I've been a nurse for a little over a year now. They say we all get into nursing because we have the need to serve and care.. I thought nursing would be a fulfilling job. I wanted to have a meaningful job. I wanted to find purpose.
I hate my job. I hate nursing.
I've been working in a hospital on a telemetry unit for 7 months.
I feel my intelligence is slowly fading. I almost cried the other night because one of my patients actually said thank you- that is how rare hearing those words are. How screwed up is this? My night revolves around refilling water, taking patients to the bathroom, getting extra blankets, filling up cups with "just the right" amount of ice and fluffing pillows. I'm lucky if I get a chance to look at labs, critically think, and evaluate the care plan. I'm overwhelmed.
I feel as nurses, we have done this to ourselves. We have entitled our patients to some sort of gratification; and we have no choice because we are micromanaged and everything is money related. Managers round and only care about patient satisfaction; compared to their actual health care outcomes. What can we do about this? I've thought about leaving the profession because nurses are treated like dirt. Because I don't get the respect I deserve, as a human being, let alone as a health care provider.
Are there any other nurses that feel this way? Are there any nurses that feel completely swamped, down in the dirt, and have to drag themselves to work? I get anxiety just thinking about the night ahead when I do have work. What have you done? What can I do? I need some advice because I feel completely lost and I'm about to abandon ship.
"How screwed up is this? My night revolves around refilling water, taking patients to the bathroom, getting extra blankets, filling up cups with "just the right" amount of ice and fluffing pillows."
Its screwed up that you think the above things don't matter.
Patients remember the little things.
I wish I could get paid for what I do per hour to do just things like this LOL. I would rather be the comforting, "taking time to hold the hand and talk " nurse than be stressed with all the responsibility of not harming the patient and getting all charting done in an 8 hr period.
I still, resonate with what Anna says. HHC might be different than the acute hospital care. True, the hospital has understaffed us, but when I'm unable to say "wait" to a patient that needs water for fear that they will complain about me, because I have one person in the bathroom on the call bell, another on a dilt drip with a pressure now in the 80's and another wants a pain pill, that one patient that needs water can only see they want water, but to another, their life is on the line.
I still, resonate with what Anna says. HHC might be different than the acute hospital care. True, the hospital has understaffed us, but when I'm unable to say "wait" to a patient that needs water for fear that they will complain about me, because I have one person in the bathroom on the call bell, another on a dilt drip with a pressure now in the 80's and another wants a pain pill, that one patient that needs water can only see they want water, but to another, their life is on the line.
You are hanging on to keeping the patients responsible. The reason you can't say "wait" is because your employer will legitimize their complaint of not having the perfect ratio of ice to water.
I still, resonate with what Anna says. HHC might be different than the acute hospital care. True, the hospital has understaffed us, but when I'm unable to say "wait" to a patient that needs water for fear that they will complain about me, because I have one person in the bathroom on the call bell, another on a dilt drip with a pressure now in the 80's and another wants a pain pill, that one patient that needs water can only see they want water, but to another, their life is on the line.
This just goes to show that we don't work in a vacuum and validates my previous post, that having a motivated and competent tech can go a long way in making hospital nursing more enjoyable. Instead of having to worry about the patient that needs their water right now when you obviously have patients that need your attention more acutely, having a tech get water and warm blankets, help the patient in the bathroom, etc... would create a more satisfying work environment for nurses. Sure, RN's can get water, blankets, etc... but techs can't titrate that diltiazem drip or get a patient pain meds.
"How screwed up is this? My night revolves around refilling water, taking patients to the bathroom, getting extra blankets, filling up cups with "just the right" amount of ice and fluffing pillows."
Its screwed up that you think the above things don't matter.
Patients remember the little things.
Patients remember the little things but they will also remember having to stay in the hospital an extra two weeks after getting intubated due to severe and unexpected respiratory distress that took over an hour to get noticed because they couldn't find their call light, and their nurse was busy answering dozens of call lights and helping fall risk patients go back and forth to the bathroom.
You are hanging on to keeping the patients responsible. The reason you can't say "wait" is because your employer will legitimize their complaint of not having the perfect ratio of ice to water.
I think this is an important point.
How it works is that when patients fill out their patient satisfaction survey, they can comment about why they gave the score they did. You will see comments like "Nurse Awesome was really friendly and listened to my concerns" for a high score, or "I had to wait too long for my water pitcher to be refilled" for a low score. In the final tally, whether the comments are legitimate (maybe the reason the person had to wait to have their water pitcher filled was because everyone was busy in a code) or not are not taken into consideration. The scores stand as they are, regardless of what else might have been going on. So, if the unit is getting scores lower than what administration would like to see, then the pressure is put on the nurses to increase those scores.
As a nurse on the unit, you have an opportunity to speak up about what resources you need in order to do that, for example, hiring CNAs.
The reality is that you and the patient are in this together. You and the other nurses on this unit are in this together. The best way to solve this would be for the nurses to stand together and present a compelling argument to management that if they were to hire CNAs, patient satisfaction scores would increase.
Do you have a unit council? If not, have you considered forming one? These are the exact types of issues that are addressed by a unit council. Now mind you, a unit council doesn't necessarily have any teeth, and management can choose to turn a deaf ear to your concerns, but on the other hand you may be able to effect some change for the better- you won't know until you try.
The fact is that administration is going to continue to pressure nursing to improve those scores while putting as few resources into it as possible (it's all about the bottom line). The patient is not the enemy- you're both in the same boat. Your enemy is complacency, defeatism, feeling powerless to make changes. What you need is to get the other nurses thinking about it, and to be united together in your efforts to improve patient care on your unit.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
I made the mistake of letting nursing identify me in my first year or two.
I then learned boundaries and began to leave work at work, and home at home.
I don't look for or expect kudos or thank-yous for just doing my job. I guess I really never did. I was brought up that a job well done was its own reward.
Yes, thank-you's and recognition mean a lot, but again, I don't look for or expect them; so I am never disappointed.
Not long ago, we had a thread about Christmas gifts/bonuses and the complaints people made about their gifts (small, nominal or poorly-thought-out) and there was such outrage. I had to laugh. Ridiculous. IF you get a Christmas bonus or gift, or a thank-you, just be grateful. For Christmas and performing well, I get to keep my job. It's enough for me. Again, I am not looking for anything special; if surprised, hey it's good. I have some very grateful patients who love to bring in goodies and thankyous and I am always tickled.
Seriously......lower your expectations some and you are less likely to be so disenchanted or disappointed.
Our hospital is currently budgeting, so we're pressured to take now 5 patients, without any aides to help (I'm starting to feel this is more my hospital than a nation-wide problem). I'm starting to become disenchanted, because I came to work and gave 110% of myself, my time, my feelings and my thoughts. Time to start to care about me a little, too. Nursing is hard, I've been a nurse for only a year and I'm just now starting to feel comfortable 10% of the time. Oy.
I agree with you 100%. Patient satisfaction, not patient outcomes havae become the new siren song of Nursing departments. Hospitals and Physicians are being pushed to focus on outcome based care for reimbursment but Nursing isn't seen as being vital to the process of good, best practice , outcomes. On top ot that, medicare and other payment providers are insisting on a level of "patient satisfaction" before they will provide payment. AAAUUUUGGGHHHHH!!!!! One of the stupidest, most useless nurses I've ever worked with got great patient sat numbers because she was always patting hands or giving hugs, but her patients often ened up in the ICU or the morgue. That just increased her pt sat numbers- Families complain they couldn't get the nurse to spend time with them when the skilled providers were spending time fixing the patient- keeping them out of ICU. The nurse I was talking about was always recognized as the "one that was there for us when Mom went down the tubes" They will never understand how that a fluffed pillow and full water pitcher may be why Mom ended up in the morgue.
I hear ya Susanna. I have a great team of coworkers with me, but when we're all under the same pressures, its hard to often get support. I think Medicare is broken. Patient SATISFACTION truly has no place in hospital reimbursement. How I see it- give us the money we deserve, plus extra, like a tip, for patient satisfaction. the fact that 30% of the money comes from how well I kissed my patient's orifice is completely absurd. I'm a glorified waitress with a four year degree. GRRR.
Specializes in Infusion Nursing, Home Health Infusion.
I work bedside nursing as well on a hectic IV/PICC team and yes there is a huge difference in my home health job and my hospital job. I despise the whole patient satisfaction score focus and am sick of hearing about it! I have just had to accept it but not without doing my research I do think that the fact that a percentage of Medicare reimbursement is based on the patient satisfaction scores is just Medicare's dirty little trick to save money. The truth is that hospitals with high patient satisfaction scores have higher admit and readmit rates and mortality rates so yes you are more likely to leave in a body bag! I am well aware of this, I have just had to find a way of not sacrificing the standard of care I wish to provide and will not compromise while at the same time focusing in the things that tend to make the patients feel cared for realizing that sometimes it conflicts with what is truly best for the patient. Have you read the survey questions and what they actually rate their experience based on? Look at this sample:
During this hospital stay, how often did the nurses treat you with courtesy and respect?
During this hospital stay, after you pressed the call button, how often did you get help as soon as you wanted it?
During this hospital stay, how often did your doctors listen to you carefully?
During this hospital stay, how often did the staff do everything they could to help you with your pain?
Would you recommend this hospital to your friends and family?
When I left the hospital, I had a good understanding of the things I was responsible for in managing my health.
What does this really measure ..its too vague and so terribly subjective and it not based on any clinical indicators. So if the patient was cured of pneumonia but did not get their ice water fast enough because you were on the phone asking why their IV antibiotic has not been delivered and the patient got it on time because of you may get a bad score. The whole thing is a mess. I still try to do provide great care without comprising my standard of care in order to get a higher or high score,
Specializes in Infusion Nursing, Home Health Infusion.
I work also bedside nursing as well on on a hectic IV/PICC team and yes there is a huge difference in my home health job and my hospital job. I despise the whole patient satisfaction score focus and am sick of hearing about it! I have just had to accept it but not without doing my research. I do think that the fact that a percentage of Medicare reimbursement is based on the patient satisfaction scores is just Medicare's dirty little trick to save money. The truth is that hospitals with high patient satisfaction scores have higher admit and readmit rates and mortality rates so yes you are more likely to leave in a body bag! I am well aware of this, I have just had to find a way of not sacrificing the standard of care I wish to provide and will not compromise while at the same time focusing in the things that tend to make the patients feel cared for realizing that sometimes it conflicts with what is truly best for the patient. Have you read the survey questions and what they actually rate their experience based on? Look at this sample:
During this hospital stay, how often did the nurses treat you with courtesy and respect?
During this hospital stay, after you pressed the call button, how often did you get help as soon as you wanted it?
During this hospital stay, how often did your doctors listen to you carefully?
During this hospital stay, how often did the staff do everything they could to help you with your pain?
Would you recommend this hospital to your friends and family?
When I left the hospital, I had a good understanding of the things I was responsible for in managing my health.
What does this really measure ..its too vague and so terribly subjective and it not based on any clinical indicators. So if the patient was cured of pneumonia but did not get their ice water fast enough because you were on the phone asking why their IV antibiotic has not been delivered and the patient got it on time because of you...you may get a bad score. The whole thing is a mess
MidLifeRN2012
316 Posts
I wish I could get paid for what I do per hour to do just things like this LOL. I would rather be the comforting, "taking time to hold the hand and talk " nurse than be stressed with all the responsibility of not harming the patient and getting all charting done in an 8 hr period.