You think the "Nursing Glut" is bad now?

Despareux · Sep 26, 2013

Nursing school not only entails a heavy course-load, it also entails a certain quality in character that is nurtured through the afflictions one experiences throughout the course of their education and this cannot be said of an MA or NA. Patient satisfaction [HCAP] scores are heavily weighed on staff professionalism, knowledge, and pain control; and hospitals depend on satisfactory scores for funding, I don't know if a 3 month education of a MA or NA can accommodate those higher level needs of the patient and the hospital, even with on the job training. Please accept my apologies if I have offended anyone, I'm not trying to be offensive, but I am stating something to be mostly true, as I'm sure there are some MAs or NAs who just get it.

Nabberdo · Sep 26, 2013

"Quote from Esme12

It is about saving money.....I think it is an effort to get rid of the red ink and decrease their budgets by getting rid of what they feel is an unnecessary expense..... the NURSE, WILL STILL be held accountable.

"I want a nurse to take my B/P for maybe she can pick up on a subtlety that she can act on that the CNA/MA missed and save/improve my life."

Esme12 - I so agree with you! In this economy, it is all about the money and the RN WILL still be held accountable.

And the part about wanting a nurse to take your B/P - another truth! After graduation, I was unable to find an RN job and so I worked as a nurse aide in a hospital for over a year. I can tell you there were many patients experiencing subtle, and some not so subtle, symptoms that I brought to the attention of the RN and effected a more positive outcome for the patient. And who, as the public, would have known otherwise?? Scary.

Esme12, ASN, BSN, RN · Sep 26, 2013

You may be right, but I can't help but think, given 1-2 years of the same experiences as myself, someone such as an MA with his/her current education curriculum could become equally as qualified or better.
I truly believe in a bare bones novice to expert theory. Bare bones of it.
In reality, I see daily how much more nurses know and do than MAs in today's environment, but given the opportunity, could the MAs learn to thrive in a nurse's role? Could they learn through job experience how to perform nursing tasks and even make assessments? Lots of people learn more on the job than they ever did in school... couldn't that be applicable to an acute care MA? The foundations like 5 rights, pharmacology, and basic patient care seem to already be there... We can go into the pathophys and etiology of it all; that might differ between an MA and a nurse and provoke "critical thinking" required for certain tasks. Yet, while I've never been in an MA program, who am I to say they don't study pathophys with their education/curriculum? What if they did or actually do!?
I remember seeing and doing some of the most ridiculous mistakes from new nurses (LPN, RN, BSN), some of which I have done myself (although I won't list them here for sheer embarrassment)...
4mg Zofran IVP followed by a GI cocktail. Pt vomits GI cocktail. MD informed. Md asks, "Did you think to let the zofran work before you administered the GI cocktail?" Lesson learned and never once repeated. Lots of new grad LPNs, RNs, and BSNs have made this mistake. LOTS!! But it is a learning experience. I imagine an MA probably making a similar mistake and learning from it.
Pt discharged from ED without full infusion of antibiotics. Seen the new RNs do this plenty of times only to have the pt called back to have the infusion continued.
EKG not performed until after Xray, IV, and what not due to suspected asthma attack only to realize it wasn't an asthma attack but an MI. I'm sure that nurse will never make a mistake like that again.
Phenergan 25mg/1mL given over 3 minutes undiluted into a saline lock without maintenance fluids running behind it. Note: the pig tail/adapter holds total of 2mL . Then rapidly flushed with saline flush.
Larger sized Xfr tubes (NG/OG/Foley) are better for sucking up clots as opposed to the more easily placed 14fr tubes.
Always have an IV and a bag of saline handy when administering any form of Nitro.
These are things I have seen people learn on the job. They didn't seem to learn them in school the first time around, so perhaps having seen it in real life was better and perhaps these people will never forget! We learn from our mistakes. We should only hope our mistakes do not result in harm. With appropriate on the job training, I think we can make a successful apprenticeship for MAs as our peers!
::EDIT:: Correction- An MA friend said she did learn pathophys and etiology in her accredited associate degree MA program; but this may not be accurate for all MA programs.

I appreciate what you have said. Much of nursing is learned after school....experience is everything in nursing. I have had more than my fair share of blonde moments (I can say this....I am blonde) ANYONE who says they have never made a mistake is either very lucky or a good liar. I have never hurt anyone..... but the potential is always there. Personally, I want someone caring for me who not only knows how to do something because someone showed them....I want someone who also knows why.

While anyone can be taught the physical tasks.... it is the nuances....the subtle notes in between...that extra ....something that will save someone's life. Paramedics are different as well...they go to college...get degree....they have different scope thn the bedside nurse. They are learned professionals. I know this becasue I was a medic once...when I did flight nursing. I have worked with the finest medics and they deserve more respect and money.

I have said for YEARS that nursing was going to educate itself out of the bedside....now I know I'm right.

I think to make the jump that all of my schooling means nothing and anyone can be trained to do my job it s stretch. MA's have their place in healthcare....it is not as a replacement of the RN. This is going to be a huge mistake. You get what you pay for....if you are paying someone less to do the me job...you will get less.

This is a money issue being made by non medical administrators with no thought for patient safety nor quality of care.

I am afraid where this is going.

Howardhughes, ASN, BSN, RN · Sep 26, 2013

Hay Jonnyvirgo....Your statement is a example of a

RN

? (hope not) that should not hold a license. No we don't prescribe ... HOW ABOUT KNOWING HOW THE MED WORKS WITHIN THE BIO SYSTEMS , SIDE EFFECTS, ANTIDOTE ( YOU MAY WANT TO BE ABLE TO DO A ASSESSMENT ( WHICH REQUIRES KNOWLEDGE OF PATHO/PHARMACOLOGY AFTER THE PATIENT STARTS SMACKING HIS LIPS RAPIDLY

statements like these as of late have really been beginning to irk me. Im all in favor of knowledge of pharmacology an pathophysiology, but you're not a low/mid level provider to act autonomously. CNAs MAs LPNs even RNs dont pass or prescribe meds based on their own findings. They assess, and pass it on to the all-knowing all-seeing docs from above that then tell us what to give. They know better, and if thats whats ordered, thats what we give. The knowledge only comes in handy if we're looking to make sure the doc hasn't overlooked something or made an error, which happens to just about anyone and everyone in healthcare at some point in time. Sure you could save a life, and sure it could cost a life, but the bottom line is, we're not nearly as autonomous as we'd like to think. We're merely extensions of the doc, being at all the places they cant be to free up time for them to Dx and Rx

#46

xoemmylouox, ASN, RN · Sep 26, 2013

I am just shocked at how many think so little of their Nursing education & responsibilities. If you don't care about being replaced by an MA that's fine, but I like being a Nurse. I enjoy using my skills and knowledge to save lives.

Frink · Sep 26, 2013

So, let me get this straight: at least where I live, LPNs and ADNs are being told to get a BSN or they won't have jobs much longer (many of them cannot get jobs now, of course.) So then we get word of MAs, with even less education, possibly replacing RNs or at least a good bit of what they do. Baffling.

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.

veggie530 · Sep 26, 2013

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.

States with unions.

brandy1017, ASN, RN · Sep 27, 2013

My understanding is RN's have already been phased out of dr's offices, first for LPN's, and now LPN's are being phased out for MA's simply because they are paid such a low wage, starting $10/hr lots of places for an associates degree. Think about it you can get an ADN RN and be working for $20-25+/hr starting why would you become an MA? The instructor warning students against RN is doing them a disservice, would she rather have them become MA's and work for peanuts. As far as MA's taking over RN jobs, this type of thing has been ongoing for a long time already, by unlicensed assistant personnel, aka techs, who work under the RN's license and supervision and are paid much less. Short of federal legislation and widespread unionization, I don't see how we can stop this trend. I'm sorry but I don't think shared governance or magnet status will stop this. It is the chase to the bottom, bottom dollar that is, to maximize profits for the suits!

Funny thing is I've talked with some coworkers who were techs elsewhere bragging about all the things they've done, and I just thought where did it get you, you are still making peanuts and struggling to get by. Why didn't you go back to school and get an RN and start to make some real money if you are so skilled and wonderful! Not to dis techs as there are some very talented ones out there, but unless they are in the few well paid specialties like nuclear med or echo or possibly resp, the wages are pretty dismal!

applewhitern, BSN, RN · Sep 27, 2013

The MA's in my area still work as nursing assistants. Our doctor's offices use LPN's, and a few RN's. I really can't see the MA's I work with as doing the same job as I do.

hope3456, ASN, RN · Sep 27, 2013

Yes it is confusing. We hear that BSN should be the entry point into nursing but I have read on another forum as well that there is starting to be an increased use of "techs" in the hospital setting. I suspect we are returning to the model of the RN having 15 patients and then the techs do most of the "hands on" work.

The admins have the upper hand - not sure there is much we can do about it.

elijahvegas, ASN, RN, EMT-P · Oct 5, 2013

Hay Jonnyvirgo....Your statement is a example of a RN? (hope not) that should not hold a license. No we don't prescribe ... HOW ABOUT KNOWING HOW THE MED WORKS WITHIN THE BIO SYSTEMS , SIDE EFFECTS, ANTIDOTE ( YOU MAY WANT TO BE ABLE TO DO A ASSESSMENT ( WHICH REQUIRES KNOWLEDGE OF PATHO/PHARMACOLOGY AFTER THE PATIENT STARTS SMACKING HIS LIPS RAPIDLY
[*]#46

People keep saying this and the like and I reply why ? What's the point other than to answer questions that your patient may or may not ask that you'll have to explain in layman's terms anyway?

Hey doc, I know that you're pushing lopressor because of x and y to produce z result.

Fantastic nurse. Here's a cookie. Now go push the lopressor like I told you. I have other things to do.

Womp womp.

allnurses Guide · Oct 5, 2013

People keep saying this and the like and I reply why ? What's the point other than to answer questions that your patient may or may not ask that you'll have to explain in layman's terms anyway?
Hey doc, I know that you're pushing lopressor because of x and y to produce z result.
Fantastic nurse. Here's a cookie. Now go push the lopressor like I told you. I have other things to do.
Womp womp.

You're kidding, right?