Disheartened by Profession Realities

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I've been a nurse for about 10 years now. I completed the ADN, obligatory BSN (second bachelor's degree), took a board certification exam and have worked in three specialties. I LOVED the science (A&P, micro, patho, etc) and find myself going back to it for inspiration. Does anyone else out there feel as if we went to school just to eventually end up doing paperwork and charting? 

The challenge of nursing lies in multitasking and dealing with difficult patients and families. I long for the challenge of actually applying the science. We are so obsessed with patient throughput and keeping that money grossing machine turning. I had zero interest in studying finance. When I entered the nursing profession, I didn't anticipate the responsibility of perpetuating superfluous patient appointments (disguised as "lost to follow up") would fall on my shoulders.

Specializes in NICU/Mother-Baby/Peds/Mgmt.
On 4/26/2021 at 10:41 AM, Been there,done that said:

No. The challenge of nursing lies in your observation skills. It's up to you to watch your patient.. comfort your patient.. and do whatever it takes  to restore them to health.

 Nursing is NOT about what the nurse needs.

And since so many employers don't care about what the nurses need they're leaving the profession. Sorry, but it's not ONLY about what the patient needs.  That's the main thing but where is it written that you can't do what the patient needs AND get what you need? 

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On 4/26/2021 at 7:58 AM, JKL33 said:

It's hard to imagine what things would look like if they weren't corrupted by other interests.

Much of the excessive charting people now associated with EMRs is a direct result of terrible, lazy and greedy decision-making by people whose primary concern is not patients.

For one example (of innumerable), there is a guideline/standard of care that certain patients should be screened for a certain thing. But someone comes along and says, "Well we need to just screen every patient because otherwise blah, blah, blah these dumb workers here won't know who to screen." So that documentation piece is built into the EMR and additional lazy and complicit people can audit compliance by seeing whether it was done 100% of the time or not. Next thing you know this is something that the department needs to accomplish 200 times per shift instead of 15 or 20. 

Then there's the time, energy and peace and well-being that is sacrificed in the name of figuring out why it was only done 60, 70 or 80% of the time. What will we do to get the numbers up! ?  Get angry. Threaten people. Write people up. All the angst, the drama.

 

This is it right here!  Nursing in 2021.  Chart that you are doing things for your patient without actually doing those things so it looks good on paper.  Because no normal human being would be able to chart all the crap you want us to chart and then turn around and physically do every single one of those things.  Unless you are working 24 hour shifts, it's not possible.  You can take care of your patients and your charting will look ***, or you can make sure your charting is perfect and neglect your patient.  But you definitely cannot have your cake and eat it too.  You just have to decide what's more important.  Making sure your patient gets out of the hospital alive or having coworkers badmouth you behind your back because your charting sucks?

Choose wisely.

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With that being said I didn't put a single nurses' note in throughout the entire pandemic.  Not even one.  They are lucky I bothered to chart assessments, sometimes I didn't even do that.  I worked Covid ICU.  I didn't document drip titrations.  I'm waiting for the lawsuit that they talked about in nursing school to actually happen.  But it never happens. I've been waiting for 14 years! Why isn't it happening?  Because if you take care of your patient the best you can, and you put your all in to the patient, and the family sees the effort you are putting forth, even if the patient doesn't make it they will be grateful because you spent 10 hours of your 12 hour shift in that room.  They know you did your best.  And they will be forever grateful.  Now imagine you spend 10 hours out of the 12 hour shift at the nurses station charting instead of being in the room.  The family is going to be PISSED.  Especially if the patient is critical.  And they will threaten you with a lawsuit before the patient ever dies.  This is how it works.

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I don't want to give away my secrets but if a family member visits a patient daily, and every time they show up you are in the room with the patient doing something, ANYTHING, with their loved one, you would have to do something pretty *** awful to make them mad.  The fact that they show up every day, and every day you are already in the room and they never have to put the call light on to ask for hardly anything.  That's how you avoid a lawsuit. 

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If you prefer to spend 10 hours out of a 12 hour shift at the nurses station gossping, playing on your phone, or pretending like you are charting when you are really on amazon shopping, then you have no business being a nurse.  Yes, I went there.

*mic drop*

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Other nurses say to me "but JCAHO..."  My response is does "JCAHO sign my paycheck?  No?  Okay.  They are nothing to me."

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If there isn't something that stands out that they can fine a hospital for, then they will just dig until they find something to fine them for.  I'm making their job so much easier.  They should actually thank me.

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Don't even get me started on "magnet status".  Because I'm going to say "so you spent 4 years in nursing school and can write a paper APA format but you don't know how to operate a zohl?  Let me know when you find a nursing job that pays you to write a paper in APA format."  God help us all.

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1 hour ago, Covidnursedropout said:

Chart that you are doing things for your patient without actually doing those things so it looks good on paper.

I've never done this (that I know of/on purpose) and don't ever plan to. I've always prioritized according to my own training and nursing judgment and have been willing/ready to defend myself if someone has a concern about the things I do or don't prioritize. Haven't heard anything yet and I've been doing this job awhile now.

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The whole system, it's lunacy.  You'd have to be a lunatic to not see through all of it.  A coworker and I were talking about it today, COVID in the hospitals.  A patient would be in covid ICU sick with covid, finish their convalescent plasma, remdesivir, and dexamethasone, stay in the covid unit for 14 days, get discharged to a SNF, fall and break their hip in the SNF and when their admitting diagnosis is still "covid".  Not "broken hip".  Their admitting diagnosis is "covid" and they go and have surgery on their hip and get admitted to the covid unit, despite the fact that they were treated for covid over a month ago and medically cleared for the SNF.  They break their hip and the covid test is positive but the PCR is negative, and they still admit them to the covid unit.  Meanwhile there are 20 patients holding in the ER who haven't been treated for covid yet who are dying and need help.  Tell me what's wrong with this situation.

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Working in a hospital is the worst. 

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For non-covid nurses, here's how it works.  A standard covid test will tell you that you are covid positive for up to 90 days.  The doctors differentiate by doing a covid PCR test.  The PCR test will only be positive when you are actively shedding the virus.  These patients were discharged to a SNF, almost a month ago.  Fell and broke their hip in the SNF, their covid test was positive, but their PCR was negative.  They had surgery to fix their hip and were put in a covid a room even though they recovered from covid a month ago, while patients with active covid died waiting in the ER.

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