Nursing school is easy, so I'm told. How could there possibly be a nursing shortage? So I'm talking to a nurse the other day about nursing school.
Nurse: "Nursing school is easy." A lot of it is just common sense"Me: "You paid all that money to learn common sense?"Nurse: "Yep"Me: "Medical school was a bitch."Nurse: "You know what they say about a BSN, don't you?"Me: "No"Nurse: "It's a lot of B.S. It doesn't even train you well for the real world. Real world nursing is so much harder. You get better training in associates degrees with more clinicals."Me: "Interesting. So you pay a lot of money to learn BS. And then get full pay for 6-12 weeks of on the job training while you're practicing on patients?"Nurse: "That pretty much sums it up."Me: "So it's kind of like a residency, only you're getting a real paycheck to learn what your school should have taught you."Nurse: "Yep"Me: "Shouldn't nurses in on the job training be paid a fraction of what they normally get?"Nurse: "Of course not. It's part of the job."Me: "What, the training?"Nurse: "Yes"Me: "Then why aren't medical residents paid full doctor salary for their three to seven year residencies/fellowships if all other health care professionals expect to earn full wage to learn on the job?"Nurse: *silence* "Good question."
ADN's do do more clinical. I have another degree, and chose ADN specifically because of this. The majority of my class are already quite accomplished. Rumor is that BSN's sit at the nurses station all day. ADN's are at bedside and communicate with physicians better.
ReplyDeleteAnd folks... I've just opened a huge can of worms, lets go fishin!
-Second career nursing student
Hmmmm. I've worked with both ASN and BSN students, and I far prefer the ASN. They work harder and understand they have to get their hands dirty. This might be because they tend to be older. And, while the BSNers come from University of Texas, which is a hard school to get into, they don't seem to be any smarter. Real conversation I heard with my own ears:
ReplyDeleteInstructor- So you're going to cut this 25 mg pill in half. So how much will the patient get?
BSN Student- Half a pill?
Instuctor- How many milligrams will the patient get?
Student- (blank look)
Instructor- How much 25 divided by 2?
Student- Let me get my calculator.
To be fair, Happy, although I earned the full of hourly wage in my training period, that hourly wage was not very much - $12.01/hr, back in 1991. And we only got 4 weeks of orientation, and I took my own patient load after the first week or so. I worked nights for years and years to make a desperately needed extra 15%. In 1998 my base pay had risen to the princely sum of $15.50/hr. Contrast that with physician salary and perks when they have completed their "orientation." I'm not begrudging you that - you guys earn it. But as little as the hospital paid us GN's, I think they would have had a revolt on their hands had they suggested we be paid even less.
ReplyDeleteResident pay approximately $41,000/yr. Divide that by 50 weeks (assuming two week vacay), you get $820/wk...80 hour weeks you get $10.25/hr.
ReplyDeleteRIDICULOUS. Especially for the time you've put in and loans you've taken out.
Just saying.
What i dont get is why he calls himself "happy" hospitalist.
ReplyDeleteI wonder what he defines as happy...
Who would read a blog called unhappy hospitalist?
ReplyDeleteSounds like you have alot of time on your hands Happy...Did my Internship 88-89, made $22,500 salary, $1,000 moving allowance, 2 weeks vacation, and the week after Christmas. Conservatively figuring 80 hr weeks, came to a little over $5/hr... thats why I stole like $30,000 worth of scrubs...
ReplyDeleteFrank, M.D.
Welll, I'm chatty today, but I just have to address your nursing shortage comment. I don't believe it. There's a hospital nursing shortage, yes, but it's one the hospitals have brought upon themselves, for two reasons.
ReplyDelete1)It's my firm belief hospitals are slow to hire so they can tell their staff "hey, we got no one else, you're just gonna have to work short today" so they don't have to spend the money on adequate staffing. I recently went job-hunting, and I knew from previous experience that the hospitals' preferred online application process would get me nowhere. It took going up the unit, in my scrubs, resume in hand with the announcement "here I am, I can work today." This is for a PRN position - very low risk from the hospital's point of view. My coworkers have had similar experiences - it took them weeks to get hired for even posted positions. So I have to conclude they deliberately underhire so they can keep us short which translates into saving money for them.
2)Hospitals are rigid and inflexible. They pay lip service to "nurse friendly" and "nursing congress" but there's this undercurrent of "like it or leave it." Area hospitals only hire for 12 hour shifts, period. Well, for women with small children that doesn't cut it. They'd get more staff if they allowed 8 hour shifts, every 3rd weekend instead of every 2, implemented the Baylor program, tripled the holiday pay so there'd be plenty of volunteers, etc, but they don't want to go the trouble or expense of working out the details.
The multiple entry pathways to becoming a registered nurse has been asked and answered ad nauseum, and I have no reason to replay the fray here.
ReplyDeleteHowever, the individual you quoted is patently an ass, and likely stupid to boot. Nursing is a second career for me, and with a BA already under my belt I went the BSN route. Frankly, I studied my tail off, and I am fairly skilled academically. Maybe my focus on the elements of nursing that AREN'T "just common sense" had something to do with graduating summa cum laude, with the Clincal Excellence Award for the year, and all after getting a grant to cover all my tuition and books [smart + poor = money from my Uncle Sam] This is not meant to be self agrandizement, but the truth is that good nurses are smart nurses. A chimp can learn procedures, but as earlier stated here, the "why's" are the tricky part.
Pattie, RN [BSN, CRRN, CHPN, COHN]
Then Happy, you need to refocus that unhappy part of Happy into a teaching Happy. I am sure you would build a great relationship with those new nurses who, would now be so happy when they see you, happy coming down the hall.
ReplyDeleteThey will look forward to your visits, knowing that you are not just a "drive-by" internist, and that you will actually tell them what you think might be going on with their patients, and ask them if they agree, or have anything they think you should know...
After all, some of us have spent years working with corporate execs on a totally collaborative level, and do form negative opinions of co-workers who don't play well with others on the team. We see you guys (Docs and nurses, etc.) as a co-workers, not at all of the executive realm. So when there is a lofty attitude, or witholding of needed information, we tend to move to eliminate you from our team as the weak link. The second career folks know they have a lot to learn in this new field... we are more open to it than most. And tend to be more the cool heads.
-Second career nursing student
Happy is 100% correct. I don't agree with everything you say, but I agree with this.
ReplyDelete-RN turned MD
I don't know about fairness of the Residency payment, but there is certainly precedent. For instance, at least when my bro-in-law went through, apprentices in the building trades got considerably less than the Journeymen (Journey people?). IIRC his apprenticeship was about 5 years at the time.
ReplyDeleteNursing school is definitely not easy, but I don't think it's difficult in the way other academic disciplines are difficult. I have good standardized test scores and took an upper level bio course in Virology last semester, doing well compared with the senior level biology majors. I'm "struggling" in nursing school in the sense of constantly having work to do and being anxious all the time, but I haven't done much reading and have gotten decent exam scores. Just like real nursing practice, there is a lot of time wasted on paperwork.
ReplyDeleteI did 13 weeks of everything, ADNs do much less. 13 weeks peds, 13 weeks L&D/postpartum/crotch, 13 weeks psych, 13 weeks public health, 13 weeks med/surg, 160 clinical hours of critical care, blah blahAs per my comment above, what are we doing in these 13 weeks of X, though? Care planning where the majority of time is spent looking up research articles? That teaches you a methodology, but not patient care. BTW, 160+ hours of critical care clinicals is not the norm for a BSN program.
That they are screwed so often financially is evident by the big nursing shortage which has arrivedActually, the research shows that the patient load is a bigger factor than salary. The nursing shortage is a result of the vast number of nurses who leave nursing work after a few years on the job. One study showed that over 60% would return to work in nursing if patient-staff ratios were better controlled.
As a new-graduate nurse, I made less per hour during my orientation period than when I was on my own. Granted, it wasn't as big of a difference as with residents/attendings, but proportionally it may've been somewhat close.
ReplyDeleteMaybe nursing school WAS easy for THAT nurse, but it doesn't mean that nursing school is easy. Go and ask ten or twenty random nurses that you admire if they thought it was easy, too...
ReplyDeleteFurthering nursing education is great, and pretty much essential, but numerous degrees, and fluff, can not replace the importance of a nurse who actually cares, has compassion, and has a load of experience. An experienced bedside nurse can pretty much out shine any self promoter who enjoys listing degrees as a past time, versus someone who is humble, intellegent, vigilant and is calm and cool in the middle of any emergency and knows exactley what to do. I don't care about all the other stuff, just as long my care is the nurse's priorty and knows and understands what I need, and when I need it.
ReplyDeleteSpeaking of nurses, and education you know I am an RN, and I have known and worked with some of the brightest, and smartest nurses that are not all RNs, but LPNs, mind you they had quite a few years of experience, but these skilled nurses where able to recognize serious potential life threating issues, that an otherwise experienced RN had missed. I have been an Rn for only 3 years, and my first job I was trained partially by an experienced LPN, and she was amazing, she taught me things I never knew, even after I was on my own, and handeling my own emergencies. She eventually went back to get her ADN, but in my book she already had the knowledge of an RN, and I would take her as my nurse any day.
ReplyDelete