my "rant" on the state of nursing in my neck of the woods:
in the past year or so, i feel like i constantly have to be on the defense, defending myself and my work to the manager and coordinator. it has become such a punitive work environment, and this has already caused me some serious health problems.
never in my 23 years in the workplace have i felt my job was threatened until the past couple of years. it feels as if someone is always waiting for me (not just "me" ...... "me" =nurse) to "slip up" and then discipline me for it. this creates added stress in an already stressful environment, which then increases the chance of mistakes and omissions. nitpicking, threatening, and tearing people down are actual factors that create an error-filled work environment, not the opposite desired effect of having an error-free environment.
we have even recently been told that we must always speak positively of our workplace, and that those with negative attitudes will be disciplined. (not gonna mention the threats of lay-offs at every opportunity... despite the fact that our institution has over 200 vacant rn positions) the words "you will be disciplined" are very rarely omitted from blanket emails and other communications from the manager. come on now! do you really think that a bunch of grown women and men are going to take kindly to this?
staffing is good sometimes and horrible other times. there are some days where you may be working with only one or two other 'regular staff' and the rest have been sent by the resource staff or come from other units through bidshift. many of these nurses (including some of the more recently hired regular staff) obviously haven't a clue how to take care of icu patients and just go through the motions hoping that nothing bad happens during a given shiftso no one notices their incompetence. it appears that those in management turn their heads to incompetence when the regular and icu-competent staff can clearly see it for what it is.
the newer nurses (three-years and less experience) are being placed on pedestals as if they can do no wrong; last year's new grads are precepting our current new grads while the more seasoned rn's are cast aside like week-old bread. very inexperienced rn's are being placed in charge nurse roles, and many of them don't even have the basic icu skills mastered yet. it is as if the knowledge and wisdom that has been gained from decades of experience pose some sort of threat to management and/or administration.
if a crisis happens in the unit, the more seasoned nurses are often left to rescue the patient for the pedestalized newer nurse, literally. you can imagine the hostility that is created here, yet the "seasoned nurses" just keep marching along like good little soldiers, taking a beating along the way, and pretending to like it.
i feel like i am no longer allowed to use my nursing knowledge, judgment, and wisdom because of all of the black and white rules that have been imposed, and i have no sense of autonomy for fear of being disciplined. many of these rules are said to have been mandated by administration due to cms, jcaho, and the likes. critical care nurses are supposed to be able to think critically and to recognize and act upon variances in the patient's condition to prevent crises. it seems that administration would prefer to have robots that they could program to do everything the same way and at the same time, without ever questioning if what is being done is really going to help or to harm the patient. patients and health crises are not one-size-fits-all. it seems we are forgetting the human aspect of nursing.
the bottom line is: nursing, especially critical care nursing. is not black and white, but many shades of gray; and when you try to take something that is gray and make it function like it is black and white, it causes system failure, and that is where i fear that we as nurses at my hospital are headed today.
our staff used to be happy and worked great together as a cohesive team. management and administration have created such a punitive and hostile environment, (perhaps unknowingly), that it seems no one is happy with their jobs anymore. it has become one scary place to work.i am normally a very optimistic person who is committed and loyal to my workplace and to my co-workers. i am quickly losing this optimism, commitment, and loyalty because of the bureaucracy that has decided to see just how hard they can make it on the nurses who are caring for our patients. the patients whose lives we save, whose families we comfort and reassure. the patients who are the reason we are all here in the first place. feeling this way saddens me deeply.
is this just at our place? or is it universal?
staff note: font size changed from 1 to 3 for easier reading.
