Nursing as a Second Career: Trading One Problem for Another
I fully expect to get some angry responses to what I’m about to write, but it needs to be said.
I have started to get an uneasy feeling as of late. I wonder if we aren’t trading our Nursing shortage for something worse…
It seems we are seeing a major change in the way people enter the Nursing profession, and its a bit alarming. What I am talking about is the trend for a great number of displaced workers to enter into Nursing through extremely short second-career training programs. This path was typically used by allied health professionals who chose the route based on the increased earning and employment opportunities - but with some lateral knowledge and interest in healthcare in general. Thats great. We’re talking about respiratory therapists, paramedics, phlebotomists, etc.
Where I become concerned is when you have state and federal governing bodies promoting, funding, and legislating the mass retraining of people who had no interest in healthcare to begin with, so that they can simply plug holes in an area where there is a chronic shortfall. This when there has been little effort to address the causative factors in the first place.
Causative factors as I see them:
1. Compared to their less educated clinical counterparts, teacher pay is substandard.
2. Funding for expansion of Nursing programs is hard to come by.
3. Nurses have yet to exercise their power to change their work environment to facilitate improved care and efficiency, thereby leading to a high rate of turn-over.
4. Nurse/Physician collaboration needs to move beyond buzzword and into a formal framework across the profession, inclding co-education in medical/nursing programs as a standard.
So, back to the displaced workers:
Do they think that a bunch of people who are facing unemployment, loss of benefits, and possible poverty are going to say “No, thank you. I don’t want a good job in a stable profession.” No, I’m sure they’d jump at the chance to get into any job that offers that…and in a year, sign me up. I understand that.
So why my concern? Healthcare is becoming exceedingly complex. You can’t learn all you need to know in a year. If my experience with community college grads is any indication, you can’t learn it in two years either. Frankly, most new BSN grads have had the bare minimum of clinical experience to function in the role. No, I’m not some elitist type. I started my career as a hospital diploma nurse and spent six years working to earn an MSN, and I am still working at the bedside 50-60 hours a week.
One of my favorite quotes applies here: “Nine women can’t have a baby in one month.”
You can’t rush the training of new nurses. Regardless of the challenges of working short-staffed (and I’ve done it for years), working with a shift full of half-interested clock-punchers who have a whopping one year of training is worse. That will lead to the loss of the experienced nurses who are already fatigued from the burden of training new hires (so when do we care for the patients?)
Alternative:
What we need to do is throw the stimulus dollars at nursing education…bring in bright and experienced clinicians (and pay them properly) to train students to be functional new grads on a scale that addresses the shortfall. Set a minimum entry-level point as the BSN, and mandate enough clinical time so that they graduate being functional new Nurses. This would take some of the burden off of hospitals, who end up footing the bill to provide the clinical orientation (bringing the new hire up to functional standards that they should have had prior to graduation).
Thoughts?
