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

[Fieldenleehs]

I really appreciate your letter.

[cacwell]

We already pick up the slack, and yes, I'm currently at one of those hospitals who treat nurses like disposable commodities. It's wrong. If nothing else there should be laws in place mandating required personnel needed to care for high-acuity patients. Corporations are making money hand over fist. The laws need to be changed. Why would anyone take or job or stay at a job when they make $12 an hour? Ever try to provide for a family on that wage? I haven't and I can't imagine even trying. The reason nurses have no representation is because they have accepted some of the deplorable conditions and condemn any movement for change. It is a shame

I agree... there should be laws mandating staffing levels, which is why we need lobbyists and not Unions.

As far as corporations making money hand over fist, I'm not so sure anymore with all the changes in reimbursement.... for instance: hospitals not getting paid for: readmission based on factors that are out of their (the hospitals') control; central line infections, UTIs secondary to catheterrs, etc. Money is getting tighter.

As far as the 12 bucks an hour thing: yes I have taken care of a family on less than $12/hour, which is why I went to nursing school :)

[herring_RN, ASN, BSN]

Some of the selfies in the Show Me Your Stethoscope group- eek. Not all of them, or even most of them. But a few of them.

Advertisers are pulling their sponsorships, so it's definitely making an impact.

The View: Advertisers Exit After Miss America Nurse Monologue Joke Backlash : People.com

I agree, it would be amazing if we could get nurses to unite for safe staffing.

There is a Senate bill and a House bill already introduced. I've written to thank the sponsors and co sponsors. If enough nurses lobby their elected senators and representatives they may move forward. This means emails, phone calls, letters, and for true activists a visit to the local office to educate the staff.

Senate Bill Summary: https://www.congress.gov/bill/114th-congress/senate-bill/864

Text: https://www.congress.gov/bill/114th-congress/senate-bill/864/text

Co Sponsors: https://www.congress.gov/bill/114th-congress/senate-bill/864/cosponsors

House bill. This link includes so letters from nurses. it is a shame there are so few: https://www.opencongress.org/bill/hr1602-114/show

[NurseDiane]

I read that after the windbags on "The View" trashed nursing, 5 advertisers pulled out from their show: Johnson & Johnson, Eggland's Best, Party City, Snuggle, & McCormick. They're all big companies & to have them pull out is HUGE for ABC. It could cost them the show if they can't get sponsors. That is the ONLY reason they issued an insincere apology---they were told by ABC executives that it was an apology or their jobs. I am sure the ABC execs were as made as hornets when they lost those 5 advertisers. Behar should have been fired on the spot, along with any others that fed into her brainless rhetoric.

I would love to hear the opinion of Meredith Viera, whose husband has been suffering with MS for decades. She probably has more experience with nurses than any of those pig-faced losers. There's a reason why Viera moved on in her career & Behar is sitting her fat ass back in the seat at "The View": Because Viera doesn't put her foot in her mouth in an effort to make a joke. Behar is not funny----she's an old, burned out stand-up comic who never did well. ABC must have been desperate to fill that seat left by Rosie Perez. Who would want to be on a show with Whoopi Goldberg (she should have stayed an actress instead of a talk show host), Raven Simone (who is as dumb as a stump), and the others who I don't even know.

There's truth in the saying "What comes around, goes around." There is going to come a day where Behar, Goldberg & the rest of them end up in a situation where they need a nurse---whether that be in the ED, the OR, PACU, or elsewhere. Will they then believe the same crap they spewed on TV? Kharma ladies---it's real.

Here's some news for the brain-dead hosts on that rapidly declining show: Many experienced nurses have just as much, and sometimes more, knowledge & common sense than physicians do. Many times, in teaching hospitals, its the nurses that train the residents----there's a saying in teaching hospitals "Don't piss of the nurses. They can make your job a walk in the park or a walk through the gates of hell. They can be your best friends or they can be your worst enemies. The choice is yours. Carry on."

Hey, Joy Behar---we wear a stethoscope around our necks not for looks or wearing a costume, but because we are the ones that continuously monitor the patient's cardiac & pulmonary status. The doctors don't stay & monitor the patients 24 hours a day----they rely on what the nurses tell them about the patients.

Hey, Behar---Nurses catch errors in medication orders that doctors make ALL.THE.TIME. Nurses catch near-misses in the O.R. when the surgeon wants to operate on the wrong side of a patient's body or do a completely wrong procedure.

And guess what, Behar? Nurses even inject Botox, which you happen to L-O-V-E, nurses do laser procedures & nurses first assist in your plastic surgeon's office doing face lifts. They also give the anesthesia so you won't feel pain during your face lift & tummy tuck procedures.

[NurseDiane]

You hit the nail right on the head. Bravo.

[NurseDiane]

My response to that would have been "I'll do the admission, but I want to call the Department of Labor first to see if forcing me to work about 5 extra hours without overtime pay is legal." I would have done that instead of resigning. You would have gotten a much different response from your employer. You can only be taken advantage of if you allow yourself to be taken advantage of. It's true.

As I always say----FOLLOW THE MONEY. Employers DO NOT CARE about their employees, particularly healthcare companies. And home care companies are even worse than facilities. They EXPECT their nurses to do whatever they say because they are usually run by nurses on a power trip because they own the company. They will suck the lifeblood out of you, and when there's no more blood, they'll move on to somebody else & kill them the same way.

[Ruby Vee, BSN]

Quote from shermrn

I haven't noticed much of an uproar from nurses over the whole planned parenthood issue and the videos that have been released. It's sad that comments from Joy Behar, or the killing of a lion, draw more attention than the deaths of untold numbers of infants.

.

Although abortion and Planned Parenthood are grossly off-topic to this particular thread, you'll never be hearing an uproar from me regarding those issues. I am fully supportive of Planned Parenthood's efforts and feel that their clinics should be located in every city and town in the US.

I am also pro-choice, although I respect the views of those who identify as pro-life.

Pro-choice here too.

[ChrisRN2015]

I'm going to disagree to some extent. I think the Joy Behar debacle is probably the best thing that could have happened to nursing. The reason? It showed us as nurses how powerful we are when we unite. All of the things you listed that we struggle with in the nursing profession are the stumbling blocks that prevent us from speaking out. We feel powerless- otherwise why would we put up with these conditions? But the silly comments by an ignorant woman on TV ignited a fire in nurses. Probably for exactly the reasons you mentioned in your article. We do put up with so much that how dare anyone minimize or marginalize our profession? And because of the overwhelming response from nurses and doctors across the country I think now we have the impetus and the support to really start looking at issues within nursing that need fixing and to do something about it.

[ElizethSloanDavidson]

This post speaks exactly my feelings on this topic. I'm currently in the dissertation phase of obtaining my PhD and bullying in nursing is my topic. I sure hope we as a profession can come together to stop this problem! Because it is eating us up from the inside out.

[Bat Lady]

As a nurse, I worked with my union. We were constantly trying to address many of these issues. Progress has been made, but you have to have a historical perspective. When I started working, there were no safety devices for needles, no universal precautions, no mechanical lifting devices, state staffing ratios, family medical leave, etc. We now have classes on bullying and how to combat it. In California there is a campaign to address workplace violence. I didn't feel helpless because I was always working on solutions.

This is lovely, until you spend your entire working life in right-to-work (or as my late husband was fond of calling it, "right-to-slave") states. When I applied for my first job, I was told flat out that there were no unions, and that if I was caught trying to organize or in any way promote union activity, I would be fired (this was in the 1980s). Union organizing or activity was similarly frowned on, though not so explicitly forbidden, at all other hospitals and agencies where I worked during my career. When I worked as a traveler, I once had an assignment at a hospital in a state where unions were a routine thing. This hospital had a nurses' union, and I could see where it definitely benefited the staff. Of course it did nothing for us travelers.

[NurseDiane]

First of all, there is no way an experienced nurse could teach you "everything she knows" because it would take as many years as she's been a nurse to teach you those things. You have to build up your own "experience bank" & you can be an experienced nurse too. A nurse can only "take someone under their wing" for a certain period of time, and then that person has to fly on their own. It is exceedingly difficult to precept a new nurse who wants the experienced nurse to "show them everything" without the new nurse taking any initiative to do things on their own.

I sometimes wonder if new nurses are expecting too much in their training period. It seems to me that many new nurses want their hands held for much longer than necessary. I do not disagree that "mistakes" made by new nurses are overly criticized by management----but, when those mistakes are major, like a med error, they need to be strongly criticized. Not paying attention to the minor mistakes can lead to major mistakes & sentinel events, which are major issues.

Plus, those "experienced nurses" most likely have certifications for doing extra work outside of their required jobs. They put in some time of their own away from work to take classes, study & take certification exams to further their own knowledge. You can do this too---you're never prohibited from doing that. In fact, to work in critical care areas, you NEED certifications in advanced cardiac life support & critical care nursing (or emergency nursing or trauma nursing or flight nursing or post anesthesia care nursing, etc.). Relying on other nurses to "teach you everything they know" and not showing any motivation to learn extra things on your own reflects poorly. I know that you can read a book about nursing related tasks---putting in a Foley cath, irrigating an NG tube, etc.---but it is totally different than doing it.

I also wonder how much nursing school is responsible for putting out nurses that don't know what they're doing. I know in nursing school----it even happened in the late 80's when I went to nursing school---that you're given a couple of patients to take care of with one of the staff nurses & that's it. When you get out into the real world, and find out that your patient load is 10 or 12 for the day, you don't know what to do. The biggest issue is time management---the other "tasks" can be learned. But if you can't manage your time, you're in big trouble. Sometimes, that is something that cannot be taught & you have to learn it on your own.

There's also this: The "orientation" period that hospitals offer now differs greatly than what used to be offered. Gone are the 12 week orientation periods with a preceptor. Hospitals do not want to pay a nurse who isn't going to take an assignment & is essentially being paid to do nothing. Hospitals are now stressing "one year of experience". So, what the hospitals want is someone that worked someplace else for a year or two to have a sudden change of heart & go to their hospital for a job so they don't have to give them an orientation period. The whole thing is rather ridiculous----but they sure make sure in the orientation period that the nurses do get that they give out the "script" about what to say to the patients for a better "patient experience". Hospitals want nurses that can put their feet on the ground and run---they don't want nurses that put their feet on the ground & fall down. That doesn't earn the hospital money. Hospitals do not subscribe to the "you have to spend money to make money" way of thinking. Their way of "spending money" is fancy landscaping, a new facade on the entry, valet parking. A hospital out by me actually has a mini grape vineyard---yes, you read that right, a grape vineyard---in the front of the hospital. Every time I pass it I chuckle a little to myself. They don't spend the money on internal staffing because that does not impress the public----the public doesn't know if there are 2 nurses working in the E.D. or 20. But the public sees the fancy landscaping & grape vines, and thinks it looks "so nice", and that "the hospitals must be doing well if they can afford to do that fancy landscaping". Yeah, right.

[jrbl77, RN]

I agree with most of what you say and you say it very well. I for one am tired of being told what to do, how to do it and what will happen if I don't do nursing a certain way. I have made my voice heard to administration with no response, only more added tasks. My goal as a nurse,was always to give the best care that I could! My goal toward the end of my nursing career is now to get out alive! I have true concern about the state of healthcare in our country.