“Old School” vs “Gotta Get Into School”

Nursing genocide has been a long time coming. There, I said it. And here is why.

Ever since I graduated with a 2 year Associate of Science degree in nursing, I was asked the question – “So when are you going back for your Bachelors degree?”

I would quickly reply with a resounding “Never, unless I have to!” which lasted for about 2 years… I then decided that this was not enough, I wanted to take it to the next level. Not just a BS nursing degree (pun intended),

I wanted to go for it all and get my Masters as a Nurse Practitioner.

Education is incredibly important in the healthcare world and nursing is no different. I strongly support all of my friends and colleagues that have taken the road of furthering their education with an advanced degree (Nurse Practitioners, Nurse Educators, CRNA’s, etc.). But here is the problem. We have put SO MUCH emphasis on “what’s next” that we are rapidly educating talented nurses right out of incredibly vital bedside positions.

In my experience, over 2/3 of the newly hired/new graduate nurses in critical care units have a plan. Typically a “work for 2 years until I can apply for __________ school” plan.  Get the minimum required experience in order to get to the next level. Don’t get me wrong, I think it’s great to have a plan.  But what is the real reason driving this mass exodus of the sharpest and most talented bedside nurses? There are many factors that play into each individual’s decision to take on student loans and sacrifice family/social life. A primary motivation for many is money.  Advanced degrees equal better paychecks.  Perhaps a better schedule and less stress. Another motivation is desiring to have the knowledge and abilities to make a bigger difference in the lives of the patients we care for. Others include moving into educational roles, more respect from peers, possibly a doctorate degree, increased autonomy, the list goes on and on. Truthfully, there is absolutely NOTHING wrong with being motivated and getting an advanced nursing degree (clearly I feel this way since I did it).

Here is another reason to ponder. Many ICU nurses become burned out within the first year. I have seen it happen over and over again in large hospitals. A new graduate nurse is hired and gets oriented by a nurse with less than 1 year of experience, and as soon as they have been there for 6 months they are now asked to orient another new graduate nurse because there is simply nobody else with more experience available. When you are just getting a solid feel for the complexity of patients and interactions with physicians and families, the last thing you feel comfortable doing is training another nurse. However, you want to keep your job and keep your managers happy, so you agree to do it. Why does this happen? Because so many of the clinically strong and qualified nurses have recently quit work to go back to school for an advanced degree because they are tired of being overworked and are feeling burned out. They don’t feel respected or appreciated by upper level management. They don’t feel like they are truly getting to make a difference. Critical care nurses are being asked to do more and more with less and less in many hospitals. With the trend of 24 hr open visitation for family members, this had added yet another dimension of stress to nursing staff, on top of increasingly redundant charting requirements, evolving technology, and not to mention the push to improve satisfaction scores.

I clearly do not have all the answers, but I am writing this solely for the purpose of bringing this issue to light. Something has got to change. There has to be a way to continue supporting advanced practice education while supporting and empowering bedside nurses, especially in the critical care setting.

Please comment below with your thoughts and ideas for potential solutions for this problem. Let’s think outside the box. And if you have a very different experience and completely disagree with me, I would love to hear that as well!