I am going to be writing a paper for a communications class I am taking and have decided to focus on hospital nursing..after reading so many posts on here about the downside of hospital nursing and my own opinion ..I began to wonder - "Is hospital nursing really that bad or are our expectation too high?" I would like feedback from nurse who currently work in the hospital setting..preferably those with over a years experience ONLY because new Grads, obviously, have a tendency to feel overwhelmed anyway..My opinion is..hospital nursing has changed tremendously in the past decade and, for me, not in a good way. I know work is work but I do think there needs to be a certain level of satisfaction, a sense of accomplishment in ANY job we perform. We are exchanging time in our life we cannot get back for it..I have worked as an RN for over 20 yrs - mostly in the hospital setting until 2010...Though there are parts of the hospital I miss, I have to be honest...I don't miss the 12 hour shifts which end up being 13-14, getting up early, coming home to get straight to bed so I can get up early again, I don't miss the 6-7 patient load, emptying potty chairs, cleaning up vomit, the repetitive paperwork or going from being so-so busy you can't eat or use the bathroom for hours to sitting around with nothing to do as the hours drag on. I can't say I would never go back into a hospital setting but for now, right now..no.
But for those of you who are working in the hospital setting - has it gotten as bad as I think it has/was or was it just time for a change for me? Do you think working PRN or part-time makes it easier or worse than FT? I just don't recall so much unhappiness and dissatisfaction in the profession even 10 years ago..nor so many unhappy new grads -aside from the job market sucking...thanks in advance for input.
I have been working on a busy med/surg floor for the past 4 years now. This was my first and so far my only nursing job. I love the patients but I am definitely feeling burned out. Most of the time we are understaffed, we don't have a float pull here so they just pull from floors whether they can afford to give them up or not. I do love staying busy though cause it helps the time fly by. I also love doing 12 hour shifts since that equals more days off a week to spend with my husband and daughter. I am sick of tired of how it seems the most important thing around my hospital is just making the managers look good. They don't care about what a good job you do with your patients. We usually have about 5-6 patients a piece although lately our census has been low which has been a nice relief. I currently am a LVN, going to school for the LVN-RN bridge. I realize I need to work at another facility before I totally bash hospital nursing, it may just be the hospital where I work that sucks. Although the other responses beg to differ, haha. I am greatful for hospital nursing though. It truly has helped me enhance the skills I have learned and use them daily. As far as breaks and such I don't have a problem finding a stopping point to pee, get a drink, eat, etc.
Specializes in Trauma Surgery, Nursing Management.
Nursing has been likened to being in an abusive relationship, and I have to agree with that.
Very interesting analogy.
Let's see....maybe something like this?:
I am only important to you as long as I am constantly giving.
If I do not have the energy to give and give and give today with no regard to my own needs, I am 'persona non grata' and have failed in your eyes.
If I make the slightest mistake, I am severely punished with the threat of becoming homeless, losing anything that I have worked for, and the neverending fear of further harm.
If I ask for a basic need, I am given a lecture about selfishness.
Every move that I make is scrutinized and criticized, "for my own good".
I should never desire recognition for the things that I do well, because I am expected to do them without error.
You tell me that I am allowed to voice dissatisfaction, but when I do, I face harsh consequences.
I am expected to do the most unpleasant things with a smile on my face, because I don't want to seem ungrateful.
If you ask me to go above and beyond, no matter my fatigue level, the word "no" can never escape my lips.
I can see how nursing can be compared to an abusive relationship, however...we as nurses can always seek another job. We don't have to endure the injustices that we experience day to day, such as not taking a lunch, or having to work overtime because our relief called out sick. We can move on, although it has become more difficult to do so in today's economy.
I think the larger picture that many of you were hinting about is that we have recognized that our profession has become more like 'medical waitressing' and less like the real patient care that we crave to deliver. I know that this issue is immense and has been the topic of discussion in many threads on this forum. It almost seems like we are in a Catch-22 situation: we need our jobs, we have worked very hard to get the requisite education and skills in order to provide safe and effective patient care. We seem to have more and more work piled onto us, and if we complain, we are seen as 'whiners'. If we rally other nurses to stand up and fight for better working conditions, we are labeled as 'troublemakers'. It is quite the conundrum.
I work med/surg too and agree with so much of what is said here. My big gripes about working for hospital corporations is how nurses are seen as an expense, not an important commodity. If there were no nurses, there would be no hospitals, but the administration looks at us like we are simply dollar signs, and will do pretty much anything, IMO, to avoid having to hire nurses, or appropriately compensate or support nurses.
Examples:
**My husband works for a large banking corporation. Sometimes they are very busy, sometimes they aren't. Sometimes he comes home and says he looked at things on the internet all day and listened to Pandora, and went out to lunch with clients. Granted, sometimes he has to work late and is very busy, too. But my point is, never in the middle of his shift do they say "Hey, we're pretty slow. We're sending you home (oh and you have to take some of your PTO to cover the hours lost)". Never do they "float" him to a more busy department.
I hate floating, and I really don't like being low censused and be forced to take my PTO. In what other professional industries do either of these practices occur? How many days do we work short staffed for the benefit of the hospital?? And then on one of those days when we, heaven forbid, actually have enough staff or are one patient over the (ridiculous) staffing grid, they ax a nurse or float one away. (And you all know what happens the second we send someone home or float someone....here come the admits!!)
**Speaking of other professional jobs, where else do you get "demerits" or "occurrences" written up as bad marks on your file when you take a sick day? A nurse is treated like he/she committed a crime sometimes when they call in sick. Every other one of my friends/family who have jobs get sick days. My husband gets 10 sick days per year. He calls in sick, uses one of his days. His vacation time/PTO is not touched, he is not reprimanded. He is not begged to come into work anyway, or asked what is wrong with him, of if he's really that sick. He doesn't need a doctor's note to "prove" he was sick. He simply has to call into an automated voicemail to say "I'm not feeling well." We are told sick leave is a benefit provided to us, but is just earned as PTO along with our vacation time and pooled together, yet we are written up and get in trouble if we use the benefit they claim they provide us. Why should we be punished for using a benefit that we have earned??
**Another issue I have with hospital nursing is understaffing. There is a way to avoid understaffing 99% of the time, but administrators don't seem to care about that. There is a float pool at most hospitals, and also agency nurses, or PRN nurses (or heaven forbid, they actually HIRE enough people to staff the beds in the first place). But instead of using these resources, or even putting enough people on the schedule for the day, you show up and, oh you're short-staffed today, but it's ok. It's just for today. You're just going to have to work a little harder. No one even says "sorry this happened". It's just "do more with less, ok? you know we're on a tight budget." I don't care at all about hospital budgets when I'm so busy I want to cry (and sometimes DO cry), and fantasize about walking out and never coming back again. Again, looking at other professions...when would it be acceptable if a teacher showed up to school one day and was told "well we don't have enough teachers today so we're going to have to add 10 students to your class." This doesn't happen. Ever. Class sizes are mandated. A teacher calls in sick, there is a substitute provided 100% of the time. Why is it so "impossible" for there to be a substitute nurse provided every time there is a shortage. MONEY! That is the only reason why. And it's gross.
**One more example, and then I'll stop.
My floor consistently gets very good Press Ganey scores. We have been the top score in the hospital system for the last 4 quarters. My manager reported that recently they scheduled a administrative meeting to basically "pick her brain" to see what she does to make such a "successful" floor. And you want to know what she could think of?? Nothing! She told us she is actually baffled as to why our Press Ganeys are always so good. Us nurses told her, it's pretty obvious. Our floor works together and takes care of each other. We trust each other and people are always willing to help, and we hold each other accountable. The comradery shows, I believe, and the patient feels safe and taken care of. Of course, since she never works on the floor, she has no idea about anything! And guess who got a big raise this year....she did! For doing absolutely nothing. And guess who doesn't even get mentioned....the nurses who EARNED those Press Ganeys. No "way to go!", no bonus, no nothing. All it earned us is more doctors "requesting" their patients be placed on our floor, and getting all the VIPs. Ugh.
Anyway, I digress. No job is perfect, but I think nursing is one of the most physically and emotionally exhausting jobs out there, and we are generally treated like expensive mules, or children, or fat that needs to be cut.
I honestly think it depends on where you work and the environment you work in. I work part time at a hospital and part time at a clinic and enjoy my hospital work much more. Sure, it is more intense and definitely more tiring, but I also think it is more satisfying.
I would not want to work in a hospital on a FT basis anymore - they all are shifting focus to business type - hotel type - flavor. Money, money, money, do more with less and by allll means make the patient and their family happy no matter what (as one person said Earl Grey tea 3 x day). I'm not suggesting we don't try to meet the patients needs and provide a little something extra for them when we can but the focus of patient care has become very blurry and less hands on...sad.
I love it when I hear someone saying they want to be nurse because they want to "help people" and they think it's a "noble profession." Yes, indeed, you do help people and if you constantly strive to help people and give it your all every time you go to work, then you are definitely doing a noble profession. Greed and money is what drives healthcare these days. The main goal is to get employees to do the most amount of work for the least amount of money. Hospitals really don't invest in their employees anymore. For example, I have tried to call in with the explanation that "I will not be a safe nurse tonight." I think my patients deserve a safe nurse. Well, after almost a year without calling in, I was told to throw some water on my face. I was truly disturbed. I'm seeing a scary trend where nurses with less than a year of experience are training new grads.
On the good side, I don't believe that there is any other profession that can give me the kind of flexibility that nursing does. I must say that throughout the recession, I have been offered more jobs. I think we should be paid more, but we make a pretty good salary. Part of the dissatisfaction comes from administration or co-workers. Sometimes you may not like your hospital, but you love your co-workers. That can sometimes make all the difference. It's not an easy profession. There are draw backs to every single profession. Sometimes I think the new grads are shocked at the amount of responsibilities and stress you have deal with everyday. Nursing school can't prepare you for the real world completely.
Yes, it really is that bad. Most of the patients in M/S tele or PCU deserve an ICU bed. There are way too many codes and rapid responses because no one has the time to know their patients, let alone time to detect subtle changes in mentation and perfusion.
What I see in a RR is an upset nurse who is feeling very guilty being grilled about a pt who never should have been admitted to MS at all.
Last week a very respected man was admitted to the observation unit (no monitors) on quick orders for CP and SOB. He was never seen by a physician, just a PA, and the hospitalist was busy with her many other admissions. He coded within minutes of being transferred to his bed. PEA.
Unsafe staffing is now the norm to so called bed coordinators and hospitalists who play fast and loose with public health, safety and welfare. I for one will not be a part of this charade any longer. Read your American Nurses Association Code of Conduct.
Nurses are just a controllable expense to the overpaid administrators who have run American hospitals into the ground. And who work us like dogs while spending hundreds of thousands on ridiculous PR campaigns and glossy brochures.
If you express a safety concern, you are being "negative, argumentative and not a team player."
I would tell anyone that is considering a nursing career not to do it. Do nuclear med tech, OT or PT. Same $ and way less stress. Or maybe you gen Y ers can fix it. But I doubt it. This baby boomer has seen enough wrongful deaths to write a book and I am getting out.
I will have to say, many of the posters here have hit the nail on the head numerous times. It truly is a horrid job on some days. I just came off a day like this yesterday, so I am right now very raw, exhausted, and dreading my shift tomorrow.
I just wish every last nurse in the US would simply get up and walk off the job for a few weeks. We ARE the ones who do the work and make it work, every single day ... they just don't have any idea of what we really do. However, NOW we're being threatened with having foreign nurses come in and take our jobs ... . if we walked off of them.
What disgusts me MOST in all of it are these administrators ..and many of them are former nurses who somehow made it into the Big Girl's ranks, and are the FIRST to backstab their former floor mates every single day. Watching them walk around in their heels and pearls, fresh steaming cups of coffees in their hands while YOU are elbow deep in poo and your phone is ringing off the hook ....well, I just can hardly stand it some days.
With this last shift I pulled, I am really questioning if this is really my calling. I prefer NOT to be the martyr either. The nursing working environment is PATHETIC. No normal person could bear it. I don't know how many of us do. It's just hideous. And I REALLY wonder about the ones who have been doing it, on the floors, for many years ...what has happened to them? What do they leave out, to survive their days?
To me it's one big headache. I'm getting my grad degree in nursing, hoping to become an NP. I'm about to quit and just go get an admin job somewhere until I graduate .. .i just can't STAND working on the floors. I feel it's becoming detrimental to MY health.
The ONE thing I DO enjoy? Once in a while, it's talking with patients, doing something good for them, or advocating for them and having it turn out positive .. .having them thank you. Or having a little old lady, or their family members, reach up and give you a hug ... That feels good. You REALLY had an effect on someone's life at that moment .... I guess that is the intangible part ...
But what sucks is to have too many patients and to NOT be able to do that for any of them, either due to an unfair assignment, a lazy tech who won't support you, a lack of equipment or supplies, or what have you. Too many barriers get in the way of doing what you WANT to do as a nurse .. . well, many others here have said the same thing.
Specializes in L&D; Case Management; Nursing Education.
I have also experienced much of what has already been said (overworking, no recognition for hard work, horrible management, ridiculous patient demands, etc.) while I worked in a hospital for nearly 20 years. But 5 years ago I left the hospital and began working for a private business. Initially it felt so good to be working a M-F desk job (despite the fact that I had to take a $12,000/yr. pay decrease!), but my perspective on this has changed now.
Two years ago we had 3 rounds of layoffs - the most unproductive nurses were laid off. That left the rest of us with alot more work in the same amount of time and no extra pay given - and the pay stinks as it is. Now our company was sold and all the employees have been laid off!! In just 6 weeks the company closes and I haven't found another job. I've gotten sick of working 5 days a week for crappy money. I want to go back to the hospital where the pay is best and I had 4 days off a week! But, apparently the hospitals must think I've been away too long because despite the many years of experience I have, no one will hire me. The only job I've been offered so far is with another private company making $5,000/yr. less than I'm making now!!! That's a $17,000 decrease in just 5 years. So next time you think you might want to get out of the hospital, think again!
Specializes in peds, allergy-asthma, ob/gyn office.
I left hospital nursing in 1994, for many of these reasons that you all mention have increased in the past 10 years. Probably my number 1 reason for leaving was staffing. I worked 3-11 and they were always short staffing us... send a nurse to float, and/or the PCA. Often the charge nurse had to also act as unit clerk. This was a very busy time of day, people back from surgery, always new admits, TPN and milk drips to change. One night we were short and slammed with admissions so badly that I could not get stinkin' Tylenol for my pedi patient! The pharmacy was overwhelmed with the admits as well, and no amount of me walking over to pick it up, begging, or threatening was going to get me that Tylenol. And we did not have the appropriate liquid in floor stock of course. I got my behind chewed out by those parents, and, I can't really blame them. Short staffing stinks.
"Funny" - the main complaint seems to be lack of support and short on shifts..and yet look at all the nurses - new grad and experienced - on here looking for jobs, applying all the time, going on interviews that pan out to nothing...which bridges to the point many are also making on here - the bottom line is money - getting more work from less nurses - saves money but what about quality care? And lives?
Mulan
2,228 Posts
Nursing has been likened to being in an abusive relationship, and I have to agree with that.