Most Pressing Issues in Nursing Today - page 4

Was listening to a podcast that said "Within your area of expertise, find a problem and begin to solve it. When you begin doing that, you will begin to find happiness and purpose." In Post Modern... Read More

  1. by   pmcgrady
    Quote from nursesunny
    The biggest problem in nursing is the focus on patient satisfaction and lack of personal responsibility. We are so scared of bad HCAP scores that we don't hold patient's accountable for their actions. Diabetics eating donuts you say? Must mean that nurse didn't educate them properly not that they are a noncompliant trainwreck....
    I love what you said about personal responsibility. So true. I see way too many noncompliant diabetic and HTN pts. It's no wonder they need cardiac surgery
  2. by   hppygr8ful
    Quote from pmcgrady
    I am not shutting it down at all. Saying something can't and won't change is defeatist.
    I don't now Some things literally can't change. A zebra will never be a horse and a horse will never be a zebra - but the two together can under the right conditions produce a zorse.

    zorse-png

    I myself will always be an alcoholic albeit one that chooses not to drink.

    I think the biggest problem I see in nursing today is the perception that anyone who gives honest criticism to a fellow nurse is a bully. People need to quit whining, own their mistakes and learn from their peers who have been around for a while. If we all just learned how to work effectively together we might finally have better pay, better ratios and better working conditions. Although I must say I have all of those and work for a great facility.

    Hppy
  3. by   pmcgrady
    Quote from hppygr8ful
    I don't now Some things literally can't change. A zebra will never be a horse and a horse will never be a zebra - but the two together can under the right conditions produce a zorse.

    zorse-png

    I myself will always be an alcoholic albeit one that chooses not to drink.

    I think the biggest problem I see in nursing today is the perception that anyone who gives honest criticism to a fellow nurse is a bully. People need to quit whining, own their mistakes and learn from their peers who have been around for a while. If we all just learned how to work effectively together we might finally have better pay, better ratios and better working conditions. Although I must say I have all of those and work for a great facility.

    Hppy
    Totally agree with the whining. People need thicker skin. Facts don't care about feelings
  4. by   TriciaJ
    Quote from pmcgrady
    Totally agree with the whining. People need thicker skin. Facts don't care about feelings
    There's your project. Define the specific types of behaviours identified as "bullying" "lateral violence" and "nurses eating their young". How much of this can be attributed to thin-skinned people who take umbrage at every little nuance, real or imagined? (Previous AN threads should give you plenty of fodder.)

    To what extent do managers pit nurses against one another to keep us all divided and conquered? It's pretty hard to present a united front when people are rewarded for tattling on one another and constantly nursing their hurt feelings. And we know working conditions will not change until we do stand up together.
  5. by   pmcgrady
    Quote from TriciaJ
    There's your project. Define the specific types of behaviours identified as "bullying" "lateral violence" and "nurses eating their young". How much of this can be attributed to thin-skinned people who take umbrage at every little nuance, real or imagined? (Previous AN threads should give you plenty of fodder.)

    To what extent do managers pit nurses against one another to keep us all divided and conquered? It's pretty hard to present a united front when people are rewarded for tattling on one another and constantly nursing their hurt feelings. And we know working conditions will not change until we do stand up together.
    haha I genuinely dont have a project. But I am hoping that discussion may facilitate change. And this is a fairly large platform for a discussion. I believe there is an entire generation of new nurses that are entitled and have been told they are special and that they deserve respect without earning it. Snowflakes.
  6. by   nursemike
    Quote from Been there,done that
    It's best not to feed it.
    I know, I know, I know...but, dagnabit, it's a question worth asking, and there are people on these boards with ideas worth hearing.
    It's a question that particularly hits me, today. I've been back to work almost a year after a year on disability. Being off, and fighting really hard to come back, have made it vividly clear to me that I love this profession. I'm sorry to be maudlin, but I've been forced to ponder why I am alive, and I can't escape the conclusion that a big part of my answer is: to be a nurse.
    I am very possibly the luckiest person I've ever met. My facility is a not-for-profit with better ratios than a lot of places. Twenty years ago, at new employee orientation, our CEO said our motto was "Putting Patients First," and that by that he partly meant putting ourselves first, because the administration genuinely wanted us to be happy and understood that was key to making our patients happy. I am not actually gullible--I realized from the get-go that there would be limits to how far they would go to achieve that--but even now I believe he, and his successors, meant it. And, as it happens, my particular unit is arguably one of the most collegial ones in our facility.
    And I left work this morning muttering, "I gotta find a new job."
    I've had time to gain some perspective. Bad shifts happen. A lot of the time I actually am about as happy as I know I ought to be. But, still...why am I sometimes not? And I'm going to be thinking about that for awhile.
  7. by   pmcgrady
    Quote from TriciaJ
    There's your project. Define the specific types of behaviours identified as "bullying" "lateral violence" and "nurses eating their young". How much of this can be attributed to thin-skinned people who take umbrage at every little nuance, real or imagined? (Previous AN threads should give you plenty of fodder.)

    To what extent do managers pit nurses against one another to keep us all divided and conquered? It's pretty hard to present a united front when people are rewarded for tattling on one another and constantly nursing their hurt feelings. And we know working conditions will not change until we do stand up together.
    To what extent are we pitting ourselves against each other? In psychology it has been studied that marginalized groups of people (and rats) when oppressed start infighting. I believe some, not all nurses, feel marginalized and oppressed which leads to lateral violence. The question is how do we rise above it?
  8. by   Wuzzie
    Quote from pmcgrady
    I apologize if you thought I was being argumentative. But I was simply stating that I don't believe something can't change. Is nursing really a no-win scenario?
    Apology gladly accepted and welcome to AN. I actually really like your question and the discussion that has ensued. Right now I'm sitting back and mulling over the excellent points that have been made but I did want to address the last part of the quoted post. Is nursing "no-win"? I hope not but it's not an easy thing to change. One thing you have to understand is that, historically, any time women rise up and take a stand for something (right to vote comes to mind) they are often painted in unsavory terms. Men that rise up are heroes, women that do are witches (can't use the term that is most accurate). Because nursing is an overwhelmingly female occupation it affects us even more. Think of striking nurses. The vast majority of strikes occur because nurses are standing up for better care for their patients yet they are vilified by management, by the press and by the public as selfish women who are letting patients die to get more money. Furthermore management looks at nurses as disposable. Get rid of one and there are 10 more available to fill that spot. In nursing the squeaky wheel doesn't get the grease, the squeaky wheel gets fired. In my three+ decades I have seen more than my share of "noisy" nurses lose their jobs. And the world of nursing is very, very small. Whats more the percentage of women as primary breadwinners is growing exponentially so this is a big deal. They simply cannot risk their jobs so they put their heads down and take what's handed to them. Frankly, nurses are the modern day version of the turn-of-the-century sweatshop employees in that we don't like what's happening but we have to eat. I don't think it's defeatist I think it's survival.
  9. by   Kayauhs
    Staffing/nurse pt. ratios.

    The only solution that I see is either legislation or social media pressure.

    In my humble opinion; increasing staff is the single greatest intervention in preventing falls and adverse events.

    The problem is that increasing staff costs money and the powers that be in most facilities don't get the connection.

    My other opinion is that if staff is chronically short then the census needs to be cut. Period.

    Over fatigued staff who routinely work double shifts will make errors. Errors can cost a lot of money.

    The cost of defending one large lawsuit will completely overshadow the cost of adding one or two nurses.

    Abolish double shifts. Make that illegal.

    SERIOUSLY. 17 hours a day??? It's insane.
  10. by   Kayauhs
    Quote from TriciaJ
    There's your project. Define the specific types of behaviours identified as "bullying" "lateral violence" and "nurses eating their young". How much of this can be attributed to thin-skinned people who take umbrage at every little nuance, real or imagined? (Previous AN threads should give you plenty of fodder.)

    To what extent do managers pit nurses against one another to keep us all divided and conquered? It's pretty hard to present a united front when people are rewarded for tattling on one another and constantly nursing their hurt feelings. And we know working conditions will not change until we do stand up together.
    I think you are giving managers FAR too much credit for being intelligent enough to plot out keeping us divided and conquered.
    One of the main problems I've seen is that facilities hire "In-house" and some nurse that has just clung on long enough will be promoted to 'Manager' when he/she has absolutely no management skills.

    Lack of management and BAD management are the death knells of any unit. I have found that the whole management title just goes straight to their head.

    Once managers understand that they are actually there to facilitate and support the nursing staff, things will change. I don't see that happening any time soon.

    The truth is, we often seem to think that the main of these issues is exclusive to nursing and it is not. A whole lot of this is just human behavior on the job. We have a large manufacturer close to us with a huge sales and marketing department that is comprised mostly of women. A great percentage of people I know work there and they routinely quit because of the in-house fighting.

    This makes me wonder how much of the bad parts in nursing are nursing or just another day at the office?
    Last edit by Kayauhs on Mar 6 : Reason: spelling
  11. by   kbrn2002
    Unfortunately in the management vs nurses scenario management almost always wins. As another poster mentioned a lot of this is because nurses as individuals usually need their job. They may be the primary breadwinner in the family. Even if they aren't losing the income generated as a nurse is a huge financial hit for most families. It's been seen over and over that the one or few who make waves don't usually stayed employed. In our current era of huge corporate conglomerates owning just about everything that means if you are fired at your job you can't just go down the road and get another job since that place is probably owned by the same company that just fired you.

    Even when standing together concessions that are made are not very often meaningful. We have two major medical systems that own everything in our region. One of these had recent contract negotiations that were all over the local news. They were asking primarily for better nurse/pt ratios. Lower cost insurance and higher pay was of course also on the table but they weren't the primary want. There were threats to strike and multiple trips to the negotiating table. The union ended up accepting a contract that included a raise of a whopping 2% this year and a guaranteed 1% the next 3 years. Be still my heart! The employers promised to "look into viable competitors" for insurance coverage, which of course means absolutely nothing. Most important, the main thing nurses asked for was safe nurse/pt ratios and that wasn't even on the table when the contract was finalized. Why the union caved so completely I guess I'll never know. I'm just glad I don't work for that healthcare group since I'm pretty sure I would be beyond ticked off to be paying so much in union dues to get so little in return.
  12. by   OldDude
    Quote from Wuzzie
    Apology gladly accepted and welcome to AN. I actually really like your question and the discussion that has ensued. Right now I'm sitting back and mulling over the excellent points that have been made but I did want to address the last part of the quoted post. Is nursing "no-win"? I hope not but it's not an easy thing to change. One thing you have to understand is that, historically, any time women rise up and take a stand for something (right to vote comes to mind) they are often painted in unsavory terms. Men that rise up are heroes, women that do are witches (can't use the term that is most accurate). Because nursing is an overwhelmingly female occupation it affects us even more. Think of striking nurses. The vast majority of strikes occur because nurses are standing up for better care for their patients yet they are vilified by management, by the press and by the public as selfish women who are letting patients die to get more money. Furthermore management looks at nurses as disposable. Get rid of one and there are 10 more available to fill that spot. In nursing the squeaky wheel doesn't get the grease, the squeaky wheel gets fired. In my three+ decades I have seen more than my share of "noisy" nurses lose their jobs. And the world of nursing is very, very small. Whats more the percentage of women as primary breadwinners is growing exponentially so this is a big deal. They simply cannot risk their jobs so they put their heads down and take what's handed to them. Frankly, nurses are the modern day version of the turn-of-the-century sweatshop employees in that we don't like what's happening but we have to eat. I don't think it's defeatist I think it's survival.
    Case in point from another post where the "nursing shortage" was the subject...hospitals have never had a nursing shortage - nurses had to shoulder a staffing shortage and still have to - but I've never been aware of a patient being turned away from a hospital because of a "nursing shortage." Throw in all the new brilliant cost cutting ideas, patient satisfaction surveys, and salary market analysis, and there you have it...Nursing 2018 - love it or leave.
  13. by   TriciaJ
    Quote from pmcgrady
    haha I genuinely dont have a project. But I am hoping that discussion may facilitate change. And this is a fairly large platform for a discussion. I believe there is an entire generation of new nurses that are entitled and have been told they are special and that they deserve respect without earning it. Snowflakes.
    I really don't think it's the "entire generation of new nurses". In the past several years I've worked with many new nurses who are fantastic and certainly open to feedback. But negative experiences always "stick" better than positive ones, and one huffy snowflake (at work or on this forum) can really be a PIA.

    But I don't think they're the burning issue. The real issue is how we're pitted against one another. Like "BSNs vs ADNs" and "Newbies vs Seasoned Nurses" "Lateral Violence" and "Incivility in the Workplace". There are "nurses" who sit behind desks and think this stuff up, do "studies" and publish papers because they still get to call themselves nurses without having to actually nurse.

    Hospital management has latched onto a corporate business model where it's always better to keep people divided and conquered, even when they're herding you to Service Excellence Rah! Rah! Yay Team sessions. Then they tell you to "manage up" (which means loudly sing the praises of your coworkers) even while they encourage petty tattling.

    We need to all stop being sucked in by this peripheral nonsense and learn to present a united front. I think unions that are nurses-only are a good way to go. I've belonged to them and gotten excellent representation. The large unions that represent a number of occupations are less effective for a variety of reasons. Having no union makes us all individual sitting ducks, with the more vocal among us having targets on our backs.

    I really think there should be a class in nursing school that addresses workplace and labour issues for nurses. The good, the bad and the ugly; no propoganda. I think we'd have more newbies ready to function like professional adults instead of being thrown to the wolves like they are now.

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