Is this what nursing has turned in to? | allnurses

Is this what nursing has turned in to?

  1. 10 I am so disappointed. I have done psych for the past 6 years and did 2 years of med/surg prior to. I did days, then nights for med/surg, and have done days for psych. We underwent a change in management about 3 years ago and it's been crazy ever since. Our manager leads with threats and about what is NOT being done rather than positivity and what we are doing right - things which are rarely mentioned even though we work our butts off for the most part. The management is beside the point though - I know that that is obviously going to be different anywhere you go.

    We are being asked to do more, more perfectly, and with much less. We are being asked to max out patient assignments in terms of nursing and techs. We have to be budget conscious, which is understandable, but to a severe degree that we can't give out toiletries without the patient asking for them. This just creates even more for us to do as getting a bucket ready with toiletries was a huge time saver. The charting and documentation takes up ALL of my shift almost with most things having to be double charted. Flowsheets must be perfectly filled out and our notes must be detailed and document everything done on the shift. I am VERY efficient with the computer - I type very quickly and know what I'm doing. Even I am having a ridiculous amount of difficulty getting things done on time. That's another thing - we are being told we will be punished for clocking out late. Staying late is the only way we can get things done!! With all that is being asked of us - patient care is suffering. We aren't able to be with our patients who need us. I don't always have patients when I am working, but when I do I can spend an average of maybe 15 minutes with each patient per 8 hour shift. Are you kidding me????

    I didn't get into nursing to sit at a computer all day. I get that we need to document and that is necessary but I feel like we are being pulled in 20 different directions and being barked at by 20 different people to do 20 million things perfectly and without a thank you. I am so disgruntled by this profession. However, it wasnt like this when I did med/surg. Is it just my unit? Or is it like this everywhere? I haven't worked anywhere else since the economy started to tumble, so I just want to know if everywhere else has been under such harsh conditions? Nursing is busy - I KNOW THIS. But there is NO reason that going 12 hours with no break should be considered the norm, as well as having to stay late to get things done as well. So do way more, with way less, and do it RIGHT.

    Sound familiar?
  2. Visit  vegnurse21 profile page

    About vegnurse21

    Joined Jun '05; Posts: 99; Likes: 30.

    18 Comments so far...

  3. Visit  HippyDippyLPN profile page
    1
    Oh yeah I hear ya! I have only been working as an Lpn since 2010 and that's the only conditions I have seen. Clinics are a bit better but LTC is always the same....no breaks ever, management who only sees the bad and the bottom line, being told you need to take 35 patients today because budget is low and we can't afford more help...I had a facility force us to take hour lunch breaks to cut back on costs, well if you wanted to get out a decent time you have to work through that hour without pay. I've been told to clock off and them chart if my shift is up and I didn't have time to get to my skilled charting between said 35 patients...I had to step away from nursing for a few months and decide if it was what I really wanted. I felt like a glorified maid since day one on my own...it is what I want to do so now I am just trying to not let the constant negative energy influence my care and attitude...
    sneeds likes this.
  4. Visit  marydc profile page
    4
    No, thankfully it's not like that everywhere. Posts like yours help me realize how lucky I am to work at my hospital. Over the 26 years I've worked here we also have become much more budget conscious; however not at such extremes. I also work in psych and we are kept adequately staffed. If I have to stay late, all that's required is to explain the reason.

    Best of luck to you. I don't think I could work under such circumstances.
    SoldierNurse22, WeepingAngel, CHCRN, and 1 other like this.
  5. Visit  RNperdiem profile page
    4
    The attitudes you are facing are not unique to nursing.
    My friends in corporate jobs have been doing a whole lot more with a whole lot less with the occasional round of employee layoffs to sink morale further.
    Teacher assistant jobs were once common in elementary schools in my county. Now they are mostly gone. Parent volunteers can only go so far to relieve the added workload on teachers.
    The trends you see are here to stay for now in a slow economy, and new emphasis on auditing of charting and quantifying what we do. Computer charting makes it easier to monitor and audit charts.
    Some jobs will be better than others. Good managers are out there; you just need to find them.
    Altra, Vespertinas, forthebirds, and 1 other like this.
  6. Visit  HippyDippyLPN profile page
    8
    One of our most ridiculous budget cuts is when of my dementia unit residents ask for a snack, I am to tell them the kitchen is closed (I am told the facility can't afford snacks but just built a whole brand new rehab) I don't adhere to that. If I resident asks me for some food I am getting them a snack damn it. It's absurd. We also are not allowed to give them tissues boxes that our facility bought for the cars so if they have a runny nose we are to call their POA to bring them a box. We are only allowed to give them single tissues until a box is brought. It's assisted living so apparently the 5k rent they pay per month does not cover tissue boxes.
    annietart, TopazLover, Orange Tree, and 5 others like this.
  7. Visit  Esme12 profile page
    9
    Quote from HippyDippyLPN
    One of our most ridiculous budget cuts is when of my dementia unit residents ask for a snack, I am to tell them the kitchen is closed (I am told the facility can't afford snacks but just built a whole brand new rehab) I don't adhere to that. If I resident asks me for some food I am getting them a snack damn it. It's absurd. We also are not allowed to give them tissues boxes that our facility bought for the cars so if they have a runny nose we are to call their POA to bring them a box. We are only allowed to give them single tissues until a box is brought. It's assisted living so apparently the 5k rent they pay per month does not cover tissue boxes.
    That is unbeleiveable......and the tone of the future

    Greedy pigs
    TopazLover, bebbercorn, BrandonLPN, and 6 others like this.
  8. Visit  NB19938 profile page
    0
    Quote from RNperdiem
    The attitudes you are facing are not unique to nursing.
    My friends in corporate jobs have been doing a whole lot more with a whole lot less with the occasional round of employee layoffs to sink morale further.
    Yes - I totally agree with RNperdiem's comment. I work in a non-health related field, and since 2008 we have faced budget cuts and layoffs that have been ridiculous. The people who haven't lost their jobs have lost most of their benefits and are expected to pick up the work of those who were let go. Even the most minute company purchases have to be approved now, and are usually denied. Morale is awful, and when someone complains management tells us good luck finding work elsewhere in this ecomony.

    Our CEO recently told us the new theme of America is "doing more excellent work with less people." I'm seeing it all over the place, so it's not just nursing.
  9. Visit  midwestmadness profile page
    8
    Your scenario sounds all too familiar. I wish I had followed my instincts, and the advice of seasoned, well educated nurses when I was young. They spelled out the future of nursing and it has come to pass in spades. There is little acknowledgement or appreciation from management for nurses who do an outstanding job of patient care but who may incur overtime in the process-yes, instead, nurses who never have overtime and have a happy disposition because they do not completely assess risks for their patients and act accordingly, which leads to stress, overtime, etc. are rewarded. These are the nurses who state that they just know "how to manage their time better" who routinely leave out patient baths, changing iv sites, walking patients, don't call anesthesia/surgery when a central line change is overdue, don't call an attending when a resident's order is clearly not addressing the problem, etc. I understand that "do more with less" is a corporate mentality that affects every area of work in the modern world. However, in nursing, when you are the patient's advocate, when you are on the front lines in a fast paced, life or death work environment, it becomes much more difficult to "shrug it off". When nursing management, hospitals and facilities cut corners increased mortality and morbidity occurs-it's that simple.
    My advice, after working over 19 years in the nursing profession and leaving it for the frustrations you have written about, is to, if you can, leave it now!!! Or.. increase your education and become an ARNP or PA. Nothing will change until at the very least, minimal staffing requirements are legislated in all fifty states. Nothing will change until nursing is billed separately as is every other service a hospital provides. Until this occurs, we are just viewed by management and unfortunately some patients, as "maids with a stethoscope". And, unfortunately, the ANA on both of those issues of reform is at best mute and at worst, guilty of obstruction in allowing those reforms to take place.
    Esme12, elprup, DavidKarl, and 5 others like this.
  10. Visit  sneeds profile page
    2
    Let's not forget too that the nurse is so liable and responsible for so much. I'm responsible to follow up on my ACT's work, reviewing orders to make sure they won't harm the patient. and deal with noncompliancy with the patient. All while being told to smile and increase customer service numbers. But wait, that's not all... We have to make sure core measures, discharges and admits are done perfectly in addition to all the documenting and care. It's like a squirrel cage or a work camp. I forget to pee and eat. What a scam! I get so angry everytime they show the J&J commercial to encourage becoming a nurse. They forgot to say they you literally have to be in all those places at once! LOL... ok a little exaggeration. Thank goodness for this site.
    CherylRNBSN and Wise Woman RN like this.
  11. Visit  Zuag profile page
    0
    Quote from RNperdiem
    The attitudes you are facing are not unique to nursing.
    My friends in corporate jobs have been doing a whole lot more with a whole lot less with the occasional round of employee layoffs to sink morale further.
    Teacher assistant jobs were once common in elementary schools in my county. Now they are mostly gone. Parent volunteers can only go so far to relieve the added workload on teachers.
    The trends you see are here to stay for now in a slow economy, and new emphasis on auditing of charting and quantifying what we do. Computer charting makes it easier to monitor and audit charts.
    Some jobs will be better than others. Good managers are out there; you just need to find them.
    So true. I currently work in insurance and will be starting my nursing program soon. Doing more with less has been a common theme across many industries, especially in our current economy. My company is still going through restructuring, and we've already lost 1000 or more employees. Those left are expected to do more with less. And no, no consideration will be made to hire new help. In spite of the times, good managers and supervisors can help make things more bearable.
  12. Visit  LithEruiel profile page
    1
    Unfortunately this sounds exactly my last job on a med/surg unit. My current job (acute rehab in a hospital) is not as bad, but definitely some of the same problems. At my last job I went to nights because then at least I could eat and drink while I was charting without being yelled at, otherwise I wouldn't get to most of the time (my doctors were telling me I needed find a way to drink more because I was dehydrated...). Totally hear you about the documentation as well and if you forgot to chart something it had to be because you're lazy and stupid according to my former manager, not because you're busy, overwhelmed, or just plain forgot. Same as you I'm proficient in computers and typing, but usually was staying late to chart. It's terrible. Unsafe for both the patients and nurses.
    IowaKaren likes this.
  13. Visit  Sugarcoma profile page
    3
    This has been my experience at both jobs I have held as an RN. It is one reason why I abandoned my attempt at a BSN with only one semester left so I could figure out something else to do. In my very first week as a nurse I knew that I had made a huge mistake career wise. I foolishly believed that I would be caring for patient's. I foolishly believed that the hospital and the management were concerned about keeping patient's safe, but I learned quickly that no one really cares about the care patient's receive. It is just the illusion of care.

    All you really have to do to satisfy management is make sure you check off all your little boxes. It doesn't really matter to them if you actually do what you chart, just that you chart you did it! They don't care that you didn't really give your meds, just that you charted you did. They don't care that you actually know what you are doing, just that you made sure your new AMI patient was prescribed a beta blocker and they met the core measures. They don't care that you successfully coded your patient they care that you were so loud the guy in the next room complained! Doesn't matter to them that you are drowning with an unsafe ratio, as long as you don't hold up the ER so they can continue to advertise less than an hour from door to bed.

    Then of course you have the added benefit of being responsible for everyone else's job. Room not cleaned well....nurses fault. X-ray tech leaves pt. cranked up in the air and they fall....nurses fault. Food is cold...nurses fault and of course the nurse must rectify all of the above. I often toy with the idea of asking the housekeeper, dietary, pharmacy, x-ray etc. for a cut of their wages since I have to assume part of their job duties so frequently.

    I feel bad when patient's ask for something (like a snack or tissues) and I have to tell them I cannot give it to them because we don't have any. Especially when it is someone who has been NPO all day for a procedure and comes back after the kitchen is closed. I have actually offered patient's my own lunch. I used to make excuses as to why we didn't have these things. My pat answer was "Our delivery was delayed due to unforseen circumstances" but now I just tell patient's that we are out. What I would really like to say is that the executives of this hospital system have decided that million dollar ad campaigns and their bonuses are more important than your comfort!

    It is so very disheartening. Sometimes I wish I could be more like some of my coworkers, the ones who don't care. The ones who manage to do all their charting in the first hour of their shifts, spend as little time as possible with the patient and always leave on time.
    LithEruiel, vegnurse21, and sneeds like this.
  14. Visit  Nurse_Rae profile page
    4
    Expectations of doing more for less work is everywhere. However, not all careers involve caring for the LIVES of others. This is what's unfortunate about nursing.
    Sugarcoma, Aurora77, KarenJordan, and 1 other like this.


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