"I don't want to do bed side nursing"...SAY WHAT!

[lauralassie]

had a couple different nursing students say: "well, i'm going to school so i don't have to do bed side nursing". one even told me she want to work in plastic surg. office, not at the bed side. o.k. , i'm an "old nurse...47 yrs old", but when i went to nursing school in the 80's , we knew we knew we would most likley have to work our way into other areas of nursing after some experience in an acute care facility or some other such place. i hate to sound like i want to eat my young but, a part of me wants to see these new nurses go through the ranks like many of us did. not because i want to see them go through he double thooth picks, but because i feel , taking care of pateints, hands on , learning orginizational skills, pt. asses. , are the best way to learn nursing skills. as a critical care nurse of 27 years, i continue to be amazed at how much i can find out about a pt. during a bath and bed change. we have beds that turn, vents that suction, monitors that alert a critical care team half way across the city, bells, beeps and whistles,,,,what ever happened to good old hands on. i think it is funny that a nursing student thinks if she goes to a plastic surg. office she will only see tummy tucks, face lifts and boob jobs. she's forgetting the big ugly draining wounds , burns, and amputations etc..these office settings see. would love to be a fly on the wall when she takes care of her first pt. with these things and says......"oh my gosh, a plastic surg. takes care of these people too...!" guess i'll go into dermatology.... ha , if you've been around the block you know what awaits her there too. hee heee....but i swear i don't like to eat my young ! :rotfl: :lol2:

[kessadawn, BSN, RN]

oh and this lovely new nurse wants to work icu now......she thinks it will be like tv (she actually said this) where the doctors will do all the dressing changes and replaces all the tubes, lines, etc.....she'll just have to sit and look pretty while she charts and passes meds.

silly me, i've been doing all that stuff myself. boy, the icu docs really got one over on me, huh?:smackingf

[jaslo98]

Having worked in Plastic Surgery, I wanted to comment on this thread. (I am posting under my husbands screen name--we are both nurses) I started out in med surg and when I moved to the city after marrying my husband, got a job in a Plastic Surgery Center. I worked on the office side and they had an OR suite in the other half of the building. Because they had an OR they were pretty much only interested in RN's. They wanted nurses who could help on the surgery side if the need arose. And they preferred experiend, ACLS certified RNS. ALSO, with plastic surgery you are dealing with an ENTIRELY different type of patient than your typical "sick hospital patient". These are patients with ALOT of money ( alot of times, not always) and they can have VERY demanding personalities. You have to have Excellent customer service skills, and be able to schmooze. And it can be very difficult and exhausting to cater to their every whim. Now, to be fair, I also had patients who were very sweet and pleasant to be around. But the sweet ones weren't the ones who drained me;) So, if the nurse doesn't have a super pleasant attitude regardless of how demanding the patient is, I can gaurantee that there probably won't be any plastic surgeon around who will hire her. AND, if she does get hired, she'll quickly get fired if the Surgeon finds out she isn't schmoozing with his/her patients. If the Surgeon's entire staff don't have the right personalities, the surgeon quickly loses business to the Surgoen down the street or even the one in another state (we had patients coming to have plastic surgery in Ohio, from places like California for various different reasons. Remember, these people have money and they'll go where they are treated the best)

As for the "icky" stuff, I saw Plenty!! And the surgeons I worked for didn't even do burn patients. If the nurse wants to go into plastic surgery to get away from wounds, drainage, blood, barf etc... she better do a little more research.

[Antikigirl, ASN, RN]

I feel it is best to go through the ranks in order to always have something solid in your foundation to fall onto if something were to go differently in your life, and you would have to take on a job as a med surge nurse or what not for a time. (like having to move, divorse, loss of job, sick kids or family...etc.).

However, I knew some nurses that were not only hating bedside nursing..but really were bad at it! LOL! They really did a great job in doing clinical nursing, or even specialties like wound care, ostomy, or other task not involving much bedside nursing.

So I am rather in the middle on this one...but I think I would vote on doing the old rank system in order to always have a foundation of learning and skill to be able to fall back on incase life throws something your way, and you have to take a temp or even perm job in something more bedside.

[Quickbeam, BSN, RN]

I was a CNA before I became an RN. Very valuable experience.

I have a community health job that requires every single thing I ever learned in 20 years of bedside nursing. Talk about knowledge is never wasted. I am constantly amused by the flood of calls I get from nursing students about how to get my job. I realize from the outside it looks ideal.....M-R, 10 hour days, no nights, weekends or holidays. No on-call, no covering or scheduling or working twice as hard because someone's kid had an earache.

But...I have to do presentations to hundreds of people, every week or so. I testify at the legislature. No one covers for me...I haven't had a sick day in 8 years. I have a knowledge base of occ health, statutory regulations and crisis intervention in my head. The tens of thousands of file reviews I do every year test my nursing knowledge to the last fact. I'd not have been able to do this job without experience.

It makes me sad that people are getting out of NS without any interest in patient care.

[pattymac]

I just wanted to add my 2 cents....I feel that nursing is a philosophy, not a job. For those that want to go into "nursing" without caring for people, they need to call it something else. Nursing is an action verb. Thanks for letting me say what I feel.

[scribblerpnp]

I haven't read all the responses, so maybe someone mentioned this before.

I think that with with the nursing shortage, there are a lot more openings in other areas that will take new grads that used to be off limits. An office that previously would have wanted an experienced RN, now can't find one (or doesn't want to pay when they do), hence it makes it easier to "skip rank." Do I think it is OK? Maybe, maybe not. Bed-side nursing is an important part of being a nurse, but if you really know what you want to do and it isn't that, do what you want. Sometimes I think we view bed-side nursing as "paying our dues," and that everyone should do it. I disagree. If a nursing student comes to me saying something like, "You know I really love psych nursing, but everyone says I should do med-surg first," I would encourage the student to try psych first. Why be miserable?

I remember saying the same thing when I was in school. I wanted to go straight into pediatrics after graduation and a few instructors tried to talk me out of it by saying I needed to get some experience in basic med surg. WHY? I didn't want to take care of adults and I knew I would hate it. So I did what I wanted to do and what was best for me: I went straight into pediatrics and lever looked back. I'm glad I made that decision. I haven't performed nursing care on adult since I was in college- and I am JUST FINE and a pretty good nurse (I would like to think).

It is possible the student has her optomist glasses on, but what nursing student doesn't at some point or another. We ALL do this to some degree.

[Spidey's mom, ADN, BSN, RN]

One of the strengths of "nursing" is how many avenues it offers.

We have a husband and wife team who went to nursing school to be able to do the bureaucratic paperwork stuff that keeps us all in compliance with the government and I'm happy to have them.

There is an abundance of plastic surgery centers focusing on keeping women looking younger and they don't take the "icky" patients requiring debridement after a burn.

I came into the medical field in my late 30's with no experience and was advised not to take a CNA class because that is exactly what we would be learning at the beginning of nursing school anyway and that is exactly what I did learn.

As to whether being a CNA makes you a better nurse, I'd have to say that what makes a nurse a good nurse is a healthy sense of ethics and teamwork. I have worked with nurses who were CNA's and then worked their way to LVN and then RN who hated to "wipe people's butts" and didn't answer call lights or help a patient up from the BSC or clean up vomit. Not every nurse who was a CNA or LVN was this way but I don't think that being a CNA guarantees that you will be a great team member.

Being able to go directly to the area in which you want to work is also fine with me. I graduated with nurses who went directly to ICU and NICU and ER and OB (granted they had orientation time). They are all fine nurses. And it is also fine with me if someone wants to put in a year or more in med/surg prior to moving on.

Each person needs to make an informed choice and do what is right for them. There is not, in my opinion, ONE path for all.

Allowing everyone the freedom to make informed choices is a pretty good idea.

steph

[rach_nc_03]

OK, going to probably make some people mad.

I had to leave bedside nursing after less than 1 year experience because of medical problems, and later went to work in clinical trials. I had worked only in ICU and step-down, I was an EMT before nursing school, and got my ACLS certification while I was a CNA and nursing school student. (After we got finished with ACLS testing, incidentally, the instructor said he couldn't believe how well I'd done in the megacode scenario- better than the cardiac nurses in my class who had multiple years of experience. Regardless of the experience these particular nurses had, they hadn't learned to think on their feet, and were at a loss when asked to explained the rationale behind the use of different drugs, or to adjust fire when circumstances changed. Just pointing out that someone who doesn't think critically won't just magically absorb it by working on a hospital floor- most do, but clearly, some don't.) I subsequently participated in multiple real-life codes- obviously didn't run them, but I did know what was going on, and felt comfortable participating.

After a few months of working in clinical trials, my husband got a job in another state. When I told management I had to leave, they were dismayed and said I was one of their best nurses- because of my background outside of nursing (I'd worked as a researcher in the tech industry before nursing school), I'd picked up the necessary skills to work in clinical trials quickly, and it appealed to me on so many levels- and it drew on skills and aptitudes I already had. All of the things I disliked about hospital nursing were absent in that environment- the physical demands, the need to rush so much that there was little time for in-depth analysis of what was going on, constantly being pulled in sixteen different directions because of staffing levels- and, frankly, the constant bickering and backbiting amongst the nurses I worked with. People would actually YELL at each other- in front of colleagues, patients, and family members. WTH??? In an emergency situation, fine. But come on- yelling at someone over some nitpicky interpersonal disagreement?

So, while my departure was precipitated by my medical issues, I was delighted to find an a job where I could work as an RN without dealing with the aforementioned aspects of bedside nursing. The patient care experiences I had in the hospital were, indeed, incredibly valuable in subsequent jobs. But I'm a million times happier now that I'm out of the hospital setting, definitely.

Maybe in another era, the 'old school' notion that all nurses needed to put in a few med-surg years before moving into a specialized area was a valid one. Maybe it's still true for some new grads today. Heck, maybe it's still true for the *majority* of new grads, I don't know.

what I *do* know is that some people will never be fulfilled by doing bedside care, but they will make excellent nurses in other settings. Some hospital nurses have no desire to work in clinical research, pharma sales, etc....so why begrudge those who do? i just endured 6 days of inpatient care by nurses who obviously didn't care much about taking care of me. As another poster said, I'd MUCH rather be cared for by a nurse who WANTED to be doing it- not by someone who was simply 'doing his/her time' until they could move into an area they would enjoy. I read too many posts by people who are absolutely miserable in their jobs!

And yes, I realize not everyone has the type of knowledge and skill set as a new grad to do something outside of bedside hospital nursing, as it is the primary focus of all nursing school curricula. But that's simply not true of all new grads. Also, another poster said something about not understanding why someone would go into nursing if they didn't want to do total patient care. Well, I did. When I decided to pursue nursing, I had the ultimate goal of working in research. Life circumstances landed me in that area before I expected it would, but it was always the ultimate destination. I worked as a CNA in an ICU while I was in school, and I certainly knew I didn't want to work as an RN in that environment for the next 5 years. I don't believe that I'm 'less' of a nurse- or not cut out for nursing- because of that.

Kudos to all of you working at the bedside- especially to those of you who love it. I think, personally, it's among the toughest jobs out there, and I hope nobody thinks I felt like I was too *good* to work at the bedside. That's absolutely not true- I just know it wasn't the right place for me, and I truly believe a job should be something that enriches your life- not something that makes it miserable.

And that, folks, is my worth.

[rach_nc_03]

I just wanted to add my 2 cents....I feel that nursing is a philosophy, not a job. For those that want to go into "nursing" without caring for people, they need to call it something else. Nursing is an action verb. Thanks for letting me say what I feel.

Does caring for people only take place at the bedside? My MIL worked as a cancer research nurse for nearly 30 years- she rarely did any direct bedside care (if ever), but she cared for hundreds of patients.

[SmilingBluEyes]

I guess I am a dissenter, in that I see nothing wrong with knowing what you want, even out of nursing.

Look, for some of us, nursing is a true calling from a higher power. I respect that. For others, it's a means to make a living, or become a professional and ascend up the clinical ladder to some different goal than bedside care. I respect these reasons, as well. For some of us, it's a bit of both------best of both worlds, so to speak.

Count me as one of those upstarts who knew what she wanted. No way was I interested in "doing my time" in the requisite 1 or 2 years in med-surg. I knew I did not want that. I did want OB and that was what I went for. I also knew someday I would want to teach others, and now, for me that dream is well coming true. I have a an aquaintance interested in hiring me for her childbirth education business. WOOT!

Does that make me a bad nurse, not to want to "do time" in bedside nursing, as most know it? Hardly. I saved myself a lot of dissatisfaction, as well as patients, I daresay, going directly for the reason I came into nursing for.

I say hearty congratulations to those who know what they want and have the guts and drive to achieve it. If your goal is to be a bedside nurse, great! We need as many as we can get, no doubt. But if the goal is something different (note I did not say "higher" )-----no one should ever stand in your way. It's a big career field and there is plenty of room for us all at the table! Nursing is caring for people----all kinds of people and that can certainly take place in any number of venues. The only limits are one's drive and imagination!

Just don't forget to thank those who mentor you on your way!

[Spidey's mom, ADN, BSN, RN]

rach_nc_03 - Your post was right on the money and I appreciate your viewpoint and agree wholeheartedly.

Deb - you too!

Count me in!

steph

[bluesky, BSN, RN]

had a couple different nursing students say: "well, i'm going to school so i don't have to do bed side nursing". one even told me she want to work in plastic surg. office, not at the bed side. o.k. , i'm an "old nurse...47 yrs old", but when i went to nursing school in the 80's , we knew we knew we would most likley have to work our way into other areas of nursing after some experience in an acute care facility or some other such place. i hate to sound like i want to eat my young but, a part of me wants to see these new nurses go through the ranks like many of us did. not because i want to see them go through he double thooth picks, but because i feel , taking care of pateints, hands on , learning orginizational skills, pt. asses. , are the best way to learn nursing skills. as a critical care nurse of 27 years, i continue to be amazed at how much i can find out about a pt. during a bath and bed change. we have beds that turn, vents that suction, monitors that alert a critical care team half way across the city, bells, beeps and whistles,,,,what ever happened to good old hands on. i think it is funny that a nursing student thinks if she goes to a plastic surg. office she will only see tummy tucks, face lifts and boob jobs. she's forgetting the big ugly draining wounds , burns, and amputations etc..these office settings see. would love to be a fly on the wall when she takes care of her first pt. with these things and says......"oh my gosh, a plastic surg. takes care of these people too...!" guess i'll go into dermatology.... ha , if you've been around the block you know what awaits her there too. hee heee....but i swear i don't like to eat my young ! :rotfl: :lol2:

are we talking about people who want to go straight to graduate school or people who just don't want to work at the bedside in a hospital?

i support anyone who falls into the later group... why not let them just go to the environment they feel is right for them?

the former group, however, who want to become decision making, order writing clinicians with no previous experience in their environment of choice, do scare me a little.