Quote from TheCommuter
Although I'm a lowly LVN, I'll still answer your question with the hope that it will help you out. I welcome the RNs to expand on what I have already conjured up.
1. The lack of respect from doctors, patients, family members, coworkers, managers, and society
2. The increase in accountability for patient outcomes, without the corresponding increase in salary
3. The fact that new nurses are churned out into the workforce every 6 months, further saturating the job market for nursing
4. The general consensus that nurses are warm bodies who simply fill shifts
5. The low workplace morale that can often be observed at many healthcare facilities
6. The low self-esteems and passive aggression of some nurses
7. The increase in lateral workplace harassment
8. The public's very outdated perception of the nursing profession
9. The fact that there is a myriad of different ways to become a nurse (LPN, ADN, BSN, MSN, Ph.d)
10. The female domination of the nursing profession
11. The desire for hospital administrators to maximize profit margins, without regard to nursing staff or patient safety
12. The practice of recruiting new nurses, rather than the retention of highly experienced nurses
13. The expectation that nurses can "do it all" while working understaffed, and lacking supplies
14. The lack of integrity of some members of the interdisciplinary team (i.e., the admissions rep who will allow anyone to be admitted if the insurance is good)
15. The expectation that the nurse is also the customer service rep, bellhop, concierge, waitress, clerk, messenger, courier, pillow fluffer, and receptionist
Possible solutions: (From my personal perspective
1. Respect is both given and earned from within. I would not work in an environment that did not provide a level of respect to me and those around me. If I found myself in such a situation I would have to leave.
2. Nurses are always accountable for their actions - I do not believe there has been an "increase" in nurses being "held" accountable for their actions; I think nurses are being held (finally) accountable for things they should have always been doing...elevating heads of beds, safely and promptly giving medicine, teaching patients why they should not smoke, following orders, protecting patients (time out anyone?), and documenting why and when they can't.
How much should a nurse be paid for doing the job? Nursing salaries are not a secret...nurses make what they always have...the myths out there about fantastic money have always been over blown.
3. Churning...not so much...passing licensure in record numbers...not so much...lack of qualified educators and facilities...yes...retiring in record numbers...yes. Please see http://www.cdc.gov/ncidod/eid/vol10n...fs/04-0253.pdf
4. The general concensus I am aware of is of smart angels who work very hard.
5. Low moral versus unhappy people versus perception......career change? Work change? Why would a group of individuals so unhappy stay together?
6. Low self esteem is an individual assessment. Passive aggressive behavior is a sociological phenomena that is tolerated by too many bobble heads who do not speak up and confront this behavior.
7. I had to look into this one...see http://nursingworld.org/mods/mod440/lateralfull.htm
some helpful ideas here and also please see response #1.
8. Who gives the public their perception? TV/Movies? Well there you go...if you buy into that, that is another discussion. My peers, colleugues, friends, family and extended family are very clear on what and who nurses are.
9. The age old argument...well my perspective is there are excellent CNAs, LPNs, 2 year RNs, BSNs, MSNs, and there are horrific CNAs, LPNs, 2 year RNs, BSNs, MSNs. There is room and need for all and this is not a clear cut issue.
10. Are there more females in nursing...yes. Is that changing...yes. 'Domination' is not good for anything, well except in protecting your life. Have females been traditional nurturers and caregivers...yes...are females hardwired for this behavior???? Is this a good thing????? Can there ever be equality???? Will men ever 'dominate' nursing? No, not so much. Hmmmmm, I will need many hours and lots of wine to resolve this one.
11. People are greedy every where. We are all guilty of this one. Some administrators are "greedy" in order to keep the doors open and some are greedy to get their bonus. Who is best served? The community without a hospital or the community with a hospital, but less than desired staffing?
12. The new always replaces the old, as they should, because the old dies. Are there bad, experienced, greedy nurses who need to be replaced? Sometimes. Does time served equal quality? Not in my experience. New grads do make less, but are there hospitals with quality problems and the same staff for 20 years? Yes. I, personnally, have never seen admin come in and get rid of high quality, experienced nurses just so they can hire less expensive new grads...so I reject the premise.
13. Nurses can do it all..that's what makes us so valuable. That said...if a nurse is working in an environment where they are expected to cook, clean, repair, scrounge and document at the same time, I suggest they get a new job. If a nurse feels overwhelmed by their work load, I suggest they discuss the situation wih a peer or boss and if they cannot resolve the issue...get a new job. Life is too short.
14. If a professional nurse is working in a situation where the admissions rep decides who gets admitted to the hospital, this nurse should get a new profession, because I cannot believe they are a nurse with a conscience.
15. Nurses are
all of these things for patients who cannot care for themselves. There is nothing unexpected, demeaning or untoward in a nurse fluffing a pillow, hanging up pajamas, answering the phone, getting a dish of ice cream, calming a family member, or reading the mail. If there is abuse, nurses own some of it for allowing it to continue.
I guess what I am trying to say is this. Nursing is a choice. If you do not like something in your situation...do something. Leave follow or get out of the way is never more true when applied to today's nurses. People who complain without action further drag down nurses. Worse, people who support and perpetuate bad situations through the - dare I say it - passive aggressive stand of "this is where I work, I can't move my family, I can't drive that far, there are no other jobs near me, I've already been here 10, 15, 20 years, I can't go back to school, I have bills, family, etc" are perhaps root causes of many of the issues nursing is facing. There are no surprises in money and I resent the continuing statements that nurses are not paid enough - Here me now
- no one is ever paid enough in the serving - and yes you hear me - serving professions. Not nurses, cops, fireman, teachers, soldiers, social workers, burger flippers or the guy at 7-11. Nurse salary information is and always has been readily available. People confuse the ability to be gainfully employed with unrealistic expectations for incomes. Please see the post about an optomitrist who wants to be a nurse so he can make 100-120K per year- paleez.
Finally, to the OP, I think additional research is needed and then extrapolated and applied into why nursing is chosen as a profession. Then the information should be honestly marketed and applied to individuals seeking to be a nurse. I also think additional research is needed on what defines quality nursing and what constitutes a high quality, cost effective care delivery model and then that should be implemented.
Wow, do I feel better.....