Whatever happened to going to school to be a nurse?

Cob94 · Dec 2, 2016

I'm proud to be a nurse, just a nurse. My career goal at this point is retirement! I love caring for people hands on. I'd go nuts if it were any other way!

kakamegamama · Dec 2, 2016

I'm proud to be a nurse, just a nurse. My career goal at this point is retirement! I love caring for people hands on. I'd go nuts if it were any other way!

Just a nurse? You are more than "just" a nurse. You give when others quit. You comfort when no one else can. You push yourself when your body says "you've got to be kidding me!". You usher people into this world, you hold their hand when they leave. You chase doctors down in order to get that order signed. You advocate for people that sometimes you'd probably rather just leave you along. You do so much more than be "just a nurse".

Thanks to all of the bedside nurses. You are my front line of defense against errors, against infection, against neglect. You are the ones who watch over my loved ones when I can't be there, even when you're busier than a betsy bug.

I miss the bedside. I'm still directly involved in patient care as a mid-level provider, but I do miss the bedside.

Sometimes, it is nice to have an advanced degree. I got mine with the premise that should something happen to my husband (the primary provider for the family), I would prefer doing something that would not keep me at the bedside nights/weekends/holidays so that I could have more time with my kids. Thankfully, that wasn't necessary until our youngest was a junior in high school. My advanced degree had already helped me obtain a job that wasn't at the bedside, and allowed me to give her the attention she needed during this most difficult time of both of our lives.

emmy27 · Dec 2, 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.

RNNPICU, BSN, RN · Dec 2, 2016

I also think that there are so many more opportunities beside working at the bedside, there are mission trips, education roles, leadership roles, the field is expanding because the education and insight a nurse has. With a degree in nursing you don't only have to work in a hospital setting, which years ago may have only been the only option, now there are lots of options. Working in direct patient care is also now becoming more and more difficult. One has to worry about patient satisfaction scores and nursing sensitive indicators, plus much more

PrimeRib · Dec 2, 2016

Bedside nursing can be hard work, there's no two ways around that fact. I continue to be amazed by seeing nurses 25+ years my senior who can run circles around many of the younger staff, staying for doubles or coming in early, picking up extra shifts, etc. Working at a large academic medical center, I have certainly observed that a good majority of the young(er) nursing staff have some intention of eventually moving away from the direct bedside, whether it's to advanced practice or more administrative roles. Of course, I don't know either what is directly responsible for that trend, and whether it's necessarily a good or bad thing.

A cynic could well surmise that a portion of the younger generations just don't know how to work (physically) hard anymore, at least not like their parents or grandparents. If this is true, it really is sad, and I'm not excluding myself from that demographic. I've always put forth a good effort academically and of course always do my best at work, but sometimes it seems like the physical and emotional requirement in bedside nursing in terms of picking up extra shifts to really get ahead financially outweighs the cash. Sometimes it feels like there has to be a better way, but the grass is always greener on the other side (advanced practice nursing or administration), and that just may be the soft

I do think that advanced practice nursing has become a lot more visible in the public eye, to the point where now kids are saying that they want to be nurse practitioners or nurse anesthetists when they grow up, I don't know if this was really the case even 20 years ago. Nursing has become a more academic profession, and you do see many academically inclined people joining our ranks. The fact is that bedside nursing is not always necessarily very intellectually stimulating. Even in the ICU, where nurses do their best to think on a physiologic level with regard to all of their drips and interventions, it can be hard to feel intellectually challenged when you're giving a bath or cleaning up code browns for an entire shift. I do enjoy my job and feel very thankful to have it, but I can't really imagine staying in this particular role for another 30+ years.

Kate_Peds · Dec 2, 2016

Well, I think it has to do with many factors.

I agree with a previous poster that stated nursing schools are pushing advanced degrees more aggressively than ever before. This is to be expected, as many newer generation RNs are obtaining a BSN as opposed to an ADN. Keep in mind, in order to teach higher education classes, you must possess one degree higher than the degree you are teaching. This means that many of the instructors in today's BSN programs are advanced practice nurses already. I think I had one instructor who still worked at the bedside. She had an MSN but was not a practitioner. She was my favorite and an absolute gem!

I do remember sitting in class and being told repeatedly, "When you go back for your master's..." It was almost expected, and I must say, having enrolled in a graduate program this early on in my career, the constant push for higher education worked on me and many of my fellow classmates.

I also think we need to take a look at how nursing has evolved. Hospital nursing used to be an 8 hour/day job. You could wake up, take your kids to school, go to work, and come back in time to catch the second half of their softball game. Now the only jobs with these hours are clinic jobs. So, you can seek out a competitive clinic job as an RN and take a major pay cut, or you can work at that same clinic as an NP and take a huge pay increase. I have to say, this is a major motivation for me. I want to start a family soon, but 12 hour night shifts have put a halt on my desire to do so at this time.

Another poster mentioned the stability and pay associated with nursing. While stability has almost always been true of our profession, the pay has been average until the introduction of these graduate degrees. I understand the awkward place that many veteran nurses feel our profession is in. It should be about caring for others, promoting health, and improving outcomes. That's not something you get rich doing! At the same time, I feel that nursing is entitled to advance. We are deserving of the ability to obtain these advanced degrees if we put in the hard work. We are capable of developing as a profession. Hardly anyone cared when PT and OT decided to move to the doctorate level...but nursing? Oh no, you silly women sit down. You're just the "doctor's assistant." All sarcasm aside, I think the profession as a whole is shifting, and it must be careful to foster new opportunities for the future while also not alienating the very much needed bedside nurse.

It's very important the bedside nurses are valued because, like many of you, I have seen several of my fellow young colleagues say "I cannot imagine doing this forever." Even as I work on my own graduate degree I feel myself counting down the days, and it's sad. I thought I would love bedside nursing. I don't think it has to do with the patient base for me, as I love my patients. If I had to consider what it was for me, it would have to be this:

From day one, they told me that my BSN was the first step and that I was going to have all of these career possibilities because of it-- whether it be practitioner, research, or administration. When they advertised the program to me they made sure to mention the countless graduate degrees that they offered after completing the BSN. Almost every single instructor that I looked up to and aspired to be like was a practitioner. They sold me on the idea of being an APRN, not a bedside nurse. So when they send us out into the world and we are actually working at the bedside, I must admit, it's a bit difficult to sustain without the desire to advance. You find yourself saying, "this is it?" Because what you were sold on was so different than what you end up doing.

I'm telling you, from my own experience, this shift is beginning in some of the BSN programs. They are competing with local ADN programs (time, money, etc.) and so a significant portion of their appeal is focused on what the BSN can give you that an ADN can't. That is, transition from the bedside and everything that comes with it. The magnet status and "recommendations" from various boards simply encourage this by fueling the fire. Is it a good thing? It's hard to say. I don't believe we have seen the full effect yet.

Not every BSN program is like this, but of the few in my area (I had friends at nearly all of them) it seems to be the case.

SaltySarcasticSally, LPN, RN · Dec 2, 2016

Many people went into nursing after the recession hit. In 2008 I was in LPN school, half of the students were former auto line workers that were laid off. Going from $35/hr in a union job to $23/hr that is physically demanding was a rude awakening for them. I suspect that is the case for even those seeking job security in a field they knew little about. The thing is, nursing does not have to be a "calling" but at the end of the day, I do believe you have to love it otherwise you will be miserable in direct care. I have little desire to get away from bedside care, it is why I chose nursing but if I didn't love it, there is no way I could keep my head and heart in it long term. Plus we really aren't paid all that great, I'm shocked at the amount of people in my bridge program who think they will start out at $30 something an hour in a hospital. More like $23/hr in my area, that's a big gap.

JenTheSchoolRN, BSN, RN · Dec 2, 2016

I was actually in school in a Direct Entry program to be a NP because that was where health care was heading, I was told (I was naive). I ended up getting a job in school nursing after passing my NCLEX and pulled myself out of the NP portion of the program, graduating with my BSN. And I don't regret the choice. I love my job. I love taking care of the kids and seeing them grow. I also teach health, so if I go back to school, it may be for my Masters in Public Health or Teaching, but it won't really change my job. May not be hospital bedside, but it is hands on care.

Of course, I entered nursing school with a goal to work in the community in preventive health care and chronic disease management. I thought I wanted to work with the aging population, but like I said, fell in with the kids and haven't looked bad. I can't imagine doing anything else.

indish · Dec 2, 2016

Emmy 27. I would argue patient ratios have gone down over thirty years, where on medsurg I had six on evening shift and ten on nights, the last med sure unit I was on was four on days/evenings and max six nights. Acuity also has gone up in that you can't be admitted for "general mailais anymore, or admitted the night before surgery for prepping and teaching or stay as long. But nursing has always been physically hard, emotionally draining and plain old hard work. I change up where I work about every ten years, specialty wise. PACU was always on my want to do list and after just working a ten hour shift with one twenty minute break because of all the emergent add ons I would disagree that it is

easier than the floor. It's different, but just as stressful and I've been there about a year and a half so not long enough to get a un realistic view.

I agree that longevity is not something appreciated by the big business of healthcare, if anything it's almost a liability. I don't believe I blamed it on generational caliber. I just asked the question, why are people not satisfied to be nurses? Expierence at the bedside can be the difference in life or death in some situations, but it seems to just be a launch pad to something else. My point was thirty years ago going to nursing school was to be a nurse and take care of sick people. Now it's a career path

CrunchRN, ADN, RN · Dec 2, 2016

This all makes me wonder who will care for all of us 50+ year old nurses when we retire and start to need care ourselves. I don't see all these Masters and higher level education nurses doing bedside care. It seems the younger nurses will get out of bedside care ASAP so who will that leave? Maybe they will have a huge shortage and have to improve pay and conditions for the bedside nurses. Wouldn't that be nice.

indish · Dec 2, 2016

Crunch RN. Right, that's why I asked the question, so what happened to nursing that people don't want to do it? I often felt "just leave us alone and let us do what we know how to do without adding all this other crap". I think a lot of good points have been made about what is wrong with nursing, but I don't think it will change. I also think it's interesting that we have never been united as nurses as a former critical care nurse who went to a medsurg unit I expierenced critical care nurse egos that felt they were superior to us on the floor as well as ER and cath lab etc. why do we do this? Why don't we truly respect everyone's contribution to the care of patients?u

DeeAngel · Dec 2, 2016

My last job all the day charge RNs (BSN only) on a super busy 48 bed med surg floor would all have less than one year experience working as a new nurse. All the older nurses with 25, 30, 40 years working experience left for other things. This is actually the way the hospital wanted things, at least that's what I believe since no effort was made to remedy the situation.