An open letter to the #NursesUnite movement

[disillusionedrn]

An open letter in response to #NursesUnite:

It is amazing that you have finally found a cause to unite over (#nursesunite), however, I find it hard to jump on board this superficial bandwagon that actually serves the nursing profession no purpose whatsoever.

I have pondered over the last week why it is that so many nurses take such offense to the few words of an ignorant television host, being that Ms. Behar has zero impact or influence on the healthcare profession or the role of nursing, yet they do nothing to end the many real issues plaguing the nursing profession.

The only conclusion that I can come up with is that nurses feel that they can't do much to change the real problems in nursing, so they unite and attack over something that really makes no difference at all to us as a whole.

There are so many other REAL aspects of the nursing profession to unite over to influence change that will actually make a difference to nursing. There are many "dirty secrets" of nursing that go unspoken and ignored, many of which are cultivated by nurses themselves.

Bullying, horizontal violence, inadequate training, nurses "eating their young", 12+ hour shifts, no breaks, high acuities, too many patients per nurse, etc.

I went into nursing because I like to help people. I am empathetic. I am a quick thinker. I am smart. But that isn't actually what makes a nurse successful in this profession, as I have come to find out. As I have come to find out, nursing has less to do with how competent or compassionate you are, and more to do with how much you can, or are willing to, put up with. The nursing culture is full of "suck it ups" and "oh well, it is how it is."

What seems to make a nurse successful is the ability to withstand bullying, intimidation, being talked down to by supervisors, patients, family members, and doctors. The ability to get over inadequate training and support provided by management and your peers and to be okay with unsafe patio to nurse ratios. You'll feel more confident in time, it's just a part of nursing.

To be successful in nursing, you have to be okay with having zero time to take a break (even a bathroom break) and most times, taking your lunch sometimes 8 hours past your start time, or sometimes not even getting a lunch. You have to be okay with being dehydrated while hanging patient's IV bags and shaking from not being able to take a break and eat while you are checking diabetic's blood sugars and teaching the importance of proper urinary hygiene to avoid UTIs while you've been holding your own urine for the past 5 hours. Nurses are expected to just be okay with it. It's just a part of nursing, right?

You have to be okay with coming in early to "get familiar" with your patient load and not getting paid for that time. You have to be okay with staying well past your shift to give report on a regular basis, taking your total time on the clock (and off) well into 14-15 hours, which means that you are so tired driving home that you hope you make it there without crashing because your brain is tired mush. But long shifts are just a part of nursing.

You have to be okay with having to do more with less, even if it affects patient safety and outcomes. You have to be okay with doctors yelling at you and treating you like you're an incompetent idiot rather than a professional colleague in health care. You know that if you call a doctor to clarify orders or to update on your mutual patient, you may be met with disdain and sarcasm. But that's okay too, because it's just a part of nursing.

Nurses know this to be true. Nurses know these are the dirty secrets of nursing. Nurses know that bullying is rampant. Yet, the answer to this problem is "grow a thicker skin" or "you'll just get used to it".

Nurses know that understaffing is a given and that high acuity and high patient loads per nurse is more common than not. Nurses know this isn't safe, they know the care being given isn't what it should or could be, but they do not unite together against it and demand change.

Nurses know that there is often a lack of adequate training and preceptorship for new grads and new employees entering new specialty areas and that too many times nurses get thrown to the wolves and it's a sink or swim mentality. But, this is just a part of nursing we accept.

Nurses know this. They live it. They experience it. It is the culture of nursing. Yet, there is no call to end it. No hash tag. No selfies. No viral campaign on social media. No standing up to it. Just the continued mentality that these things are just a part of nursing that you have to accept or leave.

So, instead of uniting together against something or someone that has no impact on nursing, why not stand up and unite against the things that are killing the nursing profession and demand they change?

Sincerely,

A disillusioned nurse

[Laurus Nobilis]

Amen!! You summed up what I've been feeling and thinking about the whole Joy Behar debacle and my experience as a RN. Thank you, thank you for putting this out there!

[dleechpn]

I recently retired from nursing for many of the reason you bring up. I had planned to work to 65, but left at 62 after working 10 hours, seeing 7 hospice patients, driving 161 miles and being told at 1645 that I had an admission to do which would take another 5 hours and another 50 miles, and would not be considered overtime. I gave my 2 weeks notice the next day. The focus was not on the patient, who was stable and in a facility. The focus was not on my safety, or public safety related to having an overworked tired nurse on the road. The focus was getting census numbers up. I truly miss my patients and co-worker who are wonderful caring people, but do not miss management. I've been management and know the pressure they are under, but the focus has to be those who are on the front line, not those in the ivory tower.

[rn777]

I think you are missing the big picture here, which is the idea of nurses being united around an issue. There are many issues in nursing that need to be addressed, but nurses need to start somewhere. Starting with this issue does not exclude addressing the other issues you mentioned. Nurses can and should use this momentum and this issue to unite and address other problems as well. It's a good thing, separating yourself from the movement does not help.

[Catcar1963]

Exactly! It IS possible for nurses to have a say in their own professionalism and get the respect we deserve. Someone needs to start a new hashtag movement, uniting for the betterment of the nursing profession as a whole. #respectnurses, #nursesdeservebetter, #happynurse=happypatient

[EiEiO_55120]

I suspect the real problems in nursing are the reason behind the outcry. Although we shouldn't expect a pat on the back for our martyrdom, it does sting particularly bad to have the utter disrespect for our profession broadcast by public figures.

[SC_rn4]

While I do believe there were some good points made in this letter, I have to say I also disagree with a few things. As another commentor previously stated, you must take a historical perspective to the field of nursing and see just have far it has really come in promoting best practice and patient saftey even just in the past few decades. This shows there are dedicated professionals working together for change - and that the change is sticking.

I think the biggest problem I have with this letter is that the cause keeps getting dismissed as "superficial" or diregarded because it doesn't address the real problems of the profession. Were the comments of one TV show host uniformed and disrespectful? Absolutely. But this movement that has spawned out of those comments actually shows how the medical community can unite. Look at the posts that go with the hashtags, glance through the pictures on the Facebook groups. You will see not only RNs, but medical assistants, physicians, patients ect. showing their support for the nursing community. As you say in the letter, nurses are "talked down to" on a daily basis - this group should be a comfort to you. It shows that physicians really do respect and rely on their nurses and medical team. It shows that you really do have an impact on the lives of your patients and their families. No, this may not be an act of Congress and it may not move mountains in the medical field. However, I do believe it shows a united front and that in itself is a positive outcome.

[RyzenRN, ASN, BSN, MSN]

To RN777- This was my point as well. Thank you.

[SEAJULES]

I cannot agree with you more disillusionedrn!! I think bringing attention to the stethoscope controversy does nothing for nurses. I too went into nursing wanting to make a difference because I knew in my heart that I love helping people. I love the science behind diagnosis and investigating. When I graduated with my associates I was accepted into a program for novice nurses at the local hospital. I unfortunately had to take a position which really didn't interest me but thought this is a way to get my foot in the door so to speak. This particular floor the nurses were accepting and real team players. We had to count on each other. After a year there I decided to bid for that med surg job I had wanting since I started nursing school. I was the one whom got the position only because I had the most time vested. The first thing out of the nurse managers mouth was, "you realize this is a med surg floor?? Because I started on a psych floor I guess this made me less valuable. I was so excited to get started and was meet with bullying, pushy supervisors whom at ever chance would point out my mistakes instead of taking a genuine interest in my future as a nurse. There was no regard to anything positive that I did, only the negative. As a novice nurse yes I made mistakes, but instead of trying to help me and take me under a wing, I pushed to resign!! I completely understand what you are saying about bullying and intimidation. I have been wanting to write a similar post since I started at that hospital!! I brought it to their attention that I wanted to get more experience in the med surg not psych and was left defeated and dissatisfied. Thank you for starting this conversation and it should be shared!! What makes a good nurse? My thoughts, such as yours is having empathy and compassion with your nursing education. Where are the experienced nurses who care enough to take someone under their wing?? I would voluntarily work with one whom could teach me everything she knows and she would carry on a legacy knowing she helped in their career. Are they out there?

Lets keep this conversation going.

[ketchasketch_RN, ASN]

I disagree with the ballyhoo toward the view and I also disagree with the post set forth here. Nursing is hard... deal with it. I have been in nursing for 20 years... ER, med surg, geriatrics, hospice, and now, home health. I have never been bullied and I always try to do the best I can to get ahead. I have faced my overtime and being tired at the end of the day. But I knew this coming in. In fact, I expect it. Otherwise it would not be nursing. The reason we, as nurses, get so much praise from others is because our job is so hard and we do wonderful things... for the most part. I love my career! And I am not disillusioned!

[miszsantiago]

Well said, and I couldn't agree more. You don't need a movement to stand up for rights that you are already entitled to. Stand up for yourself.

[cacwell]

Unionization does nothing to solve these issues... I've been down that road and all that a union does is add another level of bureaucracy that looks out for itself and not the individual nurse. Like it or lump it, true change in today's world (at least in the US) requires a strong group of lobbyists to convince the government that what we do is valuable (for a good example see the AMA and everything they have done for the doctors over the years). Else-wise, the hospitals will continue to do the math and realize that with the new HCAPS reimbursement system, it makes more financial sense to improve the quality of food than it does to actually staff enough RNs.

Oh, and PS: just wait till this $15 minimum wage comes through... the hospitals will either have to lay off support staff ("environmental", food services, clerical, etc.) or staff fewer nurses... in the end you know that it will be the nurses that are expected to pick up the slack.

[SC_rn4]

It has already gained momentum and nation attention - why not jump on the bandwagon and use that attention to push your platform of "real change" for the nursing profession. That seems more logical to me that slamming this movement. Especially considering that fact that it sounds like you want issues in nursing to come to light and not continue to be shoved under the rug.