021 Discussing Healthcare: Understanding Nursing

Gloria Lewis, EdD, MSN, MHA, RN, CCM

Gloria Lewis, EdD, MSN, MHA, RN, CCM

Gloria Lewis, EdD, MSN, MHA, RN, CCM currently works as a per diem palliative care nurse at the John Muir Medical Center in Walnut Creek, California.  She is also a faculty member at the University of Phoenix where she teaches in the nursing and health science program.  Gloria earned her RN (registered nurse) degree in 1986 and after working in many roles as a nurse she obtained a BSN (bachelor of science in nursing) in 2001.  She continued her education and went on to earn her MSN (masters of science in nursing) and MHA (masters of healthcare administration) in 2007 and most recently in 2013 obtained her EdD (doctorate of education) with a focus on nursing education.  Her dissertation was titled “Burnout and Stress: a phenomenological study of ICU nurses experiences caring for dying patients.”  She is also a Certified Case Manager (CCM). Gloria’s experiences in nursing include: medical/surgical, critical care, same-day surgery, long-term care, home health hospice, palliative care, and case management.

Are nurses prepared for the future of medicine?

The goal for the future is to keep patients out of the hospital which means more care will be given at home or at skilled nursing facilities.  As our population ages we will need more nurses who are educated to work in an outpatient or skilled nursing facility setting.  We will need more nurses overall, but we need to ensure that they are trained to work outside of the hospital as well as in the hospital.  The state of California has started to educate nurses in this manner.

There is a shortage of nurse educators to train new nurses.  As a result, there are not enough nursing students to fulfill the future nursing needs.  There is a push to have nurses obtain a masters degree to help train more new nurses.

Nursing Degrees

  • Licensed Practical Nurse or Licensed Vocational Nurse (LPN/LVN): an LPN/LVN is a nurse who is involved in basic patient care.  They obtain patient metrics, such as: vital signs, height and weight.  They can administer some therapies and monitor catheters as well as bathing and helping patients transfer/walk.
  • Associate Degree Nurse (ADN): an ADN is an entryl level nursing degree that allows you to sit for the National Council Licensure Examination for Registered Nurses (NCLEX).  Once a nurse has passed the NCLEX the nurse is considered a Registered Nurse (RN).  This degree that can be obtained in as little as two years of training.
  • Bachelor of Science in Nursing (BSN): a BSN is a nursing degree that allows a nurse to take the NCLEX.  However, this is a more advanced degree as compared to an ADN.  This degree can be obtained in as little as 4 years of training.
  • Registered Nurse (RN): a nurse with an ADN or BSN who passes the NCLEX.
  • Masters of Science in Nursing (MSN): is a postgraduate degree for RNs.  This degree is often required for nurses seeking jobs as nursing administrators, clinical nurse leaders, educators or health policy experts.
  • Doctor of Nursing Practice (DNP): is a postgraduate and professional degree that prepares nurses to function as healthcare practioners.  They are allowed to diagnose and treat patients.  Each state regulates DNPs differently, but in some states the DNP can see patients without physician supervision while other states require physician oversight.  This degree can be compared to that of a Physician Assistant (PA).

More advanced nursing degrees equip nurses with critical thinking skills and the ability to provide higher levels of care.  Nursing skills are generally improved with experience, but the advanced education of nurses allows for even higher levels of care.  Nurses need to be prepared to assess and treat patients in both the outpatient and inpatient setting.  They are the primary healthcare contact for most patients and the more capable the nurse the better the healthcare that can be provided to each patient.

Hospital Acquired Infections

The New England Journal of Medicine published an article titled “Multistate Point-Prevalence Survey of Health Care–Associated Infections.”  The data shows that 1 in 25 patients admitted to hospitals will acquire a new infection related to the hospitalization.  It is well known that there are significant numbers of healthcare associated infections, but we need to understand why and how to improve the situation.  Efforts have been under way for the past several years and certain types of infections are decreased.  However, we need to continue these efforts and improve our efforts to decrease the number of hospital acquired infections.

About the Author

I am Joshua Lewis, MD, the creator of Discussing Healthcare, LLC and a board certified Emergency Physician who currently practices in the Phoenix, Arizona area. I hope you will gain meaningful insight into our healthcare system through the information provided by Discussing Healthcare. Thank you for your interest and I encourage you to contribute by calling, emailing, or leaving comments on the website.

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