What Do You Think? Can You Be A Nurse If You Can't Do Bedside Care?

[Kooky Korky, BSN, RN]

Should a student have to be able to do direct care in order to become licensed as an RN?

Must an RN be able to give direct care in order to stay licensed?

This topic came up in a discussion at work recently when one of our techs was involved in an accident that left her unable to give hands-on care.

I think that a person who can learn what a nurse needs to learn (chemistry, anatomy, physiology, biology, etc.) and can pass the exams, there is no reason this person can't be licensed as an RN.

Feasible work would include teaching, doing the questioning part of Admissions, maybe other tasks.

What do you think? What are some other tasks this type of RN could perform?

[applewhitern, BSN, RN]

I can tell you that when I do hands-on care myself, I see things about the patient that I wouldn't have otherwise known about. Skin issues, mobility issues, etc. As far as teaching goes, I personally would want an instructor who has actually done hands-on tasks with many patients. If I have one that doesn't ever touch a patient, I might as well just read the books.

[Sour Lemon]

Nursing schools have physical capability requirements, so that would be the first hurdle. And if there were a way around that, I say it would still be a poor investment. Hands on care is basic nursing care. It would be difficult to skip over the basics and somehow be qualified for anything else.

[KatieMI, BSN, MSN, RN]

I went to undergrad with one guy who couldn't lift anything above 5 lbs. and a few more who couldn't do some parts of "traditional bedside care". All these people found their niches after a while. Later on, I met an amazing nurse navigator (blind and using guide dog), a nurse educator specifically made for this trade by God (wheelchair and Flolan pump) and quite a few of talented nursing IT specialists who never worked bedside due to physical disabilities.

IMHO, to name or not someone who never struggled bedside care "a nurse" is a technicality. If one graduated ftom nursing school, he/she is a nurse. What and why this person is going to do with it is nobody's business.

[Jedrnurse, BSN, RN]

I don't feel thrilled about the idea of someone who can't do a lot of the job going directly into teaching others how to do it, if this is part of what you meant. I would consider these people "direct entry" nurse educators, not the same as those who have work experience but can no longer perform some of the duties for various reasons...

[Kooky Korky, BSN, RN]

KatieMI said:

I went to undergrad with one guy who couldn't lift anything above 5 lbs. and a few more who couldn't do some parts of "traditional bedside care". All these people found their niches after a while. Later on, I met an amazing nurse navigator (blind and using guide dog), a nurse educator specifically made for this trade by God (wheelchair and Flolan pump) and quite a few of talented nursing IT specialists who never worked bedside due to physical disabilities.

IMHO, to name or not someone who never struggled bedside care "a nurse" is a technicality. If one graduated ftom nursing school, he/she is a nurse. What and why this person is going to do with it is nobody's business.

You give me hope for the future of the person I'm writing about.

What is a nurse navigator?

What is a Flolan pump?

Thanks!

[Kooky Korky, BSN, RN]

Jedrnurse said:

I don't feel thrilled about the idea of someone who can't do a lot of the job going directly into teaching others how to do it, if this is part of what you meant. I would consider these people "direct entry" nurse educators, not the same as those who have work experience but can no longer perform some of the duties for various reasons...

I guess the person who has never done bedside care would not be teaching skills. I agree, that would not be a good idea.

But he could teach theory/lecture. Or History of Nursing/Fundamentals/Introduction to Nursing or other subject he has mastered.

Also, I envision the person would observe in the clinical arena, so would have at least some knowledge of that setting. It wouldn't be the same as actually doing the hands-on care but would be at least some exposure to actually doing it.

[dishes, BSN, RN]

There are a number of nursing specialties that don't require hands on care such as; infectious disease, case management, public health, quality improvement, telephone triage. Suggest your colleague look up the requirements for the individual specialties, many do require previous bedside experience but some employers will make exceptions for employees with a disability.

Also suggest your colleague speak too an academic adviser as they can advise them if it is possible to complete a nursing program without hands on clinical experience, if not, they can advise them of suitable education programs.

The website exceptional nurse com might be a good resource for a potential nursing student with a disability. The more knowledge they have about navigating their career path with a disability the better, as they are likely to encounter attitudinal barriers and people who will try to dissuade them.

[elkpark]

Nursing licensure in every state requires having completed a program of nursing education that includes a defined number of hours of supervised clinical practice. Being licensed as an RN involves being legally accountable for a basic set of nursing knowledge and skills. Of course there are individual nursing positions that don't involve performing any bedside care. But I would hate to see us start letting through school and licensing people who are incapable of basic nursing practice and skills. There is a huge difference between "observing" and actually functioning in clinical.

Does "unable to give hands-on care" involve things like CPR? How many healthcare employers would be willing to employ someone who can't get certified in CPR and provide CPR in an emergency? Every nursing job I've ever had, including teaching and surveying jobs, had a job description that required I maintain current CPR certification as a basic requirement of the job.

[KatieMI, BSN, MSN, RN]

Kooky Korky said:

You give me hope for the future of the person I'm writing about.

What is a nurse navigator?

What is a Flolan pump?

Thanks!

Nurse Navigator is a type of personalized case manager. Navigators help patients who face long and complicated treatments (in this case, breast cancer) to learn where to get particular care they needed, how to get into clinical trials and big teaching hospitals, what can and cannot be done for them, how to manage multiple appointments and conflicting opinions, etc. The job requires extensive knowledge of the system of care. The nurse in question never worked bedside; she was doing cancer case management and some rad/onc specific wound care and got her Masters before she went blind. She is absolutely awesome, the heart and soul of local breast cancer program.

Flolan (prostacyclin, epoprostenol) is a medication used for treatment of severe pulmonary hypertension. It has t 1/2 of less than 2 min and so has to be given constantly through permanently inserted central line. The device used for this is named Flolan pump and looks like a small, funny-looking backpack. Most of patients who use it are also tied up to supplemental O2, frequently high-flow. Despite all that, some of them continue to work and have interesting lives. The nurse I talked about travels nation-wide to teach and give speeches about multiple topics (awareness of CHF, dangers of smoking, acceptance of transplant donors among minorities). I so hope that she already received her Gift of Life!

[Meriwhen, ASN, BSN, MSN, RN]

KatieMI said:

IMHO, to name or not someone who never struggled bedside care "a nurse" is a technicality. If one graduated ftom nursing school, he/she is a nurse. What and why this person is going to do with it is nobody's business.

This.

Couldn't have said it better myself.

[Ruas61, BSN, RN]

Kooky Korky said:

Should a student have to be able to do direct care in order to become licensed as an RN?

Yes, it is part of the schooling process for the 'nurse'. They should be able to do it in order to pass and thus be eligible to test. It's a standard in the course of nursing education for basic entry at this time.

Kooky Korky said:

Must an RN be able to give direct care in order to stay licensed?

No, I don't believe it is necessary. There are many avenues in nursing employment that do not require direct care. I work at an insurance review nurse. My job doesn't even involve direct member contact. I did many years of strictly administrative MDS nursing, in those positions the most hands on care I did was some mobility or simple feeding tasks with the most strenuous being CPR. Of course, I had years of experience in both acute and sub-acute along with LTC experience before I got into those jobs.

Is someone can pass the schooling and the exams to become licensed and there is an employer, why not?

However, it might not work out so well in some venues like acute settings.