Expert Insights

Nursing My 40 years Journey

                So You Want To Be A Nurse!

     When I started my career over 40 yrs ago you were able to complete Vocational

LPN training while still in high school. You were able to graduate and complete your 

nursing training and become eligible to take your state boards. This was according to your

state and school system. In the 1970's it was a time of chaos and confusion for me so I

decided to leave NY state and go to a Nursing vocational program in Cleveland Ohio. In

Ohio you were able to work as a LVN (Licensed vocational nurse)and earn credits toward

an RN college degree. Due to urgent family issues I had to return to NY and decided to

complete my training. I soon discovered NY state didn't  accept Ohio's vocational credits.

So I had to enroll from the beginning to start classes again for the Nursing program.

     I enrolled at Dutchess Community College's Nursing program in 1981. I heard a

rumor that due to the nurses's shortage the  4 year curriculum program had to be

condensed in 2 years. It was a very tough and stressful program.  There are a few things

to consider before enrolling in a nursing program. The first year is prerequisite course

such as chemistry, math and Biology(A&P) 2nd year Microbiology.  English is also a

requirement along with a computer class.(Now a much needed requirement). The first

year you are going to learn a new language medical terminology and nursing legal

abbreviations. The whole nursing education was evolving from being specialized in

nursing schools to merging within the college university and culture. The discipline and

structor of nursing was now being challenged with the free spirited environment of a

college university. How many students I wonder looked forward going to a Nursing

school? And now, they are practically non existent. The nursing uniforms and caps retired

I believe after my graduating year in that college. Our class had to wear whites

(uniform)and caps after the year our class graduated students no longer wore caps in the

hospital.

     The Great Transition, on beginning  my nursing career I felt like I was in a caring

warm and healing environment at the VA. The pressure of cost and not having what we

needed for patient care wasn't a problem. Staffing wasn't a problem, people came to work

and wanted to be there. Then subtle changes happened when DRGs were introduced

which is a Diagnosis Related Group code. Later I learned was a way of monitoring the cost

of individual care of each veteran. This system started in New Jersey in the late 1970's.

Medicare adopted this system in 1983, the year I graduated. The nursing we knew was

ending, and now we were starting to become oriented to the the business aspect of the

New Medical model of Finances. Hospital's previous directors and CEO's of the hospital

were now being replaced by MBA's instead of MD's. This made sense financially but MBA's

are not in the field of medicine or Human services. MBA's worked with numbers and stock

holders of companies not hospitals' patient's or staff. Our graduating class knew nothing

of this new system. Many of us who had this knowledge were employed by Nursing

Homes or Home Health with on the job training. The rest now is HISTORY.