Changing Nursing for the better; what can we do?

[Altruisticnurse]

Being a newer RN and reading many of the posts, I see that many fellow professionals in nursing seem burnt-out, dissatisfied, or generally unhappy as to how we practice our profession.

My question is this: How would you change the practice of nursing so we could better do what we are meant to do? Given carte blanch as to what could be changed and make a better working environment, what would you change? Would you decrease nurse-patient ratios? Would you follow the military model of nursing in which the RN is more of a supervisor of care and heads up a team? One-to-one or team nursing models?

After all that, how could we actually make these suggested changes possible?

I look forward to hearing your thoughts on this subject.

[mauxtav8r]

Follow the money. Real change will start when our profession is compensated in the same way as other professions. Payment by the billable hour for services rendered. Accountants, engineers, lawyers, architects, and, of course, doctors, all provide a professional service for which they can lose their license and professional standing if the job is not properly done.

Nurses must work toward an environment where our quality of care is nurtured, not stifled by unreal ratios and billing methods that consider our services an "expense" like toilet paper or mop buckets, rather than "REVENUE" like other professional services.

[snowfreeze, BSN, RN]

Initiate appropriate nurse patient ratios across the board, all areas of nursing including but not limited to ER, tele, ICU, CCU, PACU, PCU, Med/Surg, orthopedics, pediatrics, short stay, LTC, sub-acute, home care, outpatient clinics, penal system, rehab, acute rehab, neonate, OB/Gyn, postpartum, Trauma, step-down, isolation, long term vent unit, GI lab, radiology nurse and CRNPs in all areas too. Lets all stop "just doing whats needed" and start writing e-mails and written notes to managers and medical directors and DONs about unsafe staffing issues. When we are made to take more patients than we can reasonably handle and give optimal care, put it in writing.

Yes I know all the complications with this but we need to do something! What we have in most instances IS NOT WORKING.

Please offer other suggestions or fine tune my suggestion.

[medsurgrnco, BSN, RN]

Hire competent managers who listen to employees, not just the gossipping backstabbing favorites. Encourage teamwork and discourage malicious gossipping. Decrease patient:nurse ratios. Use good computer systems or paper documentation, and decrease the overkill documentation expectation. Appreciate good employees!

[lvlissl2ebecca]

Aside from what everyone else says, which is all very true: Management that listens, Coworkers who are more competent, etc... I think the major issue is not something we can so easily change, unfortunately. A lot of the "burnout and tiring" that nurses experience are d/t heavy patient load, demanding patient and families, and lack of respect from those they supervise, families, the higher ups, etc. and not to mention the major understaffing that facility managers expect you to work to compensate for. I don't believe that nursing can change for the better, until these things are observed and some steps can be taken to change these things nationally. Do I see this happening? No. Why? Because: 1. We can never change the demands that patients and families put upon us. 2. Generally, management likes to do things their way and change is not often welcomed. 3. There is a major shortage in nursing, for a reason. All of the reasons stated above, and then some. This all turns into a vicious cycle: Demands and staff do not change, nurses quit or do not practice and in that, they discourage others to enter the field, and so on and so on. As you know, cycles are the hardest things to break. It's much easer to put a wall at the end of a straight path, then it is to straighten a sphere. I really wish things were different. I would LOVE for things to change and to see nursing become a career that most love to do. I wish people would want to be nurses and want to STAY nurses.