I am an RN in a suburban hospital. I work on a telemetry unit. I have been back in the hospital setting for about 15 months. I worked at an outpatient endoscopy center for 3 years and before that I worked on a med surg floor in a larger inner city hospital. Since returning to the hopsital setting I have noticed both suttle and very obvious differences. I realize the hospital settings are different but I feel that the differences go beyond that fact. I do not feel that my facility supports their nurses. The hospital is driven by the needs of the Physicians first, patients second and the staff a distant third. I want to state that I feel that my Nurse Manager is as supportive as the system will allow as are her immediate boss and the DON. The hospital has gotten into a rut where Nurses are very unit oriented and interaction between the units often results in pickering among fellow nurses. But the conflicts that arise between units are very often the result of decisions that evolved from demands of the Physicians; i.e. unexpected longer hours in specialty procedure units and no policy for recourse from the staff involving these issues. I am asking fellow Nurses if their facilities have any programs or policies in place that show support for their staff. Examples being; grievance boards, monthly achievment awards program, interaction committees between units with different scopes of practice, etc. I realize this has been a wordy post but felt it important to give the details to explain the type of information I am looking for. Thank you.