If Truth Be Told...

[J.Adderton, BSN, MSN]

I have been moved by the awesome outpouring of gratitude from the public during the coronavirus pandemic. My spirits are lifted each day as I pass the homemade "Thank You" signs and banners that line the road leading to my workplace. I have especially enjoyed reading the cards and letters sent by the youth to encourage the nursing staff. It gives me hope that the younger generation will carry a deep respect and appreciation for healthcare workers.

Gut Reaction Concerns

But, there are some expressions of gratitude that have been gnawing at me. When certain people cheer on front-line workers, I immediately have a major internal "eye-rolling" moment. Since I'm not a cynical person by nature, this gut reaction has bothered me. When I am struggling with something internally, it always helps to write it down. I So, I did just that.... fleshed it out for insight. I write under a pseudonym, which gives me the freedom to openly share my experience and thoughts when I write.

Insincerity?

Now that I have a better understanding of my angst, I suspect I am not the only lonely tree in this parking lot. The "people" whose apology I often perceive as insincere are executive administrators, politicians and lawmakers. Recently, healthcare administrators sent messages praising how we've "all come together", "stepped up to provide competent and compassionate care" and "supported the organization's mission during trying times". But, thoughts like these below keep me from truly accepting their gratitude.

Because I'm a Nurse

I am a nurse, and like other nurses, this is just what we do. Yes, it is unprecedented and scary times. But because I am a nurse... I care for COVID patients with the same high level of commitment that I have for all patients throughout my career.

Feeling Under-Valued

I don't feel valued by executive leadership and this is a common occurrence throughout my nursing career. There are many reasons for this, but the majority seem to be "universal" regardless of the employer.

The "Executive Silo"

I have had exceptional supervisors, managers and directors over the course of my career. Unfortunately, there have been times the voices of nurse leaders are not heard. Decisions made by executive teams are often made in a silo. This "executive silo" too often consists of non-medical individuals or individuals who are long removed from day to day realities.

Disregarding OUR Safety

My safety, as well as my co-worker's safety, has been undermined by decisions driven by profit. Safety concerns run the gamut, from available PPE to violence against healthcare workers. I have worked the past few years with less than a $1.00 raise despite stellar evaluations. However, I have never lowered my patient care standards based on pay gaps and poor incentives.

FACT: I suspect that Senator Walsh's "card playing" remarks are shared in political circles. At minimal, her public comments certainly did not help build a rapport of trust.

Recognizing and Addressing Personal Biases

I've given much thought to what it is that I can do to address my biases. Ultimately, I need to use my voice and get involved. I plan to communicate to upper management that I appreciate the recognition for the quality of care I and other nurses have always provided. I also need to network with other nurses and educate myself on the barriers that keep nursing from being perceived as a profession. But most of all, I need to advocate for the profession I love.

Final Note

I wrote this article about my experience during the COVID-19 crisis. I acknowledge that my thoughts are limited to my own personal experiences and circumstances, which may be hugely different from your own. Even though my facility had a large number of COVID patients, we have not reached a point of an overwhelmed system.

I invite you to tell us about your experience.

[Daisy4RN]

Thank you for your thoughts!

In my opinion, based on experience, I doubt that the majority of administrations are indeed sincere. I was a pretty optimistic person until I became a nurse. I worked other jobs/professions and never had any admin, or other staff for that matter, treat me as bad as those in healthcare. I am cynical because of all my years working in different healthcare settings they have all had one thing in common: total and complete disregard for their nursing staff. I have gone through facilities trying times (although not as bad as those hard hit covid facilities) and have heard those words also from admin “ praising how we’ve “all come together”, “stepped up to provide competent and compassionate care” and “supported the organization’s mission during trying times”. Blah blah!

I never had an eye rolling moment in the beginning but somewhere along the line this became the norm for me because I learned that it was just empty praise, just like all their empty promises. I would have much more respect for managers who were honest and would just come out and say, no this/that isn’t going to happen as the decision was made in the “executive silo”. I read other managers posts here sometimes so I know there are some good ones out there (who at least try) I just haven’t experienced it myself. I would also hope that this would provide a new appreciation and respect for healthcare workers but I am sure that once all this blows over we will go right back to the status quo (although I hope I am wrong).

[J.Adderton, BSN, MSN]

1 minute ago, Daisy4RN said:

. I would have much more respect for managers who were honest and would just come out and say, no this/that isn’t going to happen as the decision was made in the “executive silo”. I

I so agree with this! There have been times when I've been asked to "hold on a little longer", "changes are coming"...... but approval for improvements are never obtained from administration. It's almost like a "false hope" and bad spot for middle management. They don't want you to leave or transfer, but they also know administration has not/will not approve changes.

[Daisy4RN]

On 5/4/2020 at 6:15 PM, J.Adderton said:

I so agree with this! There have been times when I've been asked to "hold on a little longer", "changes are coming"...... but approval for improvements are never obtained from administration. It's almost like a "false hope" and bad spot for middle management. They don't want you to leave or transfer, but they also know administration has not/will not approve changes.

LOL, I have heard those exact lines also!

[scribblz, BSN, CNA, LPN]

I agree with you that appreciation without action to back it up often rings hollow in my ears too. My hospital is very busy with Covid patients, but fortunately not yet overwhelmed bed wise. Nursing wise though the staff feel overwhelmed. We have a relatively new nurse governance committee, but our suggestions are often disregarded by leadership. On a managerial level I feel heard. My manager is even helping make homemade PPE out of clear trash bags... and PPE suits out of ponchos. I do find it disappointing that this is necessary.

For weeks our census has been slowly trending up. Meanwhile all the Endo, many OR and other outpatient staff techs and RNs are out of work and using up more of their time than they can afford. We had the time to cross train the PACU RNs to back up the ICU RNs, the Endo RNs could back up med surg and the techs could back up our aides. But only now when we floor nurses are feeling so overwhelmed are they considering our suggestions. We have a higher level of acuity and more frequent codes than I've ever seen before. We needed help yesterday... not daily keep up the good work and all will be well emails. That "Iight at the end of the tunnel" isn't what our leadership thinks it is... it's the incoming train...and they aren't the ones on the track.

[Charlatte]

The problem is that healthcare employs non-clinical folks in the C-suites. These people with MBAs without any practical experience in providing care lead from a business perspective only... no heart. Nursing is all about heart.. for our patients, families and care teams. We can’t break the bank... we understand reimbursements are not coming close to covering the cost of care... insurance companies have created this crazy situation stemmed from greed. The answer is less hospital administrators - their high salaries take away from those providing direct patient care... streamlining is needed to eliminate nonessential positions in response to reduced revenue.

[JKL33]

On 5/4/2020 at 3:58 PM, J.Adderton said:

I’ve given much thought to what it is that I can do to address my biases.

I would start with not referring to them as biases when they are reactions based on observed inconsistencies. If one's walk quite can be readily observed as not matching one's talk, that's not so much a bias on the observer's part.

On 5/4/2020 at 3:58 PM, J.Adderton said:

I plan to communicate to upper management that I appreciate the recognition for the quality of care I and other nurses have always provided.

May I ask why?--Why you consider this to be legitimate recognition and why you would thank someone for performing an action so incongruous that it amounts to pandering?

[HiddenAngels]

When I first came to this profession there were a lot of nurses who warned me to be careful "nurses eat their young".. Surely being a buck I didn't know what to expect but I learned fast... I was outed for not using the dictionary of terms in the alaris pump but instead starting the fluids as "fluids" with the correct rate and volume in an emergency situation but never going back to type in the words...ooops. But that nurse told the boss floor mgr who didn't do anything so then she went above that manager and so on and so on. How humiliating for me and stupid. Yes stupid now that I look back on it. She could have just said don't forget to program the drug in there... I would never do that to a new nurse.. That was an excellent teaching moment...I said this to say we have to work together...

As for our profession, with all due respect, I believe the general consensus is that people see it as a subservient role, I should say some people, not all. It is because of this that we are EXPECTED to suffer. This expectation is what allows us to be overlooked, undervalued, and sometimes not appreciated. Not fair, I know, but somewhere along the lines we need to see some policy change that reflects and respects how instrumental and pertinent our well-conceived vocations are with the work that we do as we continue to shape the framework for healthcare.

[NurseSpeedy, ADN, LPN, RN]

On 5/4/2020 at 6:17 PM, Daisy4RN said:

LOL, I have heard those exact lines also!

I have heard those lines for almost 20 years!

[NurseSpeedy, ADN, LPN, RN]

54 minutes ago, Charlatte said:

The problem is that healthcare employs non-clinical folks in the C-suites. These people with MBAs without any practical experience in providing care lead from a business perspective only... no heart. Nursing is all about heart.. for our patients, families and care teams. We can’t break the bank... we understand reimbursements are not coming close to covering the cost of care... insurance companies have created this crazy situation stemmed from greed. The answer is less hospital administrators - their high salaries take away from those providing direct patient care... streamlining is needed to eliminate nonessential positions in response to reduced revenue.

So many years past experience doing the job before managing it and it’s funding should be a requirement. Years ago people had to work their way up-also let them know what it’s like to fight for what they need to do their job-now we have people with zero experience clinical wise, sometimes without even clinical degrees-healthcare management or MBAs-good Lord, give me a break-these people are clueless.

[LockportRN]

On 5/4/2020 at 6:22 PM, scribblz said:

My manager is even helping make homemade PPE out of clear trash bags... and PPE suits out of ponchos.

On 5/4/2020 at 6:22 PM, scribblz said:

"On a managerial level I feel heard. My manager is even helping make homemade PPE out of clear trash bags... and PPE suits out of ponchos. I do find it disappointing that this is necessary. " This is awesome from the perspective of a great manager, but as a profession, this is sickening. We should not have to work without PPE's.

The last article I read here was talking about execs getting their bonuses and many nurses that that it was fine and dandy. But this is yet another reason why I think not.

Your post really puts things in perspective. It does sadden me though, that we, as a group of professionals, can't be heard. There are enough of us don't you think?

[J.Adderton, BSN, MSN]

On 5/4/2020 at 5:22 PM, scribblz said:

That "Iight at the end of the tunnel" isn't what our leadership thinks it is... it's the incoming train...and they aren't the ones on the track.

This makes a great quote!