Fed UP IN MISSOURI!

I have never posted a new topic and am hoping for responses regarding: State Inspections/JCAHO/Managers. I work in St. Louis in one of the larger hospitals. JCAHO is going to be inspecting and the entire managerial staff is grilling us re: Questions Joint may ask? Auditing Charts like mad, POLICIES, pt safety etc etc etc. I AM SICK OF IT! They are having us/secretaries etc police the doctors about signing off verbals/telephone orders, and all the BS that goes along with accreditation. Yesterday our manager was freaking out about who was covering a patient while his primary nurse was taking a patient for testing. Now this man was stable, 24 hours post-extubation, full-code, hemodynamically stable. I work in the ICU and we do not have PCA's, NA's. I really had no idea who was covering, but told her that I would cover him. She continued to question everyone about him because his wife had wanted an update on his condition (she had phoned, the secretary told her to call back because his nurse was off the floor with another patient). We were told that if covering another patient, we HAD to accept phone calls re: that patient. That it was unacceptable to put a family member off. Now it turned out that the nurse covering his care was in an isolation room and unavailable. Apparently that did not matter. In effect the impression we all had was we should have DETAILED info re: ALL patients on the floor not just our own. I was fuming! HOW MUCH ARE WE SUPPOSED TO BE RESPONSIBLE FOR?????
The next incident happened with our nurse educator, we had just rec'd a code from the floor, (the 2nd in 10 min), as we were stabizing her, the educator came in the room and asked, "What happened to the O2 tank? Was it secured?" Now lets talk about priorities here, do we stabilize the patient? OR do we make certain that our butts are covered for JCAHO???

Now I must know: What direction is nursing going? Is our job to provide care to patients? Or to drown in RULES/Paperwork? To what extent does family dictate care? And how much verbal abuse do we need to take? Recently I was reprimanded for angering a family member. Now this man advanced upon me, was IN MY SPACE shaking his finger at me, telling me that I had a bad attitude etc. To his credit, I had, HAD A ROTTEN DAY! No break, worked from 645-2030, and yes I was fed up. But I wasn't hateful, nor was I unprofessional, I WAS short with answers, and NO I wasn't overly sympathetic to him (his failure to thrive 89 year old wife, alzheimers, 44 kg, broken hip/broken humerus etc.) I told him she needed to go to a nursing home, and he didn't like that. When he got in my face I told him to step back and to get his finger out of my face, because that was RUDE. Of course when called to the office, guess what....Yep I was wrong.

Nursing is becoming impossible to perform. It is the only profession where your break time is not given, where others can be abusive towards you, where you have to lift more than your own weight with little help. Where you constantly are put in positions of defending your CAREER. Patient directed/state mandated. Where rules are in place that set you up for failure.