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    Monday, June 21, 2004

    Nursing Education: A reader sends these observations on why registered nurses are no longer the masters of the bedside they once were:

    Old fashioned nurses were working class girls who went to 3 years schools. They studied one year, then worked for two years on the wards part time while studying. Then they got an RN degree. By the end of three years, they could bedside nurse.

    Then the ANA, about the time women's lib started, decided nurses should be "professionals" and would be better nurses with a B.S. --they would study Literature and be more refined and well rounded. But the BS degree was too expensive for working class girls like myself (I went to Medical school under a Great Society scholarship which was one of the few scholarship programs that did not discriminate according to sex, but without a scholarship could never have afforded college--and the local nursing BS colleges gave few scholarships back then). As a result, working class girls ended up either nurses aides or with a two year associate degree. The two year nurses were useless in bedside nursing until they worked a year or two.

    So, nurses, now "professionals", usually "supervised" nurses aides rather than bedside nurse (Except in ICU etc). I had surgery in one of the best Boston hospitals ten years ago. For the first day, I was cared for ok, but after that, I saw a nurse (?) when I got pain pills. I was given two every six hours, when what I needed was one every four hours. So I was oversedated for three hours and in pain two hours. After several requests, I started hiding my pain pills so I could take them when I wanted to take them. No one noticed. They didn't supervise me, so when I was told I wouldn't go home until I moved my bowels, I lied, so I could go home. No nurse asked why I had no visitors, nor checked post discharge planning, so I was sent home in a taxi to my waiting teenaged adopted sons who barely spoke English, couldn't drive, and who of course couldn't pick up my pain medications (luckily I still had my stash from ones I didn't take).

    But what was worse, is that when I walked myself (no help) down the hall, the nurses were busy typing medical information on their shiny new computers....And as soon as the other patients found I was an MD, I was grilled about their medical problems. (nurses used to teach, but the computers came first. As for doctor visits, that was five mintues a day).

    Nurses are also responsible for all the documentation that has to go into the chart. And suffice it to say that in today's litiginious environment, documenting care has become more important than actually giving care.


    posted by Sydney on 6/21/2004 07:51:00 AM 0 comments


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