Saturday, November 26, 2011

Nursing, Not For Everyone, Not For Most People, by Andrew Lopez, RN, Nurses Views of The Nursing Profession

Nursing, Not For Everyone, Not For Most People, by Andrew Lopez, RN, Nurses Views of The Nursing Profession

Pros
Ultimately Fulfilling, Satisfying, Above Average Pay, Experience Opens up multiple career options (Travel Nursing, etc)

Cons
Backbreaking Work, Expect To Work Shortstaffed, Expect To Be Unappreciated By Employers

The Bottom Line
Nursing is no longer an attractive profession for young women to go into.

Updated 07/29/05:

This review has come under a lot of fire since I first published it. It's sole purpose is to shed light on the darker side of the Nursing Profession. The side and the details you won't hear about working as a nurse from Nursing Schools, Guidance Counselors or most nurses themselves (they're only too aware that a shortage of nurses makes their jobs much harder to do).

It's a difficult article to write knowing it will potentially turn people off to nursing, or persuade them to choose another career path.

For all the talk of a nursing shortage, little is said about the fact that many licensed nurses are no longer practicing. The toxic conditions on the floors have driven them out, literally. If every licensed nurse was working, we'd have plenty of nurses and there would be no shortage. Instead, more nurses are working less or quitting completely.

A common concern among nurses is "Who will take care of us, when we get sick." It's a valid one considering how many nurses are leaving the floors.

I feel it's important and necessary that all sides of the issue be explored. I've no intention of leaving the nursing profession, don't feel I'm burned out. I do intend to open your eyes so you'll know full and well what you're in for.

It's a fact that nursing students on graduation are deciding to leave the profession after only a few months on the job. The abuse they get is simply too much. Imagine after getting through nursing school, only to find it was "much harder" than you imagined to work in Nursing.

It's a fact that seasoned nurses are leaving the floors, burning out, retiring early, and still eating their young.

It's a fact that nurses are badly needed and will offer stable job opportunities for the next two to three decades if you can hack it.

Having said that, please read on:

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Nurses are Licensed Professionals who's practice is regulated by Nurse Practice Acts, and the State Board of Nursing of each State.

Nursing is a profession of caring. The actual practice of Nursing is about something entirely different.

Nursing is no longer an attractive profession for young women (historically the largest segment of the population entering Nursing) to go into. It is having difficulty competing with corporate and other service industries that offer better working conditions, higher pay, no weekends/holidays, more prestige and much less stress.

It's a given that as a nurse, you're on a daily basis exposed to hostile families and patients, deadly diseases, abuse from doctors, families and other nurses.

This is unfortunate when a simple fact is true. When Nursing Staff in hospitals and Nursing homes are not adequate, patients get sicker and your family members die needlessly. The worse our working conditions get, the less time we'll spend on the floors, the less nurses there will be to care for you and your family members.

Paying Nursing salaries makes up one of the single largest "line items" in a hospital's budget. It is an item they cannot do without. Without nurses, hospitals shut down. Period, end of story. Entire hospital units are shut down, surgeries are delayed, Emergency Departments are put on "Divert" when Nurses cannot be found to work.

Why then, are nurses clearly expendable in the eyes of those that employ them? It feels like we're resources to be used and abused till we're no longer able to work. At that point, we're simply tossed into the trash and forgotten. Once a nurse becomes disabled due to back injury (the most common injury due to lifting/moving patients (often without help)), age or illness, their bedside Nursing career is over.

A lucky few may be able to transfer their nursing skills to Case Management, Legal Nurse Consulting, Managed Care and related fields.

It's a profession that's long since been twisted and manipulated to the financial needs of insurance companies, managed care and hospital administrators looking to milk and stretch and get the maximum amount of return from nurses for the least bit of pay.

I've been a nurse for over four years and worked in a variety of settings. My initial training was on a Medical/Surgical/Telemetry floor caring for acutely ill patients with a generous dose of patients in for Cardiac concerns. Since moving on from that environment, I've done Home Health, Nursing Home and continue to do Hospital Nursing through agencies.

Regardless of the facility or type of environment, the same concerns are clearly visible.

Too many patients, too little Nursing time to give them the care they need.

Insurance companies simply don't care that a patient may be too ill to go home, they're only concerned with the cost to keep them in the hospital.

Nurses are burning out from overwork and there is no one to take their place or give them relief. Nursing is a 24 hour, round the clock obligation, someone has to be looking after the patients.

This has two effects on the two types of Nurses most likely to enter the profession.

1. Those who enter the field because they love the work and caring for people. These often are family members who have seen the care that was given to their loved ones and want to provide the same type of care to others, they inevitably burn out:

* These nurses are frustrated by their inability to give their patients the care they deserve.

* They see their sick patients going home before they are fully recovered (insurance companies will only pay for so many days). It is usually very clear to nurses which patients will be returning for exactly the same ailment due to their early release.

* They are often given more patients to care for than they can safely handle and asked to work extra shifts and overtime despite already being tired and having family obligations.

* They do not have time to "teach" the patients they are discharging (or family members) how to care for themselves at home. Many problems could be alleviated or minimized with proper patient teaching of warning signs or medication usage. However, time for teaching is not factored into our patient loads.

* Realizing the futility of their situation, these nurses may do the minimum needed to get through a shift. In the end, it's the patient that suffers.

2. Those who enter Nursing because it's lucrative and in most places high paying, they often burn out, leave or move on:

* These nurses often become overwhelmed by the amount of work that' involved in providing adequate patient care. It's a profession that requires you to "get your hands dirty." A good comparison for nursing is plumbing. It's a trade that pays well and requires hard labor and skills. It also requires you to kneel down and reach into places that the average person would balk at.

* They see Nursing as a career "stepping stone" that will open doors to bigger and better opportunities (Nursing does this quite well as you can go far with Acute Care Nursing Experience behind you). In the meantime, knowing that they'll be leaving eventually, they do not do their best or put forth 100 percent (110 percent is required these days) in caring for their patients.

* It may come as a surprise to some after graduating Nursing school that they'll "actually have to touch" patients and do direct care. This is especially true of nurses who go through BSN programs hoping to go straight to administrative positions with at best a minimum of bedside skills. These nurses may do the minimum needed to get through a shift. In the end, it's the patient that suffers.

It's frightening to think of how little time nurses have to spend with their patients assessing their illnesses and providing direct care.

A common slogan among nurses when it comes to patients is "Do you want to talk to the Doctor in charge, or the Nurse who knows what's going on?

A physician, if their lucky, might spend a max of 10 minutes per day per patient in a hospital. They are also "stretched out" by managed care companies that overload them with patients to care for.

Nurses do slightly better at 10 to 15 minutes per day, the difference is we're there on the floors with the patients, passing medications and looking in, in case anything does go wrong.

Nurses are responsible for the 24 hour/day monitoring of patients in hospitals. It's our charge to keep the doctor informed when patients are going downhill or have complications. When a patient is going bad, we are the first to know, not the physician. It is the nurse that must call the physician, inform him/her of the patient's condition and carry out any orders or treatments.

In short, a hospital cannot function without adequate Nursing staff. To do so means compromising the quality of care patients receive. Many hospitals will deny this fact and flatly refuse to consider Nursing concerns when we raise them about our inability to provide safe care with the resources a facility provides.

As a result, nurses are leaving the bedside in droves. Those that are left, must deal with staffing shortages that mean working extra hours (many hospitals have instituted Mandatory Overtime policies that required already tired Nurses to stay unexpectedly when call outs occur) when it is not safe for them to work and to ignore family, childcare and safety concerns.

Will I stay in the profession? Yes, I went into it because I enjoy giving patient care and know it means the world to the patients safety and well being.

Would I recommend it to others considering the profession? Depends on why they are going into it and how well informed they are about the work.

Typically I recommend that a student work as a Nursing Assistant in either a hospital or Nursing home before considering Nursing School.

This will give them a firsthand look at what Nursing entails and how nurses and the staff in Hospitals and Nursing Homes interact. It is often not a pretty picture.

After seeing things firsthand, many quickly change their mind about going into the profession.

Sincerely,

Andrew Lopez, RN


The Shortcut URL To This Section Is: http://www.nursefriendly.com/views/


In this section, you can hear from Registered Nurses, Licensed Practical Nurses, etc, new and old on why they would or would not recommend going into Nursing as a career. Our articles are frank, uncensored and brutally honest. We hope they'll help you make your decision if you're unsure about nursing being for you.

It is not our intent to "scare you off" from Nursing, some of our reviews are quite positive. It is our intention to help you go into Nursing with "open eyes" and aware of what you can reasonably expect as students and entry-level nurses.

Do you have questions or comments about our articles? Like to express an opinion? Visit our forums and make it known!

See also:
Licensed Practical Nurses, http://www.nursefriendly.com/lpn
Registered Nurses, http://www.nursefriendly.com/rn/
To Stay In Nursing or Not: http://www.nursingdiscussions.com/stay


Nursing, Not For Everyone, Not For Most People by Andrew Lopez, RN
Nurses are Licensed Professionals who's practice is regulated by Nurse Practice Acts, and the State Board of Nursing of each State. Nursing is a ...

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The Beauty of Nursing by Rebekah Hinton, BSN, RN, Virginia Nurses Views of The Nursing Profession:"I have been a caretaker for as long as I can remember. I am the oldest of four daughters and have always been a second Mother to my siblings. Going into nursing seemed to be a logical choice for me. As a student I was eager to learn and worked very hard to get the best education possible. I entered into a Bachelor of Science in nursing program without knowing the difference between a RN program and a BSN program."

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Nursing: How Do I Find Out If It's For Me? by Angela Eichenlaub, RN, BSN:"The face of nursing has changed" or "Nursing is not what it used to be" are phrases I often hear from seasoned staff. I wish I knew what nursing "used to be" so I could compare! My own personal advice to anyone considering a career in nursing is to take your reason for entering the profession into account. Some go into nursing for money, some because they have always wanted to and some people go into nursing because they don't know what else to do."

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To Be Or Not To Be, by Sharon Jones, RN, Ohio Nurses Views of The Nursing Profession:"To Be…Or Not To Be… was never the question for me. I had always been a caretaker of sorts even at a very young age. The decision to return to work was based more on a career that I could relate to and be employed at. To be it was… and I started school at a local college for a Registered Nurse program. Almost two years into school, all my pre- req. courses completed and a waiting list to get into the nursing classes (a very unbelievable thing looking back- too many students- many had to wait) forced me to change course of action that lead to LPN school."

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Twenty Years of Nursing by James E. Meekins, North Carolina Nursing Views:"Thirty years ago I walked into the Navy recruiters office; laid off, without a real skill and signed up to be a Navy Hospital Corpsman (medic). I learned basic patient care---and basic first aid; and learned to work under the direction of a physician or nurse. I enjoyed what I did, the pride of being part of a team; accomplishment of a common goal, first aid in the field with Marines, or care of a patient in the hospital. . . ."

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Nursing: Pros and Cons by Christy Picton, RN, BSN, Illinois Nurses' Views of The Nursing Profession:"I struggle when asked whether I would recommend the nursing profession as a career. In the end it comes to down to a weighing of the pros and cons. Let me begin by introducing you to some of my patients, my "pros" so to speak. . . . "

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"One of The Lucky Ones" by Christine Cruz, Minnesota Nurses Views of The Nursing Profession:"My name is Chris. I have been an RN for ten-years. I have worked in a wide variety of nursing settings, from home care, long-term care to telephone triage, clinics and nursing management. Upon graduation from nursing school in, May, 1993, I had eagerly anticipated a new RN position at a local hospital, in one of its med-surgical units. . . ."

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You Want to Be a Nurse? -- Better Leave Your Heart Behind by Pennye Diane Morgan Shaw R.N., Texas Nurses Views of the Nursing Profession:"So you're thinking about being a nurse? You probably are a person who wants to make a difference, to help others, to be a compassionate healer. Are these are the same reasons I entered the nursing profession about 9 years ago. I had been through the emotional experience of watching my father being diagnosed with colon cancer. I had been by his side though radiation therapy, and though surgery and recovery. I watched as he struggled to cope with the drastic changes to his body as he tried to return to a normal life. . . . "

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My Advice for New and Potential Nurses, by Pam Lowry, Illinois Nurses Views of the Nursing Profession:"According to the American Association of Colleges of Nursing (AACN), "The United States is in the midst of a nursing shortage that is projected to intensify as baby boomers age and the need for health care grows." They also state enrollments in nursing colleges are at a six-year decline. According to JAMA there will be a shortage of 400,000 nurses in the U.S. by the year 2020. AACN goes on to state there are declines in nursing faculty leading to limitations on enrollment, the population of R.N.'s is the lowest it has been in 20 years, and vacancy rates at hospitals are high. . . "

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An Insight Into Nursing by Leah Stockdale, R.N., B.S.N. Maryland Nurses Views of the Nursing Profession:"Although I am extremely proud of being a nurse, I will have to say that I am not sure if I would choose the profession if I could go back. At the same time, I probably would not choose any career in the health care industry. In my opinion, as far as hospital nursing is concerned, the negatives outweigh the positives. That is why I am currently in the process of applying my nursing skills and education to another field. . . "

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A Letter To A Future Nurse by Kristina Rzanca, LPN, Michigan Nurses Views:"Being a Nurse is a career you can be spiritually, emotionally and financially satisfied with. In this day and age this is a unique opportunity, but it is not for everyone. A special person with qualities such as empathy, compassion, intelligence and above all patience should only apply. . . . "

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To Be A Nurse Takes A Special Kind Of Person By Vicky Oliver, LPN:"As an LPN for the last ten years I believe I could give some insight on my experience as a nurse. I am the type of person who is always doing something for others instead of me. My experiences in nursing consist of Medical Surgical, Doctors' Office, Emergency Room, Surgery, GI Lab, Urology, Utilization Review, Recovery Room, and the Nursing Home. Anyone that goes into the nursing profession needs to be a very caring person, someone who wants to give to others and someone that is very dedicated. . . "

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After Fourteen Years As An RN, I Am Not Sorry For My Choice By Lynn Kash, RN:"Would I recommend the nursing profession? That is a good question that requires a lot of thought. Nursing was not my first choice of careers. I studied accounting in college, and after working in the business world, decided it was not for me. I fell into a job as a nursing assistant and found patient care to my liking. I then started nursing school and the rest is history. . . .

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A New York BSN's Point of View, By Melina Begun, BSN, RN, Clinical Administrative Liaison Nurse:"Nursing is suffering. Thousands of caring people enter into this profession every year only to become disillusioned by its reality. When I first started to study nursing, I immediately felt a connection with its history and our potential to be leaders in the medical community. Excited by all of the knowledge and skills I acquired in my Ivy league nursing program, I was astonished by the harsh reality of nursing in today's hospitals when I started working as a staff nurse. . .

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Tips To A Good Start In The Nursing Profession by Diane Hartley:"My name is Diane and I have been in the nursing profession for 12 years. In those years I have seen very many changes with this profession. One of the first changes was in DRG's. This for those of you who do not know what they are is diagnosis related groups. . . "

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See Also: Certified Nursing Assistants, CNAs, Certified Registered Nurse Anesthetists, Disabled Nurses, Male Nurses, Men In Nursing, Legal Nurse Consultants, Licensed Practical/Vocational Nurses (LPNs/LVNs), Registered Nurses


Please choose from the following (Links will open up a new window):
Nurses Views Recommending The Profession,
Nurses views Not Recommending The Profession.

Choose Nurses Views by State: Alabama, California, Florida, Indiana, Louisiana, Michigan, Missouri, New Jersey, New York State, North Carolina, Pennsylvania Tennessee, Texas, Virginia

Male Gender Bias - Entrance to No Mans Land by Nurseman
Are you a male and thinking about entering the world of nursing? Have you ever wondered why they're so few men in nursing? If you are young, single ...

    Gender Bias Against Male Nurses:
    http://www.nursingdiscussions.com/gender

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      Do I want My Daughter to be a Nurse by Raye
      I am not sure why I became a nurse. I enjoy the smile on the face of someone I have helped. I worked Emergency and got quick fixes and instant ...

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      Is your life worth the BIG BUCKS? by SurgRN911
      Why are patients and families feeling they are getting less attention, and sometimes less than adequate care in a hospital setting? I wrote an ...

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      It's not all bad! by LauraRN
      Wow.. a chance to give my opinion on nursing.. here goes.. :) When I was in college, I thought I wanted to be a math teacher. As I got higher in ...

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      Requirement: Have an off-beat sense of humor by clooneyfan A review by of my favorite writers (SurgRN911) about the nursing profession prompted me to write my own review. You can read her original review at ...

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      Nursing Is In My Blood! by Dunkjam
      When I was a little girl I always thought that I would be a singer and marry Paul Anka! I thought I would live a glamorous life and travel around the ...

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      Where Are Our Leaders? by Moonflowerck
      I have been an R.N. for 28 years. My range of experience encompasses nearly all aspects of critical care and pediatrics. I am a bedside nurse; that is my forte. I give quality nursing care; I am a good teacher; I am empathetic and intuitive. However, I am not a leader. My experiences in various leadership roles during my career were neither fulfilling nor very productive.

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      Nursing: Is It A Career For You? by Bobstein
      When I was faced with choosing a career I wasn't clear exactly what I wanted to do with my life. I enjoyed the sciences and helping people, and with high unemployment rates in the mid-1970's I chose to enter the nursing profession.

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      10 CONCEPTS TO CONSIDER WHEN DECIDING IF THE NURSING PROFESSION IS FOR YOU
      by melissasrn
      Pros: The opportunity to make a difference in someone's life; decent pay; flexible schedules. Cons: Short staffing; floating requirements; little respect; dealing with bodily functions.

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      An LPN's Story of Progress by: NJNurse
      The Decision to Become A Nurse. When I was starting to decide on a career after high school I wanted to cry.

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      The Nursing Shortage: Reasons Nurses Are Leaving The Profession by Rebel5877
      All across America, There are shortages of Registered Nurses (RN's) and Licensed Practical/Vocational Nurses (LPN's/LVN's), and Nurse's Aides entering ...

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      Response to NJ's work in progress by jt1013
      There is a shortage of nurses. That is a given. I have a large amount of respect for LPN's. My sister is one in Kentucky. She has been one for 32 ...

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      My Opinion of The Nursing Profession, by emsopinion
      I have been a nurse for over twenty two years. In that time I have worked in many different fields of medicine.

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      Feast or Famine by lovepepsi
      Pros: the feeling you get when you helps someone
      Cons: short staffing, not being able to save everyone

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      See also:

      "Burnout in my 5th year...another nursing statistic", Aboutmyjob.com:"I always knew I would end up in a helping profession. Nursing seemed like the perfect choice. It combined my natural curiosity about health and science with the giving, hands on, human interactions of bedside care. I also knew that nursing offers a great deal of flexability within the profession. You can change specialties, change shifts, and work in a variety of settings. Before I decided to study nursing, I considered teaching,conservation and journalism. Prior to becoming an RN, I worked in recreation/parks, the foodservice industry, and held a factory/production type job. I graduated a few years ago with my BS in Nursing. I certainly don't regret having gone that route, but to be honest I feel disenchanted with the health care environment and nursing in general.It certainly is nothing like what I thought it would be.The hospital setting is like a pressure cooker type of environment."
      http://www.aboutmyjob.com/575/burnout-in-my-5th-yearanother-nursing-statistic/

      "I am getting out of nursing to become a teacher", Aboutmyjob.com:"Hi. I made the decision to get out of the nursing profession about two years ago. I have been an RN for three years. I have floated in ER, ICU, Med/Surg and Labor and Delivery. In the back of my mind I always thought, "working conditions will get better with the more experience I have". I finally have come to the conclusion that my working conditions are not changing, in fact, are getting worse. I come home every night with knots in my shoulders from the stress that I go through. I too get physically and mentally strained from being a nurse. Families are so insultive and expect things to happen ASAP. Do they not realize that I am running around with my head cut off trying to keep up with all the requests, duties, and paper work?"
      http://www.aboutmyjob.com/601/i-am-getting-out-of-nursing-to-become-a-teacher/

      "Unhappy in nursing profession too....10 year RN", Aboutmyjob.com:"I have been an RN for nearly 10 years now and I must agree with many of the others who wrote their stories. I always wanted to be a nurse, because I like people and thought I would really want to work helping them. But, the reality of the job is utterly overwhelming. I've tried long-term care,home health, dialysis nursing, physician office and now in-hospital on a Rehab unit. I have yet to really find anything I loved. We are almost always short-staffed both nurses and aides. We are being pulled to other floors now due to the shortage of nurses. I was pulled to a MICU and I've never done that type of nursing ever!! I was a nervous wreck, these patients were very high aquity, on tele, multiple lines etc. I received no orientation, just here are your 8 patients...go to it. It was nerve-wracking."
      http://www.aboutmyjob.com/554/unhappy-in-nursing-profession-too10-year-rn/

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