Are we experiencing mass burnout in healthcare? - page 4

by SheaTab 10,270 Views | 70 Comments

This was written in response to a thread where a nurse experienced lateral violence at the hands of her preceptor. I thought it would be an appropriate discussion to start in this area. Thoughts? And so it goes in the world of... Read More


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    Shea,
    Why don't we hear more of your thoughts for once? =)
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    Quote from meandragonbrett
    Shea,
    Why don't we hear more of your thoughts for once? =)
    I'm assuming that was a facetious comment! What more could I possibly say?
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    Nurses experience burn out for a variety of reasons. Working longterm in a career that is largely unempowered is one of the reasons. The people who make decisions about care in the hospital and other health delivery facilities ARE now and have been in the business of removing tasks that were once nursing functions to other lower cost disciplines...think about drawing blood and starting IVs just to name 2 that come immediately to mind. Today, it seems that hospitals are intent on improving their "customer service" primarily by building new facilities...new hospitals, new clinics, new urgent care centers, new physician office suites. Nurse patient ratios are not part of the equation for some very odd reason. Do we have studies which demonstrate that higher nursing ratios improve care, decrease errors, and improve outcomes? I have been on nursing units in hospitals (notice that terminology, people largely stay in the hospital because they require frequent nursing care and attention) where there are more physician and physician extension personnel on the floor than nurses during some parts of the day. How ironic.
    inshallamiami and lindarn like this.
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    Quote from tewdles
    Nurses experience burn out for a variety of reasons. Working longterm in a career that is largely unempowered is one of the reasons. The people who make decisions about care in the hospital and other health delivery facilities ARE now and have been in the business of removing tasks that were once nursing functions to other lower cost disciplines...think about drawing blood and starting IVs just to name 2 that come immediately to mind. Today, it seems that hospitals are intent on improving their "customer service" primarily by building new facilities...new hospitals, new clinics, new urgent care centers, new physician office suites. Nurse patient ratios are not part of the equation for some very odd reason. Do we have studies which demonstrate that higher nursing ratios improve care, decrease errors, and improve outcomes? I have been on nursing units in hospitals (notice that terminology, people largely stay in the hospital because they require frequent nursing care and attention) where there are more physician and physician extension personnel on the floor than nurses during some parts of the day. How ironic.
    Tewdles:

    You have some very insightful thoughts. And so it goes in the world of capitalism that more is better. The problem is, our profession and patients are reduced to rubble in the effort to build an impressive empire. What do you suggest might help us out of this quagmire? What actions in your community and in the larger nursing community have you noted to be making a difference?

    It's interesting that even while patient quality measures at local hospitals are widely reported through publicly available sites like hospitalcompare.hhs.gov; nursing still hasn't experienced much in the way of relief from a national level. Many of the quality measures, to a large degree, are impacted by nurses. Many organizations that would seem to advocate on behalf of the nurse and patient are taking a stand against mandatory nurse to patient ratios. This includes the American Nurses Association (ANA), the American Hospital Association (AHA), and the American Organization of Nurse Executives (AONE). Nurses are not ignorant to the fact that mandatory ratios will increase the demand for additional nurses to care for our patients. We also understand that the reimbursement practices of major health insurance providers will not offset the cost of increasing nursing staff. This conundrum matters very little to me; however, because I am interested in having a rewarding and manageable career and in having the tools I need to safely care for my patients. The latter represents my most pressing concern and drives my passion for healthcare quality improvement and in advocating for safer ratios and addressing burnout in the profession. I don't care that increasing nurse staffing will result in little or no revenue for healthcare systems. I think our government has a moral and ethical obligation to fervently address this issue and to put an end to the abuse and overuse of the nursing profession. Frankly, billions of our tax dollars could easily and responsibly be diverted from areas of lesser importance and redirected toward improvement of healthcare quality. Not to beat a proverbial dead horse, but safe nurse staffing levels are at the heart of quality patient care. If you'd like us to adhere to the National Patient Safety Goals, meet our Core Measures, and provide expert nursing care to our patients, staff appropriately. And, ANA, AHA, & AONE, we know that you have proposed alternative solutions to mandatory nurse to patient ratios. The problem is that it would seem that these ideas are largely intended to generate little more than idle talk. Since the inception of the nursing profession, there has not been a staffing standard that is universally applied and adhered to. Stop talking and start making a difference! Without federal guidelines to mandate minimum standards, hospitals will staff appropriately when it is convenient. When the push comes to shove, nurses and patients will continue to suffer. Acuity systems are only as good as the folks who faithfully use and understand them and also when they are consistently enforced. There is no national gatekeeper.

    Additionally, it is time to stop the unfounded scare tactics that there is a huge shortage of Registered Nurses. I know of many new nurses who are struggling to find nursing positions and even of experienced nurses who are having similar trouble. Additionally, improving the work environment for nurses would result in many students choosing nursing as a career path.

    Thank you for your thoughts. I'm anxious to hear more.

    Tabitha
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    Tabitha, I appreciate your enthusiasm for this subject. Forgive me for being on the opposite end of that spectrum at this point in my life. I encourage you to continue to seek ways that you can impact nursing for yourself and the next generation of nurses. I have been a nurse for more than 30 years now. I have experienced, in the past 5 years, some ridiculous behavior and attitudes on the part of employers. The direction we are heading is not good. I am at the end of my nursing career. Given that I have no retirement, I plan on just being a nursing grunt until I am too old to employ. I don't intend to try to change anything except what my employer suggests that I need to change in order to remain employed. I will leave the revolutionary process to my younger ambitious peers.
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    What if nurses and doctors called the shots? By that I mean, what if they ran hospitals, clinics, etc.. democratically?

    What if they voted on ratios, proper equipment, allocation of money.. etc..
    lindarn likes this.
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    Quote from GCTMT
    What if nurses and doctors called the shots? By that I mean, what if they ran hospitals, clinics, etc.. democratically?

    What if they voted on ratios, proper equipment, allocation of money.. etc..
    They'd probably fold within a year.
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    "What if nurses and doctors called the shots? By that I mean, what if they ran hospitals, clinics, etc.. democratically?

    What if they voted on ratios, proper equipment, allocation of money.. etc.."

    In theory, that sounds like a brilliant idea! I think we have gotten ourselves into the mindset that business professionals must run healthcare in the effort that we remain profitable enterprises. Maybe that is exactly the problem, we simply can't safely run hospitals and amass a fortune any longer. I imagine that with doctors and nurses at the helm, we would make better decisions with regard to safe patient care which is the point from which all decisions should spring from.

    Keep the good ideas flowing!

    Tabitha
    lindarn likes this.
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    Quote from Onekidneynurse
    They'd probably fold within a year.
    Would you mind elaborating further? I think I know where you're headed, but I'd really like to hear your thoughts.

    Tabitha
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    There are quite a number of physician owned surgi-centers, hospitals, etc. Recent studies have shown that the cost of healthcare is significantly increased in those areas where the docs have a direct financial benefit for services ordered and provided. There was a thread on ALLNURSES which discussed this recently. The more economical health delivery seems to occur in systems where the docs are employees of the larger provider...as in Mayo Clinics practice.
    lindarn likes this.


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