What do you think is a major problem in nursing? - page 7

If you had to pick one thing that you thought was a major problem in nursing what would it be and what would you do about it? Just curious! :)... Read More

  1. by   DARLINGLILITH
    Courtesy and professionalism and just plain respect for oneself and one's profession. I have worked hard since feeling "burnt out" several years ago to increase my respect and repair my manners for myself and my patients (and my colleagues!). Amazingly enough, it has paid enormous dividends not only in my working relationships, but my homelife as well. I love nursing again- can't imagine ever being anything else. PS a few years ago I was almost ready to quit and go back to waitressing (or almost ANYTHING else!)
  2. by   caroladybelle
    Quote from blue chips
    IF YOU HATE CNA'S SO MUCH, WHY NOT TELL THE HOSPITAL TO GET RITE OF THEM SO YOU CAN DO ALL THE BATHING, TQ2, AND FEEDINGS.
    Plenty of hospitals/units already have.
  3. by   Antikigirl
    Where I find the lack of professional respect towards nurses to be one of the major problems in todays world of medicine, I find the lack of respect between nurses to be the core behind the heartbreak, hopelessness, powerlessness, and detourment in nursing today!

    I am seirous, I have seen more respect from even MD's fighting passionately over probelms they can't agree on, but they show eachother a respect level because they are MD's!

    Some Nurses..heck no! Some nurses will easily send another nurse down the river if they assume there is a probelm with a co-worker than actually find out what may be the probelm and help! Be quick to jump to conclusions, be quick to say that things must go as they know them to go vs someone actually having a different way of doing it. Pointing out errors may it be spelling or anything else...

    (I screwed up the other day when swamped and accidentally put on a fax to an MD Ensure, One can by mouth for >50% of meal eaten instead of <50%...okay so the MD correct me and I had a giggle and said "oopsie!"...ANOTHER nurse had the gall to copy it, post it in the Nursing office, highlighted it and said..."these types of mistakes kill people..watch it!"...I was so saddened by this 'example' I was made to be...and if she had just talked to me I would have said "yep, I goofed..thank goodness it was only ensure and it was caught by the MD (which is a miracle in my opinion..mostly they just sign without looking...LOL!!!!)..I will right greater/lesser instead so I don't accidentally make that mistake again...What a Witch!).

    IF I didn't have to watch my own back all the time, then add my own collegues who are actually more backstabbing, manipulating, brick headed, and more 'know it all' than a cardiologist on a good day...I would be more apt to enjoy my work, feel the satisfaction I know has to be out there, feel the teamwork I so feel is necessary for my patients and ourselves, and work with a group of folks I feel I can trust and even help from time to time which is what I like to do.....

    Once those hurdles are overcome, and nurses start really banning together, things will improve substantially! I mean, we all are in this together...we share very common probelms, delemas, joys, sorrows, happiness, fullfillment goals...why not see that and band together for the greater good of the patients..and ourselves too .

    (remember I am not talking all nurses..I have met quite a few that are more like me and find helping is better than complaining or harming..and we open communiation up before sending a nurse to 'trial' with other nurses or admin...I show respect, just wish I got some back more than not like it is now!).
  4. by   allamericangirl
    Yes, I understand that they have gotten rid of CNAs, and instead of hiring educated, licensed Certified Nurse Aides, they are hiring people off the street calling them by catchy titles like "patient care technicians", "patient specialists", and other creatively contrived labels. How lovely. I would think professional nurses would be appalled.

    I just finished my clinicals in a LTC facility where I never observed a nurse in a resident's room, not once! And the nurses station was totally unstaffed 80% of the time. I have no idea where they were, but I can assure you that they were NOT in the patient's rooms or anywhere else easily found! Call light alarms rang for a minimum of 30 minutes continuously during the ten days that I did my clinicals there.

    The facility ordered too few Depends and we were told to not change the residents except after BMs, because they didn't have enough disposables to go around and wouldn't until a new shipment came in, some two weeks later. The DON didn't even have enough sense to go to the petty cash drawer and send some one out to buy the needed supplies from the thousands of Walgreens, Walmarts, and grocery stores in the Denver area. When I did their perineal care, their bottoms were inflamed, they stank with urine, stool, and dirty body odor, greasy unwashed hair, etc.

    When I did nail care, every resident had wedged, caked dried goo, food, feces, and grime under their nails, and their poor little fingers had to be soaked over and over to soften it so it could be removed with an orange stick. It had been there so long that it had become part of the skin, and if not extremely gentle when removing it they bled when it was removed!

    Light bulbs in rooms remained burned out the entire time I was there. Sinks in many bathrooms would not drain because they were so stopped up. The linens were grey/brown dingy and the fabric was so hard that it was absolutely scratchy. The towels were more like brillo pads. Everyone had decubitus somewhere.

    I heard the RNs and LPNs say things harshly and rudely, over and over again to residents like: "There is nothing wrong with you! Be quiet! STOP THAT! Don't do that! What's wrong with you?! Now what?! Why are you doing that?! What now?! You never stop do you?!"

    I observed residents who had fallen asleep in wheelchairs, leaning so far forward that only guardian angels were keeping then from falling out onto the floor. There is so much more that I could go on for hours. I observed others that couldn't hold their heads up with their heads over to the side, forward, back, in extreme cortorted positions with no support. I went home at night and cried. My clinicals ended yesterday. I called the omnibudsmen this morning and reported everything that I observed.



    So hospitals and Medical facilities are under staffed and you prefer not to have the help of licensed and educated nursing support? I assume by your comment that you prefer to be working with unlicensed individuals that have not had any formal training in patient care. Choice! Isn't that something?!

    Quote from caroladybelle
    Plenty of hospitals/units already have.
    Last edit by allamericangirl on Mar 9, '05 : Reason: typos spelling
  5. by   CrunchRN
    TriageRN -

    I am so sorry about the situation you faced. I totally agree that nurses undermining each other is one of the most disheartening things about the problems. You have my total sympathy - at least you know where you stand and her true colors. You always sound like a really great nurse in your posts which I have enjoyed and followed for some time. Keep it up!
  6. by   caroladybelle
    Quote from allamericangirl
    Yes, I understand that they have gotten rid of CNAs, and instead of hiring educated, licensed Certified Nurse Aides, they are hiring people off the street calling them by catchy titles like "patient care technicians", "patient specialists", and other creatively contrived labels. How lovely. I would think professional nurses would be appalled.


    So hospitals and Medical facilities are under staffed and you prefer not to have the help of licensed and educated nursing support? I assume by your comment that you prefer to be working with unlicensed individuals that have not had any formal training in patient care. Choice! Isn't that something?!
    That's a rather naive assumption of you.

    Actually, ma'am, have you heard of the phrase "all RN staff" or "all licensed staff"? That is where I work, and would prefer to always work, given a choice.

    No CNAs, no "patient care techs", no "nurse techs", no orderlies. No unlicensed or "certified" care staff.

    A hospital/unit staffed only with well educated licensed (not "certified")personnel, all responsible fully for the care that they give, doing their own baths and vitals and answering their call lights.

    An interestingly, magnet status - for some reason the staff is more fulfilled and there are less problems with shortage and turnover.

    Some of us are darn proud of our education and our bed bathes and skill with putting in an NG or putting someone on the bedpan. My vitals are done manually by me. And on night shift, I put together my own charts.

    No dealing with the us vs them attitude...from either side. Or tacky petty passive aggressive behaviors. And the patient's seem much happier. At least two of these facilities rank in the US News top 15, for at least two years in a row.

    So I suggest you take the 'ya'll couldn't manage with us doing the bathes and the vitals" and dump it in the trash where it belongs. Plenty of us on this BB, professional nurses clean our own patient's fannies....and prefer it that way.

    Primary Care Rocks!!!!!!!!!!
  7. by   allamericangirl
    You know ... NO ... I have NEVER heard of such a facility before ever.... but then, I'm just a 58 year old stupid beginner, and have only had the experience of going to three, maybe four hospitals before in my entire life. So, yes, I guess I am naive. Aren't you fortunate to work in such a fantastic place and aren't you patients fornunate to have access to such a wonderful place. I don't think the my assumption is all that naive, however, considering that a facility like yours is the exception and certainly not the rule.

    I have just finished my first session of classes, and will be taking the national exam for CNA, Home Health Aide. I hope very much that I will be able to find a job as a CNA so that I can use my income to begin the next phase of my education. There are some hospitals that prefer to hire folks off the street rather than hire someone who has had some training.

    By the way, I don't think that a snooty attitude toward CNAs is a good thing, since they are a needed componet in health care, except in the exceptional cases, like yours. Perhaps you were able to start at the top of the heap, its difficult to tell by your demeanor in your post, but many have to start at the bottom, and some, by choice, or by circumstance never move up the nursing ladder.

    Here I see a lot more cuting down and cutting out of qualified personnel than full staffing of all RNs. Count your blessings. Have a nice day too!


    Quote from caroladybelle
    That's a rather naive assumption of you.

    Actually, ma'am, have you heard of the phrase "all RN staff" or "all licensed staff"? That is where I work, and would prefer to always work, given a choice.

    No CNAs, no "patient care techs", no "nurse techs", no orderlies. No unlicensed or "certified" care staff.

    A hospital/unit staffed only with well educated licensed (not "certified")personnel, all responsible fully for the care that they give, doing their own baths and vitals and answering their call lights.

    An interestingly, magnet status - for some reason the staff is more fulfilled and there are less problems with shortage and turnover.

    Some of us are darn proud of our education and our bed bathes and skill with putting in an NG or putting someone on the bedpan. My vitals are done manually by me. And on night shift, I put together my own charts.

    No dealing with the us vs them attitude...from either side. Or tacky petty passive aggressive behaviors. And the patient's seem much happier. At least two of these facilities rank in the US News top 15, for at least two years in a row.

    So I suggest you take the 'ya'll couldn't manage with us doing the bathes and the vitals" and dump it in the trash where it belongs. Plenty of us on this BB, professional nurses clean our own patient's fannies....and prefer it that way.

    Primary Care Rocks!!!!!!!!!!
    Last edit by allamericangirl on Mar 9, '05
  8. by   caroladybelle
    Quote from allamericangirl
    I don't think the my assumption is all that naive, however, considering that a facility like yours is the exception and certainly not the rule.

    By the way, I don't think that a snooty attitude toward CNAs is a good thing, since they are a needed componet in health care, except in the exceptional cases, like yours. Perhaps you were able to start at the top of the heap, its difficult to tell by your demeanor in your post, but many have to start at the bottom, and some, by choice, or by circumstance never move up the nursing ladder.
    Your naive assumption was the idea that I prefer untrained personnel to CNAs. It was assumption that you made along with the one that, "nurses can't do without CNAs to do the dirty work". And it was without any basis given my post.

    We can. We do. And we will continue to give great care with or without ancillary personnel. Especially if they come in with the inaccurate assumptions that you carry.

    Ancillary personnel can be a great help and provide awesome teamwork. Or it can be a hindrance. But until CNAs carry the same legal burden as RNs, I will prefer working primary care.

    And these facilities are becoming the rule more acute care settings, and less the exception.

    Carolina

    PS . I did work as a nurse intern. And while I believe that I did an excellent job, I still firmly believe that every patient deserves to have only licensed personnel working with them.
  9. by   PDCNurse
    I spend most of my day doing redundant paper work. There is no reason for writing the same information on the same chart 4 different times. If the people who came up with this stuff had to use it, there would be some changes.
    I really get angry when I can't do the kind of patient care I should do because the administrators are trying to save a buck. They don't care if someone dies as long as they don't have to pay for more staffing. Someone better wake up and smell the coffee--nurses are getting stressed out and leaving the profession.
    Health care facilities should be a nurturing place to work. If employees don't feel appreciated, the quality of work they do decreases. A pat on the back and a thank you would be nice once in a while. Hire the best people you can and get rid of the dead wood and the envionment will improve.
  10. by   NurseFirst
    Someone mentioned passing a message from one doc to another? Yikes! That's just a communication disaster waiting to happen! If someone wants to say something to someone, I refuse to be the medium; after all, if the receiver of the message has questions (which is often), I don't have the answers, and have to refer them back to the sender. Easier, faster, all the way around, if sender and receiver communicate directly. Now, granted, a CNA coming to tell me that my patient needs me...that's appropriate--because it is not the full message; it is a "meta-message" -- the patient needs me for some reason, which they will tell me when I see them.

    BTW:

    CMAs do NOT work under an RN's license, they work under the physician's license.

    NurseFirst
    Last edit by NurseFirst on Mar 10, '05
  11. by   Jenny99
    Hi Everyone,

    The biggest major problem in nursing without question is the "territorial battle" that has gone one for many years now between the different educational levels in nursing. From Master degree nurses on down to the LVN/LPN - including the CNA's, it even flows through to the nursing educators and the cirricculm that is taught in the various school settings.

    This territorialism is the basis of why nurses and the nursing profession have the problems they do today

    The views of various facitlites and hospital administration is another thing totally and left for another day to discuss.

    Jenny99
  12. by   NurseFirst
    Quote from blue chips
    YOU THINK YOU ARE BETTER THAN THE AUAs BECAUSE YOUR NAME TAG SAYS RN, PLEASE GET OFF YOUR SOAP BOX :angryfire :angryfire :angryfire

    sound of siren in the background
    sound of siren slightly louder
    sound of siren coming closer
    sound of siren right near by
    sound of siren stops

    a bunch of firepersons get out...hoses ah, um, a'firin...

    ***** SPLASH *****


    AHHHHHHHH.....So much cooler now!!!


    NurseFirst
    Student Nurse
  13. by   RN34TX
    Quote from Jenny99
    Hi Everyone,

    The biggest major problem in nursing without question is the "territorial battle" that has gone one for many years now between the different educational levels in nursing. From Master degree nurses on down to the LVN/LPN - including the CNA's, it even flows through to the nursing educators and the cirricculm that is taught in the various school settings.

    This territorialism is the basis of why nurses and the nursing profession have the problems they do today

    The views of various facitlites and hospital administration is another thing totally and left for another day to discuss.

    Jenny99
    Well said!!
    In LPN/LVN school I was told to explain things in simple, easy to understand, non-medical terms when delegating tasks to the "non-licensed and non-professional" personnel, even though when I took my CNA course we were taught and were expected to know many of the correct medical terms.
    Then in RN school I was told that LPN/LVN's are taught to perform tasks but really don't understand the reason and science behind it and not to expect too much from them. Oh yes, I also was told not to let LPN/LVN's be allowed to do too much because they will take over RN jobs.
    There's your territorialism!
    God knows what they are going to teach me this fall in BSN school.
    Last edit by RN34TX on Mar 12, '05

close