Why hire RN's when other disciplines can do the job

[Marisette]

Has anyone noticed that pharmacist at major drug chains administer flu, pneumonia, and other vaccines at large pharmaceutical chains. The medical assistant at my doctors office calls in medications for me because they don't hire RN's. In the hospitals we have nursing aids, & patient care technicians assist with patient care. I know the value of RN's doing the many functions, but I ask myself when did personnel or professionals from other disciplines start performing what was once mostly performed by RN's.

Could this be part of the reason new grads. can't find employment, or frankly many nurses in different markets. Why bother hiring RN's ? I Know that nurses do more than administer medications, call in medications and perform other physical labor, but sometimes I ask myself if the push for more anxillary health care help is slowly replacing the need for RN's. I recall getting injections from RN's at the large pharmaceutical chains years ago, but now the pharmacist administers. They hire nurse practioners for the outpatient clinics at the large phamaceutical chains or drug stores, but they are advanced degree Registered Nurses. Does anyone value a nurse with a simple RN behind her name anymore?

[EmergencyNrse]

I have said it more than a dozen times here and other forums.

We (Nurses) are being dumb-ed down for the sake of cost-cutting

measures. We are too expensive. They would rather hire a CNA than

an RN because it's cheaper. Don't need the professional nurse these

days, Right? How do they accomplish this?

They start by taking away the things that the professional nurse is

capable of doing like medical shorthand. "Can't use THOSE abbreviations

any more..."

By not allowing us to mix medications. The pharmacy needs to mix all

IV medications and doses, YOU can't be trusted to do it any more. It's

all about patient SAFETY..."

All IV medications have to be on a pump. We now use guardrails to

program all those medications. "You're no longer required to calculate

drip rates. We'll do it for you..."

What do you feel that you're actually responsible for anymore that

can't be done by ancillary staff? Assessments? HA! Keep holding onto

that. See how long it will be before THAT is no longer needed.

[nursel56]

Personally, I think all of us are being played for fools as we have two different spheres of influence or power bases that don't talk to each other very much. The people who hold the purse-strings who care very little (if anything) about the philosophical issues of "what is a nurse" that we like to talk about here and those who consider the history, function, respect issues etc. In short, the things the money people care nothing about.

To me there is an aspect to the "BSN required now" discussion that makes me cringe a bit. It certainly isn't the only issue but illustrative of the different reasons the two groups do things. I feel "BSN required now" by for profit corporations has very little to do with them studying the issue in depth but is more opportunism on their part because well- I guess if I had a choice to hire someone with more education and I didn't have to either pay for it or pay more wages for it welll sure!! Come on down! Will they fight for us when they have something to lose? That is what bothers me.

I hate to sound like the Grinch but the people who don't hesitate to treat us like 5 year olds getting stars on their charts will not likely have our back when the going gets tough.

I can't shake the feeling that should the economy turn again "BSN only" will be tossed aside without a bit of restless nights over the decline in quality care that will result from hiring people to do tasks and the RNs supervising a larger cadre of unlicensed people doing the tasks. Our colleagues may see us as more professional. Coroporate profit centers don't care.

[lindarn]

I have said it more than a dozen times here and other forums.

We (Nurses) are being dumb-ed down for the sake of cost-cutting

measures. We are too expensive. They would rather hire a CNA than

an RN because it's cheaper. Don't need the professional nurse these

days, Right? How do they accomplish this?

They start by taking away the things that the professional nurse is

capable of doing like medical shorthand. "Can't use THOSE abbreviations

any more..."

By not allowing us to mix medications. The pharmacy needs to mix all

IV medications and doses, YOU can't be trusted to do it any more. It's

all about patient SAFETY..."

All IV medications have to be on a pump. We now use guardrails to

program all those medications. "You're no longer required to calculate

drip rates. We'll do it for you..."

What do you feel that you're actually responsible for anymore that

can't be done by ancillary staff? Assessments? HA! Keep holding onto

that. See how long it will be before THAT is no longer needed.

AMEN!!! I have also warned about the encroachment on nursings professional practice. Our professional practice is being stripped away, with the intent to "wean" the public from nurses at their bedside. What better way than to continue to eliminate the need for nurses.

It is IMPERATIVE that nurses band together and educate the public! Other professions hold onto their professional practice like glue. Teachers, PTs, OTs, Pharmacists. In some cases, professions like pharmacy, are taking over what used to be an exclusive domain for nurses.

Nurses, wise up and organize today! If we wait any longer, we will not have a profession to fight for!

JMHO and my NY $0.02.

Lindarn, RN, BSN,CCRN

Somewhere in the PACNW

[MinnieMomRN]

Ten bucks says that those flat screen TVs were initiated because of the new rules for Medicare reimbursement being tied to patient satisfaction... I think we're going to see a lot more of annoying "patient satisfaction" improvement measures and less (or at the sacrifice of) safe care measures. Just an aside.

can't afford the ten bucks.... wage freeze

[MaleBSNRN]

Many of these places might be "contracting" out work typically done by registered nurses because registered nurses might be hard to come by.

My concern with companies that abide by this practice could be unsafe. Let us assume that a pharmacist administers a shot and the client has a bad reaction to it. Will the pharmacist have the training to recognize and react to the situation?:uhoh21:

[SDALPN]

I'm pretty sure a pharmacist would know what to look for. They know side effects of meds which include allergic reaction symptoms. They probably do what private duty nurses do, call 911 and do what you can till the ambulance gets there. Most pharmacies have Benadryl OTC and first aid products. (Just hope the rescuer doesn't get charged....see the article about Walgreens charging for a glucometer).

[Cul2]

"We (Nurses) are being dumb-ed down for the sake of cost-cutting

measures. We are too expensive. They would rather hire a CNA than

an RN because it's cheaper."

This is the essence of it all. What we're seeing is the deprofessionalization

of basic bedside care in medicine. I'm not saying nurse assistants don't

have a role in the system. They do. But one must look at the motivation

for all this -- and it isn't aimed at improved patient care. It's aimed at

saving money. It's all about money these days. Follow the money. And

this trend will continue, scopes of practice of cna's and pt's and ma's will become

wider and wider, just to save money -- all this will continue until the public and

the nursing profession stands up and fights it.

[SDALPN]

If the hospitals would charge for the services we provide, just as they do with Dr's, they would make more money. Every procedure we provide (which are all time consuming...time=money) should have a price. The hospitals could afford more nurses (not just RNs) which would make the staffing ratios better and the pt surveys would reflect the more personal service as well. And the hospitals would be bringing in more income. That CEO would get a huge bonus that year for increased profits. Its a win-win situation.

[tothepointeLVN, LVN]

Many moons ago when I was a new nurse, we were expected to do hourly rounds on pts with IV's on Med-Surg and q 2 hr. on those without IV's. We did not have a script.

I wonder how all of this came about and what we plan to do about it. It is so completely ridiculous. We all have to stand up against this madness.

Is it really for patient satisfaction or is it because nursing has gotten to the point where we have to be reminded to do our jobs.

[kalevra, BSN, RN]

The corporate machine won't stop until everyone that's making more than $50,000 a year is down to $12 an hour.

The field of nursing needs to quit trying to "elevate" the profession by pushing B.S.N.'s. This will only increase cuts of R.N.'s to other types like M.A.'s and CNA's.

The money would be better spent on ad campaign smearing hospitals for replacing R.N.'s with M.A.'s CNA's, etc.

The public has high regard for nurses, and the public doesn't understand what's happening. They think all these other people are nurses too.

They need to understand that their healthcare is being delivered by people making not much better than Starbucks.

I think money would be better spent lobbying for legislation that makes some procedures as RN ONLY procedures. For example it would be illegal for a Pharmacist to push immunizations at a pharmacy. If it becomes an RN ONLY procedure then you would have to hire an RN. Prevents firing of RNs to be replaced by MA/CNA.

I mean realistically with enough experience in the field an LVN can learn what an RN does. The only thing preventing the LVN from taking the RN position is scope of practice. Scope of Practice puts down what are the procedures that an LVN or RN can Legally do. The Law is the biggest difference.

Forget the smear campaign, lets just buy some legislators to vote in favor of RN ONLY procedures. Yes I said BUY LEGISLATORS. It is the way our government works.

[tothepointeLVN, LVN]

Again I'll state I think a pharmacist giving an injection at a pharmacy is perfectly acceptable since the pharmacist does hold a much higher degree than the average flu shot nurse.

Its the CNA/PCA/MA/CMA/YMCA issue that worries me.

[kalevra, BSN, RN]

]By definition a nurse is one who "cares for the sick or infirmed". Therefore it is not inaccurate for these non-RN types to be called nurses when they are performing the act of nursing[/b']. We all have the same goal.

I think it is more important advance your career (and the field) and push for increased responsibility. As one poster said, nursing tasks are increasingly more advanced, and the less advanced tasks get passed down to staff who may not be RN, but are qualified to perform said task. It is the nature of progress.

What you wrote is a general term. You should also know that some states hold the term "nurse" in the legal aspect as someone who is an RN or LVN. So if a CNA in one of these states introduces themselves as a "nurse" then they are actually misrepresenting themselves. It has to do a lot with scope of practice issues. This has been talked to death multiple times.