Contstructive discussion

[dankimal]

Hello All:

I've been flexed off the past few shifts, so I've had a great deal of time to browse the discussion forums on this sight. The discourse has often been heated and I've noticed that so much of the space is taken by posters who are angry, frustrated, disillusioned... "burnt out."

So my aim and question is this: What problems do you see in the health care delivery systems you practice in? What can be changed? How can we change the environment and culture so that quality health care is accessible to all? How can we as nurses ensure that our working hours are uplifting to our patients as well as to our co-workers and ourselves?

May we have civil, thoughtful discussion that avoids over-simplification.

Happy posting.

Daniel

[carolmaccas66, BSN, RN]

I used to be in the nursing union and they did absolutely nothing for me when I was in a situation of being accused of things I did not do, and I was being blackballed cos I was young.

Don't waste your money and join a union. The only way things will change in our country (and maybe yours) is if limited staff are on at all the hospitals, and we ALL en masse go on strike, until our demands are met. Some nurses will not do this cos of the really sick patients, but it would teach everybody in society that hospitals and nurses are there as PROFESSIONALS at all times of the day and night, 24/7 to look after ANY-BODY and EVERY-BODY.

And then some nurses will be too scared to strike, as they can kiss goodbye to their job - and get replaced by only-too-happy-to-have-your-job foreign and/or inexperienced agency nurses.

Nothing will ever change otherwise.

[xluescluesx]

I agree with the poster above regarding unions. I'm not sure how I feel about them, but I was part of a union in my last job and they did not help me. I wasn't a nurse, but I worked in a major hospital in the pharmacy department and we were really busy. I'm curious what nurses think of unions if they're part of one. In my state, there are a lot of nursing unions but not all hospitals have them.

From my experience with my union, they are really only beneficial for people who have a lot of seniority. It is absolutely impossible to fire someone who has spent many years working somewhere unless they really screw up. Most of the people I worked with who had a lot of seniority were so lazy and spent the whole shift in the back chit chatting because they knew they wouldn't get fired. If there was a new job opening, the position did not go to the person who deserved it and earned it, it went to the person with the most seniority. Raises were not based on merit. The person with seniority gets paid more than the person who works for two people.

I got fired from this job because my manager hated me and did everything in her power to get rid of me. I worked so hard and was a really good employee, but I just rubbed her the wrong way I guess. I don't know why or how, I avoided her as much as I could so she wouldn't find reasons to pick on me. It would have been easier to fire me had I not been in a union, but if a manager wants to fire you and make your life miserable, they will do it with or without a union. In fact, on the day I got fired, my manager and my union "rep" had lunch together right before they fired me together. My union was absolutely useless. All the complaints and grievances I filed against my boss for her ridiculous write ups (example: going to lunch at 1:24 instead of 1:30) went ignored.

But then again, this wasn't a nursing position so I don't know if it's similar with nurses. All I know is that unions encourage laziness and are inefficient.

[carolmaccas66, BSN, RN]

ew....who wants to have "civil, thoughtful discussion"?

personally, i won't participate unless i can b**ch and moan, argue, aggravate, and take out all my anger and frustration on my fellow posters.:throcomp:

i don't want to act mature.

whaddya gonna do about it?

leslie:lol2:

Leslie you're heaps funny! This cheered me up no end!

[joanna73, BSN, RN]

Canadian nurses have no choice about the unions. You can't opt out. You are hired somewhere, and most facilities are unionized. You receive your Collective Agreement, and the union dues are an automatic deduction. I have never needed them, but I think working conditions, especially in this economy, would be worse without a Union. In Ontario, for example, recently, they were attempting to freeze wages for nurses. The Union said no, and some sort of agreement was reached. I like knowing that there are certain aspects of my work that an employer cannot arbitrarily mess with. It's there in black and white.

[joanna73, BSN, RN]

And we are all held to standards of the College of Nurses. They will terminate you for being lazy or incompetent. Its not that easy to get around, simply because you're in a Union. We still all have nursing standards and expectations to be met, competencies, and that sort of thing.

[canesdukegirl, BSN, RN]

Canesdukegirl,

Loved the 'McMedicine'. Fast-food medicine, that is what it is all about now. The health care industry is no longer that. It is a business and most of the businesses are 'for profit'. While I was studying to be a nurse, it was all about patient care and it was holistic. Once I graduated, it was starting to change.

When I was in nursing school, I had an instructor that insisted we refer to pts as "clients". That was the first shift that I had noticed in viewing health care as business. I flat out refused to refer to my pts as clients. Call me old fashioned, naive, airhead...but I have always viewed health care as CARING for a person in need, not as someone who employs me on retainer.

[Horseshoe, BSN, RN]

Hello All:

How can we as nurses ensure that our working hours are uplifting to our patients as well as to our co-workers and ourselves?

May we have civil, thoughtful discussion that avoids over-simplification.

Daniel

My answer to your question above: proper staffing. That may seem to be an "over simplification," but in my opinion, most of the dissatisfaction nurses feel can be traced to a poor nurse to patient ratio and lack of adequate support staff.

[McGyverRN]

These are very complex questions that cannot be answered easily. As we all know, it comes down to money. Money is more scarce nowadays. For example, if we forget an eyedrop on a discharge med list for a CHF pt, we don't get paid for the admission. The nurse gets blamed, more paperwork is piled onto the nurse so (theoretically) fewer errors are made, the nurse spends less time at the bedside to do said paperwork, patients are less satisfied, press-ganey scores are lower, we get paid less, the nurses get blamed...and the cycle starts all over again.

It needs to start at the top....fewer ceo's earning six figures and more, and more nurses on the floor. We can't change the trends of the insurance industry and their desire to do anything and everything to deny payment. So we must improve our quality control by hiring more nursing staff to make sure all of our i's are dotted and t's are crossed at the time of the delivery of service.

I could go on and on, but I will stop here.

[joanna73, BSN, RN]

It's the high paid CEO's that need a pay cut, not working nurses. We do all the work, provide all the care. These CEOs earn outrageous figures, to do...what, exactly??! They sit in their glass towers and crunch numbers all day. Very frustrating!

[nursel56]

I would welcome my American friends :) And it's not that much colder in Canada, unless you are used to States such as Cali, Texas, or Fla.

Having lived in California most of my life. . . I tend to irritate my Canadian friends by saying things like "omg I just realized -- you know how we're always talking about how **bleeping** cold it is in International Falls, MN? Well almost everything in Canada is north of that!!! The reaction generally is along the lines of :anbd:

When I was in nursing school, I had an instructor that insisted we refer to pts as "clients". That was the first shift that I had noticed in viewing health care as business. I flat out refused to refer to my pts as clients. Call me old fashioned, naive, airhead...but I have always viewed health care as CARING for a person in need, not as someone who employs me on retainer.

Looking back in my case the change started when the old partnership-based pre-paid medical plan started by two physicians was bought by an eastern insurance company which in turn was merged with a larger insurance company a couple of years later. Although the small partnership owned a hospital and clinics and nobody worked for free, they managed to keep it patient centered rather than primarily profit centered. They never even formed a corporation. I had a chance to meet one of the doctors when he was well into his eighties - he was dressed in a natty grey suit with a large boutonnière. It was a kick to watch him be squired around in sort of a victory lap. Several months later the new corporate owners fired 20% of our employees.