Nursing shortage? Read this and respond please - page 3

In the recent months our hospital appears to have trouble hiring new nurses, and/or keeping nurses in the hospital. This seems most prvalent on the evening and night shifts. A few thoughts enter my... Read More

  1. by   bunky
    Daisy, we were just talking at work about your idea of money not mattering as much as the working conditions. We are in a really desparate situation right now, with nurses quitting left right and center. The mass exodus began with the implementation of a new staffing grid which is a killer. We can sometimes look forward to having 9 patients or more on nights where we have no PCA nor unit secretary currently. The other local hospitals have been working a similar grid for awhile and their nurses have also jumped ship. I don't think it's about the money anymore, or at least the money issue isn't as large as the poor working conditions. As my hospital unveiled it's new grid, other hospitals began recruiting our staff with the promise of better staffing and better pay. Now our hospital realizing the importance of staff retention is planning on a pay raise,(the ER has been shut down twice since Saturday due to lack of staff on the floors) but most of us are of the opinion that they can shove their raise and just give us enough staff and we'd stay. It seems like a vicious circle.
  2. by   tweetieRN
    As long as I've been in nursing there has been a push to elevate and promote us to the 'professional level'. Some have suggested that this would be done by obtaining a bachelors degree and some by pursuing advanced certifications. None of which I have a problem with if thats what the individual person wants.
    I have an ADN and have worked for years in an ICU. During this time I've had many hours of training and courses to stay educated and current with increased requirements of knowledge. But:
    Has anyone ever told a little old lady that she'll have to wait for awhile to go potty? Or stood at bedside for 20 minutes while a patient takes their multiple pills one at a time with a sip of water in between each pill? Or left a GI bleeder lay in a bloody mess in their bed so you could do the paperwork? Of course not!!! And these are just a few of the many things that take so much of our time. I'm supposed to operate all this special equipment, take the readings and interpret them, do frequent physical assessments, interpret lab values, review their meds, recheck orders, review their medical history, report anything unusual to the doc. And in the middle of all this I'm to attend to their physical care - bathe them, feed them if neccessary, ambulate them, etc.
    I don't want another nurse - I want more CNA's. I've worked mostly at night, and we never get a CNA or unit clerk - they've talked about it, but it never happens. And at night we get extra duties to do during our 'down time'. Down time? And because its an ICU we often move patients in and out all night long. And guess who gets to clean the room for the next patient?
    I've always felt that a nurses' duties end up being what no one else wants to do.
  3. by   vicki
    Hi Rick,
    I just wanted to respond to the question regarding the nursing shortage. I graduated one year ago. I work in a large teaching hospital in the midwest. My orientation was a farce. On day 8 of my orientation, I was given 8 patients of my own for which I was responsible for their total care. This included assessments, meds, personal care such as bathing and changing beds. This also included taking off my orders (there was no unit secretary), to top it off I was given the narc keys. I believe my preceptor believed that it was a sink or swim situation. I cried daily, and at the end of two weeks truly felt as though I would have a nervous breakdown. All this for 13.85 an hour. A year later, the situation is not much improved. I routinely have 9-11 patients on the day shift. We usually work without CNA's and many times without unit secretaries. In addition, the nursing staff is responsible for patient transport for scheduled tests. Many times there are no techs available for phlebotomy and EKG so the nursing is also responsible for these duties. The hospitals have taken what were previously several different paid positions for different departments and consolidated them under the professional nurses responsibility, and then they wonder why we are stressed. They justify doing this by referring to cutbacks and reduced income as a direct result of insurance companies allowed payables and other government endorsed policies. Ultimately, nurses are unable to keep going under such duress and seek positions outside the hospital setting. Burnout is very real to many nurses. Unfortunately, patients are the ones to suffer the most. Until nurses and other healthcare providers learn to stand together and make one loud voice for the public and government, we can expect no real solutions to this problem. We will continue to have short-term, "bandaid" solutions.



    [This message has been edited by vicki (edited July 25, 2000).]
  4. by   oramar
    Originally posted by vicki:
    Hi Rick,
    I just wanted to respond to the question regarding the nursing shortage. I graduated one year ago. I work in a large teaching hospital in the midwest. My orientation was a farce. On day 8 of my orientation, I was given 8 patients of my own for which I was responsible for their total care. This included assessments, meds, personal care such as bathing and changing beds. This also included taking off my orders (there was no unit secretary), to top it off I was given the narc keys. I believe my preceptor believed that it was a sink or swim situation. I cried daily, and at the end of two weeks truly felt as though I would have a nervous breakdown. All this for 13.85 an hour. A year later, the situation is not much improved. I routinely have 9-11 patients on the day shift. We usually work without CNA's and many times without unit secretaries. In addition, the nursing staff is responsible for patient transport for scheduled tests. Many times there are no techs available for phlebotomy and EKG so the nursing is also responsible for these duties. The hospitals have taken what were previously several different paid positions for different departments and consolidated them under the professional nurses responsibility, and then they wonder why we are stressed. They justify doing this by referring to cutbacks and reduced income as a direct result of insurance companies allowed payables and other government endorsed policies. Ultimately, nurses are unable to keep going under such duress and seek positions outside the hospital setting. Burnout is very real to many nurses. Unfortunately, patients are the ones to suffer the most. Until nurses and other healthcare providers learn to stand together and make one loud voice for the public and government, we can expect no real solutions to this problem. We will continue to have short-term, "bandaid" solutions.

    [This message has been edited by vicki (edited July 25, 2000).]
    One year experiece and you totally got a handle on the situation. No one have given a better description of what is going on, good for you.
  5. by   CEN35
    Thank you all for your replies and input so far. I have two questions though? What is a CNA?

    One other note, someone mentioned unity? Prrofessionalism etc. One thing for sure, when you look at the medical community, the physicians have the AMA. That's it? What do we have? TheONA, the ANA, the NLN etc. That's one problem r/t nursing unity and professionalism, not to mention the griping, and arguing about BSN vs ADN, what a crock! There needs to be a lot done, before we can get to the same level of proffesionsalism as physicians.

    Rick RN CEN
  6. by   vicki
    Rick, first a CNA is a certified nursing assistant. Second, there are enough nurses in this country to bring about real change if they would ever unite for one common goal. We all know there are two ways of changing laws and trends within our government, one is money- lots of it to pay for lobbying, and the other is to have the general public behind you. The only thing that speaks louder than money is votes. The insurance companies will always have more money than any nursing organization we have. We all know that with the current situation patients are suffering because there are not enough nurses to go around, patients are restricted on what health care they are allowed, and oftentimes the hospitals hands are tied because the insurance companies call all the shots. This is why I say this is larger than just a nursing problem. This involves all healthcare workers, including physicians, and this includes anyone who is currently receiving medical care or who's family members are. I think this would encompass most of the United States. Listen to the feedback from patients and friends outside of the medical field. There are many people who are fed up and desire change.We need strong leaders and articulate people to take this to the public, and for nurses to stand together on issues. Change can benefit all of us. I'll get down off my soapbox now. Please respond with opinions.



    [This message has been edited by vicki (edited July 26, 2000).]
  7. by   mamy
    WOW! After reading all of these posts I am scared! I am in my last year of nursing school and I thought I would have a job for sure! Now I am not so sure. In Texas where I go to school, the shortage is here and in our face! The hospitals where we do clinicals used to be so happy that they had students, well the nurses were, and now they don't even want to be bothered with us. It is very discouraging! I hope that in this time of crisis we can bond together and make something good come out of it! Keep your heads up guys!
  8. by   CEN35
    Someone mentioned unity, and that all we have to do is get all the medical personal together (i.e. doctors, nurses, med techs etc).

    1st of all, the AMA have always been the biggest crowd against nurse practioners, and PA's functioning independently. They could care less about us.
    2nd? Just get one large organization? It is way easier said than done. There is so much confusion among the nursing ranks, on who or which organization you should be with? why should you be with them? LPN vs RN, vs MA vs NP etc. Nurses in general-->>> ICU doesn't like ER nurses, CCU doesn't like SDU nurses, and the RNF staff does not like anybody, cause they get the leftovers? We have all seen it so it can't be denied. Then on top of all that, it goes back to the ADN VS BSN VS MSN etc. They all think they are better than each other. If you are an ADN you HAVE TO HATE the ANA. Why? The ANA is the orginazation that decided, after a certain year an ADN or diploma program RN could not get a specialty certification, like CNS, etc. So they have allienated thousands of nurses with that move. Certainly, not the inteligence of a brain surgeon (as the saying goes).

    BOTTOM LINE--->>>> It will be a long, long time before nurses have any kind of bond or unity, to the extent that we will have the leverage to make those changes to benefit us.


    Rick RN CEN
  9. by   saphie
    I can only speak from my experience. My experience is there is a nursing shortage. I have classmates that got into specialized areas right from graduation. For myself, I landed a 0.6 permenent position before I had technically graduated. One hospital wants to fly me out for an interview. Another is totally willing to work around my schedule and put in the areas that I want to be in. So I would say in Canada there is lots of jobs up here, at least in Calgary. Not a bad place to be either!
  10. by   pickledpepperRN
    Originally posted by Mijourney:
    Hi Rick,
    Got to get my two or more cents in on this topic.
    I agree with your summaries and the previous posts. Lesliee is correct in indicating that new grads don't get enough of what they need to practice confidently as a competent nurse. PPL is correct in writing that it is not the pay that is the major problem in nursing.
    Since I have been a member of this BB, my review of posts indicates that:
    1.There is a problem with intradisciplinary support in nursing. It starts out in nursing school with nursing educators who are not objective, not politically(not to be confused with party affiliation) savvy, and have inadequate people skills.
    2.Managed care has disrupted the comfort zones of all health and medical professionals.
    3.Demands of the aged along with the aging "me" generation baby boomers and their "no, me" gen-xer children have increased the frustration level of bedside nurses who already are stressed out from all the restructuring going on in the name of "the bottom line."
    4.Many nurses are not wholly engaged in formal life long learning activities which is required nowadays to keep up with the increasingly rapid pace of change in health and medical care.
    Also experts write that the average age of nurses in practice today is mid 40's. No doubt, this is one reason many experienced nurses are going into nontraditional fields of health and medical care. This along with potential nursing candidates going into other fields that are less challenged than nursing will possibly contribute to a longer than expected shortage. Some experts predict a severe nursing shortage for the next 20 years. Also, need to include the fact that the proliferation of for profit health and medical services in the last decade have probably negatively impacted entry into nursing practice and nurse retention.
    Currently, I am in home health(HH). As a former hospital nurse, I feel that in the future, it will become difficult to distinguish between hospital and home nursing practice in terms of frustration levels. In the last several years, increasing pain has been inflicted upon us. With the advent of PPS which is similar in many ways to DRGs, the pain will become unbearable for many nurses, aides, allied health practitioners, and patients. All this in the name of "the bottom line."
    With regards to your specialty Rick, I recently read that many ERs are having a time of it with the increased number of nonemergency visits. It seems like the health care delivery system needs a good restructuring. In fact, this problem probably should have been addressed long before the money and power issue.


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  11. by   pickledpepperRN
    Originally posted by CEN35:
    Thank you all for your replies and input so far. I have two questions though? What is a CNA?

    One other note, someone mentioned unity? Prrofessionalism etc. One thing for sure, when you look at the medical community, the physicians have the AMA. That's it? What do we have? TheONA, the ANA, the NLN etc. That's one problem r/t nursing unity and professionalism, not to mention the griping, and arguing about BSN vs ADN, what a crock! There needs to be a lot done, before we can get to the same level of proffesionsalism as physicians.

    Rick RN CEN
    Hi:
    A CNA in California is a certified nursing assistant with 150 hours training. CNA is also the CALIFORNIA NURSES ASSOCIATION.
    What if nurses applying for a job in a hospital asked for reasonable working conditions in writing? I'm talking about adequate staffing with plans for admissions, lunch breaks, equipment and medications available when the patients need them, orientation and training for each unit the nurse will be required to work, respect for the work we do as shown by believing our assessment of the need for more staff, and backup for nurses who insist on being treated with polite respect by all including doctors.
    WELL? How about all of us who dread going to work who would love nursing if we could truly care for our patients applying for jobs with these requests?



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  12. by   saphie
    This is just my opinion for what it's worth but there is seems to be a lot of talk about the horrible nursing conditions. Like doctors who don't give you the time of day. I totally agree that there are some like that, heaven knows I've been yelled at when I have stood up for a patient. On the other hand, I have had doctors come and talk to me about their patients and ask my input. Welcome my questions without making me feel dumb. I believe that there is a nursing shortage and that it is only going to get worse. In my class there was some people in my year that were rather disgruntled with some earlier year students because they were in nursing because it was a "easy" degree. Our class started when there were no jobs in nursing. I guess the point I'm trying to make is that the majority of time nurses spend complaining about our job, what about focusing on the positive. No one will want to enter if all they here is negativity. I would love to see the proffessional associations do public campaigns on what nursing is and why we do it. Perhaps with more public support we wouldn't be in the bind that we are now going into. Anyway, food for thought.
  13. by   pickledpepperRN
    I agree that complaining is a waste of time. We need to ACT. Get together with fellow nurses at homes or for a meal. Instead of complaining brainstorm ACTIONS. Start small OR check out the link in my profile.

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