Conditions in hospitals getting worse

HouTx, BSN, MSN, EdD · Dec 23, 2009

You're not alone. I would suggest you check out Suzanne Gordon's website http://www.suzannegordon.com/ . Her articulate and well researched book - "From Silence to Voice" reflects your position exactly.

nurturing_angel · Dec 23, 2009

This is happening here also and I cannot believe that management does not see the problem. The blame is put on the nurse when complaints are made that someone did not get the care the desired and deserved when in the hospital. When I worked night shift med surg it was nothing to start your night out with 7-9 pts and get 4-5 admits during my shift. I was a stressed out mess all the time. Of course, my managers blamed the fact that I had been an OB nurse for many years and didn't understand the dynamics of the med surg floor. :angryfire Surprize!!!!! All my co-workers were stressed to the max also.

I agree that it will never get better. Money, not safety for the patients or the nurse, is the important issue for these hospital administrations now. They have seen that they can staff the floor this way, the work somehow gets done and they have made money. It will only get worse from here. I am glad that I am closer to retirement than I am to just starting out. I feel bad and afraid for what these new nurses are going to face. I am burning out both physically and mentally. I want to go work in the bakery or deli at Walmart...lol...no greeter job for me.

:paw::paw::paw::paw:

trulynurseatheart · Dec 23, 2009

I regret not getting my entire floor to request that our new manager work 2 day shifts and 2 night shifts before being hired, or making all these changes on the floor.

Our ratios are not bad, 5-1 days, 6-7 on nights (light tele/medsurg ortho), but we are a heavy nursing home / psych floor at times, and can barely get done what needs to be done. I feel HORRIBLE not having time to do basic care for patients many days. I am pursuing my BSN, and my Masters, and am thinking of community nursing/public health down the road. I have been a nurse for just over 3 years, and do not see my self for doing it much longer. "I will always have a job" I guess, but it takes such a toll on my stress level and esteem.

martymoose, BSN, RN · Dec 24, 2009

only my opinion- but I think mgmt knows this plain and clear. We have a license. They know it. We will either do the job, or walk away( quit). And there will be a new grad( no offense intended- just as an example , my area has 5 local colleges turning out new grads bi-yearly- tell me the market aint saturated) right behind the quitter. If I might make a quote from the "Coneheads" movie- "it's as if they've grabbed us by the snarklies" IYKWIM. I've said it before- nursing is the new scapegoat. Just because you didnt have time, is no excuse anymore for providing correct care. Mgmt doesnt realize that yes, some of us DO have a concience and want to do the job right. They dont hear(or want to hear )that we CAN'T do the right thing cause of the rediculous load they have put on us. Its all about the numbers- that the hospital has the biggest production line, and you better be on that pt production line with a big smile, and " Is there anything else I can do for you" . :angryfire Seriously- I screw up cause I cant hold down the ETOH er who is beating up his roommate, and watch the old guy fall and break his hip because he had to go to the bathroom, and he didnt want to bother anyone, and praying that the other old confused guy doesnt turp himself from his foley, cause god forbid , jcaho says we cant use any restraints anymore. Guess who will get the blame- me- guess who loses their license for negligence- me guess who cares about it- not the hospital- . If new grads knew this ahead of time, I'm sure there wouldnt be so many going into the field. I pity the poor patient who has to stay in a hospital.

deToxTech · Dec 24, 2009

I was a tech at a detox unit (hence the name, right?) and it wasn't uncommon for all the units to be understaffed. The standard ratio was supposed to be 8 pts per tech (since we were only alotted two, maybe three nurses) but there were times it was as bad as 15 pts, some being constants or 1:1's. And we were expected to keep eyes on all of them and do admissions and escort them to meetings and so on.

Even after a few elopements, and even an accidental OD, from what i've heard they still haven't "fixed" the problem. They made great proclamations and clear cut some units and hired a whole bunch of new people and put together new policies, but nothin's really changed except the paperwork. Partly one reason why i'm glad i'm not there anymore, they're cutting hours and cutting staff. The fact of the matter is that most hospitals are businesses and they have bottom lines to meet. And this is strictly my uneducated opinion so please don't take too much offense, the people who do staffing seem to have either no concept of what it's like to be on the floor, or they've forgotten it. Then again, if the hospital isn't making money, the shareholders aren't going to be happy and then they back out of the deal. So they fire the staffing/middle management ppl. well, rather than risk their jobs, staffers do what they can to appease the higher ups. And the floor staff takes the hit and we get fired for not being able to catch a bad situation.

But also, there are times where you might be perfectly staffed and you're still going to be overworked because half the staff isn't pulling their weight. So even if the numbers are ideal, if you don't have a great staff, it's still difficult.

Riseupandnurse · Dec 24, 2009

I absolutely agree with the above posters. It's a huge assembly line; it's not nursing anymore. It's not even customer service. It's giving the APPEARANCE of customer service. We have a big revolving door of nurses; new grads stay just long enough to realize how horrible it is and then they're out. And the nurses do not do anything about it, or stick together. It's all about taking care of yourself. Every time I go in I wonder if this will be the day I lose my right to practice "nursing" anymore. The not-for-profits are just as bad as the for-profits. And I am so sick of hearing nurses need more money. Money will not change the fact that what we are doing is inhumane, both to ourselves and our patients.

Sugarcoma, RN · Dec 24, 2009

I am a newbie, only 6 months and this is my first hospital job but I agree that conditions are deplorable in the hospital! I am routinely given pts. way too acute for my abilities and on our floor we have NO seasoned RN's on nights and only about 3 on days. It is scary. Couple new RN's with 1 st year SX residents and you are creating a blind leading the blind situation.

Hopsitals desperately need to do more to RETAIN experienced RN's, but management is not interested in anything other than the bottom line.

It is no suprise to me that so many are leaving bedside in droves for advanced practice and other fields.

I myself am conteplating going back to school for a degree in some other field, no way I can do this for the rest of my life. My conscience won't let me.

deToxTech · Dec 25, 2009

it's a shame that the bottom line is such a factor-but what do you think is the main cause of making healthcare so expensive? I don't think there are alot of people out there who would be willing to do such grueling work if it didn't pay some small dividend-so there's one aspect of it (then again, there is something to be said about working the job because it's a calling, not because of the money). What about HMOs? Bedside Lawyers and frivilous lawsuits? Drug Companies? Medical business people who realize that they can charge what they want because it's either health or death?

what about the idea of medicine keeping people alive long after they should have died, driving up acuity? Or using resources tht could be dedicated elsewhere? Don't ask me for an example, i'm sure you can develope your own.

not trying to change the topic as much as throwing out some other ideas as to wht might be causing the worsening conditions. yeah, understaffing is a pain-and every hospital out there is guilty of cutting corners to pad their budet. but there are ways that the medical field is its own worst enemy

starletRN · Dec 26, 2009

what about the idea of medicine keeping people alive long after they should have died, driving up acuity?

I was talking about this very subject the other day with a couple of other nurses on my unit. When is it time to say "enough is enough"? I get the impression we're keeping a lot of patients going for the families and not for the patient.

The patient is miserable. In some cases confused, non-verbal, incontinent, getting fed from a tube and hooked up to oxygen. If you could ask them what they want, I wonder what they would tell us. Would they want to be living this way? Not to mention, wanting to die with dignity.

I just don't know what the answer is. Are family members getting false hope from the doctors? Are they in denial? I don't want to sound judgmental of the family members either because I can only imagine what I would have to do if I had to make that decision for a parent or my husband.

deToxTech · Dec 26, 2009

i think alot of it has to do with the philosophy of medicine being a path of healing. that's what we've all grown up knowing-drs and nurses make people get better. They don't just "let" ppl die. as such, there's also a legal fear-a doc who lets their patient die, well that just conjurs up all kinds of negatively charged images.

and alot of it is fear,i think. not wanting to be without the person-at least as long as they're alive and the family is doing their part to keep them alive, they don't have to deal with the loss or the guilt of loss.

but ppl who've worked with death and dying and the deteriorating aspects of human health know there's an difference between existence and really living. Personally, if i'm a potato connected to a machine, i'm not living. Put me down.

JDougRN, BSN, RN · Dec 26, 2009

This same issue just came up in my ethics class. I don't understand why they do the things they do to some of these people. You wouldn't treat your dog like that, but lets shove another tube into grandpa, so he can live in pain for another 3 months. These doctors don't approach quality of life issues- waste tons of money, to prolong lives in people who can't talk,walk,communicate,eat,move.....so cruel. I think the fact that death isn't something that most people come into contact with now, they seek to avoid it at all costs, instead of seeing it as a part of the life cycle.Patients and their famalies aren't given the option of pallative care only. I see tons of end stage renal patients now- not once were any of them given the option of NOT doing dialysis....but you can bet the docs don't tell those same patients all of the bad things that are going to come along with dialysis.I wish the ethics board would get involved more often.SO sad.