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

[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.

[Over-the-hill-Nurse]

Thank you for the link gypsyd8! I sent my representative a letter. We do all need to unite on implementing change.

[nurseactivist]

Sometimes nurses have a harder time standing up for themselves than they do for their patients. Aiken study is available for those who are interested in depth reading. Here is short summary:

Dr. Aiken's study in the news

California Nurse Ratio Law Saves Lives, Improves Nurse Morale, Study Finds - Robert Wood Johnson Foundation

[rachel100639]

You hated every minute of being a nurse but you did it for 35 years?? Why?!

[rachel100639]

I discussed the archaic use of the time clock. Nurses want to be seen as professionals - professionals DO NOT punch a time clock. I did not say anyone need be "exempt." You simply keep track of your own time, as any adult is expected to do. Time clock or no time clock, nurses will be "overburdened" (that's an understatement!) with overtime until they refuse to do it anymore. Unfortunately, in many facilities, overtime is mandatory.

[NurseDiane]

I thought a lot about these posts, and the bullying & other problems that some "new" nurses complain about. I assume that the nurses that have experienced the bullying & other issues are nurses that work on med-surg floors, as most do as new nurses.

I have heard far less nurses complain about these issues in specialized units. In the ED, OR, ICU, PACU, etc., the experience & education required go farther than what is required on med-surg units (and I am not saying that the work is any easier on med-surg floors than it is on any other units). I wonder if nurses that work in specialized units experience as much of the negative issues that nurses on med-surg floors do. Because new nurses tend to start on med-surg units, is it more targeted toward the new nurses, and why?

Any input on this?

[Brian57]

To continue the debate regarding nurses and abortion.

[powerRN91]

Wow your post is really eye-opening

[Boetica]

I can relate to everything you said. It is sad but true.

[Sisyphus_01]

I think the reason so many jumped on the bandwagon of #Nursesunite is because it had a great amount of publicity. Simple as that. NOW why don't we use this publicity to our advantage and sneak in REAL ISSUES with the #Nursesunite hashtag posts ?

[Sisyphus_01]

I thought a lot about these posts, and the bullying & other problems that some "new" nurses complain about. I assume that the nurses that have experienced the bullying & other issues are nurses that work on med-surg floors, as most do as new nurses.

I have heard far less nurses complain about these issues in specialized units. In the ED, OR, ICU, PACU, etc., the experience & education required go farther than what is required on med-surg units (and I am not saying that the work is any easier on med-surg floors than it is on any other units). I wonder if nurses that work in specialized units experience as much of the negative issues that nurses on med-surg floors do. Because new nurses tend to start on med-surg units, is it more targeted toward the new nurses, and why?

Any input on this?

I work on a med-surg unit as a tech and have been totally blown away at the LACK of bullying and environment of acceptance and teamwork. Our nurses usually have 4 or 5 patients and rarely have 6, in fact, that only happens when someone calls out. However, I do work night shift so perhaps that has something to do with it?

Regardless, I am going to ask some of my nurses what makes where I work different than where they worked before. Perhaps I could pass along some of the things our floor/hospital does differently and help out.

Here's what I know:

Usually we have 6 nurses on shift and 2 techs, day shift has 3 techs and I'm not sure how many nurses.

Our nurse managers are AWESOME and used to be floor nurses themselves! We also have clinical staff leaders who act as a liaison to the nurse manager...not sure if that's normal as this is my first healthcare job.

Every week we have a weekly summary emailed out where people can give "kudos" to other staff members for the work they did during their shifts, it is so awesome reading those!

Our charge nurses actually STAY on the the floor most of the time and help out with duties when we are short handed, again not sure if this is abnormal.

Above all, we look out for each other and have one another's backs. I have had my charge nurse ask me and other nurses if we've eaten, and if we say no, she will tell us to take a break and she'll take over while we eat.

I love my floor.

[Ayvah, RN]

I work on a med-surg unit as a tech and have been totally blown away at the LACK of bullying and environment of acceptance and teamwork. Our nurses usually have 4 or 5 patients and rarely have 6, in fact, that only happens when someone calls out. However, I do work night shift so perhaps that has something to do with it?

Regardless, I am going to ask some of my nurses what makes where I work different than where they worked before. Perhaps I could pass along some of the things our floor/hospital does differently and help out.

Here's what I know:

Usually we have 6 nurses on shift and 2 techs, day shift has 3 techs and I'm not sure how many nurses.

Our nurse managers are AWESOME and used to be floor nurses themselves! We also have clinical staff leaders who act as a liaison to the nurse manager...not sure if that's normal as this is my first healthcare job.

Every week we have a weekly summary emailed out where people can give "kudos" to other staff members for the work they did during their shifts, it is so awesome reading those!

Our charge nurses actually STAY on the the floor most of the time and help out with duties when we are short handed, again not sure if this is abnormal.

Above all, we look out for each other and have one another's backs. I have had my charge nurse ask me and other nurses if we've eaten, and if we say no, she will tell us to take a break and she'll take over while we eat.

I love my floor.

Sounds like you've got a great floor! Med surg nurses over here always have 6 patients on days, rarely 7 (during the interview I was told 4-5, rarely 6, hahahaha) and 7-8 on nights. 95% of my experience with charge nurses have been phenomenal. Most CNA/techs I've worked with have been great. I've experienced no nurse-nurse bullying. But everyone is overwhelmed. Lack of breaks is very common. People clocking out and staying late to chart is common (writeups if people stay over too much). When I would ask very experienced nurses how they do it, they tell me they are unable to sleep the night before a shift because of anxiety and they've just mastered how to look calm on the outside. People don't leave because they don't feel they can get the same salary elsewhere and they are the breadwinner of the family, husband laid off, etc.

That's why it gets me so angry when certain people automatically say someone has bad time management skills or can't hack nursing without even asking the circumstances. When you have bad ratios its all about just getting through the day hoping there are no emergencies, and feeling patients are getting the bare minimum care. Med surg has been my passion but the ratios destroy the job, especially without good support (availability of an admit nurse is really big, good CNA ratios are also helpful). Getting a ratio law in place would be a huge first step.