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

[nurseluckett, MSN]

@ Ruby Vee and disillusionedrn

I've been in nursing 25 yrs I've seen both of what you speak of. I believe this sparked the debate because nursing has been disrespected by the media, TV and others for decades. It's like when you can talk about your family but you won't let anyone else talk about them. Either way nurses have found their voice and now know we have influence if we unite.

[PumaAngel]

I love this and have been thinking about it for a long time. I actually left a message somewhat like this on the facebook page only to have it removed. I think the reason this took off the way it did is that this is something nurses can take their growing frustration out on and it is relatively safe with no potential retribution. Let's face it, if we do stand up and try to get better working condition and actually expect to (gasp) be treated with respect there will be a push back and it will not be pleasant.

[rachel100639]

By posting your letter, you are doing much more than you are probably aware. It is NOT you who is the problem - your letter is simply the truth that many other nurses are in denial about; e.g., Ruby Vee up there who continues to blame you and others like you who have the courage to speak up about what is clearly unacceptable work environments in the ways you mentioned (and many more you did not mention). It IS the hierarchical, top-down system in healthcare whereby nurses are at the bottom of the heap and are indeed rendered powerless. Because there is no one else to vent their anger and frustration on at being treated with such contempt and disrespect by not all, but many co-workers, physicians, managers, patients, patients' families, the state boards, etc., they attack each other (I believe it is mostly unconscious) via withholding support, backbiting, cruelty, bullying and downright viciousness. It starts at the top (the military is this way). Lots of trauma inflicted on nurses, then nurses are blamed, as you say, for not being able to "take it" and just need to "pull themselves up by the bootstraps." As Ruby Vee insinuated, hey, all of this is your imagination! I have no problem with any of it - haven't experienced anything out of the ordinary and frankly, I just don't know what you're talking about! Translation: There must be something wrong with you. The ol' blame the victim mentality.

Study after study in the past ten years or so have shown that these kind of top-down environments are toxic, create resentment and breed contempt towards those at the "bottom" of the pecking order. In addition to being a nurse (although I simply refuse to do bedside nursing or really any nursing anymore because of all the things you discussed as well as what I have touched upon here), I have two other careers. The huge amount of negativity, meanness, hostility and bullying I have experienced AND witnessed in nursing over the years versus my other two professions is astonishing. I am the same person, of course, in all three professions, but in the latter two I am treated with respect; work with colleagues as equals; my ideas, creative input and projects are appreciated; it's a lot of fun, and my God! I eat when I am hungry, pee when I need to, and because I am an adult, I DO NOT have my time micromanaged by anyone or anything, like for example, the humiliating punch of a time clock. If you've been a nurse your entire adult life without the perspective of being in an entirely different, more respected (as it should be!) career, you might wonder what I am talking about. If I desperately need money (hasn't happened in a long time) I temporarily (very temporarily) do a bit of nursing. The times I've had to go back, I am shocked and disappointed each time by the nurses' lack of civility, and sometimes blatant hostility toward each other. It's like a giant bucket of ice water has been thrown at me. I make sure I never stay long enough to get used to it.

[Tommy5677]

Thank you, thank you, thank you... For having the courage to write this. I'm in total agreement with everything you said here. One of my nursing friends on FB (also an actual coworker) tried to turn this into a left wing vs right wing issue. First of all, I really like Joy Behar but I don't give a **** about anything she has to say about nurses or nursing. I quickly pointed out to [her] how the CNA singlehandedly brought down Arnold when he tried to destroy their nurse/patient ratio law. I'm sick and tired of nurses blaming everybody but themselves for our woes.

I just retired after 35 years and believe me when I tell you I hated every minute of it. One of my biggest issues with nursing management is their need to protect their own ass by aligning with management instead of taking care of their own. Nurses are their own worst enemy and I used to blame it on being a female dominated profession. Then I look at what physical therapists have done (another female dominated profession) and know I can no longer do that. They are taking control. There is so much we can do but we don't and it all boils down to poor leadership. We allow ourselves to be at everyone's mercy. How can I in good conscience encourage our young to become nurses given just the few things you've cited here as problems? I can't.

I could go on and on here but I'm so happy to be over and done with it. Good riddance.

[Tomascz, ASN, RN]

signed

https://petitions.whitehouse.gov/pet...patient-ratios

It's going to take a single payer health system and removal of profit from the picture to get this changed; but what the hell.

[Baby'sPDN]

The 'Show me your stethoscope' Facebook page has become less of a 'woman of The View bashing' & more of inspirational, uplifting & sometimes heart wrenching stories that nurses, EMTs & even doctors are sharing. Many are stories of a nurse going through a difficult time & I think it's amazing to have a group rally around you for support. The #nursesunit movement may have started by ignorant words but has turned into so much more!

[guest64485]

To the person who said clocking in is humiliating, being 'exempt' is not a position you want in floor nursing. That's all the more incentive for management to overburden nurses into unpaid overtime.

Ruby, while I agree with a lot of your post, I am sure you aren't oblivious to the fact that there are poorly staffed floors/hospitals which make providing good or even safe care difficult, and that this is a widespread issue in part due to lack of ratio laws. (For some reason it seems Florida always comes up as really bad nurse-patient ratios, like 7-8 day shift med surg patients bad). The vast majority of nurses don't have near the experience you do, so of course you should be handling shifts better than them. Blanket statements that nurses who stay late (the price they pay for wanting to do the best they can for their patients... especially in the conditions I mentioned) just can't make it in nursing is simply not logical. Lack of mandated ratios is absolutely a nursing profession issue.

[Bat Lady]

The ANA is out of touch with the bedside nurse.

^^^^^^^THIS^^^^^^^^^^^^

[sleepingbeauty1651]

I sometimes work 15 to 16 hour without having a break, we don't even have a break room!! Even a toilet break is seen as an absolute necessity. On top of this we are constantly bullied and threatened with disciplinary action.

Usually our supervisors,managers were floor nurses themselves, and things that they wouldn't tolerated, they are now enforcing.

There is a lot of house cleaning needed, but fear of being fired or disciplined prevent nurses from speaking up. It is easier to respond to Joy Behar that to complain within our respective organizations.

[Munimula]

Personally, I have never liked "The View" and their political leanings, but, again, that's my own business. As far as the few comments they made regarding the Miss America nurse; who cares? Was it unkind and ignorant? Yes. I feel that these days everyone on television wants to be snarky and sarcastic a la Howard Stern. Who can be the most sarcastically funny? For these people, it fell VERY flat. Also, as a 50 year old perspective (UGH, it hurts to own up to that), everyone needs to slow their roll a little because it's getting very "Lord of the Flies" in here. I mean, everyone is way to sensitive. I have yet to encounter a single person in my personal life who does not respect and hold in high regard nurses. Most people I meet say, "I don't know how you nurses do what you do." So, people may not entirely "get it", but, they get it.

[NurseDiane]

Nurses will not change anything because we are not the source of any income for anybody. The only reason that big pharma, the AMA & the government listen to doctors is because they have the ability to make money for the companies. Nurses don't. It's just like a situation where a doctor harasses a nurse in a hospital----nurse reports it, nurse gets fired, doctor stays & goes on to harass other nurses. The reason for that is because doctors bring a lot of money to the hospital & nurses are just a financial liability. It's no different at a much higher level. There is nobody out there that would listen to nurses. Nobody that has any power to influence change, anyway.

Unless you give a crap ton of money to Washington politicians, nothing changes.

[NurseDiane]

While that's a great idea in theory, the states with nurse-to-patient ratio laws don't follow it. There are loopholes, just like with every other thing in this country. Hospitals can say that they "just didn't have any nurses to cover". Where do you think "mandatory overtime" came from? It came from nurse-to-patient ratio laws. The hospitals decided that instead of hiring new nurses to adequately staff the units, that they could just mandate somebody to stay to cover a sick call. Then, a law went into effect that made it illegal to make a nurse stay more than 16 hours in a row. Based on if you work 8, 10 or 12 hours, that's the whole shift, most of the shift or part of the shift. They'll take whatever they can get.