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  1. Howling at the Moon

    Warm and Fuzzy No More: It's Time For Nurses To Use their clout

    by Mark Jorgensen RN of Omaha, Neb.

    it has been refreshing for a change to read some readers opinions that were not from 21 year old new grads, or those eternally "warm and fuzzy" types. We've read enough "save the world and pamper your patient" opinions to choke a moose. It's high time nurses address the real isssues with real clout.

    We can maintin the desire to be quality nurses concurrent with taking a hrad stand regarding income, staffing and working conditions. First, however, nurses need to be brave and accept some of the physiological reasons why we make peanuts in relation to our education. An honest understanding of actual barriers to what nurses want is essential if real gains are to be made.

    I have not seen anyone courageously address one of the major problems we face as nurses: our own physiological persona as a group. there are exceptions to the rule in nursing, just not enough. Choosing not to address this facetof our proffessional lives will ensure that our dilemma will continue until foreign nurses, or a new type of nurse, replace us.

    It's time nurses care for themselves just as MDs, pilots, electricians and other proffessionsals do. Thats not selfish, it's common sense. This is ecspecially important for single income nursing households.

    I won't go over much of the available data as to why we are in the predicament we're in, but a cursory review reveals that nurses in the workplace are overly passive, tend to not work well together, have a difficult time agreeing on a course of action and, at times, seem capable of standing up for themselves only in the break room and not the board-room.

    The "let's save the world" warm and fuzzy nurses who refuse to stand up for themselves are part of the problem, not part of the solution. They can save the world and get paid what they are worth if they would join the fight and assist the rest of us to make our careers more fulfilling. Nursing will never improve unless a unified and forceful voice in your facility emerges. Until that time, we're howling at the moon.

    Don't kid yourself for a second: Hospital and other facility CEOs are fully aware psychologically of why and how they can manipulate nurses to maintain their profit margin. thei lip service does not pay your bills, nor improve your career satisfaction. The occasional pizza or dooughnuts are appreciated but do not substitue for better working conditions or higher pay. It's time nurses see beyond these distractions.

    While we struggle, CEOs are buying new beach houses in Costa Rica from the bonuses they recieve for keeping the largest expense in check. They know how far nurses are willing to go to make their point before they retreat. They are experts at making nurses feel guilty by implying they do not have the resources to improve the nursing world, when in fact they could find a way- even if it means increasing the cost of some services.

    Do you think Delta pilots are loosing sleep because their pay raises may sligtly increase airfare? I am generally not a union supporter, but this is why unions can be important for nurses. Generally speaking, nurses need someone to organize and focus on the goals necessary to improve our career satisfaction. Nurses themselves do not get it done.

    The warm and fuzzy crowd says, "It's not right for nurses to unionize or strike", even though MDs are joinging unions like lemmings. If your facility's nurses can stick together and bypass unions, all the better. But let's be serious and use real world examples.

    How far do you think and employer could push a steam-fitters, electricians, teamsters or rail union? Not far and not for long. Are you sensing a trend here? These job fields are primarily male-dominanted. Groups of men simply will not accept no for an answer for long. Nurses are 95% female. generally speaking, nurses have accepted no for an answer for all my 20-plus years in the field. This is partly related to the idea that for a sizable number of nurses, it's "just a job", "extra income" to augment the husbands salary, or a job one may leave for a pregancy and return later.

    Too mnay nurses are content to allow burnout to complete its cycle, or simply leave the field rather than to fight for job satisfaction. What a waste of our time and money for our education!

    Another reality check is that a person who has enough of an IQ to complete a quality course in nursing is likely capable of being successfull in other fields. How many engineers are forced to regularly work rotating shifts, forced overtime, forced to work holidays, and on ad infinitum?

    A self made millionaire acquaintance, who is familiar with what it takes to be a good and educated nurse, has said that nurses rightfully should make about $75,000 a year given the stress, exposure to disease, cost of education, working conditions, hours and serious responsibilitys of the career. He lists numerous bussiness executives who make six figures with a mere fraction of the responsibility of a floor nurse!

    Only a handfull of career fields affect our fellow humans as intimately as a nurse. A brief lapse of focus may not only result in someones death, but also termination of your emans of making a living via license revocation. Civil penalties in court also can follow. yes, one lapse can cost you tremendous time and expense you expended to complete your education. Bet you can't name too many other occupations where this potential exists.

    Obviously, nursing is a serious bussiness; we are just not reimbursed congruent with this fact.

    If you are a nursebecause your subconcious "needs" positive reinforcement from nurturing, or you are seriously codependant and nursing is another outlet, you would benefit all nurses by doing some serious self inventory and growing beyond thos frailities. If you went into nursing to make ends meet and help people, try thinking of a nursing world where you were reimbursed congruent with the job's demands.

    Dance around the issues as you prefer, but these are the realities of our situation. There are not many real leaders in nursing, and those few are getting tired of dragging dead horses to the trough.

    So decide: Are you part of the problem, or part of the solution? Now is the time to act during a nursing shortage to maximize the volume of your voices, as well as hearing acuity of your CEO or administrator. Get activated yourself, and energize those comatose nurses around you as well.

    And remember to "get it in writing", Speak now or forever hold your peace.

    Mark Jorgensen of Omaha, Neb is a former Marine Corps sergent who served during the vietnam war, He has spent years serving as a nursing director and assistant director of nursing in large facilites. Since graduating (RN) in 1984, he has owned two bussinesses. the most recent as a workers compensation case management firm.

    What do you think?
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  2. 19 Comments

  3. by   katrina hays
    Amen!!!!!!

    I am now working as a travel nurse because the pay is so much better and from a business sense it would be literally slitting my own throat not to mention bank acct to work for what hospitals are paying. I had pretty much the same conversation with our neurosurgeon 2 days ago at work. I have been at the same hospital for 2yrs as a traveller, because the hospital will not pay what I demand to hire in.
    I do not want to be wealthy just paid fairly for my duties. After 10yrs I refuse to be paid peanuts anymore!!!!

    There is far to much of the catty attitudes in nursing and always has been, we all do need to get together with one strong voice and say "no more" will we work for what is degrading pay without bonuses for extra shifts worked and pay for experience.

    Look at the AMA and the protection it offers physicians.

    I feel I can do my patients a greater service if I do not have the extra stress at home of having to work 2 jobs to make ends meet, not to mention that nursing is one of the most stressful jobs out there.

    Many nurses I know work 2 or 3 jobs which is sad, in no other profession do you see a person of a nurses stature and knowledge working an extra 2 jobs just to pay the bills.

    There is a solution, but is within the profession of nursing itself that it lies. Hopefully we will find it soon before we all burnout. Which would leave our patients where?????????
  4. by   JennieBSN
    i read this article when it was originally published...was it in spectrum that i saw it? can't remember...anyway...i feel the same about it now as i did then....

    preach on, brother, preach on!!

    i totally agree. it frustrates the *@#!! out of me the way 95% of my coworkers are such doormats and will sit and moan and *@#!! about working conditions, yet won't try to do anything about it!!! i personally believe in standing up for oneself. i did not take an oath of poverty when i became a nurse. i am not a nun. i am not mother theresa. i am not superwoman. it makes me nauseous to be referred to (in songs, poetry, etc., etc) as an 'angel in white.' talk about putting false notions and expectations into the general public's heads!!!

    i'm leaving my horribly staffed, horribly managed unit now to go elsewhere. more money, better hours, more staff. why be 'loyal' to a hospital that's certainly not going to be 'loyal' to me??!!?? gimme a break...

    it's time for nursing to grow a backbone.
  5. by   hoolahan
    I have to say, he makes many valid points, but overall, I am not too impressed. He makes a few points that he does not explain, and so I am left wondering, what does that actually mean?

    "First, however, nurses need to be brave and accept some of the physiological reasons why we make peanuts in relation to our education. " What does he mean by physiological reasons??? "I have not seen anyone courageously address one of the major problems we face as nurses: our own physiological persona as a group. " Again, what is our physiologic personna? I just don't get that at all!


    Also..."The warm and fuzzy crowd says, "It's not right for nurses to unionize or strike", even though MDs are joinging unions like lemmings. " I don't think I am the "warm and fuzzy" type, but I have been a member of a union, and sadly, the only thing the union got us was benefits, there was no definition of unsafe work conditions, adequate staffing, manageable caseload of X pt's in the contract. One place I worked even had mandatory OT in the contract, and this was the NJSNA union!! It wasn't called mandatory OT, it was called reverse seniority, and it was NOT call, no call pay was given. So, while I agree nurses may be part of the problem, I do NOT agree that unions are THE solution.

    I am like an airline pilot. I would not lose any sleep over getting more money. I go where the money is, period. I have been a nurse for 20 years, I know my value and worth, and I won't sell myself short. I negotiated my salary offer for the supervisor job from a meager $30,000/yr to $45,000/yr to work weekends only, with pro-rated benefits, not bad. That is also why I work in the agencies. As kaknurse said in another thread, I change jobs like I change underwear! I do not stand for working conditions where I am not respected or paid for the hard work I do.
    Last edit by hoolahan on Aug 21, '01
  6. by   CEN35
    "i am not a nun. i am not mother theresa. i am not superwoman."

    no you are not: you are: "kristina queen of the kitchen!!!!!!"
    you didn't think i would let you live that one down did you?

    me
  7. by   nurs4kids
    Again, I think it's a chavenistic's attempt to place blame. I keep seeing men blame women for the nursing shortage. I won't deny that there may be some validity to a portion of this rationale. BUT I do not see the men I work with, nor the men on this BB who keep blaming, doing anything more than the women. The men I work with, and I work with many, have the same behavior as the women. On another thread, people were fussing about the respect and pay a teacher gets vs nurses. I do not feel teachers are paid or respected enough, but my point here is that many feel teachers are on a higher ground. Teachers are female dominated.

    Nursing is comprised of mostly women, but all women are not nurses. There are more women making damn good money in other fields than their is women in the entire nursing profession. I know the response here will be, but these women making more are working in male dominated professions. May be, but do you think the weak species you keep describing could survive alone in such a harsh enviroment. No, it takes a damn strong woman to succeed in a male dominated profession. But many do it. So, maybe instead of pointing fingers we should look at other possibilities. Perhaps the type person drawn to nursing (male or female) is the same type to carry those docile personality traits that all women continue to get "credit" for.

    What it IS time for us to do is to quit pointing fingers. If anyone thinks they can change the personality of a million nurses, let alone WOMEN, you will die a sad dreamer. If you're right in your analysis (and I don't believe you are), then there's still nothing you can do to change the personalities. If the pathetic working conditions haven't done it, then nothing will.

    When are we going to work together to find common ground and move into action? This is the only solution. Pointing fingers will only allow CEO's to keep laughing all the way to the bank. Together we can conquer, divided we will fall. We're falling fast.
  8. by   JennieBSN
    In my 4 short years of being a nurse, I have already earned the label of 'trouble maker (or boat-rocker, if you will)' from trying to enact change in my workplace. I have not been successful at either of two VERY balls-y attempts, even with backing from almost the entire staff and taking it as high up as the CEO. I have discovered that no matter how grievous the injustice or substandard the working conditions, nothing will change if the higher-ups have no backbone and/or don't give a d*** about staff. Most higher-ups hire people using the 'spoon test'...put the body in front of the spoon, if it fogs up when they exhale, they're hired. Period. Nurses have KILLED people where I work, and NOTHING has happened. I'm sure this wouldn't be the case if there were more boat-rockers like myself, but there just aren't. A good number of my peers are more content to sit on their duffs and whine than to try to enact change.

    SO...I may be 'running' somewhere else, but this time the motive is pure and simple: less crap, more money. Selfish? Yes. Realistic? You betcha. I have faced the problems head on, I have taken drastic action. Nothing has changed. So this time, screw the common good, I'm looking out for number one. I'm taking my (very solid) backbone and heading directly for the biggest dollar signs.

    Rick, you ARE on crack...
  9. by   CEN35
    Crack? Where do you kep coming up with that one? LMAO!



    me
  10. by   nurs4kids
    kday,
    I couldn't agree more with you or your motive. Maybe if more us who are "trouble makers" and outspoken will start moving and worrying about self, then the meek, buttkissers will drown in their own crap.
  11. by   nurs4kids
    Originally posted by wildtime88


    You hit it right on the nose with this. Many nurses both female and male alike have came to this same conclusion. This is why many are giving up and leaving. As you have pointed out there seems not to be a promising future for nurses at the bedside. Sometimes it is better to cut your future losses and take a different path. Unfortunately for many of the older nurses there is simply not enough time left to start again.
    well, wildtime..I'd think those older nurses would be on the forefront of some movement to improve nursing. The older nurses I work with have the "well, it ain't as bad as it used to be..I can remember when we had to.." attitude. The nursing field is wide open right now, I'm not going to feel sorry for anyone, young or old. We are in control of our own destiny right now. How it turns out depends on how we handle it.
  12. by   mustangsheba
    Interesting observation I made the other night while working at a hospital that had entertained JCAHO last month. All the managers were getting memos about how they had been over budget for the past month, so they were cutting back on personnel. Why, I wonder were they over budget while tap dancing for their expensive certification? Could it be that the requirements for certification were safe staffing?!!! No one seemed to get the picture, just cringed and whispered to each other in corners. My shifts are being canceled right and left because I'm expensive agency. That's okay. I don't have the energy to deal with the minds that are willing to accept this abuse.
  13. by   CEN35
    Well interseting enough our boss always said..........if JACHO asks anything about patient care or safey NEVER mention staffing as a problem. hmmmmmmmmm
  14. by   Mijourney
    Hi. Everyone, well said! Many valid points. Basic paternalistic or maternalistic measures will not solely address problems in any field. It is very easy to point fingers, and I acknowledge that I do this frequently. I probably won't stop anytime soon. But, I've never failed to acknowledge, as nurs4kids has, the role that nurses play in our underminings. Also, in reality, I do pick and choose my fights which means I'm not a passive stand-byer in my profession.

    The very nature of nursing and any fields associated with it demands a stronger maternalistic approach. Nurses frequently are required to offset the frequently paternalistic nature of medicine, administration, and accounting. In other words, nurses are one of the few groups that make the word industry a little more pallitable. If we as nurses were to solely adopt the paternalistic approach to nursing, I truly believe that would devastate the psyches of so many of our patients and families.

    Nurses are increasingly learning that there are other areas besides hands on skills in which they need to be involved in and which nurses can play a critical role. Wildtime, you have adeptly pointed out that in order for nurses to take control of our over all well-being, we need to pay attention to more than our hands on skills. We need to be and are involved in other areas that affect nursing practice including economics, law, business, and manufacturing.

    As I look back, I don't think the problem with nursing is so much the maternalistic nature of it. Reality is that women, who predominate the profession, have been by and large raising families and have been taught in a commercial way on how to transfer their family care skills to the bedside. I also think that until recently, most nursing school programs have been steeped in 19th century nursing education which centered around the old theory that women were to stay out of the board and business room away from the money and planning. We're finding that as time passes that is changing. As above, this is reflected in the increased numbers of nurses obtaining degrees in other areas and working in other fields outside of bedside nursing. This does not mean that nurses who choose to stay at the bedside can't learn the mechanics of business.

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