Whatever happened to going to school to be a nurse?

BeenThere2012, ASN, RN · Dec 3, 2016

I think at some point this is true. When I was at school the clinical instructors put more emphasis of the academics. Encouraged us to take courses for masters in RN after graduating from nursing school. Then I observed, that they are not proficient in bedside care and oftentimes their idea is more of theoretical or based on books and does not know how to adjust their nursing care base on the actual situation with the patient's present condition. Then they bragged that they will have their MN, MAN or PhD in nursing soon. But duh, your masters diploma/credential will not save a patient life if you do not know how to insert an IV to a patient in case of emergency because you have not master the necessary basic bedside nursing skills per se ;-)

Yep! Theory and practice are 2 different things. I can do all that is required and theoretically best to do for a given patient, but not 6 in one shift. You end up learning to prioritize, prioritize and re-prioritize until by the end of the shift, you actually accomplished about one sixteenth of what ideal care should be.

rfrishe · Dec 3, 2016

I am finishing up my first year in my BSN program and I hear this CONSTANTLY from peers. All about going for their NP or getting a Masters and moving up (some want to bypass working at the bedside before moving on!) . I'm already doing hands on care as a tech at a LTC community, so I have already decided I want the hands on part of the job as a career. I'm not a paper pusher, at heart I'm a hands on person. But I know a lot of people that will do the minimum to get through clinical and then move on to something less patient-centered in higher degrees. I get asked a lot if I'd want to get a higher degree and my first thought it 'with what money?' and my second thought is 'will I get to see patients and perform care? Or will I push paper and delegate forever?'. I am lucky, I wanted to be a nurse to be a nurse, the job security is a bonus and honestly the pay sounds amazing to me coming from working for barely more than minimum where I am now. They make us take classes on the theory of caring and understanding but I don't think many take it to heart.

dlgrn715 · Dec 4, 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.

I agree! I worked almost 20 years as a floor nurse, loved my job and had hoped to retire there... Until I became so stressed out due to anything that was added to patient care was added to the primary nurse's responsibilities. If course that wasn't the only reason it was stressful. But I found a great position which I enjoy, but still hear the word "productivity" much more than I care to!!

joelcairo · Dec 4, 2016

Newsflash: Health care is a business, and many nurses are simply tired of being used as exploited labor.

indish · Dec 4, 2016

You are right, in just a nurse I meant not going on for a masters NP or management. I meant staff nurse. And I didn't even mean med surg, I meant every bedside nurse in every specialty area, I have worked in many different areas besides med surg, but always in the role of staff nurse, sometimes charge nurse. I guess the point of the question is what happened to nursing and there has been a lot of very good points made in this discussion about what is wrong.

indish · Dec 4, 2016

I posted the original question and it's interesting to see where this topic has gone. Firstly "just a nurse" refers to any staff nurse in any specialty unit, including not limited to med surg. ive never had aspirations of management, always preferred to continue learning by moving around to different hospitals and different units within the hospitals. One poster supposed I was somehow jealous that I didn't go on myself. Heck no! I'm at the top of the pay scale and live quite comfortably, I've got a great job in PACU, no weekend or holidays, one day a month on call. For me that's heaven in staff nursing. My point was with all the going on advancing careers etc, what will happen to nursing? There are so many MSNs where I work at the bedside. Why? Because there aren't enough advance practice RN jobs to go around. I think this has been a great discussion on what is wrong with nursing and as I reflect back in my opinion it's the culture. Big business, patient satifaction (did you know the most satisfied patients are also the most dead? Google it) an addicted to narcotics patient population and google. Everyone googles everything and then tells you what you are doing wrong. 30 years ago patients trusted their providers and nurses, now they question everything. Just like pain control, we went from no information patient to too much information patient. Just a few more thoughts

Medic2RN_ · Dec 4, 2016

Okay - so a little about me before I begin. I'm a millennial. 1994. I'm a paramedic and I'm taking pre-reqs for nursing. I say this, because I work with some younger nurses (I would like less than 28 years old) that act this way. They are genuinely surprised they have to work hard or so things for themselves, and try to push it off to others (or me). A big sense of entitlement is present with the "new" nurses, and I feel like the foundation of caring for people was somehow lost here. A lot of new nurses I know are going to get their NP because they don't want to work on patients or bedside anymore. I also know a lot who have chosen Lab or research. I don't really know what's to blame for this new mindset though.... I'm thinking it is the reality that they will be working physically hard for the rest of their lives, or they want holidays off. Who knows.

BeenThere2012, ASN, RN · Dec 4, 2016

I don't know when it changed but, I worked as a nurse for 43 yrs before retirement. I worked in hospitals for most of the first 18 yrs. I did bedside care, medications, I was a charge nurse and worked as a shift supervisor and Head nurse. I loved both beside nursing and mentoring young nurses but, I grew tired of being responsible for oversight of less experienced nurses who either didn't want to be at the bedside or didn't admit that there were things they didn't know. I left the hospital and spent the rest of my career in Home Care, which I found to be most rewarding.
Over the years I talked to many nurse educated in colleges and hospital schools. Many wanted to become office nurses, or higher practice nurses to get away from working evening nights, weekends and holidays. For many college educated people the goal is to acquire more degrees and climb the career ladder. It is hard to admit to your college friends that you have found your career and want to stay, or simply move to a different area within the hospital.
I agree the financial end of health care as made bedside nursing more difficult. But there is no greater joy for me than seeing someone recover because of what I did.

Agree, agree, agree, BUT...Nowadays, you spend most of your time administering medications, and doing procedures, charting and putting out fires - all in a hurried/rushed way. The "art" of nursing is being lost. It makes me sad. That is what brought me most of my satisfaction. It was always a lot of work. It has always been taxing emotionally. But now, if I was able to get through a shift without making an error or being able to complete all orders, then that became a successful day. The "extras" and individualized care is harder and harder to accomplish.

Carabella · Dec 4, 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.

I was thinking the same thing... I've been an RN for 25 years and when I graduated, nurses at every degree level worked at the bedside (or away from it). Nursing has changed a LOT since I graduated. And administration, revenue driven health care execs, and regulatory issues have chased a lot of nurses from the bedside. I am not saying that this is a good thing, but it is a fact. I love being a nurse, however, many of us reach a point where we need to switch to jobs away from the bedside to remain sane, practice good self care and be there for our loved ones...

LadysSolo · Dec 4, 2016

A lot of people today just don't want to work, IMHO. I can't hire a young person on the weekends to help me clean stalls, and I pay $12.50/hour for unskilled labor (I teach them how!) They tell me the work is too hard! Why do you think I pay a kid $12.50/hour - I KNOW you will work hard - I do stalls very other day of the week, and just want some help on weekends! The attitude seem to carry over into nursing - people just don't want to work hard.

Carabella · Dec 4, 2016

I went to school to be "just a nurse." All I wanted to do was to help people and to save lives. I have been a cna for over ten years, so I'm definitely not afraid of hard work. After graduation, I only lasted six months in a hospital. It is a business. They care more about patient satisfaction more than patient care, and they run you right into the ground. The older nurses were miserable and made eating their young a competitive game. There's so much documentation and quality assurance measurements and cute acronyms for what the hospitals feel like nurses should be doing (icare and iwatch) which has nothing to actually do with the parient's health, that takes away from caring from the patient. I have been hiding out in a doctors office until I can go back to school to become a NP. Everyday it makes me sad that I'm not in the hospital setting saving lives like I originally set out to do, But I couldn't do it for my own mental health.

So true! I loved nursing and critical care, however as nursing became more corporate, things changed. I still love critical care but much of practicing as an RN has nothing to do with taking care of patients. It is not unusual to switch units three times in one shift. I have been working in Clinical Documentation Improvement since 2009 and it is a way to work in a hospital, use my clinical knowledge, and still have my sanity.

lsjsn · Dec 4, 2016

I too find it sad that those wanting to do bedside nursing are far less in number than when I started nursing 38 years ago. I'm proud that 95% of my career has been just that. Direct patient care is what I love best & I feel it's a calling like no other. There have been some bumps along the way like when I reported to my supervisor the Aides were freq removing the batteries from the patient's fall mats to which she informed me my standards were too high for that facility. Now days errors are shrugged off by newer graduates. There is little concern if the narc count is off @ shift change or if an antibiotic dose is not given due to not checking the MAR--I have seen 3-4 doses remaing in the bottle when administering the last scheduled dose & no one including supervisory staff are concerned but instead seem bothered that I or another nurse brought it to their attention. It appears that instructors no longer stress many important aspects/ethics like it was taught to me back when. Then I hear how my LPN salary of around $18 is close to desired minimum wages by many. I had a serious injury @ home 2 months ago & since I used most of my paid leave & FMLA taking my Mom for her cancer txs & MD appts the past 2 years I had to resign my job of providing care to Veterans with Alzheimer's at night for the past 8+ years & find myself forced to go on government handouts to survive. My Surgeon says it will be 18 months or 24 before we will know if I regain enough mobility to ever nurse again & I face poss losing everything before I can even apply for social security assistance. It just doesn't seem right but I had to start over after Katrina took my home & I had to relocate. Just a run of rough luck I guess but I will always cherish that the "Man upstairs" felt I was worthy to be blessed with the opportunity to provide care for so these 38 years & frankly "too high of standards" should never be in the same sentence as "nurse" in my book but I guess it shows I'm "old school". Sorry for venting but thanks for the opportunity.