Baldies' Blog began originally in the UK by a 26 year old journalist with a blood cancer on a mission to inform the world about bone marrow donation.

He has since died, and I took on the cause of making cancer care more transparent for everybody.

Cancer is a disease that will touch everybody through diagnosis or affiliation: 1 in 2 men will be diagnosed and 1 in 3 woman will hear those words, "You Have Cancer."

I invite you to read how I feel along my journey and
how I am continuing to live a full life alongside my Hodgkin's lymphoma, with me controlling my cancer, not my cancer controlling me.

I hope that "Baldies' Blog" will prepare you to handle whatever life sends you, but especially if it's the message, "You Have Cancer."

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Sunday, February 22, 2009

Fixing Nursing 101

One in three nurses will leave their field within a year of entering it.
Not only is the nursing shortage chronic huge news, but nursing retention is also an issue.
I don’t get why these issues are mysterious. In my world, the shouldn’t be making the news.
They should be solved, by some common sense.
First, 1 in 3 nurses leave the field within a year because the field is nasty. I’m not talking about between patients and nurses, I’m talking between nurses and nurses, nurses and doctors, nurses and pharmacists, the list could go on and on and on.
I was told upfront when I was hired at the first hospital that the nurses there “Eat their young.”
Yes, that’s what they say. You’re warned before you even enter the field. You’re screwed in many ways.
Your preceptor, your coworkers, the doctors, whoever, will treat you like an idiot and make you feel as bad as possible for screwing up. You’re expected to do tasks that can really only be fulfilled by a supernurse.
Then if things go wrong, watch out, get your gloves on, round one has officially begun.
Not many people can deal with this high pressure culture over a period of time. I was lucky I dealt with it in business, sports, and life before ever entering the field.
My final preceptor in college told me I was an idiot and would never be a competent nurse then later the same day asked me if I was first in my class (I was), he said he could tell by the answers I gave.
Talk about mixed signals.
As with everything, this wouldn’t be such a mystery if you would just ask the people you’d like to replicate what would entice them. Go ask the nurses if you want solutions to these problems.
As far as the nursing shortage is concerned, To teach requires taking a significant pay cut. Salary to oversee the nursing program at an area community hospital is $33-45,000 yearly. A masters degree is required.
That’s poverty for a masters degree nurse. As an RN starting pay on a medical surgical floor in the Bronx offered me $82,000 a year for 36 hours a week, three twelve hour shifts, not including time and weekend differentials. Not including overtime.
Nursing is sounding better isn’t it?
If I wanted to work in the ER, starting pay was $90,000 base, upgraded as “combat pay” since the same ER did require 6 guards with guns and bullet proof glass.
An RN with a masters makes more, $45,000 is downright bad.
Nurses with a master's degree, which can qualify you to be a nurse anesthetist ($150,000+ salary), a family nurse practitioner, an acute nurse practitioner, or any specialty in any area of medicine pays much better, with a lot of the perks of being a doctor (you can have your own practice), but without as much responsibility (such as call hours).
Whoa, damn, isn't that sounding good?
Also, medicare.medicaid reimburses 90% of the cost of a nures practitioner, where MDs are much more expensive and do not have the same high reimbursement percentage.
Where do you think the medical trends are heading?
So who teaches? It’s either those who love it or those you can’t work anywhere else.
We could have bottom of the barrel employees teaching our future nurses.
New nurses may come out of college bad, but many nursing schools try to prevent this by “screening” out the weak ones through vigorous academics (less than a 72 fails in some schools), often fail 1/3 of the class.
That’s 1/3 of the class every semester until graduation. I didn’t graduate with a single person I started with.
Then, if they’re still emotionally weak, they go to work unprepared to be met with nastiness from their colleagues.
When people acted up about teaching me, I would remind them of my age and then their own.
I would tell them that I had forty more years in the field while in forty years times they would probably be in my bed so they should teach me properly now, just in case I get my hands on them in the future.
They did put in more effort when reminded that I was the future, possibly THEIR future.
How do you get more nurses into the nursing field?
Pay more for teachers, hire more teachers, and open up slots. Most schools have a significant waiting list.
Start early in middle school educating on the perks of nursing. Talk about travel nursing, nursing salaries, the possible lifestyle they could have, and the working environment in terms of all the hot smart people they’ll be socializing with.
In high school, potential nurses should be recruited, just like sports. Offer scholarships, housing, stipends, or pay for college up front in exchange for signing contracts to work after college. Support people upfront and if they come through, you’ll own them later.
Advertise that federal loans are waived if you graduate and pass your boards. Federal loans for nurses function like scholarships. Everyone in high school should know this.
There are also federal scholarships available if you vow to work in a certain proximity or region for a period of time.
An intelligent person can get through nursing school almost for free.
This information should be in big red letters whenever nursing schools are advertised: Nursing School is Free!
That’s advertising. Then have a damn good guidance counselor or Financial Aid Manager to show them how to complete the process. Or just create a damn packet to guide the student. Make sure you put based n scholarship, academic performance and financial need in small letters on the bottom of that ad.
Out of school, I was offered loan repayment options, yearly education money and so on.
Where were these offers when I needed them?
You can lock in a nurse before they ever complete school. Nursing students are just as broke, desperate, and struggling as anyone else, pay for them during this period with a contractual agreement.
Send young attractive professionals to talk up the profession.
The image of nursing needs to get an image overhaul. It’s seen as frumpy and classless. It’s a thankless job.
Easy enough to change the image, show the glamour of it. Flip the script. Nursing is not just your grandma’s job.
It can take you all over the world and put you in posh areas. It can support a family on its own. You want a white picket fence and a nice cape with a dog, it’s yours.
I worked with one nurse that supported her boyfriend and family on her night nurses salary. She was twenty at the time.
Want a big flashy car and stable recession proof job? Go into nursing.
Hospitals are willing to hire anything that walks and breathes with a nursing license.
But nobody ever hears this.
They certainly should.


Heather said...

so, so true! why do nurses eat their young? i never understood it, but that is exactly what they do.

honestly, i felt like i was serving a life time sentence without the chance of parole. then i got sick, and shall i say...rescued from the profession.

but, sometimes i would like to go back. i know that with my personal experiences the past couple of years, i would be such a better

Sara Burbee said...

Great post, Hill!

gracylou237 said...

anything less than a 78 is failing in my school. This includes a 77.99. Rounding up is a thing of the past. I can't wait for the end, even though it is really just the beginning...

Kairol Rosenthal said...

Thanks for educating the rest of us lay folks about the inner workings of the nursing world.

Your blog is fantastic! I'm adding you to my 'best cancer blog's' blogroll. If you want to add me to your blogroll, feel free. I write about living with cancer in your 20s and 30s.



Anonymous said...

i so hear you, and yet when I get better I can't wait to jump right back in head first, everything you said is so true, and I agree 100%, I hope to see you later this week. luv ya

Erica said...

everything you said here reminded me of school and my 1 year of work. and brought back a few horrible memories, lol. It's too bad the profession and fellow nurses push good and usually young nurses away from the hospital setting where they're needed so badly. I saw this article a few days ago about residencies for nurses. I thought you'd like to read it I think this will definitely help out new nurses. I want a do-over!