My Reasons For Avoiding The Acute Care Hospital - page 4

by TheCommuter 20,067 Views | 56 Comments Senior Moderator

I’ve been asked the same question by members of Allnurses.com, real-life coworkers, and even some of my own family members: “Why aren’t you interested in working at a major hospital?” My relatively short nursing career... Read More


  1. 4
    The commuter:
    What a shame that so many RN's feel the same way about acute care.
    The bigger question is, in my mind, what are we going to do about it????
    Oldest&Ugliest, anniv91106, joanna73, and 1 other like this.
  2. 2
    We must all be related. This is sooo me as well.
    roughmatch and TheCommuter like this.
  3. 11
    I like acute care nursing, but I don't like the way the hospital is being run.

    I don't like the cutting back of resources while simultaneously increasing documentation requirements. I don't like the emphasis on patient satisfaction scores. I don't like words like "Quality Service Initiative", and I especially despise "Excellence", because they come out of the mouths of the very people who are cutting the resources while increasing the workload, who have no earthly idea what it is like for us on the floor. I don't like managers who behave as cheerleaders for the administration instead of going to bat for the staff on the floor. I don't like being treated badly by patients and visitors for deficiencies in care despite the fact that I have been working non-stop without a break doing the best I can.

    These are the reasons I got out of acute care. If and when the pendulum ever swings back the other way again, where patient loads and acuities are appropriate, where the expectations of what we can get done in one shift are realistic, where we are given the resources that we need in order to be able to provide safe patient care, and where the title of "Nurse" does NOT equal "Maid", then I might go back.
  4. 1
    You described my feelings perfectly. This is a factor in my indecision on whether to take that refresher class and get my license renewed. I do not want to work in a hospital ever again. My personality is like yours. Thanks for putting into words what so many of us feel.
    TheCommuter likes this.
  5. 5
    I get what you're saying.

    I happen to love the hands on procedures you dislike, and don't "mind" codes...especially when they are successful, but what most resonates with me in your post is the massive coordinating of PT/OT/ST/MD's/NP's/PA's/Dietary/ordersordersorders ad infinitum. It seems like if the inter-departmental flow breaks down at any point, it falls on the RN's shoulders.

    From admit to discharge, the RN is responsible for making sure every fikcnig jot and tiddle has come together in a tidy package.

    Acute care RN's, especially in larger hospitals, are the master coordinators. Somewhere in there they might have a moment or two to look after the actual patient and throw some meds at them.
    sneeds, Oldest&Ugliest, roughmatch, and 2 others like this.
  6. 2
    This is one of the really cool things about the Nursing profession; there is something for just about everybody who wants to pursue and achieve. My preference lies more with critical care, but I have a ton of respect for those who choose to excel in Rehab and long term care. Every Nursing specialty is just that... a specialty, and it's all good.
    Oldest&Ugliest and TheCommuter like this.
  7. 3
    Quote from ~*Stargazer*~
    I like acute care nursing, but I don't like the way the hospital is being run.

    I don't like the cutting back of resources while simultaneously increasing documentation requirements. I don't like the emphasis on patient satisfaction scores. I don't like words like "Quality Service Initiative", and I especially despise "Excellence", because they come out of the mouths of the very people who are cutting the resources while increasing the workload, who have no earthly idea what it is like for us on the floor. I don't like managers who behave as cheerleaders for the administration instead of going to bat for the staff on the floor. I don't like being treated badly by patients and visitors for deficiencies in care despite the fact that I have been working non-stop without a break doing the best I can.

    These are the reasons I got out of acute care. If and when the pendulum ever swings back the other way again, where patient loads and acuities are appropriate, where the expectations of what we can get done in one shift are realistic, where we are given the resources that we need in order to be able to provide safe patient care, and where the title of "Nurse" does NOT equal "Maid", then I might go back.
    Agree with your statement about management and resources. I love my coworkers and my patients, but it's impossible to get everything done that management wants us to do. They are sucking my spirit out of me.
    sneeds, roughmatch, and TheCommuter like this.
  8. 1
    I've only been a nurse for 1.5 years & have only worked in acute care hospitals. However, I know for a fact I do NOT want to stay in this environment forever. While I am young & energetic I enjoy this type of work (telemetry/PCU), but it is very stressful at times & just not all that personal. I am so glad there are nurses who want to work in LTC & rehab & things like that as well as others who want to do acute care for their whole careers. My long-term goal is to eventually get into primary care as an NP or hospice/home health.
    TheCommuter likes this.
  9. 3
    Quote from ~*Stargazer*~
    I like acute care nursing, but I don't like the way the hospital is being run.

    I don't like the cutting back of resources while simultaneously increasing documentation requirements. I don't like the emphasis on patient satisfaction scores. I don't like words like "Quality Service Initiative", and I especially despise "Excellence", because they come out of the mouths of the very people who are cutting the resources while increasing the workload, who have no earthly idea what it is like for us on the floor. I don't like managers who behave as cheerleaders for the administration instead of going to bat for the staff on the floor. I don't like being treated badly by patients and visitors for deficiencies in care despite the fact that I have been working non-stop without a break doing the best I can.

    These are the reasons I got out of acute care. If and when the pendulum ever swings back the other way again, where patient loads and acuities are appropriate, where the expectations of what we can get done in one shift are realistic, where we are given the resources that we need in order to be able to provide safe patient care, and where the title of "Nurse" does NOT equal "Maid", then I might go back.
    Exactly. It wasn't really the nursing tasks or skills or whatever you want to call them that I didn't like. I don't have trouble putting in foleys, hanging fluids, starting IVs, etc. I actually had a moment in the ER during school where I thought, "this would be awesome" (even though I found out in reality the RNs only responsibility during a trauma was to chart). Kind of like with the OR...at least here anyway.

    I loved the patients most of the time because most of them are lucid, friendly, and grateful. I just never had time to spend with the patients. I was so sick of the management obsessing over the fine details that the elephant in the room was overlooked. Really, I don't have time to pee, but you want me to get how many hours of computer training finished on the clock, but without overtime? Not to mention pretty much the entire staff being stressed out which made for the most hostile environment ever.

    I think the only people who really "glorify" acute care nursing anyway are acute care nurses.

    Really, most of the public doesn't think about or care what kind of nursing you do. They see your scrubs, your nametag (RN) and then think you can tell them everything they need to know to cure their entire family....even if you have worked in a nursing home for 20 years.

    Or maybe I'm oblivious to the glorification going on around me. Either way, that's glory I definitely do not want! Especially since there's no pay increase to go along with it.
    roughmatch, TheCommuter, and MedChica like this.
  10. 2
    Wow I totally agree with everything you said... I am constantly asked the same question, why won't I work in acute care.... well I never want to. Im happy in LTC and mental health. Thank you very much.
    joanna73 and TheCommuter like this.


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