Overpaid nurses

[Farmer Jane]

If that nurse was working that much OT, there should be a BON investigation re: quality of care. No one can work that much OT and be safe.

If that nurse was falsifying his/her payroll, his/her license should be sanctioned.

Yep.

And Taurus, this isn't your run of the mill, work on a medical floor type of job. This is a prison nurse position (which, btw, requires a BSN so no "only two years" talk) in a maximum security prison housing violent offenders from an area that has problems with plenty of gangs. It's also a very high COLA. I don't think $100K is all that out of line. I wouldn't do it for that in a low COLA.

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[aged2]

I know we can make a replacement for overpaid MD's someone interchangeable like a I know a CRNA then replace physicians who #itch about nursing salaries!

 

[helpfuldoc2b]

There is no such thing as overpaid nurses, CEOs are overpaid, so are plumbers, and corner store owners. Come on its America, if you can make 200K with your RN, more power to you, stop hating people!!! Some people graduate with a BS in business and make 40K all there life, while others with the same degree makes 1million+ with different choices and career options, doesnt mean one is overpaid and one is underpaid, just means one is smarter with chosing the path that makes him/her more money. Stop picking on a specific field, no on in healthcare is overpaid, they deserve every penny they earn...

 

[telenurse]

I think nurses are paid pretty fairly right now. The ones I know work their butts off for every shift, every day, but I think they do get compensated well for it. Perhaps my opinion would change if I worked as a nurse, I do not know...

I think it depends on the area.
Yeah...if I lived elsewhere, my pay would be crap.
But I can afford a 1800 sq foot house on a 1/2 acre lot with great landscaping, one car is paid off, a truck payment, and a comfortable lifestyle. I was left with some unexpected bills from my father's death, so fancy vacations are out for 2 years, but I have a very decent living. The COLA is very low in my area...in a major city I couldn't even think of affording my house.

How far will my salary go in another city?
Salary in xxxxxx:
$60,000
Comparable salary in San Francisco CA:
$114,736.25

If you move from xxxxxx to San Francisco CA...

Groceries will cost: 76.94% more
Housing will cost: 260.948% more
Utilities will cost: 15.309% less
Transportation will cost: 17.052% more
Healthcare will cost: 35.898% more


Or try East coast

Salary in xxxxxxx
$60,000
Comparable salary in Philadelphia PA:
$84,018.78

If you move from xxxxxx to Philadelphia PA...

Groceries will cost: 55.003% more
Housing will cost: 89.187% more
Utilities will cost: 10.168% more
Transportation will cost: 10.002% more
Healthcare will cost: 22.722% more

http://cgi.money.cnn.com/tools/costofliving/costofliving.html

 

[uppi]

I may and probably will get suspended or baned for this, but I honestly dont care, I have seen enough of these posts by Taurus and its just getting ridiculous.

I mean seriously have you read any of Taurus posts in other threads? I cant believe a Medical School accepted this kid. He has it out for just about EVERY (if not all) allied health professions. He has this obsurd idea that every single allied health professional is out Conquer and destroy MD's. The only posts I ever see from him are farcries about how PA's, NP's, RN's etc are going to try to take over medicine, and that when he becomes a Doctor he is going to do everything in his power to bring them down. Here is one of his recent "proclamations" and attempt to gain followers for his great cause:

I made a vow to myself.

1) I will never agree to hiring an NP or DNP. If I am in group practice, I will do my best to block their hiring in preference of PA's. If NP's or DNP's are currently working in my practice, I will do my best to replace them with PA's. If I can't get rid of NP's or DNP's in my practice, then they will be nothing more than glorified secretaries when they work with me and they can whine til the cows come home about how they're not developing professionally.

2) I will never agree to mentor or precept an NP or DNP student. I will only teach medical or PA students.

3) I will jump at the chance to give my expert opinion if I am asked to testify at the malpractice trial of an NP or DNP. I hope that the jury returns a $200 million judgment and the insurance companies take notice and jack up NP malpractice premiums.

4) I will pressure every doctor I know, the AMA, and every damn meaningful medical organization to not sell out our profession to the nurses.

Anyone else want to make this vow?

I mean come on dude. Keep in mind this kid has NO experience in actually working with any of these professionals. And if you look at his other posts, he talks about how nurses are taking over primary care, NEXT they will take over every other specialty. Same with PA's. His conspiracy is that PA's are wannabe doctors whos "ultimate goal" is to become the equal of a doc. Its like he doesnt even realize that part of a PA licesure REQUIRES MD/DO supervision. Its seriously scary to think this kid might be practicing medicine in a TEAM oriented environment someday, probably wont be for long, but the fact he might be for a little while is scary enough. Last I read talk like this was my history books....

 

[zenman]

Don't worry, the TEAM will slap him back in line.

 

[devilpup]

I may and probably will get suspended or baned for this, but I honestly dont care, I have seen enough of these posts by Taurus and its just getting ridiculous.

I mean seriously have you read any of Taurus posts in other threads? He is literally the Hitler of Medicine. I cant believe a Medical School accepted this kid. He has it out for just about EVERY (if not all) allied health professions. He has this obsurd idea that every single allied health professional is out Conquer and destroy MD's. The only posts I ever see from him are farcries about how PA's, NP's, RN's etc are going to try to take over medicine, and that when he becomes a Doctor he is going to do everything in his power to bring them down. Here is one of his recent "proclamations" and attempt to gain followers for his great cause:



I mean come on dude. Keep in mind this kid has NO experience in actually working with any of these professionals. And if you look at his other posts, he talks about how nurses are taking over primary care, NEXT they will take over every other specialty. Same with PA's. His conspiracy is that PA's are wannabe doctors whos "ultimate goal" is to become the equal of a doc. Its like he doesnt even realize that part of a PA licesure REQUIRES MD/DO supervision. Its seriously scary to think this kid might be practicing medicine in a TEAM oriented environment someday, probably wont be for long, but the fact he might be for a little while is scary enough. Last I read talk like this was my history books....

uppi,

Come on... you've just violated Godwin's Law. That "Kids"' arguments are valid to a large degree. Don't take things too personally.

 

[uppi]

That "Kids"' arguments are valid to a large degree. Don't take things too personally.

Are you serious? Im not saying that some of the things he argues about aren't valid, but how can you not take what he says personally when he plans on treating every allied health professional he runs into like S$*$. I too am questioning the validity of the DNP program, and its true reason for existence. I dont see anything wrong with MD's and DO's wanting to protect their profession by getting the AMA to act and open up more med schools, giving more incentives to go to primary care, etc and eliminating the need for a DNP. Actually there is no need for the DNP anyways, as that is what the NP degree is for. I dont agree with it either.

With that being said though, keep in mind most nurses, NP's, PA's dont agree with it either, but this toolbox just has it out for every single one of them. Do you really think its fair for a regular NP, PA, etc who has no intentions of "taking over the MD" should have to be treated the way Taurus is planning on treating them. That is unfair and absolutely unnacceptable. Taurus has the mindset that because one is bad, ALL are bad and must be treated and dealt with accordingly. His mentality is so stupid and childish that it makes me feel sorry for anyone who has to be associated with this tool. Honestly read his posts and tell me that this guy doesnt have serious insecurity problems. I think he needs some medication to balance the chemicals in that brain of his.

Also in regards to violating Godwin's law. Let me say for the record right now this is NO WHERE near the impact or seriousness of what Hitler and the Nazi's did (OBVIOUSLY). I DID NOT mean in ANY way, shape, or form that Taurus is completely equivalent to Hitler. That would not only be untrue but make me jsut as bad if not worse than Taurus. I was only trying to say that his philosophy and way of thinking are mimicking SOME of that philosophy (aimed at a different group that is allied health providers).

I am editing my earlier post because it does seem to make a direct correlation.

 

[Farmer Jane]

Yes, Taurus is extreme. He's got a good foundation of points but he's run rampant with them. He's also pretty young, and most people settle down a bit with age. I was an extremist on many things when I was his age. I got over it.

 

[Taurus]

I mean come on dude. Keep in mind this kid has NO experience in actually working with any of these professionals. And if you look at his other posts, he talks about how nurses are taking over primary care, NEXT they will take over every other specialty. Same with PA's. His conspiracy is that PA's are wannabe doctors whos "ultimate goal" is to become the equal of a doc. Its like he doesnt even realize that part of a PA licesure REQUIRES MD/DO supervision. Its seriously scary to think this kid might be practicing medicine in a TEAM oriented environment someday, probably wont be for long, but the fact he might be for a little while is scary enough.

I read with great amusement your posts. I'm not some 23 or 24 year old punk like yourself. I am in my 30's after having spent many years working in the IT and trading worlds. I ran my own business for a while. I am quite familiar of the business world and what competition means. I've worked in some brutally efficient environments where you didn't know if you had job tomorrow because management was actively trying to find cheaper labor across the globe so that they could replace you with some guy who is willing to work for a dollar a day. It's a dog eat dog world out there. If you don't watch your back, your competition will come and eat your lunch. After making the huge time and financial sacrifices to become a doctor, I and most physicians have no interest in recognizing as equals people with a quarter of our education and inferior abilities simply because they lobbied some unscrupulous politicians. If you want to do what we do, go to medical school. I think that is a simple request.

The purpose of my posts is to wake up as many people as possible to the current issues affecting medicine. If I piss off some nurses by doing so, then all the better. The problem is that when you're at the top of the totem pole everyone wants a piece of your action. Sadly, when I talk to other medical students and residents, they're so busy that they don't bother to keep up with what's going on. I was talking to a anesthesiology resident the other day and he didn't even know that CRNA's were trying to do pain unsupervised, that there is such a thing called the DNP, etc. My role is to keep as many people updated with the political moves of these groups. I'm widely read and engage in discussions on the issues related to MD, PA, NP, CRNA, AA, etc, more so than probably most people on this forum. I often include links so that other people can see for themselves what's happening. I'm not some uninformed douchebag like yourself.

I have no problem working in a team environment. However, I will not enable a non-physician so that they think that they can do what I do on their own. I've lost faith in the system to clearly delineate what each team member does. In other countries like Canada and Europe, there's no confusion as to what physicians and nurses do. Midlevels want to do what physicians do and they do so not by education but by lobbying. The clearest way you separate midlevels from physicians is by restricting what they can do. Anesthesiology and primary care screwed themselves in the foot because they allowed midlevels to pretty much do everything they did while they just supervised them. The surgeons got it right when they allow midlevels to assist them only, not to do the surgeries by themselves. Somebody can't claim to be as good as you if you restrict what they can do. If every physician had this mentality, we would not be in the mess we're in with primary care and anesthesiology. The lack of interest of med students in primary care can be traced to midlevels.

 

[milan1320]

The lack of interest of med students in primary care can be traced to midlevels.

Could not agree more with this! I would love to go into a med/peds residency but im afraid im going to get out over 200k in debt and have trouble finding a job. Everyone is a doctor now a days and can do everything a doctor does. The classmates I speak to all say the same thing, we would do primary care if we did not have to worry about being replaced by everyone under the sun

 

[Farmer Jane]

Well color me really surprised.

 

[fab4fan]

Well color me really surprised.

Wait, are you thinking what I'm thinking? Check your PM box.

 

[Jawbone]

I read with great amusement your posts. I'm not some 23 or 24 year old punk like yourself. I am in my 30's after having spent many years working in the IT and trading worlds. I ran my own business for a while. I am quite familiar of the business world and what competition means. I've worked in some brutally efficient environments where you didn't know if you had job tomorrow because management was actively trying to find cheaper labor across the globe so that they could replace you with some guy who is willing to work for a dollar a day. It's a dog eat dog world out there. If you don't watch your back, your competition will come and eat your lunch. After making the huge time and financial sacrifices to become a doctor, I and most physicians have no interest in recognizing as equals people with a quarter of our education and inferior abilities simply because they lobbied some unscrupulous politicians. If you want to do what we do, go to medical school. I think that is a simple request.

The purpose of my posts is to wake up as many people as possible to the current issues affecting medicine. If I piss off some nurses by doing so, then all the better. The problem is that when you're at the top of the totem pole everyone wants a piece of your action. Sadly, when I talk to other medical students and residents, they're so busy that they don't bother to keep up with what's going on. I was talking to a anesthesiology resident the other day and he didn't even know that CRNA's were trying to do pain unsupervised, that there is such a thing called the DNP, etc. My role is to keep as many people updated with the political moves of these groups. I'm widely read and engage in discussions on the issues related to MD, PA, NP, CRNA, AA, etc, more so than probably most people on this forum. I often include links so that other people can see for themselves what's happening. I'm not some uninformed douchebag like yourself.

I have no problem working in a team environment. However, I will not enable a non-physician so that they think that they can do what I do on their own. I've lost faith in the system to clearly delineate what each team member does. In other countries like Canada and Europe, there's no confusion as to what physicians and nurses do. Midlevels want to do what physicians do and they do so not by education but by lobbying. The clearest way you separate midlevels from physicians is by restricting what they can do. Anesthesiology and primary care screwed themselves in the foot because they allowed midlevels to pretty much do everything they did while they just supervised them. The surgeons got it right when they allow midlevels to assist them only, not to do the surgeries by themselves. Somebody can't claim to be as good as you if you restrict what they can do. If every physician had this mentality, we would not be in the mess we're in with primary care and anesthesiology. The lack of interest of med students in primary care can be traced to midlevels.

Ugh. zzzzzzzz.........

I admire your drive to support and contribute to your profession.

What about the mechanic that gets paid $75/hr for labor? The union contractor that easily clears 100k a year? The plumber that charges what amounts to be $50-100/hr?

Rather than b*tching about how much nurses earn in general, instead of how someone who calls herself a nurse is apparently committing fraud, why don't you offer suggestions on easing the nursing shortage, improving nurse-physician relationships, and decreasing the number of required OT hours nurses are working? That in and of itself would "drive down 'the nurses' salaries."

I eagerly await the day I don't have to work a minute over the 36 hours I am technically hired to work. Until then, stop complaining about how much I get paid extra for staying over my shift so my patients get the care they need...

You are a med student. You're in school. That's why you don't get paid OT for all the hours you put in. I'm sorry. I wish residents got paid much more than they do for the time they spend in the hospital. When you're out for a few years, working as an attending, and can leave after a nice 8-10 hr workday having made more than I'll make in a week, maybe you'll change your mind.

 

[Josh L.Ac.]

More importantly, why are the assistant medical examiners making more than the actual medical examiner?

 

[chimichanga]

Just talking to my girlfriend back home in Oregon who's finishing her last semester of nursing school. Came upon the subject of nursing faculty pay. It's abysmal: literally, HALF of what the graduate nurses can expect to be paid. Why on earth would anyone teach for HALF of what their students are going to make first year out? That's insane. I don't know how they can afford to teach quite frankly. Now this is just one community college (but well-respected) nursing program and perhaps the faculty don't have it as bad at other institutions, but geez.

I'm a house sup making 100k...(3 12s, easy work life overall)

RN for 12 years

I deserve that pay, but am stepping down, d/t many reasons, mostly the behaviors of people (nurses, aides, docs, etc) at my hospital, and the apathy displayed by the directors (medical and nursing) and CEO...

I am taking a CC faculty position for 1/2 my current salary...

I'm tired of the hospital drama, docs doing their own thing, nursing doing their own thing, and on and on...

As far as the dude in SF...more power to him, but he cannot have a life...who needs 300,000 K if you only take a week or so off every year...

I'm looking at 4 months off/year (1 at Xmas, and 3 summer, not to mention 5 days off for turkey, and labor day, memorial day, etc)

I can go to all of my kids' baseball games, karate, etc, and get my life back...

I'm w/ fab4...I'm leaving the hospital behind...

 

[fab4fan]

I'm a house sup making 100k...(3 12s, easy work life overall)

RN for 12 years

I deserve that pay, but am stepping down, d/t many reasons, mostly the behaviors of people (nurses, aides, docs, etc) at my hospital, and the apathy displayed by the directors (medical and nursing) and CEO...

I am taking a CC faculty position for 1/2 my current salary...

I'm tired of the hospital drama, docs doing their own thing, nursing doing their own thing, and on and on...

As far as the dude in SF...more power to him, but he cannot have a life...who needs 300,000 K if you only take a week or so off every year...

I'm looking at 4 months off/year (1 at Xmas, and 3 summer, not to mention 5 days off for turkey, and labor day, memorial day, etc)

I can go to all of my kids' baseball games, karate, etc, and get my life back...

I'm w/ fab4...I'm leaving the hospital behind...

But isn't it a shame that with your knowledge, skills and experience that you had to take such a huge hit in pay to teach our future nurses? Isn't there something seriously screwed up with that?

 

[zenman]

I'm w/ fab4...I'm leaving the hospital behind...

I'll tear up my license before I go back into a hospital again...

 

[chimichanga]

But isn't it a shame that with your knowledge, skills and experience that you had to take such a huge hit in pay to teach our future nurses? Isn't there something seriously screwed up with that?

sure...

but our kids' teachers make 40K

that's the bigger shame...not a new argument, however...

at least I'm a little ahead of that...

and I don't have do deal w/ ****head parents at my level...

 

[fab4fan]

I don't think it's a shame at all. That's a pretty average salary for a person with an undergraduate degree.

Personally, I don't see how teaching numbers and colors to toddlers constitutes some noble profession that deserves great respect and oodles of cash.

But when you're teaching in high school and have a room full of sullen teenagers, then the worm has turned.

I'm in the camp that believes teachers deserve to be paid better; kids are our future. But that's the liberal hippie in me coming out again. Plus I was kind of hard on my teachers when I was in school so I have some guilt issues.

 

[SilleAngyl]

I don't think it's a shame at all. That's a pretty average salary for a person with an undergraduate degree.

Personally, I don't see how teaching numbers and colors to toddlers constitutes some noble profession that deserves great respect and oodles of cash.

As a former teacher, I don't believe teachers are paid all that poorly, but there is much more to it than just teaching numbers and colors to toddlers. Many people believe that a teaching position supplies one with tons of vacation time and a need to only be at work when school is in session. Boy, that could not be farther from the truth.

When I look back on my first (and only) year of teaching, I did not have much free time. Evenings are taken up by grading, writing tests/quizzes, and planning for the next day. When I add it up, I probably worked about a 60 hour week. Not as much as a medical intern, but still a very full week. Summer vacation ends up getting eaten up quickly by continuing your college education, too. Also over the summer, good teachers are looking back on what they did the previous year, evaluating it, and making necessary changes in order to do it better.

Teaching definitely has its challenges. I worked at a middle school for inner city kids in Philly. You really have to work to get through to many of these kids. Its not that they aren't intelligent, they just have so many distractions at home. If you're simply fighting to survive and help support your family, the next day's test just doesn't seem so important.

I do think teaching is a noble profession, and maybe if you looked at what it really involved you would agree, Tired.

 

[bryanboling5]

I don't think it's a shame at all. That's a pretty average salary for a person with an undergraduate degree.

If only you could do it with an undergrad degree. Here, you have to have a Master's. You have set number of years to get it or you lose your job. No one will pay for it or help with your tuition and there are almost no scholarships available. My wife teaches elementary school and is working on her Master's now. Not only is it a lot of money that we are paying out of pocket, it's a lot of BS too. About half of her classes relate to teaching. The other half are general education designed to make her "well rounded". For example, this summer she's taking a class on musical theater. She's NOT a music or theater teacher. It sounds like a fun class, but she'd rather be spending her time and money doing something else.

She also teaches at a private school and makes no where NEAR $40K. He salary this year (her 6th year there) was $29K. At her school, the most she can make with 20 years of experience and a Master's plus so many hours (basically a PhD without the dissertation) is $35K. She could make more teaching in public school, but here she has 14 kids in her class and her biggest discipline problem is a kid who can't keep her hands to herself and has to sit at a table alone. She previously taught in public school, had 2-3 times the number of kids and had to have the police REGULARLY come to school to deal with the "discipline" issues. And we don't live in inner city Detroit but a small southern city with low crime.

And I'd echo what someone said about the hours. She EASILY puts in 50+hours per week. Summers are taken up with Master's work and getting ready for the next year. Oh, and she gets zero vacation days during the year. If school is in, she has to be there. We have to schedule things around holidays because she can't just take a few days off. That's true of public school too.

I don't think teachers need to make a fortune, but it is definitely NOT a cush job and the government makes it harder every day with all the rules and requirements with no extra money to pay for it. She gets $75 a year to buy supplies for her class. The school provides some things, but we spend $200-300 a year out of our own pockets to buy things that she needs for school. No other job I've seen do they pay you a pittance and force you to provide your own equipment.

 

[chimichanga]

...Personally, I don't see how teaching numbers and colors to toddlers constitutes some noble profession that deserves great respect and oodles of cash.

yea, we get it...it's not medicine, so it's relatively unimportant in your world...

anything short of med school curriculum and residency is not worthy...

 

[bryanboling5]

I agree with you, and I'm not putting down teachers. I'm just saying that in a job where you only have to show up half the days of the year, suggesting that 40-50k a year is "way to low" is a little silly. Personally I would never want the job, but the fact that the job is hard, or sucks, is hardly a justification for a high salary. I would never want to be a ticket-taker or a meter maid, but I don't hear widespread calls to put their salaries in the six figures.

I'm not saying six figures. I don't even think that 40-50K is "way to low". I think 40-50 is a good salary. I just get tired of hearing people talk about my wife's job as if it's a walk in the park and she gets to lay by the pool for three months a year.

Most people I know with professional jobs get 4-8 weeks of vacation per year depending on how long they've been with a company. My wife is "done" with the year in early to mid-June and has to go back in mid-August. That's about 2 months. During the school year, she get NO vacation days. So to say that she only has to show up half the days of the year means that most other jobs are only showing up half the days of the year. Remember, in the world outside of the hospital, most people don't work on weekends. Oh, but teachers do. At least at my wife's school. She typically spends a good chunk of at least 1 weekend day at her school getting things ready for the next week, and she's NEVER alone. Most teachers do.

She works 8-10 hours a day and then comes home and spends another 2-3 hours grading papers, talking to parents, etc. I realize that most professional jobs put in similar hours. I realize that she knew what she was doing getting into this. I realize that just because a job sucks doesn't mean it should pay more. I never said that she should make $90-100K. In fact, like I said, she could go to public school and make $35-40 right now. She chooses to teach at a small private school for the less tangible benefits of not being spit on, flipped off by 8 year olds or having to search her students for weapons (all of which happened when she taught elementary school in public schools).

I'm not arguing for more money, just a little respect. It just grates on me when people who have no idea what teachers do try to make it sound like they have such an easy job. Sorry if all this sounds a bit defensive...a lot of people have this type attitude and I have to smile and be polite, online I can unload somewhat safely....

Now, let's get back to talking about how much hospital bureacrats are overpaid.

 

[chimichanga]

...I'm not arguing for more money, just a little respect. It just grates on me when people who have no idea what teachers do try to make it sound like they have such an easy job. Sorry if all this sounds a bit defensive...a lot of people have this type attitude and I have to smile and be polite, online I can unload somewhat safely....

good post...saying that teachers (only) teach "numbers and colors" is insulting...

that's like calling a derm a "pimple popper"

 

[SilleAngyl]

The length of the school year in your state is 187 days. It's kind of hard to feel bad for you for having to plan vacations during her 178 days off.

187 days would be how many days the kids are in school, not the teachers. Teachers have in service days, parent teacher conferences, and continuing education credit days to contend with.

 

[julie walker]

hmmm..where is Yaah when we need him!

 

[SilleAngyl]

Nope. There are 177 days of instruction, the extra 10 days are for the things you were talking about.

http://www.kde.state.ky.us/KDE/HomePageRepository/News+Room/Kentucky+Education+Facts.htm

"187 days (includes 177 days of instruction; 4 days of professional development; 4 holidays; 2 planning days)

This is a minimum for the state, which does not stop individual districts or private schools from tacking on extra days. Many do this.

Tired, please don't forget that you wouldnt be where you are today without having learned the fundamentals from your grade school teachers. Without a strong foundation, you would have had nothing on which to build your medical knowledge.

 

[julie walker]

This is a minimum for the state, which does not stop individual districts or private schools from tacking on extra days. Many do this.

Tired, please don't forget that you wouldnt be where you are today without having learned the fundamentals from your grade school teachers. Without a strong foundation, you would have had nothing on which to build your medical knowledge.

Amen!

 

[SilleAngyl]

And your point is? I get it, they do an important job. So do most people. That has nothing to do with the topic at hand.

My point is that you stated above that you don't see why teaching is noble and you don't believe they deserve "great respect." You simply wouldnt be where you are now without them.

Anyway, I'm going to quit hijacking this thread now. Peace!

 

[Faebinder]

Back to the main topic.

I am glad nurses are well paid or overpaid.... really I am. I worry however about the increasing requirements of nursing.

Is there really a nursing shortage or is it just like physicians.... shortage in the regions that are unwilling to pay a reasonable price?

 

[core0]

Back to the main topic.

I am glad nurses are well paid or overpaid.... really I am. I worry however about the increasing requirements of nursing.

Is there really a nursing shortage or is it just like physicians.... shortage in the regions that are unwilling to pay a reasonable price?

Just like physicians there is no shortage. Unlike physicians its not because of locality mismatch, but problems with people leaving the field. Depending on whose statistics you look at, there is a projected shortage of around 500k nurses by 2025. However, right now there are more than 500k nurses who are not working as nurses. This is more than 20% of the field. In particular the turnover for first year nurses approaches 30% in some studies.

There are a lot of reasons postulated for why this happens, but no real good data. Burnout, unreasonable expectations and a dysfunctional culture have to play a role. Depending on who you ask, recent innovations such as nursing ratios and magnet status have only made things worse.

You also have to consider that the characteristics that make a good nurse are easily transferred to other careers. This means that good nurses suffering burnout can easily leave the profession (maybe not as easily now in the current economic climate) while those who have less than stellar characteristics remain.

The other issue is nursing education. Nursing schools continue to turn away more than 40k students per year. This largely has its roots in the nursing "over supply" in the early 90's when a large number of nursing schools closed. Faculty pay remains another issue especially in the current climate.

So no there is not a shortage of nurses. Yes there is a shortage of nurses willing to work in the current work environment. It really goes beyond a pay issue (although there remain segments of the country that are underpaid).

David Carpenter, PA-C

 

[prairiedog]

There are a lot of reasons postulated for why this happens, but no real good data. Burnout, unreasonable expectations and a dysfunctional culture have to play a role. Depending on who you ask, recent innovations such as nursing ratios and magnet status have only made things worse.

David Carpenter, PA-C

Can you elaborate on how recent innovations such as nursing ratios and magnet status have only made things worse? For whom? nurses? patients? hospitals?

 

[core0]

Can you elaborate on how recent innovations such as nursing ratios and magnet status have only made things worse? For whom? nurses? patients? hospitals?

Worse for the nurses. No data on the patients. Mixed for the hospitals.

Take fixed staffing ratios. On the surface it looks good. In California on non-critical care floors no nurse can be assigned more than 5 patients:
http://www.dhs.ca.gov/LNC/NTP/default.htm
While on this is a laudable goal (never mind the research behind it is suspect at best), the implementation has been a disaster. For example, a nurse can never be in charge of more than five patients. In one example if two nurses each have four patients and one wants to go to lunch, the other nurse cannot cover their patients because that would give them eight patients (even if for a short period of time). There are a number of ways around this but they all involve hiring more nurses that do not take patients or pushing the ratios down farther to 1:3 or 1:4. Obviously this costs money and its not like California is paying any more for inpatient care (if I recall their Medicaid is in the bottom 10 for states in reimbursement). This has led the hospitals to cut services elsewhere. Less clerical help. Less CNAs etc. This is mostly anecdotal, but at least if you read allnurses it seems very wide spread. This has resulted in very high wages for some nurses (especially in Northern California) although cost of living and unionization could be argued here. However the flip side is that many of the factors that lead to burnout (having to do multiple jobs etc) are accelerated by these staffing ratios.

Magnet status is another area that does not seem to help bedside nursing. Again it has laudable goals and some of the policies such as unit councils are helpful, but mostly it seems to be a vehicle for generating millions of dollars in consulting fees and reams of paperwork (the application was recently restricted to a stack of paperwork no more than 15 inches tall). So again here you have a process that diverts money away from nursing that could be used for such non-essential goals as hiring more nurses or giving the nurses raises. There is also an element of elitism. The program gives preference to BSNs over ADNs. This not only leads to diminishing the ADN role (some of whom have decades of experience) but also exacerbates the age old ADN vs BSN fight. Given that between 60-70% of graduating nurses are ADNs this does not help retain new nurses in practice. Examples of this would be preceptorships for new nurses that are only open to BSNs. While the nursing education community would have you believe that the outcomes are better with BSNs than ADNs (studies with doubtful validity in my opinion) they have been unable to provide a sufficient number of BSN graduates for the workforce. The ADN programs on the other hand have been the majority of the expansion for the nursing workforce. So again you have a program that while its underpinning seem sound instead increases loss of working nurses by limiting opportunity, promoting elitism, and valuing education over ability.

Just my non-nursing perspective,

David Carpenter, PA-C

 

[fab4fan]

The "M" in "Magnet" stands for "marketing" plain and simple. It is utter BS. It's a great tool for hospitals to use to draw pts. to their facility and does absolutely bupkis for the nurses. Of course, what could one expect since it's an invention of the ANA. Completely useless for the bedside nurse, but guaranteed to give the pumps and pearls nurses something to do.

I'm not sure I agree with Dave's assessment on the ratios in CA. I'm a member of the California Nurses Association, and there are plenty of nurses in CA who support the ratios. I'm not sure a PA is the best person to speak to nursing issues, just as I would not feel qualified to address issues related to PAs. PAs work with nurses but do not have to deal intimately with what we as nurses face. I don't think you can honestly know what it's like if you haven't had to actually walk the walk. JMO.

 

[deleted6669]

"While the nursing education community would have you believe that the outcomes are better with BSNs than ADNs (studies with doubtful validity in my opinion) they have been unable to provide a sufficient number of BSN graduates for the workforce. The ADN programs on the other hand have been the majority of the expansion for the nursing workforce. So again you have a program that while its underpinning seem sound instead increases loss of working nurses by limiting opportunity, promoting elitism, and valuing education over ability.
Just my non-nursing perspective"

as a non-nurse(FWIW) I have to agree with this....
if an adn does an online adn to bsn program are they really a better bedside nurse? no. they know how to write a thesis paper or design a study to evaluate the impact of hand sanitizers in the bathroom at a nursing home.
I did a post grad masters degree program for pa's who already had a bs( I had 2 at that point) and can honestly say I am not a better pa becuase of it. more employable, maybe, but a few courses in health policy, ethics, research methodology and writing a thesis didn't change the way I do my job on a day to day basis 1 bit. my undergrad thesis in medical anthro was more than 3 times as long as my masters in pa thesis so I already knew how to write a scientific paper.....
but getting back to nurses.....I will take a random adn over a random bsn any day of the week.....I would take a few of the lpn's I currently work with over an adn or bsn....it's all about the practical experience and yrs in practice.....

 

[Josh L.Ac.]

"While the nursing education community would have you believe that the outcomes are better with BSNs than ADNs (studies with doubtful validity in my opinion) they have been unable to provide a sufficient number of BSN graduates for the workforce. The ADN programs on the other hand have been the majority of the expansion for the nursing workforce. So again you have a program that while its underpinning seem sound instead increases loss of working nurses by limiting opportunity, promoting elitism, and valuing education over ability.
Just my non-nursing perspective"

as a non-nurse(FWIW) I have to agree with this....
if an adn does an online adn to bsn program are they really a better bedside nurse? no. they know how to write a thesis paper or design a study to evaluate the impact of hand sanitizers in the bathroom at a nursing home.
I did a post grad masters degree program for pa's who already had a bs( I had 2 at that point) and can honestly say I am not a better pa becuase of it. more employable, maybe, but a few courses in health policy, ethics, research methodology and writing a thesis didn't change the way I do my job on a day to day basis 1 bit. my undergrad thesis in medical anthro was more than 3 times as long as my masters in pa thesis so I already knew how to write a scientific paper.....
but getting back to nurses.....I will take a random adn over a random bsn any day of the week.....I would take a few of the lpn's I currently work with over an adn or bsn....it's all about the practical experience and yrs in practice.....

One of my wife's friends relocated to KC after Katrina and started an ADN program at a local community college while I was enrolled in my accelerated BSN. I spoke with her frequently and I do think her education was better in terms of clinical experience, but I knew more when it came to rationale. I cannot say if this was from the BSN or from my basic science background from first bachelor's degree [in biology].


But yes, her clinical experience was much better.

 

[fab4fan]

One of my wife's friends relocated to KC after Katrina and started an ADN program at a local community college while I was enrolled in my accelerated BSN. I spoke with her frequently and I do think her education was better in terms of clinical experience, but I knew more when it came to rationale. I cannot say if this was from the BSN or from my basic science background from first bachelor's degree [in biology].


But yes, her clinical experience was much better.

Probably your science background. The BSN completion program I'm finishing doesn't offer much more in the way of science than my diploma program did way back 23y ago. You probably got more hard core science than you would get in a nursing program.

 

[zenman]

but getting back to nurses.....I will take a random adn over a random bsn any day of the week.....I would take a few of the lpn's I currently work with over an adn or bsn....it's all about the practical experience and yrs in practice.....

I personally think that the more book learning you have, even non-health related, the more "brain power" you have in order to make decisions that translate to better care and decision-making at the bedside.

Not considering any personality differences, which of the following would you want if they all had equal clinical time:

ADN with one year experience
Diploma with one year experience
BSN with one year experience
MSN with one year experience
Ph.D. with one year experience

 

[wisconsindoctor]

I personally think that the more book learning you have, even non-health related, the more "brain power" you have in order to make decisions that translate to better care and decision-making at the bedside.

Not considering any personality differences, which of the following would you want if they all had equal clinical time:

ADN with one year experience
Diploma with one year experience
BSN with one year experience
MSN with one year experience
Ph.D. with one year experience

Most likely the MSN with one year expereince as the Ph.D. is more research focused.

 

[RAMPA]

I personally think that the more book learning you have, even non-health related, the more "brain power" you have in order to make decisions that translate to better care and decision-making at the bedside.

Not considering any personality differences, which of the following would you want if they all had equal clinical time:

ADN with one year experience
Diploma with one year experience
BSN with one year experience
MSN with one year experience
Ph.D. with one year experience

the one who was previously a respiratory therapist.....

 

[zenman]

the one who was previously a respiratory therapist.....

Go back to your room and play with your knobs...

 

[zenman]

Most likely the MSN with one year expereince as the Ph.D. is more research focused.

Yes, but she has more "brain power" available. Remember they all have the same clinical experience.

 

[prairiedog]

as a non-nurse(FWIW) I have to agree with this....
if an adn does an online adn to bsn program are they really a better bedside nurse? no. they know how to write a thesis paper or design a study to evaluate the impact of hand sanitizers in the bathroom at a nursing home.
I did a post grad masters degree program for pa's who already had a bs( I had 2 at that point) and can honestly say I am not a better pa becuase of it. more employable, maybe, but a few courses in health policy, ethics, research methodology and writing a thesis didn't change the way I do my job on a day to day basis 1 bit. my undergrad thesis in medical anthro was more than 3 times as long as my masters in pa thesis so I already knew how to write a scientific paper.....
but getting back to nurses.....I will take a random adn over a random bsn any day of the week.....I would take a few of the lpn's I currently work with over an adn or bsn....it's all about the practical experience and yrs in practice.....

Thus, you would take a lpn over a PA as "it's all about the practical experience and yrs in practice"

 

[deleted6669]

Thus, you would take a lpn over a PA as "it's all about the practical experience and yrs in practice"

no, thus I would take some pa's over some doctors.
not the same playing field. I'm talking about groups that overlap in job descriptions.
there are clinicians and there are nurses and other ancillary staff. very different.
and yes, there are some np's I would take over some pa's.

 

[julie walker]

no, thus I would take some pa's over some doctors.
not the same playing field. I'm talking about groups that overlap in job descriptions.
there are clinicians and there are nurses and other ancillary staff. very different.
and yes, there are some np's I would take over some pa's.

Amen!

 

[RAMPA]

Go back to your room and play with your knobs...

you forgot the about the MDIs.....

 

[fab4fan]

I personally think that the more book learning you have, even non-health related, the more "brain power" you have in order to make decisions that translate to better care and decision-making at the bedside.

Not considering any personality differences, which of the following would you want if they all had equal clinical time:

ADN with one year experience
Diploma with one year experience
BSN with one year experience
MSN with one year experience
Ph.D. with one year experience

I think you're off your rails on this one zenman, no disrespect.

 

[Josh L.Ac.]

I think you're off your rails on this one zenman, no disrespect.

Agreed. My first two classes [and last two classes] of my FNP program are graduate research and advanced nursing theory. It is a total of 6 credit hours, estimate 6 hours of work a week for each X 14 weeks = 168 hours. How much of that is actually going to translate into making me a more effective nurse?


Probably about two hours of take-home, apply it to the job knowledge.



I am not kidding.

 

[zenman]

I think you're off your rails on this one zenman, no disrespect.

One of the big arguments you see in nursing is that one degree has more clinical time than another. My argument is you take each level I mentioned above and give each exactly the same hours of clinical what would be the results?

Would a person with less knowledge and one year of clinical be better than a masters person with one year of clinical?

If research courses do not translate to better bedside care, there is a problem. Look at why liberal art grads are so valued by business. Hell, I can apply what I learned in Kayaking class to nursing. But I realize there is a problem in transferring knowledge from one area to another. My teacher wife says she can teach a kid how to study for history and he won't be able to take the same knowledge over to English.