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.
And would of the "us" be willing to BRING that leadership?
Whose to say it's NOT happening.
One thing is for sure; people can look one event and each person can have a different perspective.
We can all bring leadership, no matter what our role, whether that is providing preceptorship, improving the culture where we work or more formalised activism or academic writing.
But who brings in the money? Who sells God, faith, love, hope, etc…to the masses?…NURSES people. I believe nurses are genuine and have these intentions.
In nursing school we are sold this kind altruistic ideal of nursing….and most that go into nursing have good motives. We are sold this is how we should think of our profession…spreading love…but no one questions all the effort we put in and at our own expense. This abuse culture is ingrained from jump street of nursing school. We should be focusing on bedside patient care not fighting with management for long term positive outcomes for our patients and for our own profession. We are not taught to look out for our selves…and in the long run look out for our patients.
We are not taught to love our patients, nor is it our job to spread love and god. I would not want a nurse that espouses those things to me. I want a competent, skilled nurse. Not a Touchy feely nurse.
I realy think that the nursing schools are to blame for this "disconnect" between nursing reality and the ideal world of some peoples nursing. The schools love to preach this holistic mumbo jumbo, back rub, nursing thoerorists type of nursing. Well guess what...the world is a technical, detail driven place that is comprised of tasks and machines. Nursing is now a very technical field, more so than ever before. Nurses have far more responsibility and duties than any previous generation of nurses. There was a day og the hand holding back rub nurses, but look at the mortality rates of those days compared to today. we do more to get the patient better than any previous generation but the schools are still stuck in the old mode of thinking.
We can all bring leadership no matter what our role, whether that is providing preceptorship, improving the culture where we work or more formalised activism or academic writing.[/quote']
Thank you for proving my point.
We can vent and stew, or formulate what can be improved and DO something about it; this can be done at the bedside; the work done can be formulated and proposed for academia, or join your local nursing chapter and network, or reach out to a nursing union; grass roots style.
You can't state nothing works when there are plenty of avenues conductive to change; change does occurs despite challenge; it has in the past, it is occurring now, and it will be available in the future.
I know how change works and have helped shape my workplace; through education on a subject of a disorder a pt had, to actual policies and a preceptorship program, it wouldn't have happened if there is a so-called "abuse culture", yet people are inclined to beeline that, and I'm not, because if that was the case, or expanded roles would have NEVER occurred, including nurse execs.
We are not taught to love our patients nor is it our job to spread love and god. I would not want a nurse that espouses those things to me. I want a competent, skilled nurse. Not a Touchy feely nurse. I realy think that the nursing schools are to blame for this "disconnect" between nursing reality and the ideal world of some peoples nursing. The schools love to preach this holistic mumbo jumbo, back rub, nursing thoerorists type of nursing. Well guess what...the world is a technical, detail driven place that is comprised of tasks and machines. Nursing is now a very technical field, more so than ever before. Nurses have far more responsibility and duties than any previous generation of nurses. There was a day og the hand holding back rub nurses, but look at the mortality rates of those days compared to today. we do more to get the patient better than any previous generation but the schools are still stuck in the old mode of thinking.[/quote']
Hey! There's time for some back rubs and all of that, lol...within reason.
And if anything nursing theory-Novice to Expert IS measurable, so nursing theory is applicable, as well as many others in terms of approaching our pts.
Objectivity, I say, expansion of beyond the "cog" feeling as a novice nurse does occur.
You do this job for 27 plus years you do realize you are just a cog in the machine and you are replaceable skilled or not.[/quote']
Ahh, philosophically that's the world we live in...there are many forces that attempt to make us feel that way. I'm inclined to not feel that way. The world keeps turning-and it will...nothing changes that; in my lifetime, my objective outlook has made me understand that; that's why approaching life objectively has made me cope; even if it's me that is replaceable, I will find myself in another position or doing something else with satisfaction. We all have options and are the captains of our soul, as one poster on here put very succinctly on another thread.
One thing I learned (or relearned) as a DV survivor is that I DO have a choice. The choices I made was in retrospect to my career and had not lead me to burnout is that objectivity and the said perspective. I will always find satisfaction in what I do, nor will I diminish what I am able to do,
There's bullies too. I think nurses are more abused by their patients than by anyone else and it is not right either. I am verbally abused every shift. I have been physically assaulted a few times. I dont know if it's my floor or what, but I am starting to think there are more nutty people in the world than normal people, based on my clientele! The hospital definitely gets their money's worth out of me and plenty more. Florida nurses are not paid enough, and dont tell me the cost of living is lower here because it is not, Ive lived in CT all of my life and gas, milk, bread, electricity costs the same. Depending where you live in FL rent is the same too. I am still living pay check to pay check. I made more money waitressing. I honestly would rather live on a secluded tropical island with nothing but a hammock and just lay there, do nothing and have nothing and have no one bothering me. I feel like crying now thinking about going back tomorrow!
The problem is that nursing school shelters us, especially the Bachelors programs, with the 2x 6-hour day clinicals with a long lunch and "post-conference." By long lunch I mean anything greater than 30 minutes. Class, homework, and discussion take up the majority of your time and focus (can't speak to ADNs or ASNs curricula). And in those short clinicals when things do go wrong, you can either grab your instructor or the nurse in charge of the assignment. There is a disconnect between the student nurse and the true accountability and responsibility of the registered nurse. That disconnect is shatter with your first job. And really it shouldn't be too bad when you're on orientation, since you have a preceptor, it's once you get off that it should scare you.
I'm at a crossroads here, having read this point (which echoes some of my new grad feelings) and Ruby's (which echoes the frustrations of preceptors and floor nurses putting up with faltering new nurses only for them to leave soon) because I do want to progress to another floor after 1-1.5 years of employment. It seems more encourage me to do what's best for me then not, but I do feel guilty now that my preceptors will feel they worked for naught.
The problem is that nursing school shelters us, especially the Bachelors programs, with the 2x 6-hour day clinicals with a long lunch and "post-conference." By long lunch I mean anything greater than 30 minutes. Class, homework, and discussion take up the majority of your time and focus (can't speak to ADNs or ASNs curricula). And in those short clinicals when things do go wrong, you can either grab your instructor or the nurse in charge of the assignment. There is a disconnect between the student nurse and the true accountability and responsibility of the registered nurse. That disconnect is shatter with your first job. And really it shouldn't be too bad when you're on orientation, since you have a preceptor, it's once you get off that it should scare you.
I'm at a crossroads here, having read this point (which echoes some of my new grad feelings) and Ruby's (which echoes the frustrations of preceptors and floor nurses putting up with faltering new nurses only for them to leave soon) because I do want to progress to another floor after 1-1.5 years of employment. It seems more encourage me to do what's best for me then not, but I do feel guilty now that my preceptors will feel they worked for naught.
That's another thing I find interesting - why do floor nurses get one 30 minute lunch over a 12 hour shift? Many other professions have an hour long break...and they only work 9 to 5. And it seems for many nurses, even that 30 mins is a luxury. Yet another mistreatment of nurses that I think needs to change - you can't only eat one every 12 hours!
futureeastcoastNP - I am sometimes jealous of desk jobs for their scheduling and breaks. I don't know if I would feel comfortable stepping away from my patients for too much longer than 30 minutes at a time. Usually I don't even take the full 30. Maybe that's just new grad insecurity, but where I work I've noticed that the patients often have a pretty high threshold for decline. On top of that, there are frequently changing orders or serial labs even during the down time of night shift. Our documentation is micro- (HA, more like femto-) managed and scheduling my time with the single CNA's time to get the baths done is usually impossible. Sometimes I'm not sure if the "time management" skill gained during the first year of nursing is even possible with the amount of additional work being shoveled onto us.
Anyway, I look at it like this: the harder your first year is on you the better off you'll be going forward. Sounds harsh but you gotta have the right attitude. As far as "abuse culture," I can't really comment. My coworkers are mostly great and I'm very lucky to have them. There are several younger nurses to relate to on my floor among the older ones which is nice. The older gals are all very supportive and kind, and I really try not to nag them too much through the shift. There are some staff who are kind of nasty or at the very least apprehensive towards me. Usually I'm not sure if it's because of me, or if I'm reading into it. My approach is to go about my work and maybe try to do them favors or ask if they need help at any time. Giving an extra butterfly here, pulling up a patient there, setting up their room for an admission. It's crazy how actually being a team player can affect peoples' opinions of you
futureeastcoastNP - I am sometimes jealous of desk jobs for their scheduling and breaks. I don't know if I would feel comfortable stepping away from my patients for too much longer than 30 minutes at a time. Usually I don't even take the full 30. Maybe that's just new grad insecurity, but where I work I've noticed that the patients often have a pretty high threshold for decline. On top of that, there are frequently changing orders or serial labs even during the down time of night shift. Our documentation is micro- (HA, more like femto-) managed and scheduling my time with the single CNA's time to get the baths done is usually impossible. Sometimes I'm not sure if the "time management" skill gained during the first year of nursing is even possible with the amount of additional work being shoveled onto us.
I think that's exactly the problem. Too many nurses think that it's up to THEM to ensure patient coverage/monitoring during their breaks, when it's not. Breaks are mandated by law - full breaks, away from the workplace, with no disturbance. MANAGEMENT has to ensure that things are covered while the nurse is gone. I think too many nurses take it upon themselves to take short/no lunch break, and management allows the practice to continue because it takes the stress off of them.
My mother was a high school teacher, and she is always telling me how similar the two professions seem...same problems and issues. Whenever I tell her about my bad day, she'll be like, "I'm sorry to compare it to teaching again..." I will have to share your post with her.
kungpoopanda
215 Posts
We can all bring leadership, no matter what our role, whether that is providing preceptorship, improving the culture where we work or more formalised activism or academic writing.