What the heck am I doing?

The program I’m enrolled in is part of a new idea from AACN to promote a better prepared nurse that remains at the bedside instead of moving into management. This seems like a good plan: nurses have some exposure to the finances and administration needs in a healthcare facility, they get some team and leadership training, along with a lot of opportunity to hone critical thinking skills.

All of this is not a replacement for experience however. We are counseled repeatedly that while these skills are necessary for the future of nursing, we have to pair them with very solid experience. Don’t come out of the gate trying to boss everyone around because of your high-falootin degree. Luckily, no one in my class is of the predilection to do something like that. We mostly ask a lot of questions, and are being taught to look for the “why” behind the scenes. Being handed a drug and knowing it’s name and side-effects are the beginning of understanding: WHY is that patient being given a steroid? To reduce the post-operative swelling from the craniotomy, that’s why.

I know our program is met with horror shock disbelief cocked eyebrows from established nurses. How can you get a Masters degree if you don’t have a Bachelor’s in nursing already? The answer is because you have to have a Bachelor’s already. It sounds trite, but it just means all the General Education stuff is taken care of, and they can concentrate on nursing specific curriculum.

I’ve even asked some of the nurses I’ve worked with in the hospital what their impression of the program is. The feedback has been very good so far. They appreciate that the students are bringing a different set of experiences to nursing. This isn’t likely to be their first career if they have a degree in something else. Consequently, the students are a bit older, and not quite as fragile. This is not to say there aren’t excellent nurses that are young, fresh, and full of enthusiasm. It’s just the reality of being able to sit and hold someone’s hand while they die instead of rushing to find someone to help “fix it”. This comes from having lived a few summers longer, nothing else.

Concierge, please

I’m conflicted about the growing trend for Concierge or Boutique medicine.

It’s clearly something that is valued by some, but how about all the rest of humanity that can’t even pay for bad health insurance? If you haven’t looked at the links, or haven’t heard of it before, the basic idea is you pay out of pocket (no insurance) for premiere healthcare. You have a physician or small group of physicians that you have 24/7 access to via phone, email, text, smoke signal, etc. You will have guaranteed response in minutes if not hours. The response may include a housecall if you’re so inclined.

We have thousands of people in the US without healthcare, and chronic conditions they can do nothing to address. No money to pay for insurance, or a co-pay assuming they did have it. Sure, there are free clinics that the working poor can go to.

Let’s have a quick look at the “free” part of that though: take a day off of work, so you lose a day’s wages (assuming you aren’t fired outright for not being there); spend hours and hours waiting; bring food or be forced to pay for something there; arrange for childcare before, after, or during the normal workday hours; if you’re not seen by the time the clinic closes, you have to return for another “free” visit.

Not looking so free anymore, and that’s just a very quick rundown of obvious costs.

On the other side of the equation, not everyone has running water either. Should those of us with that new-fangled “indoor plumbing” rip it out because our brethren don’t have it?

I keep switching sides on the Concierge approach. It both horrifies and excites me. Man, I wish I could afford it. No! Bad man! A housecall! No! Must. Not. Give. In….