March 8th, 2009 by Emergiblog in Better Health Network
7 Comments »
Nursing is an extremely interesting profession. It’s either absolutely off the deep end or it’s totally unique. From the entry levels of practice to the terminal degrees available, nursing doesn’t look like, act like or educate like any other profession.
And it shouldn’t. Because nursing isn’t like any other profession.
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Let’s take entry level into practice. How’s that for jumping into the frying pan?
You can start nursing with an AA degree that should be two years but can’t really be done in two years so it’s actually more like three years with all the pre-requisites done first.
Whew!
Or…you can go for a BS degree which takes four years and can actually be done in four years unless you have to go a summer session (like my daughter), which really makes it over four years. This is supposed to be the desired entry level for practice. HOLD YOUR FIRE, I SAID “SUPPOSED TO BE”!
Or…
If you already have a BS or a BA degree, you can go into an entry level Master’s Degree program because it is really dumb to go back and get an AA degree because you already have a BS degree and you really don’t need one of those again, right, and the MS degree program is only 12 – 18 months.
And somehow through all this, you have become an RN.
Congratulations!
But…now you are wondering if you should go for a higher degree….
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So…
If you have an AA and you want to get your BSN you can go back to school either on campus or online, for which you will pay a lot of money as there are a lot of RN-to-BSN programs out there to help you if you think maybe you should do it as the BSN is SUPPOSED to be the desired degree and you feel as though it is your professional duty to do it, but you won’t get any more money for it or anything, but you will have BSN after your name which, if you are like me, is worth every penny and every bead of sweat….
Sorry, I digress…
Or, if you want to do something other that bedside nursing you can take that BSN and get your BSN-to-MSN either on campus or online or if you are really ambitions you can go right for the RN-to-MSN programs since you have an AA degree under your belt and now you can be a manager or a nursing instructor or work in public health and make approximately 50% less than you did as a staff nurse, but hey, you are willing to sacrifice for your profession.
Right?
But it gets better!
You can take that BSN or MSN and head for a doctoral program if you really want to do research and teach, that would be a PhD, or wait!, you want to be an advanced practice nurse or nurse practitioner as they are called and now you have to have your doctoral degree when you only used to need an MSN but they changed the rules and now to do that you need a doctoral degree called the DNP, which is different from the PhD because it is a practice doctorate as opposed to a research doctorate…..
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No wonder folks outside the profession think we’re off-the-wall.
But we aren’t.
We’re unique.
Our profession is flexible.
In spite of the light-hearted take on the educational opportunities, if you read between the lines what you see is that there is an entry level into nursing for everyone at any stage of their lives who are willing to work for that “RN” after their names.
What you see is an unbelievable number of opportunities to advance your education in a variety of ways. If you want it, it is available. No four-year-undergrad-followed-by-three-years-graduate school, like lawyers. Unless that is what you want to do. We have options. In that, we are unique.
What you see is a profession that has two terminal degrees in the PhD and DNP. Now, I’ve heard there is some controversy about this, having two doctoral pathways in nursing. I see it as flexibility in being able to receive a higher education that will take your career where you want it – to the classroom/research or to an increased responsibility for patient care.
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Nursing does not have a lockstep education pattern. We don’t have a “one size fits all” education system because we don’t have “one size fits all” nursing opportunities.
And we most definitely don’t have “one size fits all” nursing personalities.
Think about it. Nursing allows changes in specialties. Unlike law or medicine, we can change our focus and switch our area of specialty long after we’ve entered the profession.
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Sure, we argue and debate amongst ourselves. All the way from the best way to become a nurse down to whether or not we have one or two terminal degree options.
But folks, we’re all nurses. We are more alike than different and at our core we are solid.
So maybe we need to come together (Beatles reference!) and realize that all the different factions of nursing need to embrace the fact that we are nurses.
We can do that, I’m sure of it.
Because nursing is unique.
And that’s why we do what we do.
**The post was originally published at Kim McAllister’s blog: Emergiblog.com**
November 9th, 2008 by Dr. Val Jones in Audio, Expert Interviews
5 Comments »
I was following an interesting conversation on Twitter between several nurses. They were expressing concern about how nursing stereotypes were damaging to their profession. I invited them to discuss the subject with me via podcast.I have summarized some key points below.
You can listen to the whole conversation here.
[audio:http://blog.getbetterhealth.com/wp-content/uploads/2008/11/nursing.mp3]
Participants:
Gina from Code Blog (6 year veteran blogger, and has spent 11 years as an ICU nurse)
Strong One from My Strong Medicine (an anonymous blogger, athletic trainer and nurse of 3 years)
Terri Polick from Nurse Ratched’s Place (has held various positions in nursing, including psychiatric nursing for 20 years)
Current Nursing Challenges:
1. Nursing Instructor Shortage – nursing instructors make about 25% of the salary of nurses who do clinical work. Therefore, there are long wait times to enter nursing school due to instructor shortages. Many students can’t afford to wait, and choose other careers.
2. Inequality of Respect – some nurses feel that they have to continually prove themselves despite their training and qualifications. Patients often express disappointment or annoyance when they see a nurse practitioner (rather than a physician) in a group practice. Some doctors still expect nurses to give up their chairs when they enter the room.
3. Nursing Stereotypes – the “naughty nurse” and “nurse Ratched” images are still very much in the forefront of peoples minds when they think of nursing as a specialty. Some people believe that nurses simply pass out pills and make coffee, when in reality they are active in complex technical procedures and saving lives. These stereotypes and misconceptions denigrate the education and technical expertise of nurses.
4. Primary Care Doesn’t Pay: nurse practitioners incur higher debt and have lower salaries than specialist nurses. Just as in the medical profession, there are no incentives for nurses to choose careers in primary care.
Strengths of Nursing:
1. Nurses Are Better And Brighter Than Ever – since getting into nursing school is so competitive, the quality of individuals who are entering nursing school has never been higher.
2. Job Flexibility – nurses can easily transition to part time work for maternity purposes. Nursing careers offer a wide variety of work experiences – from nursing home work, to cardiothoracic surgery. One license offers hundreds of various opportunities.
3. Job Satisfaction – saving lives and serving patients contribute to a sense of job satisfaction.
What can be done to improve and advance the US nursing profession?
1. Establish an Office of the National Nurse. The National Nursing Network organization is promoting this initiative. The National Nurse would act as a government spokesperson for nurses- promoting preventive medicine, increasing awareness of nursing, and securing financial support for nurse education. He or she would be the chief nurse officer of the US public health service.
2. Do not be afraid to speak up. Nurses should feel comfortable defending their professional ideals, and discouraging stereotypes.
3. Blog to raise awareness of nursing challenges and successes.
**Listen to the podcast**
November 7th, 2008 by Dr. Val Jones in Expert Interviews, Health Policy
7 Comments »
There is a critical shortage of primary care providers in the United States. The public’s perception is that there is no shortage, and politicians have spent very little time talking about how to address the shortage. The American Academy of Family Physicians has been carefully studying this issue and strongly recommends incentives for physicians who would consider primary care: increased reimbursement for non-procedural work, and medical school debt-forgiveness are two of many.
The universal coverage system in Massachusetts immediately unmasked the problem of the primary care shortage. Newly insured citizens have been astonished to discover that they cannot find a primary care physician even though they want one. Wait times often exceed 6 months, and very few physicians are accepting new patients.
I have had the privilege of listening in to various healthcare reform discussions among politicians and advocacy groups here in Washington. Every time I raise the issue of “what will you do about the primary care shortage?” they offer the same tepid response: all providers will need to “work together” to provide primary care services, and innovative programs like retail clinics and nurse-driven care models will help to fill the gap in physicians.
My friend and fellow blogger, Dr. Rich Fogoros recently wrote an amusing (and cynical) post about how physicians should simply “hand over” primary care to nurses. (The same argument that many politicians seem to be making). The only problem with this reasoning is that nurses may not be willing to provide primary care services for the same reasons that physicians aren’t too keen on it: the pay is low, the workload is grueling, and there are other career options that offer better lifestyle and salary benefits.
I spoke with a group of nurses on a recent podcast about this very issue and their view was that, “we’re not suckers” – primary care is not as appealing as ICU work, for example.
Gina (Code Blog): Not every nurse wants to go back to school for additional years and shell out a lot of money to become a nurse practitioner and then not make a whole lot more than we’re making now. I’ve worked with nurse practitioners who have come back to work in the ICU because they can’t make enough money in primary care to support their families.
Strong One (MyStrongMedicine): We don’t have enough educators to teach nursing at our nursing schools. Nurse educators are paid about a quarter of what they’d make at the bedside. There are long waits to get into nursing school because we don’t have enough instructors to handle the influx. Until that problem is solved we aren’t going to see in increase in nurses entering the market.
Terri Polick (Nurse Ratched’s Place): I have a friend who’s a nurse practitioner and she had to borrow over $100,000 for her education. I’m a three-year diploma nurse so technically I don’t even have a college degree – but I’m making a lot more than nurse practitioners and I don’t have all that debt. Politicians need to know that nurse practitioners can’t just “pick up the slack” from physicians. Nursing and medicine are two different specialties and we’re trained to do different things.
So for those of you out there who may have shrugged at the primary care shortage and figured that when the docs are gone, someone else will just pick up the slack – think again. Any national universal coverage system will simply unmask what many physicians have known all along: equal access to nothing is nothing. Without making primary care a more attractive career option for providers of all stripes, don’t expect an influx of any sort into the field.
Long wait times for basic healthcare will probably become the norm in America.
