Taking nursing care away from nurses. . .

[thesundowner]

I feel like the longer I am a nurse, the LESS nursing care I provide and the more I have to focus on just meds and charting. I feel like I am losing skills and not getting a chance to learn new skills.

For example, where I work nurses do not draw blood, change PICC/central line dressings (PICC team does them), do many dressing changes (either mist therapy does them or on trauma pts the trauma PA), accuchecks (the nurse tech does them), even start IVs and do ostomy care (wound nurse)

And they just keep piling the charting on, so all I do is assess, chart and give meds on more and more patients.

I work with some nurses from other countries who are so skilled - in their countries they did EVERYTHING and just seem so knowledgeable. I mean, I work with nurses who delivered babies in their countries (I don't want to do THAT, but you know what I mean)

Do you feel like our job is turning into an administrative position??

I would LOVE to learn more skills - when I have time, I assist with all procedures but rarely do I have time.

Sometimes I wish I worked at a rural facility without many resources just so I could learn more skills.

[PennyWise]

I agree the paperwork is becoming more and more of a full time job rather than something we "do on the side".

On the other hand though, at least where I am at, the bedside care is still an expectation. I have not been relieved of any direct patient care duties. Blood draws, dressing changes (including PICC and Central Lines) and everything else is still mine to do.

I once felt as you do, that I was being pulled away from "nursing". Between there being three forms to complete for every patient who farts and medication passes getting so that they can dominate your entire day (for various reasons), who has time for "nursing"?

Then I realized, I will be written up for missing a dressing change as quickly as for not having a detailed enough "possessions on admission" form. Not that I disagree with the dressing change being important, but I am often put into a situation in which I have to choose between quality care or quantity centered care (the one that gets everything done, barely).

So, in the end, I guess I'd say I don't feel as though nursing is being taken from me. Just the choice of being a good nurse is.

[dudette10, MSN, RN]

If you feel that nursing is nothing more than a list of skills, then you will feel limited in a facility that has others do all those skills.

But, yes, the mountain of paperwork is a pain in the butt.

BTW, I work with some nurses (not all, but a couple, especially), who love to compare their education to mine. Doing all nursing care, delivering babies, etc. Then, they came to this country not too long after graduation and...have the same scope of practice that I have. Funny how that works.

ETA...my first sentence wasn't meant as an insult. It was to help you see that nursing can and should be more than just a list of skills. :)

[thesundowner]

I know, but all of those skills are ways to interact with the patient - to talk with them, educate, even assess. I feel left out of the loop, no one tells the nurse anything unless there is a form to be signed.

[OCNRN63, RN]

if you feel that nursing is nothing more than a list of skills, then you will feel limited in a facility that has others do all those skills.

but, yes, the mountain of paperwork is a pain in the butt.

btw, i work with some nurses (not all, but a couple, especially), who love to compare their education to mine. doing all nursing care, delivering babies, etc. then, they came to this country not too long after graduation and...have the same scope of practice that i have. funny how that works.

eta...my first sentence wasn't meant as an insult. it was to help you see that nursing can and should be more than just a list of skills. :)

maybe. but if you're really sick and in the hospital, who do you want to take care of you? the person who sees nursing as more than a list of skills, or the person who actually has the skills? i know for sure who i want.

[BlueDevil,DNP, DNP, RN]

So, in the end, I guess I'd say I don't feel as though nursing is being taken from me. Just the choice of being a good nurse is.

I agree with this, and I think it is the reason I finally left the bedside after 20 years. I still feel it to a lessor degree because there is a lot of pressure to see more patients and see them faster, get those RYUs up! However, while there is pressure, in the end it is up to me and I have complete control over whom I see and how I do my job. Right now, I am more patient focused and my charting is the bare minimum. This will last until I get sued I suppose, lol.

[dudette10, MSN, RN]

maybe. but if you're really sick and in the hospital, who do you want to take care of you? the person who sees nursing as more than a list of skills, or the person who actually has the skills? i know for sure who i want.

i think you misunderstood me. i used the word skills; knowledge is different.

[WittySarcasm, BSN]

I work at a LTC where the RNs mostly do all of the paperwork. :/ I can't tell you how HAPPY I am when I'm on a med cart. Because otherwise I end up just spending forever doing really blah work.

[WittySarcasm, BSN]

I know, but all of those skills are ways to interact with the patient - to talk with them, educate, even assess. I feel left out of the loop, no one tells the nurse anything unless there is a form to be signed.

SO TRUE! I swear my crew sometimes doesn't tell me until the end of the shift, then I feel stupid telling the next shift in report about a problem and when asked what the solution was going 'ehhhh...'