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

[Batman24]

The ADN programs where I live are between 68-71 credits. I will continue schooling after I graduate so I can work and obtain my Masters at the same time.

I have been raked over the coals as far as transferring classes go. I have been out of school for more that 8 years so I need to take math tests, etc. all over again. This of course potentially leads to taking more and more pre-reqs. It's all about the green.

I had one school tell me I might need to take my psych class again and I drew the line at that. Enough is enough already. Another school needed a 1 credit computer class and I had an A in a programming class worth 3 so they transferred it in as 1 credit instead. Whatever. lol

I am 17 credits into the program I prefer. I need to take 3 more science classes, a lifespan psych class, CPR course, and become a CNA before being admitted into the program. This will then complete all of my pre-reqs and will leave me with only nursing course to go which I believe is 38 credits at this school.

[lovemyjob]

This is one of the best posts I have ever read re: bsn/adn issue. It has stayed on topic and been so informative. Lindarn, I whole heartedly agree with you, and many others who have brought up other great points.

I see many nurses who became nurses because they could go to work and let work stay at work and have no interest in joining any organization to make it better. They see it as a couple 12 hour shifts a week that brings home a paycheck. I am going to venture out and suggest that thui may be a reason that nurses dont stand up against admin, the state, etc. Many want to work and go home, have a family and a million other obligations and were attracted to nursing because of its wonderful flexibility. I am not in any way bashing those who are this way, only pointing out what I have seen from talking to coworkers. There are many fiesty nurses out there like linda and many others on here who want to take action, but dont recieve the support from those who would rather not put the time and effort into it. I am not so sure they see the benefit... and the need.

[Kelly_the_Great]

Maybe unification should be the primary focus for strengthening nursing instead of in fighting and arguing over an issue (education) that may yield little returns and can be fixed internally

Hey Gerry...:),

I think a lot of ppl believe the issue of education can be the means by which unification can be achieved. In oher words, if our entry level was "uniform" all ADN, BSN, hell, some even think MSN (lol), then this would lend to more unification of the profession.

.. is there not strenght in numbers?

In theory, definetly, there is strength in numbers. Unfortunately, when we are divided...no...

ETA: BTW, not that it matters but I'm a proponent of "eventual" attainment of BSN. I believe we all come from different perspectives (socioeconomic, family dynamic, etc.) in our lives and our choices and opportunities are affected by them. However, I would like to see a system that would provide the allowance of BSN realization for all practicing nurses that we may all get the credit we deserve. jmo

[gerry79]

Hey Gerry...:),

I think a lot of ppl believe the issue of education can be the means by which unification can be achieved. In oher words, if our entry level was "uniform" all ADN, BSN, hell, some even think MSN (lol), then this would lend to more unification of the profession.

In theory, definetly, there is strength in numbers. Unfortunately, when we are divided...no...

ETA: BTW, not that it matters but I'm a proponent of "eventual" attainment of BSN. I believe we all come from different perspectives (socioeconomic, family dynamic, etc.) in our lives and our choices and opportunities are affected by them. However, I would like to see a system that would provide the allowance of BSN realization for all practicing nurses that we may all get the credit we deserve. jmo

Yes Kelly I do agree with you as knowledge is power. It would be nice to see unification start somewhere.....anywhere...Then nurses would become a powerful force within the work place. Imagine two million unified voices speaking as one! What a force we would be within the work place. But as long as we are kept blissfully ignorant, fearful, and disorganized we will always be divided and conquered.

[lindarn]

In my area RN's make as much as OT's, and more than Dietician's, and LICSW's (Masters educated). The starting salary for a new grad in Boston is $62,000 per year. I have quite a few friends who are teachers, social workers, and police officers who do not make what a new grad nurse makes. Dental Hygienist, who also have dual professional entry, start at $65,000 per year and seem to coexist just fine. I am all for advanced education and professional respect, but are we as nurses really that bad off? Would more education equate to more respect? From what I have read on this website, MD's dont respect NP's who are highly educated, CRNA's are at times not well received by anesthesioloigist, and to many lay persons a nurse is a nurse weather a Diploma, ADN, BSN, or MSN graduate. Nursing represents the largest faction of health care workers yet it seems wield the least amount of power. It reminds me of old South Africa (for lack of a better analogy) where the few ruled the many for years because the many were slow to unify. Maybe unification should be the primary focus for strengthening nursing instead of in fighting and arguing over an issue (education) that may yield little returns and can be fixed internally.. is there not strenght in numbers? Is the sky indeed falling on the nursing profession? Some whow I dont thinks so, but only time will tell I guess........Just my .02 cents

Maybe where you live Pts, OTs, earn as much, or the same as RNs. But in most of the country, they most certainly do earn more than RNs. Here in low paying, service industry Spokane, PTs and OTs earn TWICE WHAT RNS MAKE, $80- 100,000 a year. Nurses here make about $32 an hour. That comes in at less than $50,000 a year.

Teachers may not earn a whole lot more than RNs, but teachers have great benefits, and retirements, that most RNs can only dream of. I cannot quote you what cops make, but again, they are state/city employees and have great benefits and pensions. Dental Hygienists is not a dual professional entry profession. Dental Assistants are a 2 year commmunity college program, Hygienists are a four year program. They are not interchangeable with Dental Hygienists.

If MDs don't respect CRNAs and Nurse Practitioners, it has more to do with control, and the business that they perceive they are losing to them. What better way to keep the upper spot on the food chain, but to look down publically on them and maintain control over their scope of practice. It has more to do with CRNAs and Nurse Practioners allowing the disrespect, than anything else.

The publics' confusion about the role of the nurse is due to the different levels of our education, that confuses us, as well as the public. Nurses are not taught how to promote themselves, and their practice, and we do a poor job of conveying to the public how and why we are valuable to them. This is mainly caused by nurses who have rejected union representation, and live in "right to work (for less), states", where you can be fired for anything, including writing letters to the editor, educating the public about what is going on in health care in their community. This is why the public is not in an uproar about the poor care in hospitals. They think that it is caused by all of the lazy nurse who just sit in the nurses station talking on the phone and playing on the computer. And of course, the hospital just feeds into this misperception with the "customer service" babble.

WE have caused the confusion about our profession. WE have no one to blame but ourselves. WE continue to insist on being the the lowest educated group of health care professionals, and WE pay for it with our low pay, and lack of professional recognition, and control.

Lindarn, RN, BSN, CCRN

Spokane, Washington

[gerry79]

Maybe where you live Pts, OTs, earn as much, or the same as RNs. But in most of the country, they most certainly do earn more than RNs. Here in low paying, service industry Spokane, PTs and OTs earn TWICE WHAT RNS MAKE, $80- 100,000 a year. Nurses here make about $32 an hour. That comes in at less than $50,000 a year.

Teachers may not earn a whole lot more than RNs, but teachers have great benefits, and retirements, that most RNs can only dream of. I cannot quote you what cops make, but again, they are state/city employees and have great benefits and pensions. Dental Hygienists is not a dual professional entry profession. Dental Assistants are a 2 year commmunity college program, Hygienists are a four year program. They are not interchangeable with Dental Hygienists.

If MDs don't respect CRNAs and Nurse Practitioners, it has more to do with control, and the business that they perceive they are losing to them. What better way to keep the upper spot on the food chain, but to look down publically on them and maintain control over their scope of practice. It has more to do with CRNAs and Nurse Practioners allowing the disrespect, than anything else.

The publics' confusion about the role of the nurse is due to the different levels of our education, that confuses us, as well as the public. Nurses are not taught how to promote themselves, and their practice, and we do a poor job of conveying to the public how and why we are valuable to them. This is mainly caused by nurses who have rejected union representation, and live in "right to work (for less), states", where you can be fired for anything, including writing letters to the editor, educating the public about what is going on in health care in their community. This is why the public is not in an uproar about the poor care in hospitals. They think that it is caused by all of the lazy nurse who just sit in the nurses station talking on the phone and playing on the computer. And of course, the hospital just feeds into this misperception with the "customer service" babble.

WE have caused the confusion about our profession. WE have no one to blame but ourselves. WE continue to insist on being the the lowest educated group of health care professionals, and WE pay for it with our low pay, and lack of professional recognition, and control.

Lindarn, RN, BSN, CCRN

Spokane, Washington

Lindarn I do agree with you, education is important I was just stating the salaries of the various occupations in my area. Also there is a dual entry for dental hygienist in my area. There are two associate degree programs and one bachelor program. A bit of the beaten path but there are still several associate degree program for PA's (Miami Dade Community College, Stanford University School of Medicine, Riverside County Community College) and quite a few bachelor programs. And $32/hr comes out to be $66,000 per year before taxes based on a 40 hr work week times 52 weeks (where I am employed we are paid weekly). I live in a very high cost area and no OT or PT make any where near $100,000 per year in the hospital setting. And speaking to an OT and PT at this moment as I type this, I am told very few make more than $90,000 a year. Maybe they are in high demand in your neck of the woods.

As I mentioned earlier, I do agree that education is important but is it education alone that will enable nurses to get the respect that they deserve? We can all hold MSN's but until we unify in other areas also, we would only be considered educated fools in the eyes of management who will continously be dived and conquired.

[Corey Narry, MSN, RN, NP]

I too would like to see the day when nursing has a uniform degree requirement for entry to practice. Realistically, I am not sure we can make this happen since majority of nursing programs are still based in community colleges and universities are not willing to allow these community colleges to award a bachelor's degree. The solution to this is to offer differential pay to BSN graduates to offer an incentive to pursue RN-BSN. There are many RN-BSN programs and at least in my state, there is no wait list in these programs. Many hospitals also sponsor in-house programs through partnerships with local universities. However, unless there is a monetary incentive to pursue a BSN, there will be little interest in these RN-BSN programs.

[zenman]

... and universities are not willing to allow these community colleges to award a bachelor's degree.

Community colleges are not governed by universities.

[Tweety, BSN, RN]

The community college here offers a BSN Degree that is NLN approved. They award one of those Associate Degrees that is practically a BSN, then students go RN to BSN after that for 18 more months (half time because they understand the students are going to work full time, and if they do not pass boards they can finish the course they are in but are dropped from the program). It's a cheap and easy was to get an NLN approved BSN. Of course they take other RNs too. The idea was to graduate BSNs who might want to teach clinicals and alleviate the instructor shortage, and thus allow more students in, and thus alleviate the nursing shortage. :)

[jjjoy, LPN]

There are private colleges and technical colleges that grant bachelor's degrees that aren't part of a university system. Certain types and levels of coursework are required to grant a bachelor's degree and community colleges generally aren't equiped to nor were they created to do so. It's great to hear of a community college program that is working to make it easier for ASN-RN students to continue on to a BSN. I'd be curious to hear how that program works. For example, are the upper division courses provided by the community college and what college name appears on the bachelor's degree? It would seem that they'd have to be working in collaboration with another school but maybe not. Any more info on that?

[Corey Narry, MSN, RN, NP]

Community colleges are not governed by universities.

I am speaking of current developments in my home state. Both state universities and community colleges are funded by the state and are thus governed by state regulations. Community colleges in my state have been pursuing a move to be allowed to grant BSN degrees but the state universities are strongly opposing this.