In Witch's post it was mentioned that apprenticeship is going out the window. If anything it is growing and will continue to do so. Even now there is usually only one or two trained nurses on the ward and everyone else is an untrained apprentice getting on the job training only. They are not training to be nurses yet as that is years away. They are training to be health care assistants. Theyhave the option to go to uni later on and train as a nurse using credits from their apprenticeship. Nice people a lot of them but the lack of knowledge is scary. Most of them have no desire to actually become Nurses. They don't want to deal with the stress, the drugs, doctors, emergencies, etc etc.
Their lack of knowledge is appaling. That is because apprenticeship style training only is crap. Most of them are very nice to the patients. But then they do something stupid like open an IV pump up and take the tubing out (so that they can change a patient's gown and weeve the IV line through the sleeve) without clamping it...when potassium is infusing. They don't understand a thing about heart failure and tell patients on furosemide that the sure do wee a lot. Stupid things like that.
Let's be honest: Doctors do not know anything about nursing, nursing issues etc etc. Nursing is a completely different science and profession from medicine. Please stick to diagnosing, prescribing, where to get the best cocaine and cheating on your wife. Leave the nursing issues to the RN's.
Let us nurses talk about education levels for nurses,
Let 's get some facts straight.
Degree nurse does not equal nurse who doesn't believe in doing basic care herself. Quite the opposite.
My university required us to be in the top 10% of our high school class and have two years of university level science and math with top grades to get into their nursing program. They had 50 applicants for every one place each year. We were taught by masters (and higher) degree nurses who taught us the importance of being good bedside nurses.
The university nurse training in England has as much on the job training as the old style training did.
When California instituted nurse patient ratio laws ensuring that each degree educated RN have no more than 6 patients in hospital (ensuring that the RN can nurse them properly and avoid malnutrition etc) the number of applicants to their nursing program that year rose dramatically. Something like 80,000 RN's came back to the workforce as well. To do bedside nursing. Yeah.
Anyway I responded over here with the following.
Degree trained nurses are not taught to be above basic care. They get plenty in the way of hands on placements. They are always on the wards for weeks and weeks at a time.
There is not such thing as "the modern nurse who thinks she is too posh to wash". That is a myth perpetuated by fuckheads who don't know better or cannot understand the situation. I am degree trained, have nursed for many many years, and have worked with many new grad nurses.
I have yet to meet any highly educated nurse or any RN who thinks that he is above basic care. Most just are not in a position to do it. So I am thinking that maybe you are just a liar, or a goofball repeating statements that you don't understand. To posh to wash nurses must be out there someone, but they are rare. It's not something I run into as a bedside nurse among other bedside nurses.
I trained at a well respected nursing school in the northeast. I had to have two years of uni level science and math and top grades to even be considered for their nursing program. I was able to take it together and stay in if my grades were high enough.. And even then they had over 50 applicants for every one place.
Our nursing instructors had masters degrees in nursing, doctorates in nursing and PHDs.
They taught us to be bedside nurses. They hated the medical model of care.
They taught us that hospitals should not be using care assistants instead of RN's and that highly educated nurses should do all care. They taught us that if we didn't do basic care ourselves that are patients would not be assessed properly and that would lead to poor outcomes. They taught us that nursing was a completely different science to medicine and that we were nurses not junior doctors. They hated the whole diagnose and prescribe thing like the devil hates holy water. Their degrees were in nursing, not medicine.
These same instructors, despite holding master degrees and higher still did shifts at the hospital as bedside nurses. They attended our placements with us, and needed to be up to date. Therefore they stayed in touch with basic care and reality.
Not every school of nursing is this good but they should all be.
They taught us that if we were ever working in facility where we were taking on more than 6-8 patients at a time that we needed to get the hell out of there and find a new job. "If you are working for a hospital that makes you take 10+ patients you will have no choice but to triage and delegate all basic care to care assistants. THIS IS BAD. Never EVER work for such a hospital". These were nurses with masters degrees who were teaching us these things.
"such a hospital" is every fucking hospital in the NHS and most of Canada and the USA.
The new grad nurses are very well aware that people think that they are too posh to wash. When patients are having an acute atttack of CCF and are short of breath these new nurses are putting people on bedpans and handing out meals rather than notifying the on call and getting orders because they are so afraid of being labelled as "uncaring" by visitors, health care assistants, and guys like you. How sick is that?
Remember you only have one nurse for a large group of patients. If she isn't getting the diuretic drug etc for the heart failure patient who is going south then NO ONE is.
You wouldn't believe the scare stories that are happening because many of these new grads are on a mission to prove that they are not to clever to care and all that. I have seen patients with an HB dropping faster than a hooker's knickers not get intervention nor their blood transfusions etc for hours and hours because the lone RN was getting grief off of visitors and patients for not getting the bedpans out fast enough.
You people need to stop it with this bullshit (perpetuating the myth that degree nurses are not into basic care) because people are getting hurt
I don't like your link but agree about NOT using degree nurses as pseudo docs. Is that clear?
Forget about the practitioner thing. I never met one personally. Even though I know many highly educated nurses I don't know of ONE who wants to be a practitioner. Not one. Not one. I know they are out there but I don't think that they are as common as you fear.
If they forced all of us degree nurses into the practitioner role the vast majority of us would get the hell out of healthcare. Most degree nurses have no desire for the frat boy, medieval world of medicine. Let's be honest: Medicine is simply about you guys swinging your dicks around to see who has the biggest one. No thanks. If I want to make more money I can uproot the family and go abroad and work as a nurse. Registered Nurses in other industrialised nations make more money than junior doctors in the UK.
Read here and scroll down if you want to see how ratio laws requring degree educated nurses at the bedside with a very small number of patients brings RN's into the workforce and back to the bedside. And when the article in this link uses the term "Nurse" they are referring to university educated RN's.I agree with the doctors when they say that we should all just stick to what we know professionally. I will blog about issues in nursing and you guys please stick with the medical stuff. Blog about what you doctors know. Things like cocaine, philandering, cocaine, philandering, cocaine, philandering.
Re-Edited on 10/1/10 because of the glaring errors that result from my inability to type as fast as I think. Notice that I did not take out the stuff about frat boys, cocaine, and sex addiction.