an RN?

[PMFB-RN, RN]

If you notice, pharmacists and physical therapists now require a doctorate for entry level. OTs, dietitians, social workers require at bare minimum a bachelor's degree and most have a masters. Nursing has refused to raise the bar on education and is consequently being left in the dust.

*** Personally I an happy that nursing hasn't followed those other professions in raising the education bar. I have looked at several of these programs and the extra school doesn't really involve anything to make them better practitioners. I see it as just a way to get more money out of students.

In my state (Wisconsin) ADN and BSN students take the same nursing classes.

If it was up to me it would be like this:

RN - two year degree. (one that could actually be done in two years)

CRNA & NP would be BSN (like they used to be)

PT, OT, Pharm would all be 4 year bachelors programs.

However nobody with any power has asked me what I thought :)

[PANurseRN1]

Here I go again, it seems I always take the opposite side of the argument on here. However, I believe that if paramedics take over the nurses job in E.R. it is because the E.R. nurse is letting it happen. The E.R. nurses at my hospital have totally isolated themselves from the other departments to the point that they seem arrogant. They never get pulled to do bedside nursing on the floors or units because they are ER nurses (does that mean they don't now how to do pateint care?) When patients have been admitted and they are being held (sometimes a day or two ) in ER for a bed, the nurses never even touch the admission orders because they are ER nurses. Once the supervisor told the ER nurse that a patient needed a bedpan (the nurse was reading the paper at the desk). The ER nurse replied "I didn't spend 60 thousand dollars to go to nursing school to put people on the bedpan." If all ER nurses have this attitude someone has to do patient care in the ER and it looks like the paramedics are going to try. We all take the same test and we all go to the same schools and learn the same things but it seems that the ER nurses are putting themselves in a very tight and limited position. If you are not going to "Nurse" then it proves that you are not needed and will be replaced with something else.

If an ED nurse gets pulled to the floor and then is needed back in the ED, what is she supposed to do with her assignment? There are a lot of problems inherent with pulling staff out of the ED.

Why all the hating on ED nurses?

[elcue]

PMFB RN wrote: " *** That nurse is a moron for two reasons:

1. S/he thinks they are to good to do a little basic patient care.

2. What kind of a moron would spend $60K just to be an RN?"

_______________________________________

60K isn't a bad deal for a bachelor's degree these days. (and an experienced nurse earns at least that in a year in many parts of the country)

"just to be an RN" ?????? :angryfire you sure don't value your own profession, do you? and shame on you for calling the other nurse a moron

[PMFB-RN, RN]

60K isn't a bad deal for a bachelor's degree these days. (and an experienced nurse earns at least that in a year in many parts of the country)

*** I guess it depends on your point of view. It's about $50K more than what mine costs (though I am not paying for any of it). If one can become an RN for around $3000 (what it cost me in 2006)or so then the $57K left over is pure profit over the education investment.

"just to be an RN" ?????? :angryfire you sure don't value your own profession,

*** Of course I do. Nothing I have said indicates otherwise. I was commenting on the $60K, not the career.

do you? and shame on you for calling the other nurse a moron

*** Shame on that nurse for thinking they are too good to do basic patient care.

[Tweety, BSN, RN]

60K isn't a bad deal for a bachelor's degree these days. (and an experienced nurse earns at least that in a year in many parts of the country)

"just to be an RN" ?????? :angryfire you sure don't value your own profession, do you? and shame on you for calling the other nurse a moron

I guess it depends on location. In Florida $60,000 for a BSN is outrageous. But I'm sure there are private schools that cost that much. I agree calling someone a moron for spending that much is not appropriate.

Please remember to discuss ideas and the original topic without getting personal with presuming someone should feel shame and doesn't value their profession for holding an opinion. All opinions are valid whether we agree or disagree.

[Tweety, BSN, RN]

*** I guess it depends on your point of view. It's about $50K more than what mine costs (though I am not paying for any of it). If one can become an RN for around $3000 (what it cost me in 2006)or so then the $57K left over is pure profit over the education investment.

Yes, it does depend on your point of view and I'm glad you acknowledge that. However, just because you can get a BSN for $3000 (or free in your case) doesn't mean that those of us who can't are morons.

$3000.00 would barely cover one year here in a public university to get a BSN.

Many people want to become nurses bad enough they will pay private school fees to become so. They are not morons, but making a sacrifice and a choice that should be respected.

However, I agree on the point that no matter what you pay for your education and what letters you have behind your name, if you're an RN you're a moron if you think basic care is beneath you. :)

[WolfpackRed]

But really the ADN requirements are just a few credits short of BSN.

Are you sure about this? I may be taking this out of context, but there are more than "a few credits" difference b/w an associate prepared RN and a bachelor's prepared RN. Granted, the nursing education of a BSN may have a few more requirements than an ADN, but the other half of the BSN degree may demand an additional 60 credit hours of general college education.

[WolfpackRed]

I am a nursing student at a community college...I have read the entire thread and just wanted to add that not one person in my class will have finished thier ADN in only 2 years!! We have approximately 2 years of full time pre req's at my school before we can even be accepted into the Nursing portion which is then another 5 semesters...so yes I will have gone to school just as long as someone that gets a BSN...no I will not have taken all the exact classes...why would I go to school for 4+ years and get a lesser degree??? Because I could do it for less money and I could get into a night and weekend program which works better for me and my family!! It was not worth it to me to pay so much more and get done with school and only make 500 dollars more a YEAR!!! I am not saying that it is not worth getting a BSN..and I will get mine eventually...all I wanted to say is that I doubt many go directly into a CC and graduate exactly 2 years later with thier ADN...at least not around here...I am sure other programs are run differently!!!

Last year in my nursing leadership class, a small group of students looked at the different education levels in nursing. It was found that even though new grads from either program start out at the same payscale, over time, I don't recall how much time, BSN prepared nurses will earn more than associate prepared nurses. It was thought that BSN nurses had greater mobility within the profession, as has been discussed in other "ADN or BSN" threads. One study they also found showed that ADN prepared nurses, specifically nurses whose highest level of education was an associate's degree, often got out of nursing after five years. This study proposed that these ADN nurse did not have the educational background to allow them to cope with the emotional and mental stresses of working in the nursing profession, that is they could not "see the bigger picture".

I know that this may upset some folks, I do realize that one study does not make an idea fact, and I know that the findings do not apply in every situation, but I found this all interesting.

[Marie_LPN, RN, LPN, RN]

Yes, it does depend on your point of view and I'm glad you acknowledge that. However, just because you can get a BSN for $3000 (or free in your case) doesn't mean that those of us who can't are morons.

Not to mention that old phrase "you get what you pay for."