Main Problem In The Nursing Field?

Nurses General Nursing

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What do you see is the main problem in the nursing field? I am supposed to do a 10 page report on a major problem within nursing and the solutions to it. I would like to have 3 of the main ones to choose from. Thank you in advance for your input.

Specializes in NICU, ER, OR.
I'm just a student, but I think the main problem would be nurse to patient staffing ratio's and the CNA to patient/resident staffing ratios.

Well, while I certainly agree, I would like to add this: I work in the OR, and obviously, we deal with 1 patient at a time (so far lol) so, ratio is not a concern. BUT.... we deal with backbiting, information hogging, in fighting, gossiping, bullying, lack of team work to the point that the PT suffers. And these bahaviors are all from the same level of food chain : RN. It makes me sick. Literally.:madface:

One of the biggest concerns for nursing is nurse to patient ratio. Nurses are getting spread thin caring for patients just because administration is only looking at numbers. The acuity level isn't taken into consideration and there are times patients just don't get the care they should be until it's too late and they have decompensated. We don't have CNA's on our unit so we do it all and an extra set of hands could really help. It's all financial - bottom line.

Specializes in O.R., Endo, Emergency, Education, Nurser.

I think Justmanda is on the right track. Nurses tend to eat their young unfortunately. Whether it is due to overwork,competitiveness, or just mean-spirited. Nursing is the most rewarding profession in the world to me. Hospitals are short-staffed. Management is not always what it should be. It would be best if nurses & doctors could/would focus on their reason for job security (patients). Everybody has a bad day. People are human. Take the higher road. Thank you for allowing me this "speech".:heartbeat

Specializes in Day Surgery/Infusion/ED.
I've worked in all-RN units. There were no CNAs or LPNs, only a unit clerk. I've worked in total patient care and primary nurse models where there might be one CNA for an entire unit. Without a doubt, the CNA is a valuable part of the nursing team, particularly in long-term care, and her work is often underappreciated, but she is not "the first step of professional nursing," any more than a medical assistant is the first step of professional medicine. The first step of professional nursing is the professional nurse, and that nurse has a license.

You said precisely what I was thinking. CNAs are essential team members, but they are not nurses.

Specializes in HIV care, med/surge agency.

The tremendous overload of work. We need fewer pathients per nurse to make for better care, greater safety and less stressed out nurses. To get this we need to unionise Nurses and hospital workers everywhere and win some strikes.

The main problem in nursing is M$NEY!

Its all about cutting corners, saving a dime and maintaining customer service.

Do more with less.For years "society" (for lack of a better word) has tried to cut the LPN proffession, but we are needed even more so than before. Good RN or CNA or not, you CAN NOT give good quality care to a dozen of patients is a 8-12 hour time frame with or without the help of the LPN. Don't get me wrong, I'm not trying to stir the conversation into another angle but it proves my point: cut backs.

Another problem is media and technology.How many of you have a a family member or patient come to you and say ..."this is what I read off the internet", ot "this is what I heard on T.V."?Pt.s and famlies are telling the medical and nursing staff how they are to be medically treated. I see this more in ALTC, like the one I currently work in.

Again another problem is legality and complience. My eyes have seen charge nurses and supervisors being moved off the floors to do admin. work and such, not being available if there is a disruption in the staff to nurse ratio. At one time these nurses were available if you needed an extra hand, not anymore in any place I have worked recently. Whats sad, these are good floor nurses.

In general I think societys' ideas on nursing care has changed a great deal: licensed and unlicensed staff in all.

Those are just a few of my thoughts. Now, is there a solution??I'm always thinking but nothing comes to mind, I feel my hands are tied. "Do as the Romans do or be replaced."

Pegasus

Phoenix, Az:uhoh3:

-Shortage of males in the nursing field which makes it so different from any other career for one.

-we can standardize the care, but how can you standardize compassion? So, in this society that we live in, BIG companies have managed to make people work like robots. However, no robot can replace a nurses position. Therefore they need to customize their managements to suit our needs. I can't blame any nurse for under performance because they're the most hard working people I have ever seen.

IF ANYTHING WE NEED TO ESTABLISH A CARE SYSTEM THAT USES CODING. JUST LIKE THE ONES THE PHYSICAL THERAPIST AND DOCTORS USE. IF WE GET THIS, NO ONE CAN BURDEN US FOR THE EXTRA WORK BECAUSE YOU WILL CHARGE THEM EXTRA. AND YOU WOULDN'T HAVE TO WORRY ABOUT BEING UNDERPAID. IT MIGHT SOUND UNORTHODOX, BUT THAT'S HOW EVERYONE ELSE IN THE HEALTH-CARE FIELD BILLS FOR THEIR WORK. AS NURSES, OUR PRICE IS INCLUDED IN THE ROOOM! IT'S MORE LIKE A SET PRICE. THINK ABOUT IT! e.g. the PT/OT comes in and performs ROM for 10 mins, well, he or she will bill for that. Maybe someone needs to research this idea and advocate it.

Maxs

Nursing should be considered noble profession and deserves a far more powerful voice in the healthcare industry than it has, but the root of it's problems can only be changed from within the field itself.

Many of the problems of the nursing field result two reasons, (1) from nursing lacking a clear path of entry certification at the professional level, and (2) lack of cohesiveness of nurses as a group. While in nursing school I had a long discussion with a professor who I much respected about whether nursing was a considered a "profession" or an "occupation". She maintained that professional nursing did not begin until the master's level. I strongly disagreed, but now after a year and a half as a practicing nurse, my opinion has changed and I agree with her argument.

Nursing has set a standard of entry at the diploma or two-year associate degree level, which is not considered a "professional degree" level in almost any profession. I am NOT saying ADN nurses are not qualified excellent practitioners, but their degree does not confer "professional" status in the American system. BSN nurses do have a four year degree which is considered to be a "professional" level degree, however because licensing standards are the same as a ADN prepared nurse the BSN nurse is considered no different to those outside the nursing profession. In a field where 2-4 years beyond undergraduate level is required to attain professional status (i.e. PTs, RpHs, MDs) nursing will never get the respect it is due until has a four year degree entry requirement as a standard of practice. A good start would be a separate licensing path conferring RN-BSN licensure specific to the BSN degree with a "NCLEX-BSN" which would acknowledge and test the additional professional preparation the BSN should require.

The second barrier I mentioned is the lack of cohesiveness of nurses as a group. Nurses are one of the largest occupations in this country. There are four nurses to every one physician in the nation (http://www.nursingadvocacy.org/faq/rn_facts.html). However, a small percentage of those nurses belong to their state and nation Nursing Associations. Doctors do not have the power they do solely because of their education; over 97% of them belong to the AMA, which is a powerful state and national lobbying force. Money buys power and influences change.

Nursing should be considered noble profession and deserves a far more powerful voice in the healthcare industry than it has, but the root of it's problems can only be changed from within the field itself.

Many of the problems of the nursing field result two reasons, (1) from nursing lacking a clear path of entry certification at the professional level, and (2) lack of cohesiveness of nurses as a group. While in nursing school I had a long discussion with a professor who I much respected about whether nursing was a considered a "profession" or an "occupation". She maintained that professional nursing did not begin until the master's level. I strongly disagreed, but now after a year and a half as a practicing nurse, my opinion has changed and I agree with her argument.

Nursing has set a standard of entry at the diploma or two-year associate degree level, which is not considered a "professional degree" level in almost any profession. I am NOT saying ADN nurses are not qualified excellent practitioners, but their degree does not confer "professional" status in the American system. BSN nurses do have a four year degree which is considered to be a "professional" level degree, however because licensing standards are the same as a ADN prepared nurse the BSN nurse is considered no different to those outside the nursing profession. In a field where 2-4 years beyond undergraduate level is required to attain professional status (i.e. PTs, RpHs, MDs) nursing will never get the respect it is due until has a four year degree entry requirement as a standard of practice. A good start would be a separate licensing path conferring RN-BSN licensure specific to the BSN degree with a "NCLEX-BSN" which would acknowledge and test the additional professional preparation the BSN should require.

I agree that nurses deserve to have more of a voice in the healthcare industry. It is amazing that there are over 2 millions nurses in this country, and that they way outnumber doctors, yet I can only find a few books out there that are written by nurses about their experiences in nursing school, and on their job. I have found numerous books by doctors and medical students about medical school, but I am finding it hard to find books by nurses about what nursing school is like, other than the brief mentions in other books written in the past decades. Considering that nursing is the largest healthcare occupation, I would think that there would be a tremendous audience for these books (I would love to read them! :)) , but where are they? Also, as far as the professional status is concerned, I have had nurses who have a BSN degree tell me that some doctors still don't give them the respect that they deserve because they didn't have the motivation and smarts to go on to become doctors. I know this is anecdotal, but they have also told me that other people have told them that they shouldn't "settle" on being a nurse, but should go on to medical school. I don't know if more education will really bring more respect for nursing, if some people, and doctors, still feel that if you really want to be in the medical field, you should strive to become a doctor.

hahaha. you want just 3? wow. i think the number one issue is poor management. poor management translates into higher nurse:patient ratios, poor job satisfaction, higher turnover rates. when the management is bad, nurses are unhappy. unhappy nurses dont like working. therefore, work relationships suffer. you get gossiping and back biting. nurses dont support each other. problems aren't dealt with and the work environment sucks.

second issue: poor funding. ultimately, hospitals like spending money on fancy, shiny, big pieces equipment, instead of the regular stuff that every ward needs. how about BP machine for every room? adequate supplies so i can actually do a dressing change instead of running over to another ward to find a dressing tray. my manager had to fight to get funding so they could hire another nurse to be available in a 3-11 shift, to cover shift changes. it'll be a huge help and take off some of the burden.

third issue: unsafe working conditions. we have a large nursing station on my unit. unfortunately, come september, there's nursing students, residents, medical students, doctors, and the RNs all piled into the station and all of a sudden, its not so large anymore. suddenly no one knows where the charts are. i need to give out my meds, but the med profiles are missing bc someone has them. i'm tripping over bags, coats, lunch pails, and eveyrthing else ppl leave in the corners. there's not enough chairs. get the picture?

well this is just my opinion. hope it makes sense :lol2:

Oh man...you must work at the same hospital I do, lol

I think that the biggest problem we face in nursing today is with the lack of cohesion within the profession. Without a unified vision and the will to work together to achieve that vision, we can not successfully resolve all the other issues that inevitably arise.

With a united profession and a shared vision, we can solve a lot of the problems. Without the unity and the vision, we are a bunch of squabbling, ineffective wannabees.

llg

I absolutely agree with you and this is really the root of the problem. There is power in numbers but I too often see nurses who just want to go to work, do their jobs, keep their mouths shut, and collect a paycheck. They do the whole profession a disservice because there are a few...and only a few...that want to speak up and make a difference. Until ALL nurses come together for this shared vision, the work environment will continue to be the way it is and things will never change. We will continue the high nurse patient ratios, the mistreatment by doctors and management and all the other issues that other nurses have already mentioned. There are alot of great things about being a nurse these days but they are quickly being out numbered by many other factors that make me dread going to work each day. I have been doing med surg for 18 years and I'm not sure how much longer I will be able to put up with the pace. Things must change and it is up to all of us to make sure those changes happen.

Main problem - having immense responsibility/ accountability but very little authority or "voice" in our practice environment.

:yeahthat: I'm sorry but alot of nurses equate responsibility with having a voice. We as nurses always want more responsibility and I have often heard other nurses been called lazy if they actually voiced their opinion. But in truth the above poster is so right! When you sit down and think about it we have no voice whatsoever in our patients care. Yes we can refuse certain things that are not in our scope of practice, we can also be the patient's advocate but we can "merely" suggest a route of treatment (not general treatment). Often times it is ignored just to prove a point. Food for thought : a Physical therapist and Occupational therapist have more autonomy than a nurse!

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