What do you want from your hospital?

Riseupandnurse · Mar 11, 2009

As a nurse, I care about my patients. I also care about getting out on time; that never happens. I also care about getting pulled to floors I'm not oriented to and feeling like a fool. I am ready to quit over this. There are so many things going on that impact nursing practice. New regulations that require doctor participation but are not enforced for the doctors are particulary bothersome, like medicine reconcilation. I am tired of getting yelled at for trying to do my job.

nursej22, MSN, RN · Mar 11, 2009

1) What I want from my hospital:

a) I want to be treated as a human being, someone with feelings (my patient just died, I need a break, not another admit because thats what the numbers say), and physical needs and limits.

b) I want respect for the nursing knowledge that I have acquired through experience and formal education. I don't need a checkbox to fill in every shift to tell me to avoid dragging my pt and avoid direct trochanter pressure. And jeez, doc, I wouldn't have to page you so much if you would touch base with me before you leave the unit.

c) i want policies and procedures that are not only evidence based, but allow for optimal safe treatment. If my patient is in a rapid afib, I would like to be able to administer diltiazem in less than 2 hours.

2. What do I see that impacts nursing practice?

People other that bedside nurses making decisions on what the nurses time is best spent on: stupid checklists that are only for audit purposes, cell phones that constantly interrupt care, MDs who want lab results called to them, when they can look them up just as easily as I can.

3. I care about delivering safe, optimal car to my patients, and i care about my coworkers.

diane227, LPN, RN · Mar 11, 2009

1. Acceptable nurse patient ratios that allow me to give good, safe care to my patients and allows me to teach them and to follow up on issues when they occur.

2. Give the new staff an adequate orientation so they can hit the floor running.

3. A manager that will listen and act on my needs.

Roy Fokker, BSN, RN · Mar 11, 2009

1) What do you want from your hospital?

* Respect me for the professional that I am. Acknowledge my crucial role and impact on patient outcomes. Yes, I'm not the physician who brings pts. into the hospital - but without me, both you and the physician would be out of work...

* Stop wasting my time and energy on useless, demeaning paperwork. While we are on paperwork - please get rid of it and go digital.

* Stop worshiping at the altar of JCAHO. Remember the old adage: 'The road to hell is paved with good intentions'? Fits JCAHO to the T. They are parasites sucking the life blood out of nursing.

* Start staffing appropriately for the patients present on the unit. It's a mutual-benefit deal: don't expect me to deliver "quality care" when you saddle me with an unrealistic patient load. I have but two hands, two legs and one head. I am bound by the laws of physics (i.e. I can only occupy one physical space at any given time).

* Please start stocking your units adequately. I waste precious hours each shift looking for stuff because it's either unavailable or broken/not-working.

2) What do you see that will impact nursing practice?

* The rise of mid-level practitioners (NPs/PAs)

* Holding physicians to the same ethical and workplace morals/codes as nurses. Nobody deserves to be yelled at, belittled or abused - no matter what the reason. And while we're on the subject of behavior - patients need to be advised of limitations as well. Do you want to be verbally/physically abused every day at work? Do you?

* Stop treating experienced nurses as a "cost". The experience they have is what is keeping your institution from falling into ruin - therefore, rather than questioning their pensions/pay; seek out ways to retain them. Would you rather have a nurse with 20 years experience take care of you or someone with barely a year behind them?

3) As a nurse, what do you care about?

I care about the safety and well being of my patients. I care about their autonomy and their involvement in their own care. I worry about the pts. family and their coping ability.

cheers,

lpnflorida · Mar 11, 2009

1) What do you want from your hospital?

I would wish for some sort of pension . It is terrible to work in a profession and fear never being able to retire. I would wish for JACHO to go away. They take us further and further away from taking care of our patient's with all the redundant charting. Less charting equates to better patient care, not worse.

2) What do you see that will impact nursing practice?

The continued evolution of health care technology. The continued demand for high quality care at all cost.

3) As a nurse, what do you care about?

I care about the patients. I wish however they would be less narcissistic and accept all of our patients are important and deserve great care.

This mentality that one persons needs supersede another persons needs drives me wild. Let us use our skills to prioritize the needs of the patient. Quit demanding that which is less important in the scheme of things. We are a hospital not a hotel, not a restaurant, we are not Disney World.

Chewie_123 · Mar 11, 2009

1. Staffing ratios that allow me to spend real time with my patients, teaching/supporting them, instead of doing assessments and tossing medications at them.

Staffing that takes patient acuity, not just census numbers into account.

Staffing ratios fpr the CNAs and PCTs that allows them to provide the best care for patients.

Instead of trying to cut costs by limiting the amount of supplies/equipment we are issued each week (ensuring that we have to go running over half the hospital trying to find IV fluids and such) actually get the input from people who work at your freaking hospital for ideas.

Get all physician orders and documentation computerized.

More education and training.

Respect.

Administrators who have set foot on a real working hospital floor, not just gotten a spiffy buisness degree.

2. Adequatly preparing and mentoring new nurses to retain them.

Not treating experienced nurses as horrible money sucking black-holes and retaining them.

Cutting bedside staff WILL affect patient care.

More NP/APNs.

Increased technology usage to prevent medication and other errors.

3. The safety and overall well being of my patients and their families. My mental health and well being.

HelenofOz · Mar 11, 2009

as I was checking my responses I thought I was being a bit harsh and perhaps even (whisper it) burntout and (OMG) bitter, but then I re-read everyone elses' responses, and realised we're all in the same boat.........

1) What do you want from your hospital?

Honesty. I am tired of management playing mind games when we all know what's going on. And it's always our fault if there's a problem.

2) What do you see that will impact nursing practice?

The need to keep patients happy, regardless of the reality of the situation.

also

The increased use of lower skilled/educated staff and their ability to recognise and deal with situations. This is not meant to target those staff, who do the best they can in a situation that is difficult for all, but they should not be expected to fulfill the function/have the knowledge base of the 1 or 2 RN's that are overseeing them, and who are responsible for their actions as well as trying to do their own work-we've all been there-"RN so-and-so has called in sick so we've got this person as a replacement, at least they're a pair of hands" yes, they are, but they've never worked here before so I don't know what they know, and I don't know if I can trust them. I work in PACU, I need to know if I need to watch you , or if you really can maintain an airway.

3) As a nurse, what do you care about?

Doing my job properly-giving each patient the time they need and the care they need, and being safe in my practice-not taking short cuts to get the job done.

sparketteinok · Mar 12, 2009

Thank you all so much for your replies! These are great (well, sort of- it's kinda/sad/weird/freakish to know we are all facing pretty much exactly the same thing, no matter where we are).

You all are wonderful!! If only you all got the respect you deserve.... :bow:

Please, keep 'em coming!!! :yeah:

LilyBlue · Mar 12, 2009

I would like a break now and then, no grief for calling in the two times I'm genuinely ill a year, and more nursing assistants who are committed to patient care (and less committed to acquiring lung cancer standing two feet off hospital property six times a day).