Whatever happened to going to school to be a nurse?

Kate_Peds · Dec 5, 2016

To be honest, yes, I must admit that I feel I am on the defense. Had I realized that you were an NP, I may have put in a greater effort to ensure that I did not come off as criticizing you personally. I have a lot of respect for nurse practitioners, particularly those with a lot of experience. Veteran NPs have certainly paved the way for the profession.

I do believe that we actually agree. Looking back on your comment, it appears as though you were making the case that universities are appealing to students through the false idea that they can be called a "doctor" if they get the DNP. I, mistakenly, thought you were proposing this idea yourself, separate from your comments regarding universities. Having previously mentioned that I am currently in NP school, I felt like my motives were being questioned.

I do appreciate your input. You've brought many valuable points to the discussion, and again, I am sorry for any misunderstanding. :up:

And there I go again not quoting you. I'm sure I'll figure it out soon enough! :banghead:

NotYourMamasRN · Dec 5, 2016

The acuity of patients and workload expected of nurses has also changed drastically over the last several decades. Bedside nursing is a physically exhausting job in most settings and the trend, even in the single decade I've worked in the hospital, has been towards worsening conditions, not improving.
Rates of burnout and injury are high and to blame this on some imagined difference in generational caliber rather than the tightening of budgets and expectations for productivity by management is absurd. There are also pay caps at most facilities that make spending more than X years there in a staff position a financially detrimental decision, and a notable lack of loyalty to long-term staff from increasingly large corporate conglomerates.
If you still enjoy bedside nursing after many years, more power to you (although I'd point out that PACU is a little different in pace from running a 6 or 7 person med-surg team or being in the ICU- what was it that drove you to make that change- was it a suddenly discovered passion for PACU late in your career or was it the realization that it's nice to not be wrung out every single shift?). I don't think it's anything but admirable that many younger nurses are realizing that 30 or 40 years at the bedside is not necessarily a good decision for their health or happiness, and are making plans to extend their careers without burning out or finding themselves injured and out of a job in their later years.

Exactly! :up:

NotYourMamasRN · Dec 5, 2016

I think everyone should follow the path that suits them. Someone pursuing an advanced degree and not being interested in bedside nursing is just as entitled to do what they wish as someone who wants to be at the bedside. Healthcare has changed dramatically and continues to change. But so has society and the opportunities available to women, which make up the majority of the profession. I applaud everyone who reaches their full potential and does what makes them happy. Bedside nursing doesn't make me happy personally and that is ok. I did not become a nurse as an ends but rather a means to an ends. I always intended to be a nurse for a relatively short period of time because I felt that if I wanted to impact healthcare policy and legislation, I should understand what it means to be on the front line. I have met plenty of nurses who want to be at the bedside. period. They are from all age ranges and backgrounds. I don't look down on them, I just don't have the same interests. It is a slippery slope to knock someone for pursuing their interests but expect that people not look down on your for pursuing yours.

WestCoastSunRN, MSN, CNS · Dec 5, 2016

I came back to nursing after taking eight years off to focus on my kids (what a GIFT that it was an option for me). Prior to that I have 11 years in -- 10 of that in ICUs. I consider myself a nurse's nurse. I love bedside nursing -- I'm so excited to be back at it! I'm also planning on advanced practice in the future.... because I'm one of those weirdos that like school, geek out on pathophys and want to work til I'm old and hunched over.

That said, being back now.... I feel like I stepped out of a time machine. So much has changed -- and yes -- the idea of advanced practice nursing with no previous nursing background is one of those things. But I think it's cool that kids now aspire to things like NP.... really, that is good for all us. But I happen to believe it's a path that should include bedside nursing -- and learning the BASICS of what nursing is. Otherwise, to me, NPs might as well just be PAs. (and not meaning to open the can of worms comparing the two pathways.... that's another thread) I digress...

I will say, I'm glad for the opportunities nurses have these days... but there are flip sides to every coin.

paradoxically7, ADN, CNA, LVN · Dec 5, 2016

Very true. Just finished LVN school in July, passed the NCLEX & so have some of my classmates. I have been a CNA since May 2007 (started at 17). Never thought I'd be a CNA this long, & I see so many "young RNs", 23, 24, 25; I am 27. These young RNs have no idea how to clean up a patient, much less, talk to them! All they seem to know is how to pass medications, hang an IV & call the doctor for a new order or communicate a change of condition. It appalled me when I heard some of my classmates talk about wanting to get into RN quickly obtain their BSN to get into management. Yes- I 100% agree, know bedside nursing, the ins & outs so you can be a well rounded and knowledgeable manager. I am still working as a CNA now, plan to obtain an LVN position and continue to RN, my ultimate goal is to specialize in Wound Care but really don't want to be a manager, ever. I don't want to lose the love I have for the human race. It's a sad thing I have seen time and time again.

ireyes98 · Dec 5, 2016

That characteristic is what makes a good nurse. I feel the money has gotten to the minds of many.

Bxc9999 · Dec 6, 2016

When I was 22, I had my first child. I had no idea how to clean him or talk to him or be a parent. This is a universal phenomenon (shocking!) But guess what? I learned! And that's what these newbie nurses are doing too. And it doesn't take 25 years at the bedside to do it. Or 15...or 10...or even 5. Yes, experience makes you stronger, but so does education, change of pace and most importantly - UNRELENTING DEVOTION. To all the newbie nurses out there wanting to advance their mind - DO IT. DO NOT EVER LISTEN OR TAKE TO HEART ANY OF THESE COMMENTARIES (originating in bittnerness, no doubt) THAT TELL YOU THAT YOU ARE TOO YOUNG OR TOO UNDERDEVELOPED TO EVEN START GOING AFTER YOUR DREAM. Learn it all! Go after it all! Develop a tough skin and show them all how strong your determination is.

anitalaff, BSN, RN · Dec 6, 2016

I've been nursing for 25 years and I've seen the changes over nearly 3 decades. What is different now is that medicine has become part of a corporation. It's not healthcare in the old sense of the word. It's now about staffing numbers and costs and heads in beds. All this translates into management squeezing every last drop they can out of every nurse, bed space and stock item. Nurses are pulled, floated, called off, given a bunch of different admits as patients are constantly moved to a cheaper level of care. Nursing has become extremely hard work. Not that it wasn't before, but it was honest hard work. These days it's just stressful. When I was a young nurse I would come in to work, get an assignment and leave with the same assignment, never floated, had lunch and tea breaks and if the unit was quiet I wouldn't be sent home without pay, I'd help the other nurses. That doesn't happen anymore and so nurses have gotten clued into this and want more autonomy, better working conditions and less stress. It's inevitable that this has happened actually. Administration have created this with their business practices. And me...after 25 years...am in school to be an NP because I have had enough.

Thank you so much for bringing up the changing nature of bedside nursing. It needs to be said. Rather than bringing newer nurses down, let's look at the constructs that have created this situation.

AngelKissed857, BSN, RN · Dec 6, 2016

As a current nursing student, I can tell you that we hear about the need for higher education from day 1. But we are also very much encouraged to look at non-bedside avenues. Things like Discharge Planning, Patient Care Coordinator, Informatics, the list goes on. It may be, to some degree, having just come out of a period where there were more Nurses than jobs, and it's a habit. I don't know, but thought I'd share.

Simonesays, BSN, RN · Dec 6, 2016

Yeah- it's interesting to me that bedside nursing is usually just a temporary objective for a new grad now (in the US). I can think of a few reasons for this:

- Employer emphasis on certifications/further education: This seems to be a combination of Magnet status qualifications and a response to the increasing complexity of many hospitalized patients.

- Economical for employers: if employers can hire NPs instead of MDs, they save money (Maybe this is a controversial way of looking at this phenomenon. I'm open to arguments about this point!)

- Opportunity to earn more money for nurses

- More autonomy- more education= more responsibility= more decision-making potential

- "Normal" working hours. As someone who is currently working a night-shift position, M-F 9-5 sounds kind-of appealing.

- "Better" working conditions: 8-12 med/surg patients?! 3 ICU patients?! When I talk to my colleagues and learn about the ratios at their former hospitals I am shocked. I am used to ratios of 4-6 med/surg patients and 2-3 sdu patients (Canada- I guess large unions have some advantages.) I doubt I would be able to handle these heavy patient loads safely and would likely leave each shift feeling overwhelmed and distressed. I imagine I would be looking for other opportunities.

CeSoirLeCiel, BSN, RN · Dec 6, 2016

I had always wanted to be a beside, hospital nurse. That was my dream.

I slipped 2 discs in my back 1.5 years ago, and after the doctors realized my youth wasn't going to magically make my back good-as-new (although that was everyone's belief for the first few months) and physical therapy only helped to a point, I got some not so subtle hints that I either needed to pick a new major (I haven't even started nursing school yet), or start figuring out my plan to get into a nursing position that won't put so much strain on my back because I won't be able to handle too long as a floor nurse.

Of course I'm looking into less strenuous options that I can pursue with just my BSN, but I have also looked into more advanced degrees and started planning how I'll move from the bedside...all this before I actually started nursing school. I've already talked to a lot of people who plan to become NPs right after graduation, and to a couple instructors who already want to discuss a future as a nursing instructor for me, but I do know plenty of people who are still content to be bedside nurses.

imenid37 · Dec 7, 2016

If bedside nursing was really what Magnet sells it to be then...

MAYBE people would not want to be an APRN or something away from the bedside.

If nurses did help to shape nursing practice of the unit by being allowed to participate in research and be on committees then maybe that might help.

Maybe it would help not to be objects of abuse for unprofessional co-workers and providers.

Maybe being responsible for a reasonable number of patients would do it.

Maybe more money.

Maybe being recognized as a person of value who safeguards patients well-being and their very lives, rather than being micro-managed like a fast food worker would improve things a little.

Maybe career mobility at the unit level would help.

Maybe no 12 hour shifts, but instead generous PTO to enjoy real time off and not be half dead on one's feet after 3 12's.

Maybe 4 eight hour night shifts needs to be full-time.

Maybe no rotating shifts.

Maybe paying nurses extra $ when they must work short. If 5 nurses are needed and 4 are available, split the salary of the 5th nurse between the four... then there is no financial incentive for a facility to cut the staff and increase ratios.

Maybe when a facility must make cuts, they do it at the patient care level as a very last resort (ya know... patient welfare is really treated as being #1.)

Maybe it is time to rethink and restructure nursing.