Sunday Music: A Little More Love

Between her movie success coming from Grease, and the blockbuster album Physical, ONJ put out Totally Hot, and this sultry single from it, which peaked at #3 in 1978, hinted at the shift from soft pop to a harder rocking image, and the volcanic explosion that was to come on her next solo album, which kicked the doors open on the 1980s. She wasn't accidentally one of the best-selling artists of all time.

Just A Small Reminder...

Sunday Music: Nobody Does It Better

 

This masterwork was a classic in 1977 just by being a Marvin Hamlisch work performed by Carly Simon. Dropping it in as the title piece to a James Bond flick, after the single-most awesome opening stunt in Bond history, just added booster rockets to the launch. It peaked at #2 on the Billboard Hot 100 charts that year, and was Simon's longest-charting song.

Um, Sorry, But No. Not Even Close.

 

This is one potential question on the NCLEX, the national licensure exam for RNs.
Asking this to a CNA is like asking your dog to do calculus.
With an abacus. Blindfolded.
It's as wrong as two boys f**king.
For any RN, it's a lay-up. An easy shot.
Follow up questions:
Why is this rhythm important?
What should the (actual) nurse do next?
Answers at the bottom.

For whatever reason, Angus is under the severely-misled misimpression that a CNA with a one-month classroom and clinical certificate (total, all-in) is functionally identical to an RN with two to four years of upper-division college education and a nationally recognized license.

He states the difference between a CNA and an RN is "Not much."

A CNA is a 60 hour course, and less than 3 weeks' supervised clinical training. In CA.

Florida CNAs need even less than that. (Color me shocked.)

An RN, by contrast, is a two- to four year degree program leading to national licensure, including more clinical hands-on hours in any month than CNAs require for their entire certificate. (Florida RN licensure may be less rigorous, IDK, but that's why an RN from CA, NY, or IL can work in all 50 states, and nurses from the Gulf Coast belt can generally not get hired anywhere else without extensive testing and additional classes unless they go to similarly low-educated states. Mississippi nurses right out of school, for example, can generally not go out-of-state to anywhere else. That's not for nothing.)

Apparently we really have to go into why one of these things is not like the other one.

Starting with CNA's having a state-specific certificate, not a professional license recognized in 50 states and seven territories.

This is the difference between a vet tech, and an actual vet.

One of those cleans animal cages, and the other one diagnoses animal illness.

That's why a CNA (an expired-certificate CNA to boot) passing herself off as an RN is committing criminal malpractice.

A CNA has exactly zero training, experience, or competence in assessing patients, absolutely none in pharmacology, nor in pathophysiology, gerontology, obstetrics, pre- and post-op surgical care, pediatrics, psychology, critical care, or about a million other things large and small that even a new grad RN walks out the door with from school before they can pass their boards. 

A CNA literally lacks the knowledge of about a dozen 800-page nursing textbooks, whereas to get a CNA certificate, if you don't put your shoes and socks on in that order, you'll likely pass the class. The number of CNAs anywhere who could take and pass the NCLEX without years of study is going to be 0.000%, nationwide, since ever, even one with 25 years of floor experience behind them.

A CNA literally doesn't know what she/he doesn't know, any more than the guy who sweeps out the hangars at Boeing is a qualified aeronautical engineer. (As recent unqualified DIE hires at Boeing have demonstrated, in case anyone was watching.)

It's that big a difference, and anyone - family or not - telling someone otherwise with a straight face is talking out their other end.

And by "early on", apparently Angus is referring to 150 years ago, when even doctors had less actual medical knowledge than a modern EMT possesses. Yeah, things have changed a wee bit in nursing since Florence Nightingale got the ball rolling in the Crimea. Which is why CNA is a few weeks of night school, and not a college degree plus 3-12 months of directly-supervised clinical hands-on experience that an RN license requires. (CA requires 500 hours, minimum. My program was closer to 1300 hours.)

Putting it gently, Angus kind of stepped in it with both feet.

A CNA takes vital signs (with a machine that does 90% of the work), helps change dirty diapers and linens, and walks patients to the bathroom. That about exhausts their entire clinical skill set, and many of them are hard-pressed to be barely competent at any of that. Like I-didn't-realize-that-a-pulse-of-180-should-be-immediately-flagged-to-the-nurse/doctor barely competent. I've only seen that one - or one like it - about a thousand times in 25 years.

That skill set was covered my first week of nursing school, and they expanded on that to quite a degree over several years. Almost like one was a dead-end entry-level cert, and the other was a bona fide medical profession.

I don't know why anyone would lead someone to believe it was otherwise, but anyone so informed has been rather egregiously misled.

In Angus' experience wheelhouse, on the skillset continuum, it's the difference between a tank loader 5 minutes out of school at Ft. Benning (it still makes me shudder that it's not at Ft. Knox any more), and a SFC with 16 years in Armor who's the Tank Commander. (In point of fact, that loader got more - and better - training at his 19K MOS in 8 weeks at Ft. Benning than most CNAs get in school. EVER.)

*(Answer: C. V-tach. It's important because if it's pulseless V-tach, the patient is in cardiac arrest, and the nurse should get the defibrillator and zap that patient pronto while calling "CODE BLUE" loud enough for everyone within earshot to hear and respond to. Total amount of time CNAs get educated and trained to know and do this: Never. Period. 

Whereas for an RN, any RN, it should be automatic. Anyone who sincerely thinks the difference between a CNA and an RN is "not much" should let their grade-school-aged kids take out their appendix or gallbladder with kitchen utensils, and get back to us on how well that worked out. That's what expecting a CNA to be an RN is like.)

*** ADDENDUM ***:

If you came here, read this, and then ran over to dogpile Angus at his blog, please stop. (If anyone this applies to didn't read follow-ups there, that speaks for itself.)

1) Like most blogs (including this one) comments are moderated, meaning rude and obnoxious rejoinders disappear into the ether. Just like here.

2) Take the time to note Angus' multiple replies and amplifications on the original topic (and a couple of spicy ripostes for people doing it wrong. It's clear that what came out in his first post wasn't precisely what he meant to say, i.e. that CNAs doing CNA tasks do them as well as RNs. (We have no argument whatsoever with that contention, though we do wish it had been phrased better originally.) And that some jobs require far more licensure than the tasks that make up the job entail. We absolutely agree with him on that point as well, and we have no doubt some idiot managers over-mandate licensure levels a given job at hand doesn't require, in a phenomenon not limited to the medical arts.

3) That doesn't mean that the wingnut deliberately perpetrating a professional fraud in the OP deserves a pass (she deserves to get hammered into the ground, in fact) but it does illustrate that whoever classified that job as one requiring an RN license grossly over-stated the necessary qualifications to excel at it. Why anyone running a business would be as stupid as to do that in the first place is beyond explanation, but then so is demanding an RN license, and then performing no due diligence to ensure that anyone considered for the position actually possessed one. Stupid is as stupid does.

I got the clarification of what he intended by his second post on the topic. There have been at least two more since that, for a total of four, not counting the pointed reminders that going to his blog (or anybody else's, in nearly every case) to storm in and crap on the carpet will never see the light of day. The list of blogs on the internet where even being right, if you're a right dick about it, will get your missives discarded, is long, and distinguished. This should not be news to anyone.

FFS, I agree with Angus on many important things (guns, the military, and most current events, to name but three) more than even he thinks, even if we're not carbon copies of each other. What a boring internet that would be. And if you're going to disagree with anyone online who's worth the trouble, do it within the bounds of decorum. You'll get more flies with sugar than with vinegar.

If that's too much to ask of anyone, I don't want to know you.

Still Can't Find Them Anywhere...

But hey, look! RUSSIA!
World's Biggest Nothingburger!

CDC Releases Updated List...

Sunday Music: Slip Slidin' Away

 

Today's pick is a Top Five hit from 1977 by quintessential American singer/songwriter Paul Simon. Dedicated to the patient with no quality of life, made a DNR, but kept alive by his family probably out of guilt, long past the time they should have just let go, told him they loved him, and whispered into his ear "Walk towards the light...". There's nothing less fun than watching your patient's blood pressure slide down and circle the drain, without quite bottoming out, and then the family panics, and decides at the last minute they want you to do everything short of actual CPR. For some reason, couldn't get this song out of my head all night.