Glad they are flooding the market with New Grads...

[gentlegiver]

I have been reading the threads & posts for the past few weeks and have seen the same complaints from LPN's and RN's. (saddly it looks like we have something in common) It doesn't seem to matter what type of facility you work in, LTC or hospital.

I have come to the conclusion that management is getting worse. IMO, it seems that they know there are thousands of new grads looking for work, so, they are taking the opportunity to raise the whip and demand the current staff to accept treatment that would have never been tried 5 yrs ago. We have no say in how our units are run and our input is at least disreguarded if not seen as contrary to policy. We are overworked and understaffed, made to be waittresses/waiters for patients and families, we now do housekeeping and maintanence jobs, get in trouble for staying over to complete documentation, and get in trouble if documentation is not as complete as they want (because we rushed to get out on time... like they want).

We are judged by survey results written by people who have no idea exactly what we do during a given shift, we are not supposed to use the restrooms, eat, sit down to document what we did, and heaven forbid if someone sees you on the phone (you may be talking to a DR, but you can be sure it will be reported that you were taking a personal call by a family member who's gingerale was not served fast enough). So, I am glad they are flooding the market with New Grads, at least the facilities will have nursing staff (abet inexperienced) when they burn out all the experienced staff.

[Momof2inMO]

Unfortunately, there is now a new wrinkle added that will keep this attitude in place. Hospitals are reimbursed incrementally by how they are "scored" by their clients/patients. If you score less than 90-100 percentile in key areas, then you get less and less money back from medicare/aid etc. for each drop. If less than 50%, good luck.

[carolmaccas66, BSN, RN]

I certainly DO NOT touch ANY engineering tasks, or any other tasks outside of nursing - I'm not an engineer, and if you are letting people tell you to do these things - managers I suppose - you are being used and abused. I just say no I'm not doing that it's not my job. We aren't even allowed to change a lightbulb or look at air cons or anything - that isn't my job. A certified person as to do that.

And I couldn't give a fig if someone compplains that they saw me on the phone, or complains cos their soft drink was late. I can justify myself in any situation, thank you. Maybe that is what you have to start doing. If everyone complains en masse to the managers, they will have to do something about it. They can't sack everybody surely. Try and take more control of your workplace, or just keep looking around for another position maybe.

Is it really that bad where you work?

[eriksoln, BSN, RN]

Unfortunately, there is now a new wrinkle added that will keep this attitude in place. Hospitals are reimbursed incrementally by how they are "scored" by their clients/patients. If you score less than 90-100 percentile in key areas, then you get less and less money back from medicare/aid etc. for each drop. If less than 50%, good luck.

Which makes the whole lack of commitment to quality care more puzzling. You would think the admin. would react with "Oh, a couple hundred dollars spent on better staffing means thousands in better reimbursement." Nope.

I've said it before and I'll say it again: Cutting the hospital funds NEVER leads to better care. Its not like we are in grade school and the hospital admin says "Oh geeee, darn, we need to do better. I have to fix the lack of staffing and retain employees better or it'll happen again. I hope we do better next time."

In reality, the reaction is: "Oh, ok. You want to take 20% away because someone thinks the coffee was not hot enough? I'll take that loss of money, shift it over to the supplies area, not order coffee next time, then the problem is solved. Can't say the coffee isn't hot enough it you don't have any." I mean, really........DUH......they are not going to take it out of their bonuses or money put asside for future projects.

The politicians are about as detached as the admin. when it comes to healthcare. If you cut the funding, the care quality gets cut.....period, no way around it.

[eriksoln, BSN, RN]

I certainly DO NOT touch ANY engineering tasks, or any other tasks outside of nursing - I'm not an engineer, and if you are letting people tell you to do these things - managers I suppose - you are being used and abused. I just say no I'm not doing that it's not my job. We aren't even allowed to change a lightbulb or look at air cons or anything - that isn't my job. A certified person as to do that.

And I couldn't give a fig if someone compplains that they saw me on the phone, or complains cos their soft drink was late. I can justify myself in any situation, thank you. Maybe that is what you have to start doing. If everyone complains en masse to the managers, they will have to do something about it. They can't sack everybody surely. Try and take more control of your workplace, or just keep looking around for another position maybe.

Is it really that bad where you work?

You definitely work at my facility.

[TheSquire, DNP, APRN, NP]

I have been reading the threads & posts for the past few weeks and have seen the same complaints from LPN's and RN's. (saddly it looks like we have something in common) It doesn't seem to matter what type of facility you work in, LTC or hospital.

And, of course, everything you read on allnurses.com is completely, 100% objective and true. /sarcasm

So, I am glad they are flooding the market with New Grads, at least the facilities will have nursing staff (abet inexperienced) when they burn out all the experienced staff.

What makes you think the nursing schools are the ones to blame? Have you noticed the tanking economy we've had for the past few years? Not only are people putting off seeing the doctor and having elective surgery performed since they no longer have coverage, reducing the amount of money hospitals get, but the labor market's changed too. Nursing is a field where the many/most of the workforce traditionally provides a secondary income for a family: with the current recession, many nurses find suddenly found themselves as primary breadwinners, and so either came out of retirement and back to work or went from part time to full time to support their families.

There isn't a glut of new grads - there's a glut of experienced nurses. Now we all have to wait for them to either grow old and become patients or for the recession to end and new-grad hiring to pick up.

[April, RN, BSN, RN]

What makes you think the nursing schools are the ones to blame? Have you noticed the tanking economy we've had for the past few years? Not only are people putting off seeing the doctor and having elective surgery performed since they no longer have coverage, reducing the amount of money hospitals get, but the labor market's changed too. Nursing is a field where the many/most of the workforce traditionally provides a secondary income for a family: with the current recession, many nurses find suddenly found themselves as primary breadwinners, and so either came out of retirement and back to work or went from part time to full time to support their families.

There isn't a glut of new grads - there's a glut of experienced nurses. Now we all have to wait for them to either grow old and become patients or for the recession to end and new-grad hiring to pick up.

The OP already explained herself. She's not blaming new grads or nursing schools. She's saying that she's glad there are so many new grads looking for jobs because her facility is going to have to hire them to replace all the experienced nursing who get fed up with the BS and quit.

And there is a glut of new grads in many areas.

[ejm99]

I'm a nursing student, LVN student that plans to transition to an RN after I get certified.

I hear these same complaints from the Nurses we work with in Clinicals often. Unfortunately hospitals are now being looked at as "hospitality" as just like Hotels! I find this ridiculous. I sat and watched a nurse have to explain that no she would not "just go get me a pepsi from that machine down the hall"...because first it was not on her dr ordered diet, two ...if she wanted one SHE could pay for it and get it since she didnt' have a problem walking PAST it to the nursing station to request one and three ... if she didn't want to purchase one herself maybe she could ask one of her visitors to bring her something if she didn't want to comply to the diet as ordered. And she did it NICELY.... even when the pt. acted very entitled and as though she were ordering room service! I was amazed at the way the nurse got her point across w/out being nasty or insulting to her patient. It really was a learning experience for me.

[eriksoln, BSN, RN]

I'm a nursing student, LVN student that plans to transition to an RN after I get certified.

I hear these same complaints from the Nurses we work with in Clinicals often. Unfortunately hospitals are now being looked at as "hospitality" as just like Hotels! I find this ridiculous. I sat and watched a nurse have to explain that no she would not "just go get me a pepsi from that machine down the hall"...because first it was not on her dr ordered diet, two ...if she wanted one SHE could pay for it and get it since she didnt' have a problem walking PAST it to the nursing station to request one and three ... if she didn't want to purchase one herself maybe she could ask one of her visitors to bring her something if she didn't want to comply to the diet as ordered. And she did it NICELY.... even when the pt. acted very entitled and as though she were ordering room service! I was amazed at the way the nurse got her point across w/out being nasty or insulting to her patient. It really was a learning experience for me.

My father was a Marine for over 20yrs. He is a very "results oriented" man, looks at things with a concrete/realistic mindset, no fluff. He always said this to me:

"A handfull of what you do outweighs a truck load of what you say."

Yes, the general public "view" hospitals as a trip to the local fav. family rest./hotel.......they've been taught to by the surveys and handouts given them.

But the hospitals are not living up to this. Not by a longshot. As I've said, the quality of care has dropped dramatically since I was a new RN. There is a fog of apathy clouding every unit in the hospital I am at. Like I said before, lots of things are being left undone that were a simple part of the daily routine before. Bed changes, baths, refilling water pitchers, making sure everyone has their personal supplies (deodorant, shaving cream) etc are not getting done. Heck, we don't even stock half the personal supplies we used to anymore. The unit I just recently left to get off nights went weeks at a time with no deodorant stocked.

So, other than changing their pamphlets and their tune in staff meetings.........hospitals are not responding to the new demands to make medical care a service. If anything, they've taken a step away from it, letting customer care suffer in the name of scrapping a few extra pennies of profit. Staffing continues to be such that nothing but the most generic care is possible, stays that way despite increased complaints and lower survery scores, and even supplies are cut back to the point where "customer care" is not even in the picture. This does not reflect leadership who desire happy patients in my eyes.

Patients can view hospitals as hotels as much as they want, but they don't get it. And when they moan and respond with a poor score on their survey...........the money lost from those surveys comes outta.......yep, you guessed it......staffing and supplies. Hence, next time they come in, things are even worse.

[beewink]

Why, really, have the hospitals switched to catering to patients? I think it's past time to start implementing some standards for patient behavior and accountability, as in "This is our facility. You are a patient here, and as such, there are certain rules which you must adhere to: blah blah blah" "Anyone who hits, bites, strikes, kicks, or otherwise inappropriately assaults anyone else, including nurses, will be promptly evicted." "All patient care is prioritized according to needs and availability of staff and equipment; you may experience delays." "Stay off the call button as much as possible. You are not the only patient here. Don't bother the staff unless it's important. You're not in a hotel."

So, Admin, if you are not going to increase the staffing, then YOU start telling your almighty customers/patients to reduce their expectations because the old days are gone. The nurses should not always be stuck in the middle of this mess.

Why? Because of the almighty dollar - that's why. And it will not change.

Tell the patients to reduce expectations and you'll be out the door. Lots of managers receive bonuses for keeping staffing ratios low and patient satisfaction high.

Good Luck - I know I've been soured by the system, so my response is tainted by many years of seeing things get worse and worse.

[Trinitas2010RN]

Which makes the whole lack of commitment to quality care more puzzling. You would think the admin. would react with "Oh, a couple hundred dollars spent on better staffing means thousands in better reimbursement." Nope.

I've said it before and I'll say it again: Cutting the hospital funds NEVER leads to better care. Its not like we are in grade school and the hospital admin says "Oh geeee, darn, we need to do better. I have to fix the lack of staffing and retain employees better or it'll happen again. I hope we do better next time."

In reality, the reaction is: "Oh, ok. You want to take 20% away because someone thinks the coffee was not hot enough? I'll take that loss of money, shift it over to the supplies area, not order coffee next time, then the problem is solved. Can't say the coffee isn't hot enough it you don't have any." I mean, really........DUH......they are not going to take it out of their bonuses or money put asside for future projects.

The politicians are about as detached as the admin. when it comes to healthcare. If you cut the funding, the care quality gets cut.....period, no way around it.

Unfortunately, there is now a new wrinkle added that will keep this attitude in place. Hospitals are reimbursed incrementally by how they are "scored" by their clients/patients. If you score less than 90-100 percentile in key areas, then you get less and less money back from medicare/aid etc. for each drop. If less than 50%, good luck.

With regards to having input on how things are done, nursing does not have a monopoly on this problem. I'm yet to have a job where this does not exist. Landscaping, retail, resterant work, factory work......I've done a lot. The next job I go to where management listens to the work force will be the first.

I wrote a very similar thread awhile back about how the recession has given a lot of admin. and management a set of kahonees that were not present before.

I must insert here though, as I have paid close attention to the new "You need us, we don't need you" approach and watched to see its results: Words are just that, words. Yes, they talk alot about not wanting OT for documentation and insist this and that (non-nursing duties) be completed by us but.......eh, no one is actually doing it. At least not at my facility.

I've noticed a lot of nurses lately who have entered cruise control with their nursing approach. Come in, do whatever must be done, do it how you like.......and leave. If someone complains........ah well, thats life, they'll live. If something is left undone....ah well, nursing is 24/7. Lots of nurses stay VERY late, frequently, to complete documentation, and they are pulled into the office every week about it to be told they are going to be fired, and......ah well, they are still there.

So, point is, demands have risen and risen, but....ah well, they are not being met. You can demand anything you please, but when your staff have ear plugs in before you even start talking.......its of no avail. Things such as people leaving the unit to smoke, texting/talking to friends while on the clock, call offs and work being left undone has increased ever since the admin. became heavy/iron fisted. Seems to me its not working, but somehow admin. doesn't get it.

And the cold hard fact of it is, hospital leadership are supposed to be making decisions to increase care quality. The quality has dropped dramatically at my facility. The feeling of apathy overcomes any threat of job loss or lack of raises admin. can make. That apathy bleeds into the daily pt. care, I've seen it. Flooding the market with new grads will not fix the problem for admin either. In addition to the poor work eithic habits I've seen increase, I've also seen a dramatic increase in GNs starting a position and quitting before their orientation is even complete. Genious management there.......abuse your work force, try to threaten them with their jobs and point out that there is a line at the door for their job........and not be able to hold onto these people from the "line at the door" when they get in. Thats not cost effective.

Very good posts. It's sad to see that hospital are leaving you nurses with jobs out to hang. Granted alot of businesses out there right now are creating the same environment as you guys are talking about. It's just more saddening to me that this type of attitude is prevailing and effecting patient care.

[wishinguponastarLPN]

This sounds great on paper and all, but it will be interesting how quickly you are escorted out when you tell your DON this is how you feel! Hospitals are like hotels now because it is ALL about the bottom line. Were things like this is hospitals 30 years ago? No, do you know why? Right now I live in a a city where there are at least 10 different hospitals you can choose from to get your care. We are only 15 minutes away from a city that has an additional 3. So the hospitals are having to compete against each other to get patients in, to pay the bills, including nursing salaries. So if Ms. Whiner goes to A hosptial and all of the nurses tell her they aren't getting her a ginger ale because they are to busy, she is going to tell everyone she knows not to go to A hospital because they nurses are rude, even though she might have got great patient care. Yes, nursing used to be all about great patient care but in today's society where people want it all, with a smile, and quickly, it is the current trend. If you don't think you can provide this then maybe healthcare isn't for you, because this trend isn't going anywhere because Americans are spoiled!

Should hospitals hire more people to help? Yes they should, but they can't because people come to get care then don't pay their bill...that's a whole different post though.

As a RN student, you'd better believe that I am taking notes on all of the dissatisfaction and the weird kowtowing and non-nursing tasks that nurses are expected to do, with the full intention of graduating with some strategies for how buck it and create a more sensible and practical workplace.

Why, really, have the hospitals switched to catering to patients? I think it's past time to start implementing some standards for patient behavior and accountability, as in "This is our facility. You are a patient here, and as such, there are certain rules which you must adhere to: blah blah blah" "Anyone who hits, bites, strikes, kicks, or otherwise inappropriately assaults anyone else, including nurses, will be promptly evicted." "All patient care is prioritized according to needs and availability of staff and equipment; you may experience delays." "Stay off the call button as much as possible. You are not the only patient here. Don't bother the staff unless it's important. You're not in a hotel."

Seriously. Stop setting patients up to think that they rule the world. A hospital is not a hotel. Patients do not boss hospitals. Hospitals boss patients. Whenever I've been a patient in a hospital, I have not expected nor demanded to be waited on hand and foot. Hospitals made their own problems by not demanding that their patients show proper respect, imo.

I just sat through a training video in which some elderly female had annoyed the nurses & aides no end by leaning on her call button all the time, for trivia. She was still buzzing when a patient coded and the staff, of course, rushed to the code. After the emergency, somebody checked on Mrs. Whiner, and she's now spitting furious because she's soiled herself because nobody came fast enough to put her on the bed pan. "Hey, we're really sorry, Mrs. Whiner, but it'll wash off, and we'll get you a change of attire and bedding pronto now, and you'll be good as new. Sorry we had to bump you to a lesser priority, but a patient coded. Please use your call button more appropriately from here out, eh?" Nope, the nurse can't say that, ever, even if it needs to be said.

The waiter /waitress chit has to stop. Right now. I don't know who thought it was such a bright idea to give the patients so much power, but it can't continue unless the staffing is increased. And I really don't expect that will ever happen. The USA just doesn't have the prosperity that it used to.

So, Admin, if you are not going to increase the staffing, then YOU start telling your almighty customers/patients to reduce their expectations because the old days are gone. The nurses should not always be stuck in the middle of this mess.

[Cthulhu]

To be fair, nurses are not the only employees getting the shaft these days.

I have friends in other businesses, and they are seeing their benefits get cut, sick days get cut, pay raises get delayed or reduced.

The reason is because no one in their right mind is going to quit a job when the unemployment rate is 9+%, so we just put up with the abuse.

It will be interesting to see what happens when the economy changes and the table are turned.