My take on nursing

Nurses General Nursing

Published

It is sad to see how my impressions of reality have changed so very much in the last two years. While in many ways I feel as though I have grown stronger, in many ways I feel quite degraded. It was just a short time ago that I honestly thought I was entering this great profession and that I was going to help save the world. Reality shock can't even describe these sentiments that have seem to overcome my being. I have never before felt like such a second class citizen. I have never before felt like my knowledge, skills, and persona are devalued. I am not the type of person that needs to be in the spotlight, that needs continuous recognition. However, at the same time I cannot remain a martyr. I cannot even count the number of times that physicians, ancillary staff, patients, family members, and fellow coworkers have taken out their situation on me. I don't want to be a frustrated worker meandering around and just dealing with it. At the same time, I feel that nurses in many ways truly are voiceless. While we truly are the eyes and ears of the facility, our voices have been muted. We are just a "number" regardless of our background, our strengths, and our weaknesses. If you are new to a facility, you are a hindrance and if you stay too long, you are mediocre. The middle ground gets pretty slippery as you are handed more responsibilities and duties and told phrases such as "flex up". Meanwhile, your patient in bed A is screaming in pain, there is a physician shouting from bed B for this supply, and there are four patients in the ER that are awaiting a bed and while come to you aggravated because of the wait. Your fellow coworker is a few days out of nursing school and so you are keeping an eye out for their actions and the nurse who you replaced from the previous shift was negligent in her duties and so you are trying to play catch-up. You are talked down to by newly made doctors. When you suggest something, it is dismissed as being incorrect regardless of it's validity. Rather than being able to care for your patients, you spend the day documenting your actions, trying to find supplies your patients needs, dealing with equipment that is truly embarrassing you are still using, and pleading with a doctor to just listen to your rationale.

Why do we remain? I have been trying to find answers and they are truly slim.

I have been in nursing forums for a while now, and I have heard many negative comments about the working conditions for RNs. The conclusions I have reached based on my observations may anger some, but I will voice them anyway:

1. The nurses who feel degraded often don't have a very caring heart. They need status in their profession of nursing, but they don't realize that status-seeking and truly caring for others is most often mutually exclusive. It's hard to provide perineal care when you really--in your heart--just want to tell others what to do.

2. Nurses who want to tell doctors what to do and then feel disregarded by them don't seem to realize what the profession of nursing is and what the profession of medicine is. Nurses care for patients who can't care for themselves because they are sick; they assess patients and make objective observations and statements about the patients condition. They administer prescribed treatments and medications often based on their own assessments (i.e., PRN meds, sliding scales, ranges, etc.); they educate patients and families. They don't diagnose medical conditions and prescribe treatments. They diagnose conditions related to nursing care and implement nursing interventions to acheive a good outcome.

I think nursing is the highest profession, but a lot of nurses think physician is the highest profession, and they will always feel put down by physicians--especially when the physician doesn't allow them to play physician. Imagine how you'd feel if a respiratory therapist or radiology tech made nursing recommendations to you.

3. Short staffing is a problem. If one has their application in and is seeking interviews in hospitals with better nurse/patient ratios then I truly feel for their plight in regards to staffing. If they aren't lifting a finger to change hospitals, then it can't bother them that much. And here's the real sticker: every nurse I've met that complains the most about staffing is the nurse who typically does the least for his/her patients. I'm not saying there's a correlation; I'm just saying it's what I have seen.

4. A person can have a positive attitude in the worst of situations. We can't just be nurses to our patients; we have to be nurses to everyone around us. We care for the sick, but we care for our coworkers by keeping a positive attitude at all times--even if we have to fake it at all times.

Just my ramblings--please feel free to disagree and tell me about it:)

The Monist

There Are Many Parts Of A Problem......1) Maybe That When You Have Too Much To Do You Really Cannot Not Give A 100% And This Leaves You With A Feeling Of Guilt.....2) There Will Always Be Those Co-workers Who Will Set Back And Let Someone Else Do The Work This Is True Of Any Workplace Not Just Nursing.....3)another Problem Is That Those Who Hire Are Often Most Interested In A Warm Body With A License.....hardworking Competent Nurses May Be Appreciated By Those Directly Involved With You But When You Leave You Are Replace With Another Nurse And The River Flows On Good Bad And Indifferent.....4)those Who Told You To Move On Are Probably Right......take What You Have Learned And Find Someplace Where You Feel That You Are Making A Difference...... There Are Many Types Of Nursing And Maybe You Are Not In The Place Where You Should Be......good Luck With What Ever Decision You Make

Just my ramblings--please feel free to disagree and tell me about it

I completely disagree with nearly everything you said.

Except I do think one should have a positive outlook ~ until they GET OUT OF THERE~! :rotfl:

To say that nurses who make suggestions to doctors regarding patient care want to be doctors themselves is absolutely ridiculous! I personally make suggestions to physicians every single day (and if I wanted to be a doctor I would have gone to medical school). I am the one who is spending 12 hours with the patient and I am the one who has 1-2 patients, not 30-40 patients. A physician (especially a resident who has never before set foot in an ICU) cannot possibly know everything about every one of his or her patients and if he or she does not order something that the patient needs or orders something inappropriate, it is my job to advocate for the patient and question it! Generally, most physicians are very grateful for your input and if they do not take your suggestion, they are happy to explain the rationale behind it!

To CCU RN, I have to agree that it sounds like you might need a change...not even out of the ICU but maybe to a different ICU or facility. Yes, I have my bad days at work like anyone else and I sometimes encounter crabby coworkers, family members, or physicians, but in general, I love my job! We get along very well with one another and most of the other staff. I truly feel that patient care in my unit is a team effort! You should look for a happier environment in my honest opinion.

Specializes in Emergency Room.
To say that nurses who make suggestions to doctors regarding patient care want to be doctors themselves is absolutely ridiculous! I personally make suggestions to physicians every single day (and if I wanted to be a doctor I would have gone to medical school). I am the one who is spending 12 hours with the patient and I am the one who has 1-2 patients, not 30-40 patients. A physician (especially a resident who has never before set foot in an ICU) cannot possibly know everything about every one of his or her patients and if he or she does not order something that the patient needs or orders something inappropriate, it is my job to advocate for the patient and question it! Generally, most physicians are very grateful for your input and if they do not take your suggestion, they are happy to explain the rationale behind it!

To CCU RN, I have to agree that it sounds like you might need a change...not even out of the ICU but maybe to a different ICU or facility. Yes, I have my bad days at work like anyone else and I sometimes encounter crabby coworkers, family members, or physicians, but in general, I love my job! We get along very well with one another and most of the other staff. I truly feel that patient care in my unit is a team effort! You should look for a happier environment in my honest opinion.

i agree with you. i don't want to be a doctor, but i have not met a doctor yet that is offended when you mention what you think may be going on with a patient or suggest something. of course if you say something like "look doc, you are wrong. this is what you NEED to do......" yeah, you are likely to get a funny look. but doctors actually respect nurses more when they can contribute to the care of the patient in more ways than just a task oriented one. in ER it is so fast paced the docs can easily miss something and they depend on the nurses to cover for them. working with sick people can be dfficult, but i find that your environment is as bad as you create it. i try to make the patient my FULL focus. when you focus on other coworkers too much and worry about what they are doing or not doing, it makes your job more frustrating and at the end of the day you forget what you did to make a difference in a patients life.

I have been in nursing forums for a while now, and I have heard many negative comments about the working conditions for RNs. The conclusions I have reached based on my observations may anger some, but I will voice them anyway:

1. The nurses who feel degraded often don't have a very caring heart. They need status in their profession of nursing, but they don't realize that status-seeking and truly caring for others is most often mutually exclusive. It's hard to provide perineal care when you really--in your heart--just want to tell others what to do.

2. Nurses who want to tell doctors what to do and then feel disregarded by them don't seem to realize what the profession of nursing is and what the profession of medicine is. Nurses care for patients who can't care for themselves because they are sick; they assess patients and make objective observations and statements about the patients condition. They administer prescribed treatments and medications often based on their own assessments (i.e., PRN meds, sliding scales, ranges, etc.); they educate patients and families. They don't diagnose medical conditions and prescribe treatments. They diagnose conditions related to nursing care and implement nursing interventions to acheive a good outcome.

I think nursing is the highest profession, but a lot of nurses think physician is the highest profession, and they will always feel put down by physicians--especially when the physician doesn't allow them to play physician. Imagine how you'd feel if a respiratory therapist or radiology tech made nursing recommendations to you.

3. Short staffing is a problem. If one has their application in and is seeking interviews in hospitals with better nurse/patient ratios then I truly feel for their plight in regards to staffing. If they aren't lifting a finger to change hospitals, then it can't bother them that much. And here's the real sticker: every nurse I've met that complains the most about staffing is the nurse who typically does the least for his/her patients. I'm not saying there's a correlation; I'm just saying it's what I have seen.

4. A person can have a positive attitude in the worst of situations. We can't just be nurses to our patients; we have to be nurses to everyone around us. We care for the sick, but we care for our coworkers by keeping a positive attitude at all times--even if we have to fake it at all times.

Just my ramblings--please feel free to disagree and tell me about it:)

The Monist

It may be a wise idea to wait until you have worked as a staff nurse before making such judgments.

Specializes in Nursing Education.
I have been in nursing forums for a while now, and I have heard many negative comments about the working conditions for RNs. The conclusions I have reached based on my observations may anger some, but I will voice them anyway:

1. The nurses who feel degraded often don't have a very caring heart. They need status in their profession of nursing, but they don't realize that status-seeking and truly caring for others is most often mutually exclusive. It's hard to provide perineal care when you really--in your heart--just want to tell others what to do.

2. Nurses who want to tell doctors what to do and then feel disregarded by them don't seem to realize what the profession of nursing is and what the profession of medicine is. Nurses care for patients who can't care for themselves because they are sick; they assess patients and make objective observations and statements about the patients condition. They administer prescribed treatments and medications often based on their own assessments (i.e., PRN meds, sliding scales, ranges, etc.); they educate patients and families. They don't diagnose medical conditions and prescribe treatments. They diagnose conditions related to nursing care and implement nursing interventions to acheive a good outcome.

I think nursing is the highest profession, but a lot of nurses think physician is the highest profession, and they will always feel put down by physicians--especially when the physician doesn't allow them to play physician. Imagine how you'd feel if a respiratory therapist or radiology tech made nursing recommendations to you.

3. Short staffing is a problem. If one has their application in and is seeking interviews in hospitals with better nurse/patient ratios then I truly feel for their plight in regards to staffing. If they aren't lifting a finger to change hospitals, then it can't bother them that much. And here's the real sticker: every nurse I've met that complains the most about staffing is the nurse who typically does the least for his/her patients. I'm not saying there's a correlation; I'm just saying it's what I have seen.

4. A person can have a positive attitude in the worst of situations. We can't just be nurses to our patients; we have to be nurses to everyone around us. We care for the sick, but we care for our coworkers by keeping a positive attitude at all times--even if we have to fake it at all times.

Just my ramblings--please feel free to disagree and tell me about it:)

The Monist

Are you an RN? Are you at the bedside 8 or 12 hours a day, perhaps longer? Do you really have any understanding of what you have written here? Wow, I really think you are one uninformed individual. I hope for your sake that in your future posts, you really have a better understanding of the topic before you post such an uniformed opinion. Yup, you are right about this .... I totally disagree with you, but that is what is great about our country .... people are entitled to their own opinion, no matter how far out it is.

Specializes in Oncology/Haemetology/HIV.

Don't feed the trolls/SDNers?

Why do you think their is such a lack of nurses. Look its very tough being a Nurse you gotta take so much crap and get very little respect in return but thats what Nursing is deal with it. Nurses are a special breed few can take the stuff nurses deal with on a regular basis thats why Nurses are essentail their the backbone of the hospital remember that just hang in their dont let some worthless doctors bring you down just keep your head up the patients need good nurses like you even though those [TOS violation] rarely appreciate your care.

Thanks for your response. I guess I am not the type of person that can "just deal" with poor conditions. While I do agree you need to pick your battles and some things aren't worth your time or energy. However, if there are reasons that are keeping people out of nursing then shouldn't we as practitioners advocate for betterment?? We do it every day for our patients. Why shouldn't we do it for the betterment of our profession?

Your statements here can be the single voice that validates why our country is in the midst of a national nursing shortage. Who in their right mind would want to work like this, let alone make it a career for the next 20 or 30 years.

Yes, I totally relate and understand what you are saying. You describe the situation perfectly, almost as if you and I worked together each day. I feel the same way that you do .... perhaps not every day, but more days than I want too. I think that nursing is becoming a more complex job, not because technology is advancing, but because health care profits are driving the way in which care is rendered.

This is no longer simply a nursing issue. Yes, nurses need to unite and support their national associations and have a voice, but, the general public needs to understand that hospitals and HMO's are placing them in VERY unsafe sitauations. An RN that already has 5 or 6 patients and then gets another post op patient can not properly care for this patient and monitor the patient as may be needed or required. The patient's life truly lies in the balance here.

As nurses, we remain patient advocates. That translates into advocates for future patients as well. We MUST educate the public about this horrific situation so that laws can be passed to mandate safer care. This mandate will (hopefully) translate into a safe nurse to patient ratio and perhaps improve the safety for our patients and for us as nursing professionals.

I thnak you for posting this thread. Please know that there are others that feel the same as you. We continue to go to work each day because if we can make a difference in one patient's life, then maybe the craziness we deal with everyday was worth it. I know I made a difference for one patient today. And, that is a good thing.

Thank you very much for your response. It is comforting to know that I am not alone in my sentiments. However, it is also saddening to realize the state of health care and nursing. I guess that is where my post comes from. Nursing school gives you this idealistic view of the profession and well it ain't that ideal. It seems as though the longer I spend in it, the more and more evident this becomes.

Our patients deserve the very best of care and it is quite disheartening to know that the majority of our patients do not recieve it. Being a caring person, it truly upsets me. I am not necessarily isolating my unit, b/c there are some very good nurses on it. My facility is also a top hospital in the state. They are trying for magnet status at this time.

It just seems like the stories from patients about practitioners and hospitals, the things I see day by day, and the low morale I encounter from most nurses is screaming that OUR PATIENTS AND OUR NURSES DESERVE BETTER!!!

I agree with you that we need to advocate not only for our patients today but also for the future. Your post inspired me to join the ANA and I am going to become more vocal about specific things within my facility. I am even debating submitting some writing to a local paper. It may be a small cry admist a hurricane, but who knows.

Thank you again for your post and for your understanding.

CCU RN- I am sorry you are going through this. Usually I dislike when people's solution to a problem is: just quit. But you may want to try the ED. I have never seen an MD/DO/PA be rude to an RN in the (wow) three facilities I have worked in, all varying in size/acuity. We are truly a team (I am a CCT/SN and still get respect from the Drs, gasp!). And in terms of new residents, if they are even allowed to practice in the ED, they are overwhelmed, affraid, and unsure how to handle some of the patients. They look to the RNs for guidance and assistance. Why not offer to float there one day and see how you like it? The other above poster is correct though, I believe that this is why there is a nursing shortage...

Thank you jamie for your post. I am actually in the process of interviewing in the PACU at my facility and will give that a try. I am glad you have found a good fit for yourself in the ED. (Which if the PACU doesn't work out, ED is my next stop :) )

I work at a Magnet hospital on the West coast. The physician/nurse relations are actually quite good, and I feel respected most of the time. I also have a supportive manager & wonderful co-workers. We often socialize with the physical and occupational therapists outside of work. Our nurse to patient ratios are only 1 to 3 or 1 to 4 hospital-wide (med-surg floors). Overall, I feel respected as a professional.

One thing I've learned after all my clinicals and experience at this job -- choose your place of work wisely! Nurses get a raw deal almost everywhere. You have really got to be selective, if possible.

Believe it or not, my hospital is in the process of obtaining magnet status. I am glad to hear that you are in such a good situation though. Changing facilities where I live definitely is not an option. From what I hear from travelers and agency nurses, my hospital is MUCH better than anywhere else in the area....scary huh?

As I wrote above, I am in the process of changing departments. Hopefully that will make a difference.

Thanks for your reply.

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