Who took the NURSE out of Nursing?

  1. WARNING: THIS POST IS REALLY LONG. BUT I HOPE MANY OF YOU WILL READ IT. I THINK IT IS A VERY IMPORTANT ISSUE FOR ALL NURSES.

    I haven't written a post for quite some time. My husband learned today that he has a "high grade invasive bladder cancer" from a cysto and biopsy he had done one week ago; he was originally hospitalized in acute renal failure which was reversed after one run of hemodialysis, the insertion of 2 nephrostomy tubes and a foley cath all of which he came home with on 11/3 and which I have been caring for.

    During the past several years I have witnessed some disturbing trends in nursing. In a world famous MAGNET hosptital in HOuston, TX. for 6 days no nurse did a head to toe or systems assessment on my husband; no nurse did a neuro check; no nurse asked questions regarding pain or other discomfort; no nurse ever physically touched my husband. I did all of his care and I wanted to do it, but I did wonder how the nurses charted on him when the only thing I had seen ANY of them do was give him his meds in spite of the fact that he was on a telemetry floor and was acutely ill. He had been admitted because of a sudden onset of mental status changes with confusion, disorientation, visual and auditory halucinations, slurred speech and stuttering, staggering gait and weakness of the extremities, particularly the legs. The did EEG, cardiac echo, MRI and MRA of the brain and extracerebral circulation, doppler of the carotids, skull films. The only thing they did not do was a lumbar puncture and I don't know why they didn't because he was discharged minimally improved with no diagnosis. I never saw any of his labs, but I bet his CBC differential showed elevated WBC's with a shift to the right because I have often thought that he could have had West Nile encephalitis since he came down with this where the mosquitoes that carry it were prevalent and I have cared for patients with viral encephalitis and he had many of the symptoms. He gradually recovered completely after several weeks.

    The point I really want to stress however is that from what I observed back then in Houston and now with nurses and Nurse Practitioners at the VA here in Arizona, I believe our profession to be at a critical juncture. Nursing is at the brink of losing its status as a profession partially due to the continuing shortage which initially brought about much needed increases in salaries but when the pay did not have the effect of bringing more competent, quality people into the ranks, desperate measures were sought to fill the vacancies left by aging baby boomers. We now can evaluate the consequences of some of the less desirable means utilized to fill the positions for competent RN's with what amounts to the equivalent of "warm bodies". Because of the current job market, former truck drivers, auto production workers and people who would never have considered nursing as a possible future job for themselves are signing up at record rates because it is a guaranteed job. People are going into nursing because they know they have a job waiting; because they can travel; because it is one of the few professions that you can start out in with an Associate Degree and I recently read that there is a push to get RN's out and working in something like 3 semesters. Many of these candidates have no realistic picture of the myriad of tasks that are involved in being a RN. Many would rather work in a sewer than touch or be touched by another living person's bodily fluids. Some people actually consider it from the prospective of the accessibility of narcotics.

    Recently when my husband was in the hospital in renal failure, he told me that one of the nurses did not give him the correct dose of his scheduled pain medication. He said that when he told the nurse that he was supposed to get one more pill,the nurse replied, "Well that's what is ordered". Yet for the 2 days that he was on that unit, the night nurses gave him the correct dose, the exact same dosage and the same pills that he had been taking at home for more than one year so there is little chance that my husband was mistaken. Unfortunately, he did not tell me this until after he was discharged and I admit that right now turning in that nurse is not my top priority.

    I would say for the most part that the nurses who write into this forum are the good nurses. Why? Because the bad nurses could give a rat's ass about anything to do with their job after they go home. I can hardly believe that they would spend time on their computer reading what other nurses think and say about their profession. To the bad nurses, nursing is just a paycheck. And most will get advanced degrees so they can "get away from the bedside", which is a good thing when you get right down to it.

    It is so sad to me to think that all the work that thousands of dedicated nurses have done over the past 3 decades to bring nursing the respect and status of professionalism that it deserves may be lost when the public gets wind of the some of the "trailer trash" types and "gangstas" we are letting into our ranks. I can't work right now; 30 years of 12 hour shifts, most without breaks and most that ended up being 13 or 14 hour shifts, took its toll on my body. I have too many ailments to list, but right now there isn't any kind of nursing that I would be able to do. Just sitting and typing this, I have had to stop several times because of the pain and stiffness I get. Nursing is not the kind of job that everyone should do. It is a profession that you really have to desire from the heart and know that there comes with it a lot of things that most people would call "icky"; but in spite of the "icky" if you can derive satisfaction from the patient who thanks you for starting his IV because no one else could, or who remarks "You must have been doing this for a long time; I can tell just by the way you can talk and work at the same time." If you can look back and feel good because you KNOW that there are people walking around today because YOU were there to provide expert emergency care that was needed during that critical moment between life and death and no one gave you a medal or a bonus or a raise but it was enough to know that it was your hands that helped save a life, THEN YOU KNOW YOU ARE IN THE RIGHT PROFESSION. Then you know you are a "GOOD NURSE".

    I know there are still good nurses out there. There was one in the ER named Manny who is young and fit and eager to learn, yet compassionate, caring, never forgetting that it is a human being in that bed. And when I read a lot of the posts in the forums, I see that you are out there and I thank God for you. Because we baby boomers are getting old and tired and we look at you because we see ourselves on the other side of the bed someday and hope that we will get one of the "good nurses". God bless you all!!

    SORRY THIS IS SO LONG,....AS USUAL..............
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  2. 31 Comments

  3. by   TazziRN
    Sorry about your husband's experience. My prayers are with you both.
  4. by   NursingAgainstdaOdds
    Quote from celeste7767
    Nursing is at the brink of losing its status as a profession partially due to the continuing shortage which initially brought about much needed increases in salaries but when the pay did not have the effect of bringing more competent, quality people into the ranks, desperate measures were sought to fill the vacancies left by aging baby boomers. We now can evaluate the consequences of some of the less desirable means utilized to fill the positions for competent RN's with what amounts to the equivalent of "warm bodies". Because of the current job market, former truck drivers, auto production workers and people who would never have considered nursing as a possible future job for themselves are signing up at record rates because it is a guaranteed job. People are going into nursing because they know they have a job waiting; because they can travel; because it is one of the few professions that you can start out in with an Associate Degree and I recently read that there is a push to get RN's out and working in something like 3 semesters. Many of these candidates have no realistic picture of the myriad of tasks that are involved in being a RN. Many would rather work in a sewer than touch or be touched by another living person's bodily fluids. Some people actually consider it from the prospective of the accessibility of narcotics.
    <snip>

    It is so sad to me to think that all the work that thousands of dedicated nurses have done over the past 3 decades to bring nursing the respect and status of professionalism that it deserves may be lost when the public gets wind of the some of the "trailer trash" types and "gangstas" we are letting into our ranks. I can't work right now; 30 years of 12 hour shifts, most without breaks and most that ended up being 13 or 14 hour shifts, took its toll on my body. I have too many ailments to list, but right now there isn't any kind of nursing that I would be able to do. Just sitting and typing this, I have had to stop several times because of the pain and stiffness I get. Nursing is not the kind of job that everyone should do.
    I'm sorry for the difficulties you and your husband have experienced and are currently experiencing. However, I have to say I am deeply disturbed by some of the statements you made in your post with regards to "auto workers", "truck drivers", "trailer trash" and so forth. I think these statements are highly classist, and your assumptions about poor and working class individuals, who FIGHT their way through nursing school to provide for their families, are way off.

    I went into nursing so that I could provide for my family - luckily for me, I found along the way that this is something I am good at and enjoy. I was raised by "trailer trash" and "truck drivers", as was my twin sister - also an RN. My husband, our young child and I lived in trailers, low-income apartment developments ... constantly getting our power shut-off, not having money for food - all through nursing school. I recall (with bitterness) that my power was shut-off the first day of nursing school, many times in between, as well as the last day. This despite working full-time as an aide. Nursing provided me, as well as many other working-class individuals, with the ability to provide a decent future for our families and ourselves. I work myself to the bone because my family depends on me, because I will be a good nurse in spite of its challenges, because I take great pride in my work.

    I am not an exception to the rule. Nursing has provided many disadvantaged individuals with the ability to provide for their families while they discover a calling and discover abilities which had been hidden within them all their lives.

    Be PROUD nursing has done this for disadvantaged people, I know I am.
  5. by   Hellllllo Nurse
    celeste,

    Some of your comments are not politically correct, but I think they are 100% accurate. I agree totally.
    Due to all the reasons you described, we are having a resurgance of the "Sairy Gamp" nurse.
    I grew up in a trailer on the wrong side of the tracks, but I rose above it, and did not bring that culture with me to nursing.

    I'm so sorry for what you and your husband are going through
  6. by   RNSC
    "Sairy Gamp" nurse
  7. by   morte
    Quote from RNSC
    Charles Dickens created Sairy Gamp, the fat, old midwife and nurse with hoarse voice and red nose. For over fifty years she was the negative metaphor for .......
  8. by   TheCommuter
    Who took the NURSE out of nursing? While numerous nurses with "factory-worker" mentalities exist (do the minimum and go home), I also think that hospital administrators have also helped to take the 'NURSE' out of nursing.

    When nurse/patient ratios are outrageous, less time is spent with the patient. When administrators increase the amount of ridiculous paperwork that the nurse must complete per shift, less time is spent with the patient. When hospital administrators market the facility as a "Healthcare Hilton" with a hotel atmosphere, the patients are sorely disappointed when all they get is an overworked, humorless nurse who cannot be the "customer service rep" that they envisioned.
  9. by   jojotoo
    I recently had a discussion with my manager about the "unrealistic expectations" that I had of our newer nurses. I was told that I was "old school" and that I needed to make allowances for the new generation, or we wouldn't have any staff.

    This scares the h*ll out of me.
  10. by   Quickbeam
    Just wanted to say that this Baby Boomer is still working and probably will be for 20 more years! I don't know one person my age who is retired. Sure we'll be making a big hole when we do leave but we're not there yet!
  11. by   Hellllllo Nurse
    Quote from RNSC
    In nutshell, a Sairy Gamp is a nurse who is lazy, doesn't give a crap, thinks of herself first in all situations, and gives poor care. "Sairy Gamp" was also known to be a bit of a drunk, and to steal from her employers.

    Sairy Gamp is a Charles Dickens character. Some literary historians believe she based on an actual nurse.
  12. by   MAISY, RN-ER
    Sorry to hear about your husband and the treatment he received during his care. Thank goodness he had you!

    However, I am not sure "humble beginnings" are indicative of how a nurse will behave when they are working. Laziness, and lack of ambition knows no economic boundaries or educational level. It affects all types of workplaces. Education does not ensure good nursing, or even the ability to understand. It just means someone could read and retain enough to pass a test. There are many "know it alls" with no ability to "do".

    In my hospital, on the floor, neuro cks, FS, and many other orders must be placed by the physician. In addition, test results of any sort must be gone over with the family by the physician-this includes blood tests. If you were not informed, I believe your physician bears this fault. (the only area where labs are shared freely is oncology-most of those patients could teach a nursing school class on tx)

    ER is a different story, nurses are expected to think on their feets and be proactive. I would imagine other critical care areas would work the same way. Not having an order, is no excuse not to see changes in condition and instituting whatever is necessary to diagnose. ie. cp-ekg; sob-oxygen, NRB or a call for RT; ams-oxygen, FS, swallow eval, neuro ck-of course ready results given to MD. I can't imagine calling for an order, instead of giving results....would not go over well with MD. Even there, the ER docs like to give results-I have gotten the fisheye more than once when I've told a panic stricken (anxiety) patient that their labs were normal.

    I think management and the system were also mentioned. As an example: when I cover lunches and have 4 patients-it takes the entire lunch of 45 minutes to get vitals, do a once over, and perhaps complete orders that were to be done. The biggest part of this, OF CONCERN TO MANAGEMENT AND MY LICENSE, IS DOCUMENTATION! If it isn't written it isn't done. Back to cya! Writing shouldn't be our biggest job, but lawsuits and our society has made it so.

    I hope you wrote to that hospital and outlined your concerns regarding the care of your husband. I would also request a chart review to see what was written, we both know it's against the law to falsify documents. You should also advise your physician of his treatment, or lack thereof-along with that-he/she should be aware that you felt labs and tests should have been discussed. Sometimes people improve with knowledge, sometimes people don't....but if you say nothing, what happens to the next person who is hospitalized but doesn't have a nurse at their bedside?

    Best of everything to you and your husband,
    Happy Holidays!
    Maisy
  13. by   davb
    I think this is a problem with younger people in general. I have seen it in my construction trade. All the younger workers work less and get paid more, far more than what I did when I was younger (and I worked twice as hard). I have seen people who refuse to work hard come from different socio-economic classes. I am a construction worker who is going to nursing school because I want to help people just like the nurses helped me when I had a surgery (that is what helped me decide to change my major from construction management, I am only 3 classes short of a AS in that field). Our nursing school is a competitive program and I would be willing to bet everyone in the class has an IQ of around 120. I am sure half of the 240 people who don't make it in the program each semester worked very hard too. So who cares where you came from. Everyone has worked hard to get into the program.
    I'm sure there are just as many lazy people coming from upper-class families as from lower or middle class. Let's not start the class warfare thing.
    This is America, where God created all men (and women) equal right?
    Oh, wait, God created everyone equal everywhere.
    Whether they choose to work or not is up to them, not their bank account or their parent's bank account. Or their neighborhood.
    Last edit by davb on Nov 20, '07
  14. by   marie-francoise
    I also came from a truck-driving family, but I understand what you mean. It's the characteristics of the type - those who actually really do embody the stereotype - not the blue-collar background itself.

    "30 years of 12 hour shifts, most without breaks and most that ended up being 13 or 14 hour shifts"...

    I suspect that THAT kind of body-and-sanity-taxing work + today's dominance of health care as customer-service-driven big-business + all the hyper-documentation a nurse needs to do to address the constant specter of potential law suits + the now expanded career options for those who would make good nurses had they not gone into other fields = nursing shortage and all the problems attendant to it.

    I'm a nursing student, who is very wary of "what's out there" in the real world of nursing - what the field has evolved - or, rather, devolved - into. I'm not sure if any amount of altruisum can buoy the "good nurses" through years of high-stress 12-hour shifts. I think nursing is the most admirable, and toughest, job in the world, and lift my hat to all the "good nurses" out there! Here's hoping the nursing field will continue to attract potential "good nurses"...

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