General concensus of floor nursing

[chad75]

I've been coming to allnurses for a while. Mostly lurking. I have been a nurse for about 6 years and I am curious if nursing is really as bad as everyone says it is. We all know its just "nurse nature" to come here and write about an awful day they had then it is for a nurse to come on here and say there day went smooth.

I've only worked as a nurse in one state and my personal opinion of floor nursing is really negative, but nursing is my livelyhood. I don't think I've spoken with a single nurse that has been floor nursing for any period of time that has felt good about the proffesion. I have run into the occasional Florence who is on a mission from God, but I don't really count those since they are in the very small minority.

My personl concensus on floor nursing (Having worked pretty much every speciality except general peds inpatient med floors).

Pros (going to try and start off positive)

1. Pay: I don't know any other proffesions where you can compensated for two years education and make >50k a year. Yes some nurses work in small rurual hospitals, don't want to travel etc. but if you really wanted to, and were willing to move and work any unit you could approach near 6 figures in some areas with overtime and agency work.

2. Job security: I am the consemate job hopper. I could find work in

3. Variety: There are so many different fields you can work in, everyday brings something new.

4. Independence: Depending on where you work and what your speciality is you can have a large of amount of indepedence, especially if you are like me and work nights. No supervisor breathing down your neck telling he needs the tps reports yesterday. You make informed decisions alot on your own etc.

5. Respect: I know this one is debateable, but there is a certain amount of respect received from lay people being a nurse. Alot depends on enviorment though, if all your friends/family are CEO's and PhD's you may not get much lol.

6. Meaninful work: We see people at their worst and through proffesionalism and knowledge are sometimes able to alleviate concerns, save a life or get warm fuzzys from thankful pts./family.

7. Schedule: We aren't tied to a 9-5, we can work 3 days a week and take 4 off, or like some work 6 in a row and get a mini weeks vacation between shifts.

8. Comradery: As nurses we share a lot of the same burdens and experiences, were sort of a dysfunctional support group for eachother lol.

Cons

1. Patient ratios: Health care providers continue to lay tons and tons of paperwork and double/triple, sometimes quadtruble charting on nurses to be JCHAO compliant, yet excpect nurses to perform "customer service."

2. One mistake away from loss of livelyhood: One unfortuate mistake and you can loose your ability to ever practice as a nurse again. If a CPA messes up in a calculation he may lose his/her job, but as long as nothing illegal was done he will still be a CPA.

3. Were disposable: Hate to say this, but were immently replaceable, if we weren't, hospitals wouldn't treat us in such ways. They know there will be another new grad, foreign or travel/agency nurse to take your spot.

4. Egos: We work with the most egotistical, ill tempered, god complex proffesion on the planet. Physcians...yes there are some excellent ones but in my experience for every physcian that treats me with respect as a member of the health care team there is one that ignores anything I say, yells, throws charts and just generally acts like a spoiled child on their birthday. Then we have the egos of the supervisors/DON's and other such people that haven't worked the floor in their life, or worked the floor back when the BeeGees were #1 on the charts. They have no idea what the average floor nurse is expected to do. They won't get in the trenches for a shift or two either to get an idea, however they will tell you its perfectly reasonable for you to take on 8 patients in a primary care setting while they attend the 4th meeting of the day to discuss the increase of bad marks on the patient satisfaction surveys.

5. BON: I have never had any issue with my license (knock on wood), but from what I have read and the experiences of other nurses that have there tends to be a holier then though attitude. Mitigating circumstances don't count, reality of the hospital doesn't count. All that counts is that you, the nurse on the frontline did something 99.9% of floor nurses do, but you were unlucky, too bad so sad...next.

6. Responsbility: The buck stops at the floor nurse. You would think it stopped at the physcian, but in reality it doesn't. Things can be twisted. Oh you called the physcian about the patients critical PTT, he didn't give you any orders? What did you do about it? Oh, the physcian says you never mentioned that, your word against hers, of course its your fault the patient has a brain hemmorhage now. Would you like us to schedule your BON hearing now?

7. Lack of respect: For as much respect as we do get, there is still heaps of disrespect, especially by those in our own proffesion.

8. No one has the time: More and more nurses such as myself are getting burnt out. No its not agency nurse_01's fault our unit is a revolving door, its still frusterating for me to have to train a new nurse every other shift though, especially when I am overloaded as usual.

9. Nurses can be cruel: They can be hateful, burnt out witches that should have left the proffesion 10 years ago. They trudge on though and make sure everyone knows they have been a nurse for a 100 years and you know nothing as they walk right past a room that has an IV beeping in it, because it isn't "their patient."

10. Hospitals in general despise us: We are a neccesary evil, if they could fire us all tommorow and still run a unit they would...don't doubt it. I'm sure there is some lone Non-profit (not "not for profit") hospital in some rural town that truely loves all its employees, gives a xmas bonus in years that they can afford to and in years they can't afford to the executives don't get a bonus either.

11. Jack of all trades: I'm not sure if I came up with this on my own or heard it somewhere else but its a true quote none the less. "A nurse can do everyones job, but only a nurse can do a nurses job." We play unit secretary, CNA, Housekeeper, dietician, accountant, pharmacist, central supplier, receptionist, social worker, security, therapist, QA, etc. etc. To top it all off were expected to do such things on a regular basis, and if we don't were negligent and might end up answering to the BON.

12. Constant changing policys, new "systems" Policys change constantly in a hospital, one day what you were doing was right, the next day its punishable by termination, its chaos. Not to mention complete new ways of doing things, to "improve." Computerized charting and the new med administration systems which make you scan ten different things come to mind.

I could go on with negative, but I think you can guess my general concensus of front line floor nursing 04 (soon to be 05).

Why am I still here? I'm asking that of myself more and more everyday. I have decided I'm going to get out of nursing all together or get as far away from bedside nursing as I can. Infection control sounds sort of groovy, or maybe diabties educator lol.

To all those floor nurses out there, you aren't alone. Merry Xmas.

[NRSKarenRN, BSN, RN]

All careers have plusses and minus.

The hands on day to day peer support, clinical educators and head nurses I interacted with in the late 70's thru 90's encouraged and supported nurses. They helped new nurses and old timers overcome challenges, held nurses accountable to high standards and not afraid to confront/discipline those few nurses disruptive on a unit, encouraged advanced educational levels and attendance at inservices outside the facility (which hospital paid for) --- all ways to keep nurses satisfied working at the bedside.

When the "business model" became firmly entrenced, clinical educators eliminated in late 80's and 90's, head nurses became unit managers (covering 2-3 or more areas) distancing themselves from their staff, all that support and empowerment to nurses seemed to disappear... often overnight. It's taken nursing vacancy rates or 20-30% and "exit interviews" PROVING lack of bedside nurses support, to change facilites in my area to go back to providing the above---now rates down to 6-8% and nurses staying more than a year.

The nice thing about nursing is that the "bedside" just doesn't have to be within a hosptial walls. The homecare bedside attacted me part-time in the mid-eighties to help move the vent dependent patient's "hospital" to the home. With the right agency (often with VNA roots) the homecare bedside can betruely rewarding.

[DutchgirlRN, ASN, RN]

Nursing is a tough, stressful, physically and emotionally challenging job. I wouldn't change professions though. I feel like the benefits are out of this world. No I don't mean through HR !

[chad75]

Nursing is a tough, stressful, physically and emotionally challenging job. I wouldn't change professions though. I feel like the benefits are out of this world. No I don't mean through HR !

Yes, the pros to nursing are awesome. It was enough to keep me working this long, the scale is getting weighed the other direction every day for me. I know my post was bitter, and not representative of every floor nurse, in every hospital in every localation. Just my general concensus coming from a frusterated nurse

[Dixielee, BSN, RN]

Chad, I don't think your post was bitter at all. I think it was right on target! I can't disagree with anything you said. I have been doing this 30 years and will probably be doing it another 20 (God, please help me!). I am thankful for the flexibility that nursing offers. I am currently a travel nurse in the ER, and the flexibility and money keeps me satisfied. I usually end up extending my contract at least once with each assignment, but if you get an unuaually horrible one, you can be gone in 13 weeks. I recently did some agency work at a local hospital to pick up some extra cash. It was one of those hospitals with a revolving door for agency/travel nurses. There were scant core staff and it didn't take me long to figure out why. I worked 4 shifts there and don't think I will be back. I ran into a traveler and asked how long he had been there...his answer was "7 loooooong weeks". I knew exactly what he meant! But for the right amount of money, you can do almost anything for 3 months.

What I am saying is that you have to be flexible and don't be afraid to change and try something new. It keeps things interesting in any case. We do what we have to do to survive. Hang in there.

[live4today, RN]

Chad, I don't think your post was bitter at all. I think it was right on target!........................................for the right amount of money,

you can do almost anything for 3 months.

What I am saying is that you have to be flexible and don't be afraid to change and try something new. It keeps things interesting in any case. We do what we have to do to survive. Hang in there.

DITTO! :)

Also, no nurse need apologize for their take on nursing. You feel what you feel, you own what you feel, you express what you feel.......not a dang thang wrong with that!

If many of us were honest with ourselves, we'd stop making excuses for why we get battered and abused in nursing, and make it our mission to stop the insanity so patients and nurses would no longer have to be under "Big Daddy's" whip inside those walls we all pay for with our sweat and tears.

Chad ((((((((you are NOT alone in your thoughts)))))))) :kiss

[obillyboy]

It is all that and more. Pro's and Con's. I figure like this............. I'm here let's have fun. I will do whatever it takes for the pt. and document my *** off, and along the way I get to smile and laugh and cry with some great people.

When it is all said and done Here I am. Now lets do it like there is no tomorrow.Burned out yea but that just means it is time to switch jobs.

Laugh and have fun. Toss a pre filled NSS syringe at a younger person then squirt them with one and tell them to try and get you ......Not in any other pt. rooms.

Older folks. tell them a dumb joke. A simple joke. you'll get at least a snort out of them.

Just have fun and be loose.

:rotfl: :rotfl: :rotfl:

Much Peace..................... Billy

[chad75]

I hear ya, this is my last hurrah. I haven't had a full time traditional floor nursing job in over two years. Strictly agency and contract. Alot of the hospitals/facilitys out here though have over 50% agency/travelers as their nursing staff. Its a sad situation when the agency people are training the hospitals core staff.

The last couple of years I have taken on a pirate attitude just to get through my shifts. Basically whats in it for me, I go to the highest bidder. The place that pays the highest with the least amount of BS gets this burnt out nurse for a few shifts. Oh don't get me wrong, I provide good care to my patients, I always smile when I walk in a room but if I see you at Walmart and you tell me your thinking about applying to nursing program X, you better grab a chair lol.

I work in a big city mostly, but its a small world when it comes to nursing, usually end up working with a couple of nurses I know most of the time. We do our best to just get through the shift, sometimes we get pretty jovial and are consequently written up by some old haggard uptight unit clerk or housekeeper lol. I received one write up because I played a prank on one of the other nurses during a never ending slow moving shift at 3am (it involved warm apple juice in a specimen cup, was hillarious), the victim thought it was a laugh riot, but the RT thought it was unproffesional conduct lol.

A few months ago I stopped carring about things that didn't involve patient care. I refuse to clean breakrooms I didn't mess up or take out trash that was full from the shift before. I'm not quadruple charting anything. Have some convoluted charging system for supplys that takes me more then 1 minute to charge a patient for something...guess what , they are getting a free bedpan and box of kleenex, I know insurance companys only pay according to DRG's so its pointless anyways.

Don't have working equipment I need for patient care, or are the people in central supply so slack *** it takes 6 hours to get some critical piece of equipment? Guess what, I'm calling the Physcian, telling him that his order for a cooling blanket on his patient with a 105.9 fever cannot be completed because I can't get central supply to even answer their phone, much less give me a working one (Did I mention I had to argue with the central supply person for 10 minutes to convince them that it didn't work while your patient is having hyperthermic dellusions and on the verge of seizures? And after that I paged the house supervisor several times, no Dr. I don't know where she is, please don't raise your voice to me, I'm honestly doing the best I can.. here is the # to the house supervisor/administrator etc. I'm sorry Mr. Patient's wife, I know your husband is extremely ill and burning up, let me tuck a few more ice packs around him, no the Dr. isn't coming, but he has been notified....please don't sue me, I let my malpractice insurance lapse because any free time I have I don't even want to think about nursing.

The next day----No Angie (Angie is my agency scheduler), I didn't refuse a physcian order. I did what was in the patients best interest, I couldn't get him a cooling blanket, central supply couldn't get me a cooling blanket, the house supervisor couldn't get him a cooling blanket so I felt it was my duty to inform the physcian that 2 hours after he gave me a stat order I was not able to fulfill it and didn't want to take the fall when said patient ends up in a coma. If I had the ability I wouldn't have pulled the cooling blanket out of one of my orifices.

Oh, Im being written up for not completeing a stat order with in the hospital policys stated time period..Um okay. Angie: "They also want to know if you can work a 14 hour shift tommorow since they had to fire that new nurse for failing her drug screen." Um yeah, I will get right on that.

*sigh* I heard utilization review is a little less stressful

[Tweety, BSN, RN]

Some days are diamonds and some days are rust.

[Hellllllo Nurse, BSN, RN]

5. Respect: I know this one is debateable, but there is a certain amount of respect received from lay people being a nurse. Alot depends on enviorment though, if all your friends/family are CEO's and PhD's you may not get much lol.

.

I beg to differ on this one- my family if full of PhDs and they respect nurses more than anyone else I've ever known.

Especially my mil. She's an RN, PhD.

I find that it's doctors, mgmt, CNAs/techs, and nurses themselves who disrespect nurses.

Everything else you've said, I totally agree with.

I recently quit a job that had great pay and hours, because I just could no longer stomach being treated with total disrespect.

I am to start a travel assignment in one week. I'm sitting here with a my nursing-wrecked back killing me, hoping It will feel better before the job starts.

I am amazed at how fast the new grads are burning out and becoming disillusioned. It took me years to finally realize that it wouldn't be any different at the next job- that it was nursing, not a particular job that was getting to me. It's taken less than a year for a couple of new grads I know.

There are many of us out there just like you, Chad.

[VickyRN, MSN, DNP, RN]

All careers have plusses and minus.

The hands on day to day peer support, clinical educators and head nurses I interacted with in the late 70's thru 90's encouraged and supported nurses. They helped new nurses and old timers overcome challenges, held nurses accountable to high standards and not afraid to confront/discipline those few nurses disruptive on a unit, encouraged advanced educational levels and attendance at inservices outside the facility (which hospital paid for) --- all ways to keep nurses satisfied working at the bedside.

When the "business model" became firmly entrenced, clinical educators eliminated in late 80's and 90's, head nurses became unit managers (covering 2-3 or more areas) distancing themselves from their staff, all that support and empowerment to nurses seemed to disappear... often overnight. It's taken nursing vacancy rates or 20-30% and "exit interviews" PROVING lack of bedside nurses support, to change facilites in my area to go back to providing the above---now rates down to 6-8% and nurses staying more than a year.

The nice thing about nursing is that the "bedside" just doesn't have to be within a hosptial walls. The homecare bedside attacted me part-time in the mid-eighties to help move the vent dependent patient's "hospital" to the home. With the right agency (often with VNA roots) the homecare bedside can betruely rewarding.

EXCELLENT post, Karen.

[Dixielee, BSN, RN]

Chad, I think you and I must have worked at some of the same places! I worked in one hospital ER where I needed IV pumps as I was placing an MI patient on several drips. I was told by central supply that we were "out" at the moment, and they didn't have time to clean any. I told them to give me dirty ones and I would clean them. Then they said they didn't have dirty ones either. This is the same hospital that sent the "difficult cath" cart to the ER instead of the Chest tube cart I requested. (Central was in the back hall of ER so a lot of things normally kept in ER were in Central). In any case, we must be flexible at all costs!

I am currently working in a great hospital as a traveller and have just extended for a 3rd contract, so I will be here till the end of May, then will go home for a few months. They are trying to get me to come as core staff. It is about as good as it gets when it comes to management, staffing ratios etc. BUT, I can't afford an $8/ hr cut in pay, loss of travel allowances and bonuses, as well as my $1000 monthly tax free housing stipends. Then if I am on staff, I must be "oriented" to take charge, attended countless mandatory meetings, give inservices, be on QA or infection control committees, precept new staff, come in on off days because of mandatory call, and the list goes on and on. I just wonder why hospitals are having trouble keeping core staff???????????????????????????????????