I hate what's happening to nursing...

[nyteshade]

Eight years.

That is how long I’ve been in nursing. Just eight years. I haven’t been on AN in a while. I used to frequent the site a lot to vent with others, and help others with advice. Well, today is a ranting kind of day, so here it goes…

I hate what nursing is becoming. It is become overrun with elite folks who have forgotten what it’s like to just get through your shift. It’s being taken over by money hungry CEOs that are finding neat little ways to package “customer service” with healthcare. Our intelligence is being insulted here! What exactly do I mean by this? Well, what professional do you know gets “scripts” to regurgitate at patients? Why is it that we are not trusted to do our job or say the right thing?

I understand that healthcare is indeed a business. It has to be. If it weren’t, we’d all be working for free. I got that. I do my job. I put my all into my shift. I advocate for my patients. I’ve gone above and beyond…all without recognition.

But, I’m deeply saddened…Now I’m being told that isn’t good enough. All I see for the future of healthcare is walking into a patient’s room at the end of my shift saying, “My name is______, if you felt I gave excellent care call 888-tell-them, and rate me a 10.” Heaven forbid you score less than 10 three times…

Eight years ago, I felt so proud in my whites on graduation day. I felt professional, neat, knowledgeable, and respected. Now, I feel burned up, and abused. For now, I stay in nursing…patients still smile, and thank me at the end of my shift. They cannot detect how I feel under the surface.

But, I am seriously considering leaving healthcare altogether.

[mama_d, BSN, RN]

When we do bedside rounding, we are supposed to introduce the oncoming nurse this way: "Mr. Jones, this is Jane, your day nurse. She will take very good care of you today." I refuse to say it unless I know that the nurse does indeed give very good care, as there are a handful that I wouldn't trust to take care of a stable teenager appropiately, much less someone in hypertensive crisis that had CAPD and peritonitis with a drip to control their rhythm. I KNOW they're not going to get very good care in those cases, and I'll have to clean up a disaster in 12 hours. It'd be more realistic to say "This is Jane and hopefully she won't manage to send you to the unit today".

And we're supposed to push "safety" whenever possible..."I'm asking for your name/DOB for the 50 millionth time for your safety...I'm rounding on you every hour for your safety...your side rails are up for your safety...I have to escort you to the bathroom for your safety..."

Had a pt crack up the other night and ask if we did anything that was NOT for her safety...she was a FF and knew the score..."I promise I'll put that you addressed my safety concerns on that survey if you stop saying it all the time."

I won't lie to the pts, I won't script, I'll keep on calling my cute old men pts "sweetheart" if it makes them smile, and I'll do my darndest to deliver very good care without drawing undue attention to the fact, as IT'S MY FREAKING JOB to do so...no one goes into work thinking "hmmm...this feels like a mediocre care kinda day, hope my pts are ready to get screwed." The sad thing is that this probably all makes me look bad from a management perspective, even though the pts generally like me and want me back.

[mama_d, BSN, RN]

I wanted to add in a story about a pt I had recently. We did everything customer service wide that you're not supposed to do, and she told us before she left that no one could believe the stories she was telling them about us, and that it was great that she got such good care along with a dash of humor to make her feel better.

Mrs. Jones got admitted looking like she got hit by a truck. She was admitted by "that cute male nurse and tech that were flirting with me and joking with me" and was followed the next several nights with myself and one of our techs, who would sing goofy songs and encourage her to "dance" in the bed. She consistently had the same night crew, and it was to the point that we were all on a first name basis, talking about raising kids and balancing work and family, etc. On her last night with us, we got her involved in a practical joke with the nurse who admitted her...she ended up laughing so hard she had tears.

Clearly this is an exception, as she was with us for over a week and had a great personality to start with, but if we'd have stuck with what we're "supposed" to do, we all would have missed out on opportunities to brighten each other's lives and connect in the way that we did. And when someone is stuck staring at the same four walls, with a loss of control like they've never had before, I'll do what I can to bring a little entertainment and humor to them.

[november17, ASN, RN]

Hospitals have to run efficiently to pay the bills, and more importantly, to pay you! ?

People would go to hospitals irregardless if the customer service was good or not. Because people get sick. That's just the way the world goes round. It stopped being cool when the marketing vice presidents took over.

[martymoose, BSN, RN]

"This is Jane and hopefully she won't manage to send you to the unit today".

.

:lol2::lol2:

[McGyverRN]

PS: Remember this, no matter what, "The customer is always right!" Wink wink...

Yep....even if he leaves the floor to smoke, steals food from the kitchen, has sex with his girlfriend in the bathroom, and demands his 2mg IV dilaudid q 2hrs whether he needs it or not.....he's right!

[JacknSweetpea]

Alaine, I'm certain you mean well, but Puh-lease dump the rest of the Kool-Aid down the sink!!!

[dzadzey, MSN, RN]

I've already told my unit director, on more than one occasion, that if she wants customer service, hire some chirpy, empty headed 18 year old. If she wants quality patient care, stop bothering me with this tripe and let me get back to work.

But the corporate, for profit mentality is driving even the non-profits. We are told we have to make "sacrifices" in terms of pay and benefits while the CEO takes home a seven figure salary. Please, don't poor mouth me when the CEO takes home more in one year than my wife and I make together in fifteen years.

[Kimburly]

So thanks to Studor, who I am sure is making buttloads of money off their "great ideas" we are expected to AIDET and hourly round to scripts. Now we were already introducing ourselves to our patients and families and checking on them hourly, but that wasn't enough to make them score all 9s and 10s on our surveys to such questions as "When you called for help did you get help AS SOON AS YOU WANTED IT" talk about a set up for failure, of course not, they want help before they even ask for it!

So now I have to say Hello my name is __________ and I will be your nurse for the next 12 hours. I have been a nurse for ___years and I have been in this department for ______years, so I have seen over 100 or 1000 or 10 patients with your diagnosis. I am also a certified whatever nurse. I or one of my colleagues will be ROUNDING on you hourly. During those rounds we will be asseseeing the 5 P's (explain the P's) and although I may not speak to you about each of these P's every time I am assessing them. I will be discussing this P and that P with you each time since that is a need specific to you. When I round hourly I would like to meet all of your needs at this time; so if there is anything you need please ask at that time. If you have a need that CANNOT wait until the next hourly round then please use your calllight. (But we are to "gently reeducate" them if they call in between rounds for something that could wait - ya that'll make them happy!) It is our goal to ALWAYS provide you with EXCELLENT care. If at any time you feel you are not receiveing EXCELLENT CARE please speak up so that we can better provide you with EXCELLENT CARE. Is there anything else I can do for you while I am here; I HAVE THE TIME? (even though they just called me over the intercom to tell me that there is a doc on the phone, another patient needs pain med and there is clearly a commotion in the hall behind me).

Oh and during bedside reporting we must introduce so and so your night nurse who has been a nurse for 1 year or 100 years and has no experience here as it is her first night or she has been here for 50 years and either way she is a great nurse who will provide you with EXCELLENT CARE!

Just let us provide excellent care an not talk about it! And don't expect us to score 9 and 10 or ALWAYS on a survey with questions that are worded to make us fail!

Sorry so long, but now imaging actually saying that to every patient you care for today. Oh yeah and I also need to assess them, give their meds, provide their treatments, draw their labs, order their meal when they don't like the first one, call the doc because they want to know when they are being discharged, etc etc etc!

[General E. Speaking, RN, RN]

Just let us provide excellent care an not talk about it! And don't expect us to score 9 and 10 or ALWAYS on a survey with questions that are worded to make us fail!

I agree. The max score for EXCELLENT care is 5 so why doesn't mgmt jump for joy when we get 4s? Because we are supposed to explain that we want all 5's because even though 5s are the max score, it doesn't mean we think we are perfect and have room to improve, all 5s means that you received EXCELLENT care.

What a crock. It does set us up for failure. If they want all 5s all the time, why not make the damn thing go to 6? Because then 6 will mean EXCELLENT care... it's a no win situation.

[martymoose, BSN, RN]

All I can say is if this is where the medicare for service thing is headed, I am going to work a little harder to get out of this field . what a crock of crap- it will be a no win situation, and when the poop finally hits the fan , and a hospital exec says , "sorry , we got all 4's on our score; medicaid won't be paying us, so we have to let you guys go" at least I'll have hopefully found some other job.

I feel very sorry for future nurses.

[General E. Speaking, RN, RN]

To Reenski,

Keep at it, nursing is what YOU make of it. Sometimes I don't know why I look at this website, it is sad and full of negative comments.

Nurses who job-hop every few years looking for the perfect position, or who enter nursing for the wrong reasons, are usually miserable.

I don't understand why most nurses sit around and complain and hop from job to job. Stick somewhere long enough to learn what you are doing (it can take years in a complex field like nursing to get really good, at least 7 years to be an expert in your field). Become involved in professional organizations and activites that enhance your knowledge and care you provide; "do the right thing" and act like a professional, a mature grown-up, and specialize when you find your niche, your passion. ... Good Luck and welcome to nursing! Don't pay attention to the haters on these sights, you know those who are most unhappy scream (or type!) the loudest!

I was re-reading through this thread and I had to comment about this post. I do not see allnurses as full of "sad and negative comments". What I see is real life happening before your eyes. I do not see us as "haters" but rather some very skillful nurses that have been in the trenches for years and are disturbed by the way the patient-nurse relationship is moving.

I don't believe that "most" of us are "complaining" "job hoppers". My average time at a position used to be about 5 years. After that I would crave a new adventure so I would move on. Currently, I have been with my hospital for 10 years. So according to your standards, I should be an expert in my field.

I am a member of a professional organization, I do agree that we should always enhance our knowledge and care that we provide but there is only so much one can do with all that knowledge and skill when mgmt throws in all this hooey about patient satisfaction. Have you not read my post about doing everything "right" and still getting dinged for "poor scores"?

Mgmt used to be more about common sense. Just like the thread about the hospital team that coded a patient and was able to transfer them to ICU. That team saved that patient's life but yet they were called into the mgmt office the next day for "being too loud" during the code and "disturbing" the other patients! This is the crap we are speaking of. Long ago, the manager would politely listen to the complaints, nod throughout the conversation and DROP it. Never in a million years would she think about discussing with the staff to "be more quiet" during a future code.

I have a passion for nursing but it is getting more and more difficult to deal with all this other ridiculous mgmt malarkey. I am supposed to say "I have the time" when I don't have the time? There is a no win situation there. If I say I don't have the time, I get into trouble and if I say I have the time and then do not fulfill every single insignificant request, I get into trouble. Scripting and running around trying grant every single wish is interfering with ME caring for the PATIENT.

[General E. Speaking, RN, RN]

(bumping this thread hoping to get more posts)