You think the "Nursing Glut" is bad now?

[Guttercat]

I tend to keep my finger on the pulse of new(er) trends.

This subject is something I've alluded to before, yet now I am even more convinced it may become reality.

My state--a west coast state--recently (last year) redefined the scope of practice for MA's to include much of what RN's are responsible for, based on a new tiered level of education and certifications. Colleges have jumped on the bandwagon to develop intense MA programs to fill the need.

At one time, MA's were relegated mostly to Dr.'s offices (which used to be the domain of RN's). That may not be the case much longer, if the trending continues.

I was just speaking with a fellow student from a math class, who is pursuing her MA. One of our college's nursing program professors is apparently steering potential nursing candidates (friends of hers) away from the nursing program on the QT. She stated, "Now that the scope of practice for MA's has been legally expanded, the hospital is looking to integrate MA's to fill the floors, instead of the more costly RN's."

Just sayin'. Research on your own, and draw your own conclusions.

[salliesue]

The job requirements now listed in a job ads are ridiculous. If you read the job description they are basically stating you will do everything a bedside nurse does plus be pulled to go out in field when required, do Quality assurance, be responsible for all non-licensed personnel, be on-call 24/7, be specially certified in multiple areas and have an advanced degree. oh, as an added bonus, you'll make less then you did 5 years AGO!!

[Leonardo Del Toro, RN]

You are right, MA's role is changing but so are the role of RN's but you might have to upgrade to NP. With Obamacare the need for family practice MD's and NP's is exploding. All hospitals and health care systems are opening urgent care clinics...

[anotherone, BSN, RN]

You are right, MA's role is changing but so are the role of RN's but you might have to upgrade to NP. With Obamacare the need for family practice MD's and NP's is exploding. All hospitals and health care systems are opening urgent care clinics...

If I wanted to be an no i would have done that or gone into medicine. I don't want to nor do I want to see a PA or NP over a MD or DO for the same reasons posters here prefer nurses rather than MAs at the bedside...

[workingharder]

I've been saying for some time that due to technology and financial considerations the role of nursing in the hospital will be decreasing.

Although I believe nurses will still be employed in the hospital, the future of the profession lies outside in LTC, community, and clinical settings.

[Leonardo Del Toro, RN]

I see it as a good thing. The role of the RN will continue to evolve, and I think it will be upwards. Less paper-chasing, more assessment. I say let the marketplace decide. Would you rather have RNs take your blood pressure, or would you rather have them treat patients for HTN?

I agree with this. The role of nursing is changing and it's not going down. Transition are confusing and filled with uncertaities, but in no way the knowledge and license bearing responsibility entrusted to RN's will be just forgotten or just trashed. This is already happening for NP's, so yes less paper chasing and more decision making.

[Leonardo Del Toro, RN]

I've been saying for some time that due to technology and financial considerations the role of nursing in the hospital will be decreasing.

Although I believe nurses will still be employed in the hospital, the future of the profession lies outside in LTC, community, and clinical settings.

That appears to be true right now. Pt census is low, unemployment is high so the rule of the day is to get rid of nurses. But if pt pop spikes and nurses go away who would they rely to take full care of acute pt? Nursing is a funny kind of job because from one side they are not relied upon for there is the tursted and all knowing MD's but without the RN's the MD's are absolutly useless and unable to provide any care, they rely solely on RN's assessments, and all the care to be given.

[libran1984, ASN, RN]

I think the role of a nurse is mostly a learn as you go type of deal. I think an MA would be perfectly qualified after a year or two of hands on skill to perform nursing duties. I have heard that some alaskan hospitals, as per rumor, that MA's are already taking over RN duties on the hospital floors, working under the physician's licenses.

I think we are all suffering from education inflation.

Many institutions say with rising technological standards comes a rising educational standard.

1. What school has the same or can afford the same technology that is at the local hospitals? Is the school going to buy an U/S machine for their RN students to learn to place PICC lines?

2. Is the school going to buy the latest port access kits?

3. Is the school going to buy the latest ABG kits?

4. Is the school going to buy the latest EKG machine to practice EKGs?

5. Is the school going to buy the latest ventilator to practice settings for a vent pt?

Seriously... no... they may have older models that get the point across, but if technology is advancing that fast, then the older models are obsolete.

Half the time, the stuff we learn is school is all theory based b/c so many RNs (particularly many on the floor) rely on specialists to do their job for them. RT (in many but not all facilities) perform EKGs, ABGs, and Vent care. The RN, in many- but not all cases, has little to do with that. As far as IVs, ports, and PICC lines, many RNs have come to rely on PICC team to provide that type of care. It seems like in so many (but not all) places, the RN is no longer good for much other than to verify an assessment or pass meds.

An MA can pass meds. Let them pass the meds. They will learn on the job just as all the RNs did. As a new grad, did you really learn that much more than an MA from an accredited program right out of school? They both know to check an apical pulse before administering digoxin or to check a BP before administering a beta blocker! Nursing considerations, my butt... In many cases, as is my understanding, an MA gets more venipuncture practice than a traditional RN student.

As an LPN working in the ED, I don't remember jack about venti masks, or non-rebreathers from class. However, I know when to use a NC, venti, or non-rebreather. I can anticipate and identify need for Bipap or intubation all based on my experience. I learned IV skills and NGT skills from the ED also. The MA can totally do these with the same amount of practice.

Diploma RNs got the hands on experience for years and became great and amazing nurses. MA's after enough time of hands on experience can be equally as good as any LPN, diploma, ASN, BSN. The only difference, right now, is that the MAs are not frequently exposed to the type of care the LPN, Diploma, ASN, or BSN nurses are exposed to. They can totally learn that stuff on the job,and i say they would be no less dangerous than a brand new grad BSN given a proper orientation.

This reminds me a lot of Patricia Benner's Novice to Expert theory... We all start off as Novice with a basic understanding, then become experts over the years. The same can be said for the MA!

[xoemmylouox, ASN, RN]

You might be able to train an MA to pass meds, but will they understand how that medication works within the body, what effects it may have on the patient's other diseases, or what medication interactions may occur? You can teach just about anyone a skill, that doesn't mean they understand what they are doing or why. That is a HUGE reason why this is a terrible idea!

[Esme12, ASN, BSN, RN]

I think the role of a nurse is mostly a learn as you go type of deal. I think an MA would be perfectly qualified after a year or two of hands on skill to perform nursing duties. I have heard that some alaskan hospitals, as per rumor, that MA's are already taking over RN duties on the hospital floors, working under the physician's licenses.

I think we are all suffering from education inflation.

Many institutions say with rising technological standards comes a rising educational standard.

1. What school has the same or can afford the same technology that is at the local hospitals? Is the school going to buy an U/S machine for their RN students to learn to place PICC lines?

2. Is the school going to buy the latest port access kits?

3. Is the school going to buy the latest ABG kits?

4. Is the school going to buy the latest EKG machine to practice EKGs?

5. Is the school going to buy the latest ventilator to practice settings for a vent pt?

Seriously... no... they may have older models that get the point across, but if technology is advancing that fast, then the older models are obsolete.

Half the time, the stuff we learn is school is all theory based b/c so many RNs (particularly many on the floor) rely on specialists to do their job for them. RT (in many but not all facilities) perform EKGs, ABGs, and Vent care. The RN, in many- but not all cases, has little to do with that. As far as IVs, ports, and PICC lines, many RNs have come to rely on PICC team to provide that type of care. It seems like in so many (but not all) places, the RN is no longer good for much other than to verify an assessment or pass meds.

An MA can pass meds. Let them pass the meds. They will learn on the job just as all the RNs did. As a new grad, did you really learn that much more than an MA from an accredited program right out of school? They both know to check an apical pulse before administering digoxin or to check a BP before administering a beta blocker! Nursing considerations, my butt... In many cases, as is my understanding, an MA gets more venipuncture practice than a traditional RN student.

As an LPN working in the ED, I don't remember jack about venti masks, or non-rebreathers from class. However, I know when to use a NC, venti, or non-rebreather. I can anticipate and identify need for Bipap or intubation all based on my experience. I learned IV skills and NGT skills from the ED also. The MA can totally do these with the same amount of practice.

Diploma RNs got the hands on experience for years and became great and amazing nurses. MA's after enough time of hands on experience can be equally as good as any LPN, diploma, ASN, BSN. The only difference, right now, is that the MAs are not frequently exposed to the type of care the LPN, Diploma, ASN, or BSN nurses are exposed to. They can totally learn that stuff on the job,and i say they would be no less dangerous than a brand new grad BSN given a proper orientation.

This reminds me a lot of Patricia Benner's Novice to Expert theory... We all start off as Novice with a basic understanding, then become experts over the years. The same can be said for the MA!

So you are willing to allow someone of lesser education replace your position? YOu feel they can do it just as effectively at a lesser pay?

[libran1984, ASN, RN]

You might be able to train an MA to pass meds, but will they understand how that medication works within the body, what effects it may have on the patient's other diseases, or what medication interactions may occur? You can teach just about anyone a skill, that doesn't mean they understand what they are doing or why. That is a HUGE reason why this is a terrible idea!

Let's talk about our own understanding of pharmacology & pharmacokinetics, as nurses...

Zofran- an antiemetic; works on part of the cerebellum

digoxin - causes an increased strong contraction while slowing the HR

Beta blockers - slows the heart rate, causes erectile dysfunctionl, blocks beta(-1?) receptors

Rocephine - 3rd generation cephalosprin, good for uti's, skin infections, and PNAs - my speech for pts sometimes "evolves" as I forget which is minor to mod and mod to severe... Watch out for diarrhea; eat some yogurt

Biaxin - causes a metal taste in your mouth; diarrhea; eat yogurt

okay... c'mon that's what i know...

Of what do us as nurses understand about pharmacokinetics that an MA probably doesn't (from an accredited associate degree program). So few RN programs ingrain in their students that, "YOU MUST REMEMBER; phenergan and toradol are very caustic- dilute and/or push slowly". I don't even know if that is an NCLEX question, but by George it sure is a pertinent question!!

As nurses, can you say that your peers know just as much as you do? I ask my nurses what Rocephin is, and they say it is an antibiotic... beyond that they have long since forgotten. We are not on any higher educational platform upon graduation as many other professions like MA's, CMA's, QMA's, etc.

[Susie2310]

I think the role of a nurse is mostly a learn as you go type of deal. I think an MA would be perfectly qualified after a year or two of hands on skill to perform nursing duties. I have heard that some alaskan hospitals, as per rumor, that MA's are already taking over RN duties on the hospital floors, working under the physician's licenses.

I think we are all suffering from education inflation.

Many institutions say with rising technological standards comes a rising educational standard.

1. What school has the same or can afford the same technology that is at the local hospitals? Is the school going to buy an U/S machine for their RN students to learn to place PICC lines?

2. Is the school going to buy the latest port access kits?

3. Is the school going to buy the latest ABG kits?

4. Is the school going to buy the latest EKG machine to practice EKGs?

5. Is the school going to buy the latest ventilator to practice settings for a vent pt?

Seriously... no... they may have older models that get the point across, but if technology is advancing that fast, then the older models are obsolete.

Half the time, the stuff we learn is school is all theory based b/c so many RNs (particularly many on the floor) rely on specialists to do their job for them. RT (in many but not all facilities) perform EKGs, ABGs, and Vent care. The RN, in many- but not all cases, has little to do with that. As far as IVs, ports, and PICC lines, many RNs have come to rely on PICC team to provide that type of care. It seems like in so many (but not all) places, the RN is no longer good for much other than to verify an assessment or pass meds.

An MA can pass meds. Let them pass the meds. They will learn on the job just as all the RNs did. As a new grad, did you really learn that much more than an MA from an accredited program right out of school? They both know to check an apical pulse before administering digoxin or to check a BP before administering a beta blocker! Nursing considerations, my butt... In many cases, as is my understanding, an MA gets more venipuncture practice than a traditional RN student.

As an LPN working in the ED, I don't remember jack about venti masks, or non-rebreathers from class. However, I know when to use a NC, venti, or non-rebreather. I can anticipate and identify need for Bipap or intubation all based on my experience. I learned IV skills and NGT skills from the ED also. The MA can totally do these with the same amount of practice.

Diploma RNs got the hands on experience for years and became great and amazing nurses. MA's after enough time of hands on experience can be equally as good as any LPN, diploma, ASN, BSN. The only difference, right now, is that the MAs are not frequently exposed to the type of care the LPN, Diploma, ASN, or BSN nurses are exposed to. They can totally learn that stuff on the job,and i say they would be no less dangerous than a brand new grad BSN given a proper orientation.

This reminds me a lot of Patricia Benner's Novice to Expert theory... We all start off as Novice with a basic understanding, then become experts over the years. The same can be said for the MA!

I think some people are suffering from a lack of education/intelligence. Quite simply, medical assistants do not have the education and training nurses have. To respond to your example of passing meds, in nursing school, before I ever administered my first med in student clinical, I had learned the five rights of medication administration. I was taught to understand the reason the medication was ordered and why it was indicated for the particular patient, the method of action, contraindications to giving, expected effects, side effects, adverse reactions and action to take, patient assessment prior to giving and after giving, i.e. vital signs, labs. The process of giving medications safely requires education; one is not just throwing meds at patients. One is using the nursing process throughout.

I just noticed your post #21. Are you really suggesting that medical assistants should give IV meds? My RN training taught me to assess allergies, compatibility, concentration, rate, use, dose and dilution, along with everything I mentioned in my first paragraph, including IV assessment. Again, using the nursing process in order to give the medication safely.

I ask you, what quality of care do you really want people to receive? What do you want for yourself and your own family?

[libran1984, ASN, RN]

So you are willing to allow someone of lesser education replace your position? YOu feel they can do it just as effectively at a lesser pay?

As an LPN making barely $13/hr while my RNs made $22+/hr and so little distinction between our job descriptions... yes.....

I made, perhaps, $1/h more than an MA in the hospital setting, and I'm appraised by my peers for my utilization of the nursing process, which confabulates me.... I'm just doing common sense things to make sure my pt is safe and i'm not going to kill them. I've learned SOOOO much from the "am I going to kill them" question. Because, in the ER, that is a serious question when you have an unstable pt. Who want to tip someone over the edge. I know MA's that I swear had more knowledge than myself coming out of LPN school. I knew paramedics who I swear I had more knowledge than coming out of school, I knew other paramedics who I thought should have been doctors because they talked so far over my head.

I think, if people are so concerned about money, then go for the lesser paid professionals.

Here is my theory...

If an MA were to be precepted by an RN for a new job for 12-16 weeks (as is normal where i work) then learn proper protocol and basic meds and usual assessments skills, then the MA could progress along the Novice to Expert scale. Upon reaching competent or expert, they too, can train the next MA to be as efficiently trained as the original RN.

They could do all this for half the price of an RN, in theory.

From the way most ED's I've visited or worked in, you'd think most ECFs were ran by CMAs b/c no one in the ED seems to respect the ECF nurses. If respect is so low, then why even have nurses (LPNs/RNs).. let them be CMAs throughout so at least maybe morning med pass might more rounded out.

Imagine if all treatments and med passes were done by CMAs, QMAs, or MAs? You could have a higher certified personnel to patient ratio. What if all nursing homes had a 6 to 1 certified personnel ratio with normal CNA to licensed/certified personnel ratio. How much cheaper would that be? Instead of one nurse looking over 20+ people, you have 1 certified personnel looking over 10? 1 certified personel would be almost as much as 0.5 nurses nurse! The pt would probably see more attention paid to themselves. The pt may not have to wait as long receive treatment for distressing situations... and trust me, that is how LTC nurses often see a situation- is it distressing? So then they call the doctor. Maybe, the MA, with a lower pt to MA ratio, would be able to identify something is seriously wrong. I don't even know any nurses in LTC that listen to all their patients breath sounds every single morning (b/c it is not time efficient despite the dx of CHF). That is why I could never work LTC; too corrupt and unforgiving... or maybe "too forgiving".

I began to ramble, I'm sorry...

Yes, I am willing to allow someone of lesser education to replace my position because they CAN do it as effectively.

Look at the debates.. Diploma and ASNs still vouch that they can perform just as well as a BSN. Its all about experience. Grant the MA the same experience, and they, too, can perform equally as well in the field of desired work (as is my theory).