I hate what's happening to nursing...

[nyteshade]

Eight years.

That is how long I’ve been in nursing. Just eight years. I haven’t been on AN in a while. I used to frequent the site a lot to vent with others, and help others with advice. Well, today is a ranting kind of day, so here it goes…

I hate what nursing is becoming. It is become overrun with elite folks who have forgotten what it’s like to just get through your shift. It’s being taken over by money hungry CEOs that are finding neat little ways to package “customer service” with healthcare. Our intelligence is being insulted here! What exactly do I mean by this? Well, what professional do you know gets “scripts” to regurgitate at patients? Why is it that we are not trusted to do our job or say the right thing?

I understand that healthcare is indeed a business. It has to be. If it weren’t, we’d all be working for free. I got that. I do my job. I put my all into my shift. I advocate for my patients. I’ve gone above and beyond…all without recognition.

But, I’m deeply saddened…Now I’m being told that isn’t good enough. All I see for the future of healthcare is walking into a patient’s room at the end of my shift saying, “My name is______, if you felt I gave excellent care call 888-tell-them, and rate me a 10.” Heaven forbid you score less than 10 three times…

Eight years ago, I felt so proud in my whites on graduation day. I felt professional, neat, knowledgeable, and respected. Now, I feel burned up, and abused. For now, I stay in nursing…patients still smile, and thank me at the end of my shift. They cannot detect how I feel under the surface.

But, I am seriously considering leaving healthcare altogether.

[Psychtrish39, BSN, RN]

[have the CEOs ever heard of infection control? People wonder why there are so many hospital accquired infections think about it. Its management's fault critically ill people most often are in danger of infection and when you let people visit with no control think of all the bacteria /QUOTE]

Yes, especially on my floor where the families let their kids play on the bed or floor of an ISOLATION patient- and the gowns, gloves, masks, etc are on a cart right infront of the pt room door.

But the customer is always right............ and can do what they damn well please.

maybe the ceo's think they will get further business from this

Makes you think so doesn't it ? I don't think the US public gets it with hospitals being places for sick people. I know when I was growing up and I am not young anymore by any means but this was in 70s and 80s . Children under 12 couldn't visit anyone and in ICU forget about it and there it was 15 minutes each hour or two hours for close family even then. There were also visiting hours. I don't understand why it was changed. Hospitals are not the mall or Walmart for sure.

[PMFB-RN, RN]

Makes you think so doesn't it ? I don't think the US public gets it with hospitals being places for sick people. I know when I was growing up and I am not young anymore by any means but this was in 70s and 80s . Children under 12 couldn't visit anyone and in ICU forget about it and there it was 15 minutes each hour or two hours for close family even then. There were also visiting hours. I don't understand why it was changed. Hospitals are not the mall or Walmart for sure.

*** The SICU where I work has limited visiting hours. We do not allow non-patients to sleep in the rooms ever. The staff RN is free to (nicely) ask the family to leave at any time for any reason and out managment backs us up on this.

[Psychtrish39, BSN, RN]

*** The SICU where I work has limited visiting hours. We do not allow non-patients to sleep in the rooms ever. The staff RN is free to (nicely) ask the family to leave at any time for any reason and out managment backs us up on this.

That is the way it should be in all ICUs or in fact any hospital area but it really is up to management and they set the tone and what goes on in the facility .

[Cmatt13, BSN, MSN]

I understand that this is a forum for ranting--I've done quite a bit myself here. But the bottom line is that nobody ever said it would be easy or fun. At least, nobody ever said that to me. I went in with somewhat low expectations (my mom was a nurse) and have yet to be disappointed.

I work ED as a staff/registry nurse at a community hospital that it part of one of the largest health care systems in my city. The management is crap. The administration is unquestionably the worst I've ever seen. The patients are...ok. They're ED patients...90% of them not emergencies but rather in need of the safety net the ED provides.

I will pay lip service to the administration. I will toe the company line...to their faces. But in reality, my nursing is not defined by whatever corporate plan they have. It is how I care for my patients that defines me as a nurse, not how many patients call and tell the nursing office I'm great.

It's a JOB. Jobs are inherently lame. If jobs were fun, they'd be called something else, like, I don't know, vacation? Holiday? Work to live, people, don't live to work...

[country mom]

To the original poster, you sound like you're burned out. I say this because your comments very closely mirror thoughts I've had myself, especially at one particular time in my career, and it was about 8 years after entering nursing. It took me a while to recognize those thoughts and feelings for what they were. There's alot written about job burnout and compasson fatigue. You might want to investigate and see where it leads you.

[nursel56]

Nobody told me nursing would be easy or fun, either. But the "not easy" and "not fun" things were about activities a nurse expects will not be easy or fun. I wish people started paying attention to this issue in it's nascient stages, but people in a position to give some pushback were busy paying attention to something else.

For many nurses the customer service issue isn't something benign that can be ignored. It erodes morale, gives patients false expectations of what nurses are there to do, and if not adhered to can actually cost a nurse her job. One of our contributers here recounted her experience of using scripting phrases while two managers lurking outside the room to make sure she said it right.

[HangInThere, BSN, RN]

I agree. Healthcare is quickly becoming all about the money. Patient care does not even rank in the top five!!

Would things be better for patients and nurses if the profiteers (the corporations and the insurance companies) were pulled out of health care system?

[dnnc52]

OH yes: You hit the nail on the head!

I feel so much like I am giving the " Thank you for shopping Wal-Mart" pattern good bye to my patients,when we are saying "Hope you felt you had EXCELLENT care, upon discharge. CEOs have a problem with reality vs. appearance. Do they really mean they want excellent care provided or they want the appearance of excellent care?. If you want real excellent care then give us the excellent staffing, excellent tools and excellent initiatives. Not little bells and whistle like we are in romper room, but big peoples rewards like $$$$.

[DC Collins, ASN]

I cannot believe that actual Customer Service erodes morale for the employee. Making a pt or family member feel better can only improve morale for the nurse, or any hospital staff member for that matter.

On the other hand, it sounds like some management efforts which are labeled customer service are not. Reading a script is not customer service. Ending pt contact with, "please call 800-xxx-xxxx and rate my service" is not customer service.

Where I work our management encourages customer service. Massively. But that is what they do, 'encourage'. They set the cultural tone. They let us know what is expected of us but do not force-feed us methods, but rather give us ideas.

They also are up front about the money issue, letting us know that Medicare reimburses us less if our customers are unhappy, affecting money for equipment, fun things, salaries, all of it.

In fact, blame Medicare for much of this. Getting paid based on happiness when your customer is inherently unhappy seems just a little twisted to me.

All I know is that I love working for my facility. Is everything 100% perfect all the time? No. It's a job. It's a corporation. Can't please everyone all the time. However, it makes a big difference to me that they actually try, while at the same time letting us know what they expect of us, and work at giving us the tools to perform to those expectations.

If a person has a better idea for a method to reach a necessary goal (in this case, full reimbursement from Medicare) while maintaining a semblance of employment satisfaction, try bringing it up to management. If your management isn't receptive to such things, it may be time to start looking elsewhere?

[beewink]

I understand that this is a forum for ranting--I've done quite a bit myself here. But the bottom line is that nobody ever said it would be easy or fun. At least, nobody ever said that to me. I went in with somewhat low expectations (my mom was a nurse) and have yet to be disappointed.

I work ED as a staff/registry nurse at a community hospital that it part of one of the largest health care systems in my city. The management is crap. The administration is unquestionably the worst I've ever seen. The patients are...ok. They're ED patients...90% of them not emergencies but rather in need of the safety net the ED provides.

I will pay lip service to the administration. I will toe the company line...to their faces. But in reality, my nursing is not defined by whatever corporate plan they have. It is how I care for my patients that defines me as a nurse, not how many patients call and tell the nursing office I'm great.

It's a JOB. Jobs are inherently lame. If jobs were fun, they'd be called something else, like, I don't know, vacation? Holiday? Work to live, people, don't live to work...

I sure didn't think nursing would be easy or fun either. But I also didn't think it would be rare to get a break or a lunch in a 12 hour shift. Or have so many patients you can't provide safe care to many of them so that nursing becomes putting out fires instead of preventing them in the first place. But never tell your patients you have 'too many'. Instead say, 'What can I do for you today?' or 'I have time for you.' Healthcare in this country will continue its downward spiral if we continue to pay lip service and toe the company line. If we want to care for our patients we must refuse to bow down to customer service driven care and instead focus on quality patient care. I really believe it begins with us - and if we don't do this together, things will continue to get worse for all of us. (Including our patients). Sure it's easier not to butt heads with administration, but who has the ultimate power to make changes? Not us. So we need to make sure our voices are heard.

[cosmicsun]

I feel like I'm getting an ulcer with the adrenaline running through my body all the time. I feel like I walk on egg shells with trying to be perfect, knowing the gauntlet is there if I'm not. Not only are we responsible for knowing everything, but responsible for anticipating everything, and catching what doctors missed - not to mention hourly rounding. I'm constantly running from one room to the next my entire 12.5 hours. I've been making errors since they started that - you have to put exactly what time you are there. It is taking away from patient care, giving them stressed out nurses. I'll be talking to a patient with one foot out the door to go worried that I have to write on the log of the next patient.

[RICKER55]

Call it what you like Nurse Knowledge Exchange, TLC, or whatever best nursing practice those that have the powers to regulate how we as nurses provide bed side nursing to our patients, but it is here to stay like it or not. Yes there are scripted introductions monitored by ADA's or charge nurses, hourly rounds, more and more task assigned to nurses to the point of overwhelming! Picker scores are bottom line here in southern california region in competition of which hospital healthcare organizations provides the best healthcare as rated by patients. Its no longer about administering competent, compassionate, quality bed side nursing care but rather did the patient rate the hospital high on the surveys that are sent to every patient admitted and discharged!