This has been on my mind for sometime and I wanted to seek the opinion of other "Nurses". I cant speak for previous years so maybe others can. I have been a nurse since 2000 at the beginning of my career I had no idea what the position entailed or actually required. All I knew I was a "Nurse" and when asked what I did for a living. I was given answers of praise and recognition for being one at such an early age, followed by "Wow" you make good money. As years progressed I realized no one really knew what a nurse really did including other nurses and staff members alike. I get annoyed when the term nurse is used for everyone under the sun who is in a uniform or asked if I had to go to college. I feel the role of nurse has evolved so much and has become alot more comprehensive to include many more titles then "Nurse" . We are IT , Case Mangers, Housekeeping, Administrative Assistants, File Clerks, Babysitters, Social workers, Insurance specialist these are just examples and the list can go on forever because I have been continously asked to do things or have just done them for the betterment of a pt or just because.
Which brings me to a second arguement that I have been hearing about. With the recent influx of people attempting to go to Nursing School regardless of the reasons.
Do you approve of schools making the entry requirements as well as degree requirements more difficult?
Do you feel this will make an impact of how nursing is perceived if requirements are more stringent and slows down the pace of nursing graduates?Correct me if I wrong but It seems as if compared to other healthcare degrees nursing is the easiest to obtain.
IMHO, if you complicate nursing edu enough to "cull the herd", there will be no real "sense" to go to nursing unless the autonomy/salary/respect factors increase exponentially. Sure you'll have your few "I am the reincarnation of Mother Theresa"-types out there, but that's about it. Most reasonable folks will dollar-cost average things.
But my dear part of this has already happened.
Where before one was only required to pass a pre-nursing sequence with a minimum GPA, there are now various exams (NLN and so forth) before being admitted, then more exams (TEAS and the like), for retention and even before graduation. All this regardless of how well one is doing in the program.
So in the end you often get the best and brightest graduating, or at least those good at test taking. However it does not follow they will always be good nurses. Or worse, run for the exit doors several months after hire screaming "I didn't go to nursing school for this".
My personal opinion is that patient care experience, or at least a volunteer position in a hospital (or nursing home, home care, etc) should be a pre-requisite for nursing school. I can't even count the number of people who I went to nursing school with that had never set foot in any medical arena other than as a patient or visitor. Most of them failed out or quit the first semester, which is why I can't remember them...
We live in a vastly different world than our mothers and grandmothers.
There was a time when most girls came from a family large enough that they would have helped take care of younger siblings which included diaper changing. Or, to earn pin money you baby sat. Either way by the time one left one's teens you were well aquainted with goo, poo,and spew.
Today many are "only children" or parents hire someone to do the child minding. Either way young girls can easily get through their college years, marry and have children of their own without ever having to deal with, well you know.
Child minding or taking care of elderly family members, not to mention sick room duty is not exactly required for becoming a nurse, but it does prepare you for coping with bodily fluids and odors that aren't your own.
Having been a JV then NA before applying for nursing school, hospital "smells" didn't bother me at all. On our first day of clinicals one of my classmates asked as we left the locker room on our way to the floor "what is that smell?". I had to ask "what smell?", because honestly it didn't bother my nose.
Oh yes, lets not forget those who lost their breakfast on those first clinical mornings when assigned to do "AM Care". Apparently no one told some of the student nurses that a bagel with cream cheese does not always mix well with the sight and smells of an explosive BM first thing in the morning!
I'm curious if there's any stats on new nurses who leave bedside nursing or nursing altogether based on their degree? I'd suspect that more BSNs leave the bedside sooner (within 3 years) since they may have more opportunities and various expectations due to having earned a bachelor's degree. But that may not be the case.
Why are new grads not being able to cope with the duties of a nurse? First of, what exactly do you mean by 'duties of a nurse'? I'm guessing you're referring to acute care, bedside nursing and maybe even LTC and/or home health. Is that the case? Do schools adequately prepare their students for the real-world expectations of new grads in those settings? Instructors assure students that "no one expects a new grad to be fast or know-it-all". That may be true, but the pressure is on pretty fast and hard to pull a full load *ASAP* and there's lots of eye-rolling and sighing "never done what? don't know that?!" as if the newbie *should* be further along.
When what the nursing that schools teach is nothing like what nurses face in reality, is it any wonder new grads are quickly disillusioned? Students are told X, Y, Z are critical components of good nursing care, but find that in reality they can only get X done due to time and resource contraints and prioritizing. When they can't get Y and Z done with any regularity, they conclude that maybe they just aren't cut out for nursing because a good nurse should be able to do X, Y and Z and shouldn't consider their nursing care adequate if they can't do that.
In fact, students would've been failed from nursing school if they had been practicing as if it were the real world.
Anyone who entered nursing school having been or still working as a NA or some other patient care knows this backwards and forwards.
Yes, one *could* stand there and go against one's instructor and say "that's not how we do it at XYZ hospital), but then you probably value your future nursing education (if not life *LOL*) cheaply. Lese majeste is not something many nursing instructors allow to go unchallenged.
In the future I would like to see more states requiring CNA's to at least have a high school diploma. Not requiring this seems silly to me. Nursing staff want to be treated as professionals. Nursing staff begins with nursing assistants and direct care, I can't even believe that they are not required to have a HS diploma. This should be mandatory to enter the CNA course.
Too many hospitals/NH's are cutting nursing support positions. Like Unit Secretaries, nursing managers, dietary staff, activities, etc. I am sorry but when did that become acceptable to have nursing staff answering direct phone lines while doing medication passes for 40 residents?? It seems like facilities that make these cuts, also do a lot of double talk about "quality care"....unfortunately, it is mostly lip service. And that, needs to change, and in the future I hope it does.
Wages will go up as nurses are forced to band together to prevent the current abuses which occur in today's system. While foreign workers can temporarily alleviate some of the pressure to reform the system. They will soon want real wages also. Less and less people want to jump through educational hurdles to do hard labor. Even IT workers that are willing to string cable and repair power boxes in the middle of the night are becoming more difficult to find in this post-Nintendo generation.
Specializes in Acute Care Cardiac, Education, Prof Practice.
I think it is easy to blame nursing schools as the basis for recent turn-over, blame "only children" like myself for not learning at birth how to wipe a bottom, blame ADN's for lowering the standards of care, once again like myself.
I grew up on a farm, as an only child watching animals breed, get sick, and die in front of me, I did everything I could in school to get hands on experience, wiped butts, dressed wounds, watched surgeries, slaved over care plans, logged countless clinical hours. I would say I was prepared for about everything real nursing could throw at me...except for one thing. Co-workers.
What is currently driving me away from the bedside after only four years, are my co-workers. I have never been so put-down for doing my job, sneered at for stocking med carts instead of reading the internet, chastised for getting "stressed out" when my patient goes bad. Ok, perhaps I am too intense at work, perhaps my sense of duty to my patients and to my facility is too strong, or maybe they don't like that I reach to "achieve" my job. I won't say I overachieve, because in nursing I think it is physically impossible to overachieve. I believe it is merely a feat of strength to complete all the tasks assigned and still treat our patients as though they are people, not merely an assembly line of pills and breath sounds.
The future of nursing looks dismal if we don't get an handle on...ourselves. Lateral violence, backbiting, stereotyping and lack of support at work are all nails in the coffin lid of nursing as a profession. We don't act like professionals, we act like spoiled sorority brats at a hazing. And yes, I was in a sorority as well.
I believe the future of nursing will see some dramatic changes,including:
1.A drop in wages(too many nurses)
2. Elimination of the hospital as the main employer of nurses.
3. In addition to the drop in wages,medical assistants and cna's(uap's) being given nursing tasks.
4.Bsn as the requirement for entry level.
I agreed with you right up until number 4. #1 and 4 are hard to imagine happening at the same time. If they did, the market would dry up again...............a true "nursing shortage" would occur and we'd be back to square one with higher wages, only this time with BSN being min. degree required.
I don't see it going that way. I see more nursing duties being shifted to other lower paid departments. Med. Techs. will grow in popularity, secretaries (HUCS) will be hired at low wages to enter orders, CNAs duties/scopes will be expanded to do more care.............the list goes on and on. Eventually, nurses will almost be eliminated. With people holding onto the idea of being a nurse and having no where else to go, they will accept whatever wage. Heck, it could turn into a min. wage job eventually.
Tait, I couldn't agree more. As a nursing instructor who works insane hours trying to ensure my students receive an education that prepares them for real-world nursing, the only thing I refuse to replicate is the cattiness of coworkers and the general disrespect that nurses receive (from family, patients, administration, etc).
By the time they graduate, my students:
-always take a full load of patients
-have learned that we aren't in "NCLEX world" and can prioritize
-have good assessment and technical skills
-can plan care in alignment with reality, not a 40-page care plan
-are respectful
I am tired of seeing everything laid at the feet of education. This is a multifactorial issue. It belongs to all of us.
Managers- if you have created yet another form to fill out, not worked the floor in years, or are disconnected from your staff, you are contributing.
Administrators- if you can't see that $18/hr is not enough pay when you hold someone's life in your hands, and refuse to pay for enough staff, you are contributing.
Educators- if you assign excessive and unreasonable paperwork that is not based in reality, and overwhelm your students with content, you are contributing.
Floor nurses- if you have rolled your eyes, sighed at, or made the "I smell poo" face at a coworker or nursing student, you are contributing. If you've ever acted like someone new should already know something or gossiped about a coworker, you are contributing.
To all of us- if you aren't standing up for yourself and proper treatment, you are contributing.
I personally have made many of these errors as a new nurse and a new educator. I have contributed. Most of us have! The important things is to change for the better. As we know better, we must do better. Stop blaming the problem on one thing or one group of people. It is so many things: low wages, understaffing, lack of time for self, emotional and physical stress, lack of resources, lack of legislative support, coworker mistreatment, etc.
If we spent as much time trying to fix this as we did pointing fingers at everyone but ourselves we might have a solution. What is the future of nursing? I don't know, you tell me. This is a collective decision we all must make.
I think what is attractive about nursing are the many options - inpatient, outpatient, administration, education, speciality area's, public health, clinic, flight nursing, infomatics, school, research, federal agency appointments......
I have practiced in numerous area's/specialities over the past eight years and in three states. I have gained a lot of experience and picked up a Master's Degree and certification along the way.
DoGoodThenGo
4,133 Posts
But my dear part of this has already happened.
Where before one was only required to pass a pre-nursing sequence with a minimum GPA, there are now various exams (NLN and so forth) before being admitted, then more exams (TEAS and the like), for retention and even before graduation. All this regardless of how well one is doing in the program.
So in the end you often get the best and brightest graduating, or at least those good at test taking. However it does not follow they will always be good nurses. Or worse, run for the exit doors several months after hire screaming "I didn't go to nursing school for this".