I hate what's happening to nursing...

RNAM1965 · Mar 23, 2011

Wow, all these posts are so sad, Everyone is really missing the point. What I am about to type is going to sound harsh but there is no other way to say it.

People in healthcare are given scripts because the truth is most healthcare workers don't communicate appropriately. Pt satisfaction, Press Ganey, etc are here to stay and I think angry, miserable nurses who think "management" and "administration" are clueless and are the enemy really need to stop and educate themselves on what is going on with healthcare, the gov't, the payors, Medicaid, Medicare, CMS, etc.

Pay for Performance rating periods begin in July this year and guess what? Medicaid/Medicare will base their reimbursement not on services rendered, but on quality of care (the quality indicators like CHF discharge teaching) and patient's perceptions of their care. 70% of reimbursement from the "core measures"--there's 17 of them--if your facility hasn't taught them to you , shame on them. If you haven't listened, shame on you. 30% of reimbursement will be based on patient's perception of their care (HCAHPS). Private payors always follow suit.

You want to know why CMS and others are concerned about patient's perceptions of their care? Numerous research will tell you (NE Journal of Medicine for one) that when you focus on improving patient's perceptions, the quality of care follows. Facilities that have high customer service ratings also have better quality outcomes for their patients. Isn't that why we do what we do? To improve patient outcomes?

"Scripting" and other measures are implemented by facilities because they are evidence-based techniques that have been proven to reduce patient anxiety. Studies prove over and over that when you manage patient anxiety you increase their compliance with their treatment regimen and you have better patient outcomes.

"Hourly Rounding": love it or hate it, but this is a technique all of us old, and good, nurses have practiced for years. It is proactive and efficient. When it is done properly, again the evidence confirms less decubitus, less falls, and other quality indicators that are influenced by nursing. Also, less failure to rescue.

I came into the nursing profession from a prior professional career and I can tell you, I was appalled at the way most healthcare workers communicate with patients and the unprofessional attitudes. People don't introduce themselves to patients or explain what they are doing so now it has to be mandated. Put yourself in the patient's place, would you want that? Would you want the miserable, frumpy, complaining nurse who runs in and out your room quickly without explaining anything caring for you? Or your family members? Would that make you feel safe? Would that inspire confidence in you that you are receiving good care? Wouldn't you want someone who came in to care for you, to introduce themselves, check on you regularly, and act like competent, efficient, and skilled professionals?

What REALLY is the problem with a script? They are everywhere now. Wanna know why? Because when used correctly they work. They get desired results when used consistently. Really, what is insulting about a script? Is it because you don't understand the purpose of it? It really doesn't take more time to say those key things that are so important to most of our patients. I sincerely think a lot of nurses need to get over themselves and stop feeling insulted when given tools to use that are proven to decrease patient anxiety and increase outcomes. Really, give it a try. In any other profession if you refused to do it, you would be fired and you should be fired. Give it an honest chance and use it to your advantage. My heart breaks for the nursing profession; I see so many of my colleagues ***** and moan and complain and they don't really know what they are talking about. Not being mean, but it is a professional responsibility to keep up with the evidence and research out there. And the research supports the actions your facilities are rolling out to you. People don't have time to just sit around and make this stuff up. Stop being miserable for the sake of being miserable and educate yourself and constantly look for ways to improve your practice and your outcomes.

But guess what, so many nurses aren't capable of that because it is easier to "be insulted as a professional" than it is to act like one! Nursing is a hard job, always has been and always will be. If you compare what we are doing to fast food work, now THAT is insulting. And if much simpler jobs need scripting to consistently get whatever the desired outcome is, why shouldn't a job as difficult and complex as ours need scripts too? They really are no different than following a clinical practice pathway, clinical policy or guideline.

Scripting is good for patients and that should matter to any nurse. When we are at work, it is not about us, it's about the patient. If talking from a script isn't comfortable, just get over it and do it, and it will get more comfortable with time--just like anything else in life. Positive communication is good for patients and in turn, is good for you. Being positive is better for everyone's morale. I think that if most nurses could feel good about what they're doing, they wouldn't be so miserable. And scripting, rounding, etc is about making things better for the patient and improving their outcomes. If everyone would just do these things MOST of the time, all of us could be more efficient. But when half the staff are stamping their feet and whining about the professional "insults", refusing to do things and just throwing up roadblocks to any changes, how can any of us be successful? We will always have problems as a profession if we can't ever work together for the common goal of the patient? Nurses could be taken more seriously by all if they would stop acting unprofessional and just give things a try--seriously try, not being passive-aggressive or self-sabotaging.

RNAM1965 · Mar 23, 2011

To Reenski,

Keep at it, nursing is what YOU make of it. Sometimes I don't know why I look at this website, it is sad and full of negative comments.

No job or career is perfect, but if you really want to be a nurse and you really enjoy working with people, nursing can be a rewarding and satisfying career choice. Skilled RNs who conduct themselves as professionals do have a good status. Nurses who job-hop every few years looking for the perfect position, or who enter nursing for the wrong reasons, are usually miserable.

This career is like most; you get what you give. Nursing is not just about showing up to work your shift. Professional RNs are concerned with the patient's whole well-being and it is a professional responsibiilty to keep current with research and practices.

I don't understand why most nurses sit around and complain and hop from job to job. Stick somewhere long enough to learn what you are doing (it can take years in a complex field like nursing to get really good, at least 7 years to be an expert in your field). Become involved in professional organizations and activites that enhance your knowledge and care you provide; "do the right thing" and act like a professional, a mature grown-up, and specialize when you find your niche, your passion. ... Good Luck and welcome to nursing! Don't pay attention to the haters on these sights, you know those who are most unhappy scream (or type!) the loudest!

ccampbell1012 · Mar 23, 2011

Wow, all these posts are so sad, Everyone is really missing the point. What I am about to type is going to sound harsh but there is no other way to say it.
People in healthcare are given scripts because the truth is most healthcare workers don't communicate appropriately. Pt satisfaction, Press Ganey, etc are here to stay and I think angry, miserable nurses who think "management" and "administration" are clueless and are the enemy really need to stop and educate themselves on what is going on with healthcare, the gov't, the payors, Medicaid, Medicare, CMS, etc.
Pay for Performance rating periods begin in July this year and guess what? Medicaid/Medicare will base their reimbursement not on services rendered, but on quality of care (the quality indicators like CHF discharge teaching) and patient's perceptions of their care. 70% of reimbursement from the "core measures"--there's 17 of them--if your facility hasn't taught them to you , shame on them. If you haven't listened, shame on you. 30% of reimbursement will be based on patient's perception of their care (HCAHPS). Private payors always follow suit.
You want to know why CMS and others are concerned about patient's perceptions of their care? Numerous research will tell you (NE Journal of Medicine for one) that when you focus on improving patient's perceptions, the quality of care follows. Facilities that have high customer service ratings also have better quality outcomes for their patients. Isn't that why we do what we do? To improve patient outcomes?
"Scripting" and other measures are implemented by facilities because they are evidence-based techniques that have been proven to reduce patient anxiety. Studies prove over and over that when you manage patient anxiety you increase their compliance with their treatment regimen and you have better patient outcomes.
"Hourly Rounding": love it or hate it, but this is a technique all of us old, and good, nurses have practiced for years. It is proactive and efficient. When it is done properly, again the evidence confirms less decubitus, less falls, and other quality indicators that are influenced by nursing. Also, less failure to rescue.
I came into the nursing profession from a prior professional career and I can tell you, I was appalled at the way most healthcare workers communicate with patients and the unprofessional attitudes. People don't introduce themselves to patients or explain what they are doing so now it has to be mandated. Put yourself in the patient's place, would you want that? Would you want the miserable, frumpy, complaining nurse who runs in and out your room quickly without explaining anything caring for you? Or your family members? Would that make you feel safe? Would that inspire confidence in you that you are receiving good care? Wouldn't you want someone who came in to care for you, to introduce themselves, check on you regularly, and act like competent, efficient, and skilled professionals?
What REALLY is the problem with a script? They are everywhere now. Wanna know why? Because when used correctly they work. They get desired results when used consistently. Really, what is insulting about a script? Is it because you don't understand the purpose of it? It really doesn't take more time to say those key things that are so important to most of our patients. I sincerely think a lot of nurses need to get over themselves and stop feeling insulted when given tools to use that are proven to decrease patient anxiety and increase outcomes. Really, give it a try. In any other profession if you refused to do it, you would be fired and you should be fired. Give it an honest chance and use it to your advantage. My heart breaks for the nursing profession; I see so many of my colleagues ***** and moan and complain and they don't really know what they are talking about. Not being mean, but it is a professional responsibility to keep up with the evidence and research out there. And the research supports the actions your facilities are rolling out to you. People don't have time to just sit around and make this stuff up. Stop being miserable for the sake of being miserable and educate yourself and constantly look for ways to improve your practice and your outcomes.
But guess what, so many nurses aren't capable of that because it is easier to "be insulted as a professional" than it is to act like one! Nursing is a hard job, always has been and always will be. If you compare what we are doing to fast food work, now THAT is insulting. And if much simpler jobs need scripting to consistently get whatever the desired outcome is, why shouldn't a job as difficult and complex as ours need scripts too? They really are no different than following a clinical practice pathway, clinical policy or guideline.
Scripting is good for patients and that should matter to any nurse. When we are at work, it is not about us, it's about the patient. If talking from a script isn't comfortable, just get over it and do it, and it will get more comfortable with time--just like anything else in life. Positive communication is good for patients and in turn, is good for you. Being positive is better for everyone's morale. I think that if most nurses could feel good about what they're doing, they wouldn't be so miserable. And scripting, rounding, etc is about making things better for the patient and improving their outcomes. If everyone would just do these things MOST of the time, all of us could be more efficient. But when half the staff are stamping their feet and whining about the professional "insults", refusing to do things and just throwing up roadblocks to any changes, how can any of us be successful? We will always have problems as a profession if we can't ever work together for the common goal of the patient? Nurses could be taken more seriously by all if they would stop acting unprofessional and just give things a try--seriously try, not being passive-aggressive or self-sabotaging.

I just found a positive. I don't have to work with you!

RNAM1965 · Mar 23, 2011

Yep, I feel pretty positive about that fact too! Have a great day!

Over-the-hill-Nurse · Mar 24, 2011

Wow, all these posts are so sad, Everyone is really missing the point. What I am about to type is going to sound harsh but there is no other way to say it.
People in healthcare are given scripts because the truth is most healthcare workers don't communicate appropriately. Pt satisfaction, Press Ganey, etc are here to stay and I think angry, miserable nurses who think "management" and "administration" are clueless and are the enemy really need to stop and educate themselves on what is going on with healthcare, the gov't, the payors, Medicaid, Medicare, CMS, etc.
Pay for Performance rating periods begin in July this year and guess what? Medicaid/Medicare will base their reimbursement not on services rendered, but on quality of care (the quality indicators like CHF discharge teaching) and patient's perceptions of their care. 70% of reimbursement from the "core measures"--there's 17 of them--if your facility hasn't taught them to you , shame on them. If you haven't listened, shame on you. 30% of reimbursement will be based on patient's perception of their care (HCAHPS). Private payors always follow suit.
You want to know why CMS and others are concerned about patient's perceptions of their care? Numerous research will tell you (NE Journal of Medicine for one) that when you focus on improving patient's perceptions, the quality of care follows. Facilities that have high customer service ratings also have better quality outcomes for their patients. Isn't that why we do what we do? To improve patient outcomes?
"Scripting" and other measures are implemented by facilities because they are evidence-based techniques that have been proven to reduce patient anxiety. Studies prove over and over that when you manage patient anxiety you increase their compliance with their treatment regimen and you have better patient outcomes.
"Hourly Rounding": love it or hate it, but this is a technique all of us old, and good, nurses have practiced for years. It is proactive and efficient. When it is done properly, again the evidence confirms less decubitus, less falls, and other quality indicators that are influenced by nursing. Also, less failure to rescue.
I came into the nursing profession from a prior professional career and I can tell you, I was appalled at the way most healthcare workers communicate with patients and the unprofessional attitudes. People don't introduce themselves to patients or explain what they are doing so now it has to be mandated. Put yourself in the patient's place, would you want that? Would you want the miserable, frumpy, complaining nurse who runs in and out your room quickly without explaining anything caring for you? Or your family members? Would that make you feel safe? Would that inspire confidence in you that you are receiving good care? Wouldn't you want someone who came in to care for you, to introduce themselves, check on you regularly, and act like competent, efficient, and skilled professionals?
What REALLY is the problem with a script? They are everywhere now. Wanna know why? Because when used correctly they work. They get desired results when used consistently. Really, what is insulting about a script? Is it because you don't understand the purpose of it? It really doesn't take more time to say those key things that are so important to most of our patients. I sincerely think a lot of nurses need to get over themselves and stop feeling insulted when given tools to use that are proven to decrease patient anxiety and increase outcomes. Really, give it a try. In any other profession if you refused to do it, you would be fired and you should be fired. Give it an honest chance and use it to your advantage. My heart breaks for the nursing profession; I see so many of my colleagues ***** and moan and complain and they don't really know what they are talking about. Not being mean, but it is a professional responsibility to keep up with the evidence and research out there. And the research supports the actions your facilities are rolling out to you. People don't have time to just sit around and make this stuff up. Stop being miserable for the sake of being miserable and educate yourself and constantly look for ways to improve your practice and your outcomes.
But guess what, so many nurses aren't capable of that because it is easier to "be insulted as a professional" than it is to act like one! Nursing is a hard job, always has been and always will be. If you compare what we are doing to fast food work, now THAT is insulting. And if much simpler jobs need scripting to consistently get whatever the desired outcome is, why shouldn't a job as difficult and complex as ours need scripts too? They really are no different than following a clinical practice pathway, clinical policy or guideline.
Scripting is good for patients and that should matter to any nurse. When we are at work, it is not about us, it's about the patient. If talking from a script isn't comfortable, just get over it and do it, and it will get more comfortable with time--just like anything else in life. Positive communication is good for patients and in turn, is good for you. Being positive is better for everyone's morale. I think that if most nurses could feel good about what they're doing, they wouldn't be so miserable. And scripting, rounding, etc is about making things better for the patient and improving their outcomes. If everyone would just do these things MOST of the time, all of us could be more efficient. But when half the staff are stamping their feet and whining about the professional "insults", refusing to do things and just throwing up roadblocks to any changes, how can any of us be successful? We will always have problems as a profession if we can't ever work together for the common goal of the patient? Nurses could be taken more seriously by all if they would stop acting unprofessional and just give things a try--seriously try, not being passive-aggressive or self-sabotaging.

Wow...I am not novice at nursing and it is a job that does take hard work and a strong constitution to be able to go to work each day and to be "ABLE" to act in that "Professional Nurse" mode. The decision for hospitals and other facilities to adopt the stern role of SCRIPTING TO ENHANCE PATIENT SATISFACTION is not a new one. It is the way that it has come about that is the issue.

I and so many others on this site are not ignorant to what has been happening in nursing over the last decade. Evidence Based Nursing was actually more patient oriented 20 years ago than it is today. This new wave of customer satisfaction doesn't have anything to do with being "A Good Patient Advocate" nor being a "Professional Nurse". It is purely money. This whole process actually started back in 1996 when the health care system underwent a major transformation, largely driven by market forces seeking to contain costs. Then in 2002, the CMS partnered with the agency for Healthcare Research and Quality, another federal agency in the department of HHS to develop and test the HCAHPS survey. It was endorced in 2005 by the National Quality Forum. In 2006 CMS implemented it and then hospitals were subject to the Inpatient Prospective Payment System, which is dependent on patient surveys in order to recieve full embursement. Then came along the 2010 patient protection and affordable care act which includes the HCAHPS and the measures to calculate value-based incentive payments. And as I said IT IS ABOUT THE MONEY...

I personally take offense at the way you presented your argument. I never job hopped, as a matter of fact, I was at one facility for 20 years. I am not a 2 year old and do not need a script to preform my nursing duties. I personally have introduced myself to each and every patient that I have ever taken care of, I have spent countless hours with patients and their families in ensure that they have/had current teaching, answered their questions, and met their every need. I do not need a script to tell me how to do that.

A better way for facilities to have introduced the going trends of customer service would have been to implement a task force within their facility to promote collaboration, brainstorming in ideas, and achieving concensus that would have provided a optimal outcome which is patient satisfaction rather than treat professional nurses as children. They also would have a better outcome if they supplied adequate staffing, ancilliary staff to do breathing tx, answering the phones, etc instead of nurses being "Jack of all trades".

Respect is earned. Not freely given. Everyone is entitled to their own opinion. I, myself feel that I have been a nurse long enough to be able to disagree with newer methods of achieving patient satisfaction other than degrade the nurses who have given their all and still do for their patients. For us, it isn't about the money, and I don't care what facility anyone works in, it is ALL ABOUT THE MONEY AND NOT ABOUT THE NURSES.

Just my 2 cents worth :twocents:

RNAM1965 · Mar 24, 2011

Sorry if you took offense. I'm glad you don't need a script but the sad fact is many nurses and other healthcare professionals do. There would not be scripts if there wasn't a need for them. And why is anyone surprised that anything is about money? Even not-for-profits, like I work for, simply cannot afford to have reimbursement cut any more or alot of us will no longer have jobs. Doesn't matter how many nurses you need if you can't pay them.

Now that hsopitals will no longer reimbursed for the harm we do to patients, hospitals are getting serious about the fact that communication failures = worse outcomes. I just can't understand why any caring professional is against anything that has been proven in the research to improve patient outcomes and enhance the bottom line. Please tell me how that is degrading. Our hospital needs our revenue to replace our falling down building, not line the pockets of shareholders.

As a nurse who always has done exactly what you said, introduce yourselves to patients, communicate appropriately, etc. I will tell you that it is our co-workers who do not do the right thing, (and there still are plenty of them and you know it's true--this site if full of posts about unprofessional staff behaviors towards each other and that always rolls down to the patients--lots of research to support that too). It's that inconsistency that erodes the patient experience and outcomes and I applaud any measure put in place to bring all staff up to a minimal level of professionalism. It will make all our jobs easier if everyone does the right thing. I for one am tired of the way other healthcare professions view nursing and it's because nurses are always arguing, in-fighting, and getting offended about every little thing. Get offended about the big things.

All patients deserve competent and compassionate care no matter how busy we are.

PMFB-RN, RN · Mar 24, 2011

Wow, all these posts are so sad, Everyone is really missing the point. What I am about to type is going to sound harsh but there is no other way to say it.
People in healthcare are given scripts.

*** People in health care???????? Are you telling us that where you work the physicians have scrips too? Or do you mean nurses and other lowly functionaries?

I will consider scripts AFTER I see our neurosurgeons and cardiovascular surgeons using them.

RNAM1965 · Mar 24, 2011

It is hard to believe that you would only do something to benefit your patients only after a doctor does it too. Can you not see how unprofessional THAT is? Doctors don't work for the hospital. Our docs don't have scripts but they are held accountable for their behaviors, whether toward staff or patients. Scripts are given to the people who communicate with patients the most where it will make the most impact. And really, if your employer tells you to do something, you kind of have to do it. Too bad, only in healthcare are things not enforced as they should be. We are held accountable for these scripts and people can and should lose their jobs if they don't do it.

PMFB-RN, RN · Mar 24, 2011

it is hard to believe that you would only do something to benefit your patients only after a doctor does it too.

*** there is no discussion on actions that benefit patients. we are discussing scripting.

can you not see how unprofessional that is? doctors don't work for the hospital. our docs don't have scripts but they are held accountable for their behaviors,

*** i see, so when you say "people in health care" you mean nurses. i wonder why you try to less than clear with your description. i am 100% accountable for my behavior. this has been true in every hospital i have ever worked in.

whether toward staff or patients. scripts are given to the people who communicate with patients the most where it will make the most impact.

*** in reality scripts are given to nurses because they are seen as less than full professionals and far more likely to tolerate such condescending behavior from management.

and really, if your employer tells you to do something, you kind of have to do it.

*** i think you took a wrong turn some place and think you are in north korea where people can be ordered around. i refuse to treat my patients in a condescending manner. i insist on using effective therapeutic communication with my patients. if my employer tries to force me to provide less than optimal nursing care to my patients i will be out the door. i am highly skilled and very much in demand. i can have a job with a hospital that places a higher value on good patient care and customer service in a heartbeat.

as i stated early in this thread i have already refused to use scripted communication with my patients. i wasn't fired and have since been promoted.

too bad, only in healthcare are things not enforced as they should be.

*** there you go again calling it "health care" when you really mean nurses. two questions for you. how do you suppose such a practice could be "enforced"? an employer can only fire us. they have no other means of "enforcing" their will on us. second can you give me another example of college educated, licensed professionals you use scripts with their clients?

we are held accountable for these scripts and people can and should lose their jobs if they don't do it.

*** well lucky for us highly skilled and experienced nurses are not hanging around every corner for the hospital to hire when they fire their nurses who refuse to provide hospital mandated substandard care.

i do see reason for the trend to flood the market with new grads over the last few years. nurses desperate for job will do what they are told, even if it mean compromising their standards.

give us credit for understanding that we must use different methods of communication for the retired nun than we do for the gang banger high on meth, just like the physicians.

Reenski · Mar 24, 2011

People don't introduce themselves to patients or explain what they are doing so now it has to be mandated. Put yourself in the patient's place, would you want that? Would you want the miserable, frumpy, complaining nurse who runs in and out your room quickly without explaining anything caring for you? Or your family members? Would that make you feel safe? Would that inspire confidence in you that you are receiving good care? Wouldn't you want someone who came in to care for you, to introduce themselves, check on you regularly, and act like competent, efficient, and skilled professionals?

YES! These were exactly my thoughts when I was reading this thread! And I said something to this degree, although you really hit the nail on the head! :yeah:

I would like to approach nursing with an attitude similar to yours and with an open mind...it is so much more productive! Easier said than done though, I'm sure :-)

Thanks for this post...I had been waiting for someone to articulate the other side of the situation!

Over-the-hill-Nurse · Mar 24, 2011

Yes unfortunately, there are nurses who act immature and it does reflect on patient satisfaction, as well as poor quality care. Mostly here on the forum, many nurses come here to vent because it is a safe place to do that and also because we are for the most part nurses. It is difficult sometimes for the layperson to understand the frustrations, and bad days that we have.

My point is that while the economy, the regulated outcomes, and other things dictate how hospitals, and other facilities obtain revenue, it is also giving respect to its staff and realizing that for the most part, without its nursing staff, they would not be able to provide that 24 hours care.

In todays society, things have changed so drastically in healthcare and it has not been for the better. In order to retain costs, it has also meant staff shortages, not for lack of nurses, but for cost containment, heavier patient loads, fewer ancilliary help, more tasks and so much more that actually puts the patients that we take such pride in caring for at a greater risk. In recent studies, it is linking shorter staffing to a 2% higher mortality rates. But that is another topic. My point is that while we as nurses want to be able to provide good care, it is almost impossible to be able to meet the needs of every patient that you care for and to put a monetary price on that is insulting to people who pride themselves on being able to make a difference in someones life. Facilities could have made a major difference in the way they presented it to their staff by forming a team to include nurses on how best to improve on patient surveys instead of treating the majority like they are 2 year olds, and instead provided scripting to dictate how to communicate with your patients.

There is such a process that works also- it is called Evidence Based Nursing and using that process to figure out "How the hospital/facility can best adapt the process of improving patient satisfaction" by developing a team of management, nursing, ancilliary departments, etc.. and devise the best method to achieve it for their facility.

In this fashion, they maintain autonomy, integrity, and have positive outcomes because everyone works as a whole unit vs management as a unit and staff as a unit. As a whole, the outcomes are achieved by everyone to equal a better outcome which is patient satifaction.

I do agree that there are a great many who probably do need scripting because they don't go that extra mile. But like you said, nursing is a hard job, very physically and mentally exhausting and there are good nurses as well as bad nurses. And I can understand your point of view and for the most part I can agree with your statement that it is here to stay.

Times are tough and it isn't going to get any easier. And healthcare is a business. It is sad though that we went to school and all the training to be a Professional Nurse and that was no easy feat either, to be treated with no respect by the places we work. It is degrading that as businesses, they don't care. I guess I remember when I first started in nursing and it was considered one of the few professions that promoted, stood behind, and assisted you as a nurse and you took pride in where you worked. Today is different.

Reenski · Mar 24, 2011

To Reenski,
Keep at it, nursing is what YOU make of it. Sometimes I don't know why I look at this website, it is sad and full of negative comments.
No job or career is perfect, but if you really want to be a nurse and you really enjoy working with people, nursing can be a rewarding and satisfying career choice. Skilled RNs who conduct themselves as professionals do have a good status. Nurses who job-hop every few years looking for the perfect position, or who enter nursing for the wrong reasons, are usually miserable.
This career is like most; you get what you give. Nursing is not just about showing up to work your shift. Professional RNs are concerned with the patient's whole well-being and it is a professional responsibiilty to keep current with research and practices.
I don't understand why most nurses sit around and complain and hop from job to job. Stick somewhere long enough to learn what you are doing (it can take years in a complex field like nursing to get really good, at least 7 years to be an expert in your field). Become involved in professional organizations and activites that enhance your knowledge and care you provide; "do the right thing" and act like a professional, a mature grown-up, and specialize when you find your niche, your passion. ... Good Luck and welcome to nursing! Don't pay attention to the haters on these sights, you know those who are most unhappy scream (or type!) the loudest!

Thank you for this! :redbeathe