joies1 1,465 Views
Joined Feb 1, '06.
Posts: 16 (38% Liked)
My ! How this thread and topic has caused such a wonderful expanse of thoughts since its arrival !!!
The area that I seem to be missing is the lower middle class. Being a 'single' mother when my children were younger I went into nursing. But only worked part time. That was enough to cover our home, property, bills and a bit more. Certainly nothing extravagant. I cannot believe that there aren't other women or men in a similar position. Those that worked hard both for income and home and family. So, having been an RN since 1984, and absolutely loving it ! - I find myself in a place that is nearly intolerable. I have worked since 1966. Yes, nursing was a 'mid-life' change. Enougth hx. Yes, I did set up as best I could. My preference was to have one of my sons and his family live on the land with me. So when I became more ill or unable there would be someone close.
Now, because I am Social Security age, but not yet Medicare age, there are no jobs for us well seasoned nurses. And the Soc Sec does not cover my bills - much less health insurance ! I guess that should tell all younger people to screw family and home so that you can always and just focus on yourself and your everlasting wellbeing. If that is how you take it, then so be it.
I am glad for those that have planned and done well for themselves. I am glad for those that can't and, yet, receive health care. As a nurse and a human, I wish money could be taken out of all health care concerns. Obviously it can't. So, we are left with those 'in-betweens' - like me. Those that have worked for 40+ years. Those that may or may not receive Social Securiy. But cannot afford health care insurance. This is the working lower middle class. That is where we live and survive.
Other nations' view our country as unbelievable and uncivilized in the way we care for our peoples in their time of need. Our country calls it socialist, or worse. We are not outstanding, as a nation, in our healthcare. We have some great hospitals, nurses and doctors, but - overall - our general and ongoing health care is crap. I do blame the corporations for sending our healthcare system into a profit motivated cesspool.
Yes, I do think we should have 'socialized medicine' for basic and needed care. If one can't afford plastic surgery or bariatric surgery, then so be it. Too bad.
Politically speaking ~ 'Obama Care' is the best we have yet that can provide what might be marginally accepted to such a greedy and self-centered group of people as we have produced.
If you are a nurse of any moral and ethical value, could you refuse care to a person in need ?
This is an area of nursing that is so dear to me. After years in acute and critical care I had to modify my activity for health and physical reasons. Begrudgingly I began nursing in an ALF. I have to admit, I wasn't very good at the first one. I guess I really didn't understand the scope of what was needed from me. But the years and experience educated me well to this area. I guess I had been so accustomed to working with other licensed professionals, I didn't know what to expect from 'caregivers' and 'med aides'.
Anyway, initially [and continually] I found that there was little direction or training for ALF nurses. I guess they expect that if you have acute care nursing skills - you should be able to manage an ALF. What bothered me so much was that my layman staff was given so little training - - and even less respect for the jobs they do. Luckily, I love to teach nearly as much as I love hands on nursing. Over the years I developed a med aide training manual and all sorts of other training, education, delegations, forms, etc. Anytime one of my staff came up with an inquiry about a particular diagnosis that I already hadn't addressed I would make up more educational sheets ~ not required reading but available for their interest. Even though the corporation[s] I worked for gave little time to training med aids I felt it was of ultimate importance. Beyond the practicle, I wanted to feel assured that this new med aide was empathetic and held themselves as 'patient advocate'. So had the primary good nurse qualities.
ALF is a whole different arena of nursing. It is not well paid or much respected. But it is essential and will only be needing more qualified nurses as my 'baby boomer' generation continues to age and become needy.
Now that I am retired (unwillingly !) I can say things that I couldn't before. My gripe is the focus of these corporations is strictly profitability. Sure I want ends to meet and everyone to have their profit. But healthcare is a service - a hands on caring for individuals. If the profit out-ranks the care, then it will eventually either become cruel or fold.
Maybe someone here can direct me in a way that I can provide some of the educational resources I have put together for other nurses and/or facilities. Sure, I would like to make some money at it, but the important thing is to be a resource.
Always a day late ! Or, in this case a month...... As sad as it is, I am glad to see that other competent nurses are in my position. At least I know it is not just me !
I started nursing school in my mid 30's (change of vocation) and got my RN in 1984. Worked at our small rural hospital for nearly 20 years before I had to stop for medical reasons. After 4 years of illness I realized I no longer was capable of acute and critical care in a hospital. So I sought work in assisted living. It was a good choice, even though I was largely unprepared for that type of job in the beginning. But I found that - eventually - that it was perfect for me ! Hours were generally part time, I no longer had to do all the heavy lifting and running, I love to teach and nurture both staff and residents, I am very good with creating teaching materials, protocols and forms, plus it is a position of respectability and 'say' within the facility.
What could go wrong?
. . . . Age . . . I lost my job a year and a half ago - not because I wasn't doing well or not getting my job done - but because corp wanted a younger nurse who could work more hours. State survey came through a week later and facility was deficiency free. That was MY doing ! I am so disgusted with corporations that place their profitability above the service that they say they are committed to.
So now I am on Social Security ~ yes, old enough ! But that is only just about half of what I need to live and pay bills. (I have worked since 1966) I would really love to provide training and educational materials for other assisted living facility nurses so they wouldn't have to start from next to nothing. It is a needed aspect of our health care management that costs far less than hospitals or nursing homes.
So what do you do when you are older, but still capable (within limitations), have vast experience and education, want to give, share and use the abilities you have, and retain your nursing license a bit longer ? I love nursing. I just hate the way it is being used these days.
So much for me.
A note to the younger generations ~ The profession of nursing is almost sacred. It may not get much acknowledgement or reward, but it is your knowledge, your caring, your intervention, your insight, your teaching, your commitment to care ~ your touch ~ that changes and saves lives. Know that for yourselves when no one else acknowledges that. You are not there to be a slave to the computer, but to serve those in need.
I have not read through the entire thread either, but hope this isn't too redundant.
We all learned in nursing school that not only different cultures, but also, different generations express discomfort>pain in their own way. I really think that understanding needs to be kept in mind when we attempt to interpret our patient's needs.
The last number of years I worked with geriatrics, many with some dementia (and certainly much of my time in acute and critical care was also with the elderly). Most places seemed to work with the 'faces' for our elderly because the number system didn't seem to work so well. The one presentation that seemed to work the best - most of the time - was a picture of a thermometer. For some reason that had greater meaning for the elderly. They could point or verbalize. Plus it gives a scale so the patient can move up or down after pain med. I have never understood why this isn't used more often for the elderly. Of course, it wouldn't make much sense for young people who know only digital.
I so much relate and am empathetic to your concerns. I, along with -I'm sure - many others who have similar concerns share with you right now. We loved being a nurse. We loved the hands on care, education and support we could give.
Though I left acute and critical care due to medical concerns in 2000, I did finally get back to an aspect of nursing in 2004 - - assisted living. Finally after 2.5 years in dementia care, in October 2010, I was replaced by a younger nurse who would and could work more hours. (She quit after 3 weeks) I know I managed my job and facility well in my 25 hours a week because 2 weeks after they replaced me, State Survey gave my facility a deficiency free survey. Even the regional manager emailed me stating that he knew this was because I was 'a h___ of a good nurse'.
So what good does that do ? Not a thing, it seems. Who is going to hire you in your later years, with limited, yet functional ability after you have been 'offed' in assisted living ? Nobody !!!! You have already hit the bottom of the nursing pool. You are already working for the least wage per hour and without benefits. You are doing this because you love nursing, are good at it and have a lot to give of your expertise and profession. You are doing this because you have assessed for yourself that you do not have the physical and/or mental capability to work long hours under great physical, mental and emotional stress. It is not self serving or greedy - it is because it fits the tolerance of your well being and care for others.
So what now???? I hope you find better than I have. Home Health/Hospice was mentioned. You bet!, we would be a great addition. Only regretful denials from here (and I was the first nurse hired to them back in the early '80's). Volunteer - - well isn't that sweet. Between my limited reserve of energy and managing my finances to stay alive . . . . well, I must 'volunteer' for me and my family to keep things afloat. (Though, I must admit the person and nurse in me wants to volunteer for many things.) I am glad that your Social Security income 'barely' manages your subsistence. For me, it is about half of what is needed to maintain my home [of 30+ years) and other monthly bills.
So what do you do? It is so hard to say. You have a gift and a love and experience that gives you such great worth. I wish for you that it does not turn to depression and hopelessness as it seems to have done for me.
You do have options. As long as you are secure to maintain your current livelihood - do what you love and enjoy, the best you can, for as long as you can. You can be a woman, stronger than me, to advance the true concept of nursing in a way that only you can.
Bless you for the courage to start this line of forum. It already shows that you are wise and with discretion.
As usual, I am a bit late to respond - which probably isn't a concern.
What is nursing's greatest setback? Well, many of you seem too avant guard for me. I may be old, but I am not particularly 'old fashioned'. So here is my gist of things.
I became an RN in the mid '80's while in my 30's. I do live in a rather rural area so things may have a different perspective from other areas. So I will give you my view of our nursing [and health care provision].
Corporations !!!!! and health Insurance !!!!
In my northwest we were largely small, wonderful hospitals dedicated to serving our communities. The entire staff was a family of sorts with our entire focus to those in need of our care. In came the large corporation with all of its remodeling and division to take over not only our hospital, but every hospital and clinic for half the state. Not all their ideas were wrong, but so many were not focused to patient care. With corporations, presentation and profit seem to equate with a good success and the focus of their intent. I have to disagree ! As a nurse, my prime intent is as patient advocate - not 'yes-man/woman' - to the corporate people who seem to know nothing about real patient care and advocacy. It has been several years since I have worked in a hospital, but see the same thing in extended care and assisted living. Once a corporation umbrella takes over functioning facilities the whole focus turns from patient or resident care to profitability for the owner and share holders.
Insurance - I will not even go there. I just know that many, if not most, of our MD's stopped delivering babies as their liability insurance elevated to unreasonable costs. I can only imagine what things are like now. My own doctor was 'black-balled' out of her excellent practice by a corporation years ago.
So, to nursing. . . . . Nurses are held to oblige whatever the facility or corporation designs - regardless of their better judgment or advocacy. They have no say while feeling the hard edge of the boot when they cannot ethically comply or voice differently. Good nurses - REAL NURSES - face this setback every day, I suspect. Do you keep your job ? Or do you set your foot to what is needed for your patients ?
Good wishes to any and all that may continue to feel the call of this profession at its essence.
This is so against my grain, but I will say it anyway. I think private/corporate marketing to health care is the greatest set back to nurses being able to provide excellent nursing care. A 'patient advocate' nurse knows what she needs to do to provide the best care for her patients. And that should not be restricted to corp guidelines or insurance costs.
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