Is this what nursing has turned in to? - page 2
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... Read More
- 1Mar 20, '13 by LithEruielUnfortunately 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.
- 3Mar 20, '13 by SugarcomaThis 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.
- 4Mar 20, '13 by mclennanI can sooooo empathize. After working a 4 year contract as an underpaid PHN in a small non-profit clinic, I decided to go for "the big time" and get a job at the ambulatory day clinic of a big, high profile, Joint Commission certified Magnet hospital. It was M-F, 8-5, and it was a teaching clinic for resident docs that served under-insured and uninsured community patients only.
Holy smokes. 50 to 80 patients a day came through those doors for free health care. We had 12 exam rooms and different specialty residents each day. 4 RNs and 1 MA to get vitals, history, med recon & chief complaint on this endless conveyor belt of patients who spoke every language on earth. One simple intake could take 30-45 mins when we had to use a translation service on speakerphone. It was a flippin madhouse. Total chaos.
In addition, it was also time for their Joint Commission survey - so we were under the gun to memorize these little scripted answers to surveyors' questions, and every single inch of the clinic, the utility room, exam rooms, our scrubs and badges, the med fridge had to be PERFECT.
The supervisor was a classic nightmare nursing manager, a 38 year old with a MHA and a shred of actual nursing experience compared to most the 40-60 year old RNs on her staff. She was being paid 6 figures to yell at us if we clocked one second of OT, took one minute longer lunch, or heaven forbid if we had to call off or leave early for an emergency. She only ever pointed out our flaws, negatively criticized our performance and REFUSED to get floats if we were understaffed. Which we were almost every day. The hospital wrote us up for clocking in 5 minutes late. We could not have water in the nurses station and had to SBAR for coverage for BATHROOM BREAKS.
I lost 15 lbs in 3 months just from the running around. My feet and back were ruined. 3 months after that I was dx'd with a serious bladder infection from holding my pee. 3 months after THAT I was hospitalized with kidney stones and had to have cytoscopic surgery. I was out for a month. My urologist wrote letters saying it was directly related to my job but I was denied workers comp because my supervisor and her managers refused to cooperate. I went back to work early as a result, weak as a kitten and with a ureteric stent, still peeing blood.
My first day back, a crazy, drug-seeking patient in opiate withdrawal grabbed my wrist, whipped out a Zippo lighter and threatened to set my hair on fire if I didn't get him his "******* pills." I managed to de-escalate him and get away. I called Security, per protocol. They were all occupied guarding a celebrity patient in the hospital tower, so I called the police (also per policy). They arrived and escorted the patient out. Picture all this happening in a packed clinic full of crazies, drug seekers, families, screaming babies, elderly, a dozen wide-eyed resident docs in their 20s and 4 frazzled, sick, dehydrated, overworked nurses.
My supervisor was FURIOUS. She hauled me into her office and yelled at me about how bad a police call "made us look" and how I should have "waited for" her response to the multiple calls and texts I sent, trying to reach her. Luckily, one of the attending docs stepped in and defended me, and yelled back at her. I was in the middle of this shouting match.
For the first and only time in my life I walked off a job. I quietly handed her my badge and keys, turned and walked out. She hollered after me, "are you serious? Are you serious?" The attending doc chased after me and said "I don't blame you at all. This place is a waste of your skills. If you need a reference here is my card."
I went home, collapsed and slept for a month. Then I found a wonderful job in case management. I DO sit at a computer all day and call patients. I'm salaried and don't punch a clock. No more scrubs. No more screaming. No more kidney stones. I get to actually use my nursing judgment and critical thinking skills and make way better money. Thank dog. I escaped.
So yes, this is what nursing has devolved into. Get out however you can. Get a degree that gets you out of bedside, get out of nursing altogether, try a non bedside specialty, whatever you have to do, just get out. It's going to get much worse before it gets better, sorry.
- 2Mar 20, '13 by Esme12, BSN, RN Senior ModeratorQuote from midwestmadnessI couldn't agree more....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.
- 3Mar 20, '13 by southcarolinarnQuote from sneedsI can't even begin to tell you how sick I am of hearing 'core measures' blah blah and it's only just begun, we are not even treating the patient anymore we're simply abiding by a piece of paper that tells the MD how to practice medicine. I'm only 25 and seriously considering going back for my PA because I don't see this getting any better it's so disheartening also, this is not why I got into nursing, in fact, this isn't nursing anymore. You hardly have time to be at your patients bedside and even begin to build a rapport with them! Yet, they talk about nurse to patient ratios increasing and counseling for when a core measure is missed on a a patient. Whatever happened to good old fashioned medicine?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.
- 4Mar 21, '13 by vegnurse21Yeesh.
I am so sad to see that so many others have similar or even worse circumstances. Congrats to the woman above who got a new job after the horrid clinic job! SBAR for bathroom breaks?!?! You have GOT to be kidding me!!!
sugarcoma - Coulda written that myself. Sometimes I wish I could be like the uncaring "nurses" but at the end of the day I could never live with myself and obviously neither could you. It's a bit scary to me how quickly all of this is happening. Documentation of course has always been important, but even just a few years ago when I did medical I could at least be with my patient a little bit longer than I am now. However, maybe it's because I'm at a magnet hospital now and that one wasn't. It is now though and I've heard it's gotten much worse.
I am in school for my BSN and I will not be stopping until I get my MSN. I can't stand this. And you know, while it's disheartening to us nurses, it's even more disheartening to me that these patients are going to be getting cared for by crappy nurses who don't give a damn about them. The real nurses are going to burn the heck out in this field because we just can't do it all and are compelled to try anyways.
And yeah, I LOVE how it's ALWAYS the nurses's fault. ALWAYS. Doctor makes a mistake? Nurse's fault. Doctor didn't get a message from another doctor? Nurse's fault - even though you GAVE 1st doctor 2nd doctors number because you were too damn busy to put something ELSE on your plate. UGH.
The post about the hospital not giving a damn is just so sickenly true and I hadn't thought of it that way before. They really don't. Just as long as the charting is perfect and nothing makes them "look bad". Disgusting.
- 1Mar 25, '13 by LithEruielCongrats on your new job mclennan. I worry that something worse health-wise is going to happen to me. My back, feet, legs, whatever else you can think of, hurts so bad all the time from these **** 12 hour shifts. Yes four days off would be nice if I wasn't so exhausted and didn't sleep through all my days off. I'm hoping to get a non-bedside job but only have 1 1/2 years experience so it's going to be a long time...
- 1Mar 25, '13 by sneedsIt wouldn't be so hard on our bodies if we didn't have so much stress during those on days. My days off are like this: I have energy till about 1pm. After that im zoned out and planning on hopefully a better feeling day the next day. Sometimes I wonder if the hand care foam that I always apply in and out is affecting me. Seems like I'm always recovering from the stress of the workdays in ways that don't add up. I'm thinking it might be dehydration and electrolytes too. Just wished nursing was more nurse friendly.