The Nursing School to Welfare Pipeline

[panurse9999]

I am sure many people have heard of the social issue/ cause "school to prison pipeline" that many civic groups are trying to eradicate. I am here to draw attention to a similar related problem , the college to welfare pipeline.

Due to an intricate , intimate, and covert relationship between big government politicos, higher education, Bureau of Occupational affairs, and the Federal/ State Department of labor, we have a serious student debt problem in the nursing field that is only going to get worse. Nurses need to wake up and take note of the LPN to RN hoax, and the RN-BSN hoax. These are all well publicized , propaganda driven falsities that are crushing nurses into debt driven higher education requirements. These propaganda driven requirements brainwash nurses into believing that without the extra education, they will not be employed.

And to a certain degree, they are correct, but its important for nurses to see the pitfall, before taking the dive. There is little to no difference in responsibility or pay rate from LPN to RN, and most RNs are taking the lower wage, just to have a job. There is zero difference in job responsibility or pay from RN to BSN, but the dollars spent to get there are substantial. The RN to BSN pipeline is a grotesque narrative that is being sung, for the sole purpose of enriching nursing schools. The NCLEX exam is identical for RNs and BSNs, the scope of practice is identical, and so are all the pay rates. A staff nurse is a staff nurse, is a staff nurse, too.

So why go for your BSN? Its because the hospitals and other various 24/ 7 institutional care providers say so. They have all built a united wall against the ADN RN. We are becoming an extinct species, because no one will hire us. Is the BSN a job guarantee? Of course not. Is any higher education a job guarantee? Nope. Big government politicos want student debt to skyrocket , so that they can fly in and save everyone with free bailouts, loan forgiveness, and thousands of more votes on election day.

May the buyer beware, until that utopia comes to fruition. In the meantime, take a serious look inward into the pitfalls, tricks and traps of higher education in the nursing field. The powers that be want you to keep jumping hurdles , spending more and more money, hoping to get hired, and falling deeper and deeper into debt, during the process. The higher you jump, the more you spend, and the less you earn. For many nurses who fell for these schemes, the financial devastation has been both swift and severe.

[Susie2310]

19 hours ago, Workitinurfava said:

They do make it real easy on us by having a task list. All we have to do is follow what is on the list. Everything will drop off the task list if we did things correctly, or so we hope lol. I just thought of the time when I had my psych clinical and I stayed up all night trying to figure out the homework that my teacher gave me. until I got pizzed and rewrote the homework assingment along with answering it. I knew I was taking a chance because I didn't follow the directions. I tried to understand her work, I really did but dang it, it made no sense. Anyhoo, I turned the work in and my teacher said how did you do this? I told her it just came to me and she asked me if she could use it for future students. I agreed and she chucked her old homework assignment. She agreed mine was better. Anyhoo, let me get back to focusing on the task list. I just need for things to fall off the list. One task at a time, lol. I won't ask any questions.

All you have to do is follow the task list? How does using critical thinking fit in with following the task list? How do you prioritize patient care when you are following the task list? What kind of activities are on the task list? What happens if you don't follow the task list and use critical thinking and set other priorities for patient care?

[HomeBound]

On 5/19/2019 at 4:52 PM, OUxPhys said:

Just curious what was your previous career?

? Aaaaaaaand.....if I actually revealed that here.....it's a target on my back, because I already say far too much about things that could pinpoint who I am and where I work.

Suffice it to say....my original training was a 2 year degree. No requirement---EVER---to go higher---and there were (and are) no barriers that would keep me from advancing into administration if I chose. It's a merit based system. Not some nebulous...like OP says..."moving the goalposts to the right" each time you check one of their very very expensive boxes.

I produce? I advance. It's hard evidence whether I can or cannot. There is no "opinion" about the "quality" of my ability. I don't have to justify my existence by reading 15 scholarly articles per year, attend 2 conferences on my dime, perform unit based projects on my time, etc ad nauseam and ad infinitum just to keep my piddling floor job.

Oh...what cracks me up is that when you do those unit based projects and papers? Those automatically become the property of the hospital in which you work. They get to use your hard work and take credit for it. You do get a "by line" and an "atta boy!"....but the hospital is the one that benefits. Not you.

My other job....I come in....punch a clock. I do my work. I work 8s or 10s. I did get my BS but it was for MY benefit, not theirs...and even if I didn't have it? I would still be highly paid for what I do. I leave at the end of my shift. Period. I have my weekends off unless I want a job that I work them. I don't take call.

I don't put up with abusive patients, families or co-workers. I am not required to certify out the ying yang, paying for those worthless certifications and then paying any money I might save during the year to renew those worthless certifications.

Oh. I forgot. You get the "satisfaction" of being certified. MMMhmmm...my CCRN gives me so much "satisfaction" when I write the renewal check to the AACN. It gets me nothing. What it does do, however...is put a little tiny symbol over the nurse's badge that give them the "feeling" of being superior. Because I passed a test.

What kind of nurse am I? Dunno. But I passed the CCRN once! Must make me a great one.

Does that CCRN prevent administration from abusing me? Nope. Does it prevent patients from threatening to kill me and then admin doing nothing because we dont' want to offend them? Nope.

I can tell you....one time....about 22 years ago....one of my colleagues was thrown against a wall by a patient in my other job. The reason I remember this?

It was so rare...it literally caused a s#itstorm in that department. That patient was cuffed and hauled the hell-o out of there. And he was never, ever allowed back into that department. He needed that service? There's another hospital down the road, jack. Go.

I don't even tell anyone in my other profession I'm a nurse. Know why? Because it makes no difference. My other job relies on hard skill as well as bedside manner---and if I bounce someone out because of their abuse? I don't get canned. My skill eclipses this RUBBISH that it's all about catering to abusive and entitled patients.

The colleague thing....my job title has a tight reign on how many people can be certified to do it. Where there are what....5 million or so nurses? There are only 400K of my other profession. We're skilled and we can demand respect and good working conditions.

Nursing is a skill---in some ways. In others....it's all about who you know. I prefer not to have my livelihood determined by the whims of people who see nothing wrong with firing me over my "overuse" of glucostrips.

[Workitinurfava, BSN, RN]

1 hour ago, Susie2310 said:

All you have to do is follow the task list? How does using critical thinking fit in with following the task list? How do you prioritize patient care when you are following the task list? What kind of activities are on the task list? What happens if you don't follow the task list and use critical thinking and set other priorities for patient care?

I was not being serious...

[HomeBound]

On 5/19/2019 at 4:55 PM, OUxPhys said:

Im just curious....in another post you are praising the VA and all the stuff you have to do but now you are saying its a racket? I am confused.

I never said that the VA is a racket. Be precise.

I said NURSING is a racket.

I loved working at the VA. I would have preferred as NOT a nurse. The VA is an entity---it's not just a collection of nurses. It's a concept and it works. The way that the VA treats their employees is how every single employer should. The protections there are the best in the country. The benefits are the best in the country.

[osceteacher]

11 hours ago, Susie2310 said:

Did I read this correctly: You are saying that the UK government has given unlicensed caregivers - healthcare assistants - the role/responsibilities of RN's: assessing, planning, intervening, and evaluating care of patients? Healthcare assistants are giving medications and doing clinical procedures/treatments? Healthcare assistants are doing the same job as RN's without RN education/training/licensure?

They have a 2 year on the job training and are put on a register different from nurses, they have limitations such as no IV drugs but yes, they're basically upskilled HCAs doing the nurses role. Don't get me wrong, they're very competent and are given a fair amount of training but its a way for the government to pretend we have good staffing levels.

Basically they made it too hard for some people to be nurses so they had numbers dropped and then introduced this to cover their orifices.

They're supposed to be nurses-lite but you can guarantee that won't be the case in the years to come.

We had this in the 80s with the Tories and enrolled nurses.

[LC0929, ASN, RN, EMT-B]

On 5/20/2019 at 6:07 AM, panurse9999 said:

I was hoping to have it shared hundreds of times to social media,

....I wish I could “like” this entire post a million times....as I sit here, week #8, post-op.....second rotator cuff surgery......astonishingly enough, from an injury received, NOT during my career as a firefighter, but during my nursing career.....for which my long term prognosis, for regaining the use of my of my arm for anything more than wiping my own ***, putting on a bra and simple household tasks, is fair at best....with nothing but time to consider my career options....I am fairly sure that I’ll be moving on in a very different direction......maybe Marine Biologist.....I’m on the Cape, I’ve always loved sharks....actually have been “in the cage” and they are amazing.....not only that, when you are around sharks, at least you KNOW and are GUARANTEED that they want to eat you if they are given the opportunity....no guess work.... ?

[brandy1017, ASN, RN]

17 hours ago, Susie2310 said:

All you have to do is follow the task list? How does using critical thinking fit in with following the task list? How do you prioritize patient care when you are following the task list? What kind of activities are on the task list? What happens if you don't follow the task list and use critical thinking set other priorities for patient care?

I thought she was talking about the computer micromanagement. Epic for example gives you a list of tasks etc plus constantly flashes pop ups asking you all sorts of questions, some really up to the doctor. It is annoying to try to chart and have it constantly pop up questions you have to answer in order to finish passing your meds and save your charting.

[panurse9999]

2 minutes ago, brandy1017 said:

I thought she was talking about the computer micromanagement. Epic for example gives you a list of tasks etc plus constantly flashes pop ups asking you all sorts of questions, some really up to the doctor. It is annoying to try to chart and have it constantly pop up questions you have to answer in order to finish passing your meds and save your charting.

same with pointclick care. Its a beast, and is constantly displaying pop up box, after pop up box, after box, after box, after box. You cannot go to the next screen, until each box is checked. These computer based charting programs were creating to turn nurses into billers, so as to maximize the reimbursement the facility will receive.

I will repeat the remark I posted earlier. Each patient has on average 100 check boxes per 8 hour shift. times 6 pateints = 600 check marks. divide by 8 hrs, 75 tasks per hour you check off that you did do, which is greater than 1 per minute. See how easy that was? And I do not even have that darn BSN that is supposed to help me be a critical thinker! ???

[Oldmahubbard]

The check box charting eventually forces you to chart things you didn't do, couldn't possibly do, and sometimes shouldn't even do.

[panurse9999]

3 minutes ago, Oldmahubbard said:

The check box charting eventually forces you to chart things you didn't do, couldn't possibly do, and sometimes shouldn't even do.

This is why so many nurses job hop, hoping to find an employer that not does force them to commit the crime of fraud, or use a system of charting that commits the fraud, with the nurse signing off on it.

I remember the old days of paper charting , where we were allowed to chart what we did, and allowed to have time at the bedside as well. We were allowed to be nurses. Today, we are nurses, billers, secretaries, and aides.

[JKL33]

On 5/20/2019 at 6:39 PM, LilPeanut said:

Arguably, the BSN isn't about improving clinical skills. It's about developing more critical thinking skills, learning more about the theory behind what we do and making you better about to think about interventions and complications. It's to make you a better thinker, a better evaluator of research, a better teacher, deeper understanding into the pathophys, how to apply research.

It was harped into me in school that monkeys can be trained to do skills. Skills are not what make a nurse. The brain behind the skills is what makes a nurse a nurse.

Your description of what you believe BSN instruction is about is probably a fair goal of what a BSN should provide for someone with no/little experience (even then your description may be generous compared to the reality of what the instruction is). As for experienced people, the idea that critical thinking, improved thinking about interventions and complications and an actual deeper understanding of patho (or any of the Ps) is due specifically to BSN instruction is either funny or slightly insulting. I'll grant you the part about helping understand basic aspects of research, but other than that all of these (completion) programs (especially) are not enhancing the actual care-related critical thinking of any experienced person anywhere.

The BSN is an opportunity for instruction along the lines you describe (quoted above) but because we are seemingly desperate to distinguish ourselves, the BSN portion doesn't actually focus on those things but rather on other topics that have much more to do with the bidding of corporations than the care of sick patients. It's almost as if the actual care of sick patients is for someone other than a BSN-prepared nurse, and so if we are going to use critical thinking at the BSN level, it has to be about something other than patient care.

Clinical skills = putting one's own critical thinking into action at the point of care.

We seem to have lost sight of the fact that, in the RN role, if you can't appropriately "do" then by definition you can't appropriately apply critical thinking, and if you don't have a working knowledge of how your critical thinking is going to work out in reality, then your critical thinking is less useful.

BSN programs seem quite desperate to distinguish the BSN role as being more than skills. Where they have gone wrong is to also wholeheartedly believe that without a BSN, a nurse is only doing tasks, and also that with a BSN, you should expect to not have to use many "skills" because the BSN is more than that. Those conclusions are incorrect; none of this is mutually-exclusive and thus shouldn't be presented as such in our educational processes. If we are talking about BSNs being desired at the bedside, they should be the experts at integrating patient care skills with the care-related critical thinking needed to provide expert bedside nursing care.

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It was harped into me in school that monkeys can be trained to do skills. Skills are not what make a nurse. The brain behind the skills is what makes a nurse a nurse.

This is one of those things that lots of people like to say because they feel good about appearing to distinguish themselves in doing so, but my theory is they feel comfortable pretending this is true because they haven't been hanging around watching and dealing with the havoc of people who actually did not learn what monkeys can supposedly learn, and they aren't in a position to have to answer for it. They also aren't usually in positions where they would have to step up and show that they can actually do what they say monkeys can do. People who say this also sound pretty dismissive of those who consistently respond with honed/refined skills that are appropriately applied in ways that matter to patients, and who are good at this process even when things aren't cookie cutter (which involves critical thinking and problem-solving).

Clinical skills or being clinically skilled represents the integration of knowledge, thought and action at the point of care.

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When I go out on transport for a sick baby, often I do very little in the skills department, I'm there to think about how to treat the patient, then delegate that out as appropriate. I don't know how to set up the ventilator tubing on the transport isolette - the RN does. But the RN doesn't always understand why I am choosing one method of ventilation over another, why I'm deciding on certain vent settings or alternate methods of treating the disease.

You are describing a provider role, which is something other than what the BSN prepares bedside nurses for. In order to apply your example to this discussion, you must ask yourself whether it is important for an RN to be able to appropriately set up a vent based on your orders, and whether it is important that they also be able to assess the situation appropriately to even evaluate the treatment being given or the patient's condition and response. If they can't set up the vent properly or can't assess the patient or can't draw correct conclusions and act upon them, then ??‍♂️. These are "clinical skills" and that is not less true just because providing peri-care might also be called a "clinical skill."

[kbrn2002, ADN, RN]

1 hour ago, panurse9999 said:

same with pointclick care. Its a beast, and is constantly displaying pop up box, after pop up box, after box, after box, after box. You cannot go to the next screen, until each box is checked. These computer based charting programs were creating to turn nurses into billers, so as to maximize the reimbursement the facility will receive.

I will repeat the remark I posted earlier. Each patient has on average 100 check boxes per 8 hour shift. times 6 pateints = 600 check marks. divide by 8 hrs, 75 tasks per hour you check off that you did do, which is greater than 1 per minute. See how easy that was? And I do not even have that darn BSN that is supposed to help me be a critical thinker! ???

We use PCC as well and while it's probably no worse than any other charting software out there I agree it's pretty horrible. Switch to EMARS/ETARS they said, it's more streamlined and will save time they said. Yeah, right. I have been around long enough to have used the paper MARS/TARS and it took way less time to initial every box on every page of a huge book than it does to sit and do that incessant clicking! Many of those unnecessary pop-up secondary charting boxes can be eliminated by the way by editing the order.