What is the most serious problem facing the bedside nurse today?

Nurses General Nursing

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:idea: Would like to know what others might think is the most serious problem facing the bedside nurse today? Am looking for opinions based upon the, "larger perspective" (or the bigger picture as they say). Have been working on this one for awhile and have arrived at my own conclusion. I would appreciate input.
Specializes in medicine and psychiatry.

Yes I will share what I have come up with. Attitude is an expression of it. I believe the simgle most important issue facing the bedside nurse is morale. It is understandably quite low. The next question is, "What is to be done about it". I don'nt think it is reasistic to think that administration and management can make any broad strides toward the issue as they are focal to the problem.

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1/ shortages

2/ lack of respect for profession, treated like warm bodies not important medical professionals

3/ morale due to the above.

I think we will eventually not only see increased attrition due to nursing not meeting a new grads expectations due to the above, but I think that we are going to see fewer and fewer students going into nursing, partly due to the increase in mandatory 4 yr degree programs, and also because they become aware of the problems facing nurses and don't want to be a part of it.

I myself am very dissappointed in my career choice, even though I love my work. I feel the personal sacrifice expected is just too high......

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It is my belief that one of the biggest problems, relative to bedside nursing, today is the administrative attitude that nurses are manual labor and not professional labor.

What may be a contributory cause to this is that there is no uniform educational requirement to confer a RN title, like there is for those who practice medicine. I have worked alongside those with Master's degrees (even holding NP degrees) who are unable to use their advance practice degrees as it was intended.

The lack of respect for the professional attributes required to practice nursing to it's highest extent is sorely lacking in the majority of hospitals in the US. Ever notice that doctors are given leeway on having to perform the 'customer service' rituals and the nurse is given the majority of the responsibility to do whatever it takes (usually in a manual capacity) to make the "customer"/"client" happy?

DITTO !:yeah:

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Specializes in PICU/NICU.

I fell that the problem I feel is most frustrating is the pressure on nursing to give "5 star care" ---- I guess I my 5 star care is much different than administration's/JACO/Press-Gainey's 5 star care. I feel good care is about SAFELY caring for my patient which means that I have time and resources needed to do so! Including proper staffing levels, proper equipment, good communication with the team involved, and open and honest communication with the pt/family.

Instead, I feel like a am spread too thin! That I am documenting more than giving care! Too many forms, too much duplicate documentation to meet JACO or whoever's new recommendations for the year.

"Is there anything else I can do for you, I have time!!!!":chuckle But really, I don't because we are short staffed, I haven't peed or eaten in 10 hours, and I have to go document on 5 different forms about your restraints you have on to keep you from extubating yourself:eek:. But, "yes" visitors-- I "have time" to go fetch you all some cold drinks and crackers (even though I showed you yesterday where the kitchen area was) in hopes that you will give us "5 stars" on the survey!!! Because, somehow, my fetching of cold drinks and being super friendly and nice is the "5 star" care administration is thinking of. :banghead:

.....but I digress.....:nurse:

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Specializes in Gerontology.

I have a differnt perspective. I think the threat of all the new viruses, etc are the biggest challenge. SARS was a huge eye opener to just how unprepared we are for an type of epidemic.

Will all the preparation we are doing for a Flu Epidemic be enough? Will there be enough nurses to take care of the pts? Will nurses come in to work during an epidemic? Are we prepared??

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Specializes in Ortho/Uro/Peds/Research/PH/Insur/Travel.

WOW! I didn't know whose post I should quote first! The biggest problem facing bedside nurses is being asked to do more (and MORE!) with less. This expectation is becoming increasingly more stressful as a greater emphasis is placed on customer service. When you work in a market with, essentially, one health care conglomerate, does the patient REALLY have a choice? In other words, are they REALLY going to go somewhere else? Uh, NO! While I make every effort to fulfill every wish, I have NO problem reminding a patient that I am ONE nurse with TWO hands and 6/7/8/9 patients.

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Specializes in Telemetry.

i think the most serious problem in health care is the organization is too hyped on profit, i obviously realize money talks and to have more equipment we need to be in the + zone, but they really need to look at nurse patient ratios. in the end all those nurses you have just orientated who come off orientation and end up with a 6 or 7 patient assignment on tele,,,,is going to leave. therefore you waste money in not retaining these nurses. numbers are numbers we are dealing with people here not numbers acuity has to be concidered as well as safe staffing numbers.

i used to enjoy going to work, knowing i may have 5 patients tonight which is totally doable but knowing i may have 7 or even 8 and a few cardizem and nitro drips i hate it, i am thinking about switiching intot he or i can deal with high pace. i just cant deal with 8 patients at one time.

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Specializes in Nursing Professional Development.
wow, this post crystalizes the problem that I see. Well stated llg!!!!:up:

Thanks, jlsRN, but to be honest ... I didn't actually coin the term "complexity compression." I've read about it in the literature. I think it was coined (or at least brought into the nursing literature) by some researchers at the University of Minnesota.

As a concept, complexity compression fits in well with my interest in decision-making and judgment and is something that I have seen developing for many years. I just didn't have a label for it. When I first saw that tern "complexity compression" in the literature, I latched onto it. I think it is a HUGE issue that is usually an unidentified source of stress for workers (of any type).

Everyone "piles on" more tasks and more steps and double-checks within each task. Each add--on seems reasonable by itself, but when you add them all together, they make the job incredibly complex and stressful to handle. The pharmacy thinks its requests of nurses for a few extra checks or steps in a process are reasonable ... so does the lab ... so do the physicians ... so do the IT folks ... so do the infection control people ... so does the administration ... so do the patients ... so do the schools of nursing ... etc. etc. etc. So, each thing gets added to the staff nurse's list of things that must be done. But when you add them all up, the job becomes ridiculous.

Nursing needs to scientifically study the accumulation of all these add-ons and their effect on our workdays and productivity. Is anybody looking for a good project?

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Specializes in LTC, Med/Surg, Peds, ICU, Tele.
Thanks, jlsRN, but to be honest ... I didn't actually coin the term "complexity compression." I've read about it in the literature. I think it was coined (or at least brought into the nursing literature) by some researchers at the University of Minnesota.

As a concept, complexity compression fits in well with my interest in decision-making and judgment and is something that I have seen developing for many years. I just didn't have a label for it. When I first saw that tern "complexity compression" in the literature, I latched onto it. I think it is a HUGE issue that is usually an unidentified source of stress for workers (of any type).

Everyone "piles on" more tasks and more steps and double-checks within each task. Each add--on seems reasonable by itself, but when you add them all together, they make the job incredibly complex and stressful to handle. The pharmacy thinks its requests of nurses for a few extra checks or steps in a process are reasonable ... so does the lab ... so do the physicians ... so do the IT folks ... so do the infection control people ... so does the administration ... so do the patients ... so do the schools of nursing ... etc. etc. etc. So, each thing gets added to the staff nurse's list of things that must be done. But when you add them all up, the job becomes ridiculous.

Nursing needs to scientifically study the accumulation of all these add-ons and their effect on our workdays and productivity. Is anybody looking for a good project?

This reminds me of when my last job went to the Omnicell medication dispensing machine for PRNs and controlled drugs. What used to be a simple task turned into a 10 step operation to get one medication out of the machine. I remember counting the steps one day and getting 10 steps, and that's not including punching in the code to get into the medication room.

All the new systems are that way. It turns the nursing workplace into an obstacle course full of barriers to work around, interrupting and slowing down the flow of care.

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Since I'm too tired to be eloquent, I'll just put it plainly and simply: the most serious problem facing the bedside nurse today is that s/he is expected to be at far too many bedsides, caring for far too sickly individuals, within a far too small time frame.

Everyone wants better care for their ill patients, and no one seems to have the time to truly provide it. My ability to provide that care is directly impacted by the number of hoops I have to jump through on the way to my (MANY) patients' bedsides.

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