Abuse Culture in Nursing...How Far Does it Go?

[HoneyBeGood]

Time to open the can of worms...I am sure it has been opened several times...but maybe I am not seeing this topic addressed enough. Am I crazy or is the world of nursing crazy and I am just in the mix?

Why did no one tell me in nursing school? Why did I not listen to my mother who is a RN. But now my complaints are met with a common phrase "Welcome to nursing." W*T*H. This is it? The field of nursing nursing seems like a patchy grassland with some good here...nice and green...some barren dry areas...and many muddy waters (aka hospital nursing).

What are we going to do? Blame society, our polity, or the economy? Why am I so hallow on the floor?...when did I turn into a robot...who must finish her tasks and keep it moving. Little time for emotions or connections...even if a patient and family are tearful in the room because of a new life changing diagnosis. I see and hear their tears but my mind is focused on the meds I need to pass, my manager who is breathing down my neck, or whatever can of worms I must deal with in my other patient's rooms. The only reason I give a warm pat on the shoulder is because it seemed appropriate for the situation. The patient seemed to need it...and it works and the patient is reassured and more calm...but inside I feel nothing as I think of the other tasks at hand.

When I get home from work...I often reflect on my patients and how emotionally disconnected I was even when their lives were being turned upside down. I feel sympathy for them at home...disgust towards myself for my coldness on the floor...and loathing that I have to go back to that place. On the floor I have no time for sympathy. My goals are to keep my patients stable and safe and complete my tasks....so many tasks.

I knew nursing was going to be hard but I did not realize how much I would become cold. I give great customer service and give warm smiles to my patients and their families...but mostly inside I feel nothing for them. I just do my job and keep it moving. The fact I am this way brings self loathing. When did my smiles turn into a robotic tool to do my job rather than have genuine connection with an other being?

When the nursing school admissions council asked me 'why do you want to become a nurse?' My genuine answer was I want to help people and feel good about what I do. I do help people...but feeling good about helping my patients...that feeling has very much faded. I feel like a robot that must complete my tasks and keep it moving. I am even annoyed when they want to connect with me, in my mind "I have tasks to complete...I don't have time for this conversation, I don't want to get to know you better, I have tasks to complete.' And those are the nice ones. The unsavory patients, docs, and managers that leave a sour taste in my mouth, makes it all the more easier to be cold.

Weird...if I had known I would end up this way as a nurse inside...maybe I would have taken a different path.

The reason I say abuse culture...is because I have come to find in nursing that there is A LOT nurses will put up with at the expense of themselves. Stress, anxiety, depression, prescription medication, weight gain, insomnia, etc. Some realize it, some don't, and some just don't care. Any hospital nurse will lave a laundry list of the BS we have to put up with...but it is like there is a resolve that this is just nursing...it is what it is. Hospital nurses all know what's up.

This culture is so strong, that what is unreasonable in other professions...is not unreasonable in nursing. It is accepted. If a new nurse can't get with the program then she is told hospital nursing is not for you. Instead, maybe hospital nursing is not for nurses. How about that?

I hardly find people say this...nurses complain about how bad it is, how we are stretched so thin, how we don't get our breaks, how we never have a chance to eat or urinate, poor staffing, understaffing, the list goes on and on but people don't say...

Hey maybe it's not that this nurse is not fit to be a hospital nurse...forget about the 3-4 years she/he spent specifically training for nursing and proving herself/himself...but if she/he can't take crazy patient loads, poor staffing, etc...she is not a good fit? Why not the other way around?

I know it is not likely to change...these nursing conditions...but to accept it does not sit well with me. (by accept I mean: the vibe of hospital nursing is not for all nurses...no...it is...but not under the current conditions). I know there are unions and all that but very little is being done especially considering our numbers. Maybe it is not the new nurse who is struggling in the hospital...maybe it is the hospital that is dropping the ball. Maybe it is the culture of the hospital to abuse nurses and maybe it is nursing culture to accept it.

This abuse culture is so rampant you have nurses like me who are losing their souls at the expense of being good at my job. i can do my job and keep my patients safe but there is something so wrong. I am a med surg nurse. I am sure it may be waaaaaaaaaaaay better on other floors.

How far does it go that the abused don't even realize they are being abused? The ones who don't make it in the hospital are pushed to other fields of nursing. Fine...but I dare say it is not because the the nurse is not competent or can't manage patient care in the hospital conditions. Rather not every nurse can handle the hospital conditions that make it not condusive for success. Then people wonder 20% of nurses in their first year drop out of the profession completely. That is pretty high considering the time and money invested.

[madwife2002, BSN, RN]

Yes I think nurses know they are being abused but I don't think we stick together as a whole profession and shout out loud enough for the world to hear

We are afraid of losing our jobs, we cannot survive without our wages and that stops a lot of nurses from really complaining too loudly

[BrandonLPN, LPN]

I think you'll find that you need to be emotionally disconnected in order to do this job.

[morte, LPN, LVN]

Yes, on the wage thing. it is not uncommon for the nurse to be the breadwinner, we can tend to attract some dependent persons for mates. probably for the same reasons we put up with the, hmm, stuff.

Yes I think nurses know they are being abused but I don't think we stick together as a whole profession and shout out loud enough for the world to hear

We are afraid of losing our jobs, we cannot survive without our wages and that stops a lot of nurses from really complaining too loudly

[CrunchRN, ADN, RN]

Well said. And the root of the issue is that nurses do not stick together enough and instead often undermine their co-workers.

[rumwynnieRN]

I was talking to a mental health nurse practitioner when I was still working with geri-psych, and she said there was a study that came out recently (...I'm guessing within the last 5 years last year?) that looked at who goes into nursing. They found a lot of people who have a hx of abuse in some shape or form go to nursing. If you take that with everything you just said, it explains partly the overall bad-behavior of our profession and why some of us will put up with unprofessional behavior. There's also people's overall attitudes you will come across in any field. "Oh, but we always did it this way, WHY DO WE HAVE TO CHANGE BC IT'LL JUST TAKE LONGER." You also can't control the doctors (okay some doctors), and if it's not the other nurses, it's administration or the family members.

As crappy as it is now, I think it was probably crappier before. There's that thread about team nursing with 20 to 1 with an aid and an LPN (I think it might be further down from this thread) for acute care which now is almost unheard of in a lot of hospitals. Change doesn't happen overnight, but you have to give some credit where change has happened (this is not reflected everywhere). The hospital where I work will call doctors out on bad behavior (obviously not in front of people), and they've also been actively pushing for people to report bullying from your coworkers.

[LadyFree28, BSN, LPN, RN]

As some one who has been abused, no, it's not abuse..I KNOW what that feels like, and aware of the signs..this is not the only profession that is being run this way; this is the corporization of Healthcare at its finest; it's been like this for 20 years now.

If this is abuse, it's pretty damn MILD than what I've been through.

When a unit, organization is run well, a person can still feel overwhelmed, and unhappy; sometimes one has to look inside and have a "moment" to realize what their niche is.

How do I survive, or rather, thrive?

I put my nursing hat on each shift....think like a nurse, be objective and working within that logic; I get involved and be an agent if change; learn the system, work within it, get the respect for my insight where questions have been raised, and help institute changes; It has worked. I also am cognizant of my work life balance and my life outlook; if I am genuinely unhappy, it will show.

I used to bring a certain type of resilience when I was in a DV relationship; I worked MY best those days where people couldn't tell; well, I don't do THAT anymore. If I am genuinely happy in my life, and if something makes me unhappy, I know how to be professional about it; I let me have those days; but I reflect and move on; I grab the next day as a learning experience; another seat of managing health and healing.

I bring a NEW resilience in being objective and being a detective when "managing" my patients, I listen objectively, I think objectively, I intervene objectively for that individual patient and family. That's the "nursing business" that I take care of; it's never personal then it has to be, meaning, it is NOT fair to my patients or my job that I give ALL OF ME that's unhealthy! I advocate for myself professionally if things are unsafe, what I am only capable and comfortable taking; if I see something that is a potential error or miss, I step up; I'm willing to buddy to make sure breaks are taken, as well as take a BREAK, and don't care; the work gets done in a timely manner. I compromise without compromising myself, and it's STILL effective after 8 years-NO BURNOUT, and in reality, STILL get paid well, compared to plenty of professions, could be more, yes, but enough for me to own properties, manage my debt and still have savings, and be able to see the world, but that's just me. I leave work at work, and live my life to the fullest. :)

[mmc51264, BSN, MSN, RN]

I see many of the trends in education in nursing. As a former teacher (I was pushed out b/c I was an non-tenured Masters teacher$$$$$). They keep saying there is a teacher shortage just as they say there is a nursing shortage. They keep churning out both because they keep pushing the more experienced out.

I read a comment by someone to a teacher to quit complaining b/c they allow themselves to be treated the way they are. Same with nurses: complain too much, try to rock the boat, there are 20 people waiting to take your place. Right now staffing is an issue b/c hospital profits are low. Fact of life.

I am a fairly new nurse, but an older one, and I have come into this with eyes wide open. I still get surprised, but I have found a way to be the nurse I want to be. I get to know my pts the best I can and I probably talk to much about myself, but my pts like me and appreciate me. They tell my boss that and that helps a little with the stress. Do I get stressed? yes. Do I think conditions could be better and safer? you bet.

I think it becomes a waiting game because the "abusive" ones don't last long. They are job hopppers, unit-hoppers, etc. I am learning which people I can trust and which ones to take with a grain of salt. There is a lot of resentment, I think, because to some, nursing is not what people expect and they are stuck. Again, very similar to education. As a person forced to make a career change in my late 40s, it is never too late to change your mind. If nursing is not what you expected, either learn to accept what it is and what it isn't or find something else to do.

[HouTx, BSN, MSN, EdD]

I blame a lack of effective nursing leadership. These people are responsible for creating and maintaining an environment that supports nursing practice. They are completely missing the mark. I wonder if they have any conscience twinges when they cash those executive bonuses??

[LakeEmerald]

Honey,

Thank you for your heartfelt and honest post. Many of us feel the same way. You said it so eloquently. Just know you are not alone - many of us are out there, smiling and trying to care, too, with a list of tasks weighing on our shoulders. Taking an extra second for an extra squeeze of the hand and a, "I wish I didn't have to go" sometimes suffices for the pt.

As far as abuse, there are those who will try, but I refuse to let their evil in. Why let their twistedness ruin my day? They are the one with the problem. Thanks again for the post. You put into words my feelings about my "time crunch nursing" so clearly.

[wooh, BSN, RN]

I think it's just nursing is full of a bunch of pansies expecting rainbows and unicorn farts.

Work is hard. If it wasn't, we wouldn't get paid.

If you go into a profession EXPECTING it to be tough, and it is, expectation met, no disappointment.

People go into nursing expecting it to be a never-ending wonderland of rewarding feelings from helping grateful people. Then it's tough, expectation not met, disappointment and complaints.

It's not that nursing is a problem. (Don't get me wrong, we have problems. But not really more than other jobs of similar responsibility versus education levels.) It's the expectations people have going into nursing that are the problem.

[futureeastcoastNP]

Love your post, OP, and you're absolutely right! Nurses do NOT try to change things, they all just have the mentality that it is what it is and that you're supposed to be miserable. Look at ANY other profession that requires a bachelor's degree and you will see a lot more professionalism and respect.