The joy of making a difference in my patients' and family members lives is being overshadowed and diminished by the organization's politics and their #1 priority: keeping the physicians happy and making money. Our purpose as nurses is to provide excellent care and customer service. Our patients are our #1 priority not only just 12+ hours a day or an 80+ hour paycheck, they are always our main concern. Nursing is not patient care anymore, we are becoming the host(esses) of the medical field.
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I am ready to leave the nursing profession after 6 years. I have a bachelor's degree in biology and got my associate's in nursing. In high school, I decided that I wanted a career in nursing. By the time I entered college, I decided I wanted to become an OB/GYN. Halfway through college, I realized I didn't want to be a doctor. I wasn't sure what I wanted to do but I wasn't going to change my major and start over. Fast forward about 8 years, I considered nursing and applied to nursing school and here I am.....back at square one. I wish I had sacrificed and endured one or two more years of college by changing my major and pursued something else.
I often-times cringe when I think of going to work. My attitude changes, my heart races, and anxiety sets in. My coworkers are nothing less than awesome. Most of my patients rock. Both have been unexpected blessings to me and I thank God for our paths crossing. But management, the physicians, and the facility at which I work have made nursing a profession that I wished I had not entered. I never have to wonder how devalued I am when I'm at work. Our voices are not heard, and as a matter of fact, our concerns are considered complaints.
Not only am I a caregiver, but I am the business office, auditor, waitress, maid, logistics, IT, quality assurance, babysitter, personal assistant, and the list goes on. When doctors fall short, it is our job to clean the mess up.....and, no, I'm not speaking of mistakes that affect patient care. I speaking of simple documentation that they are supposed to take care of. I understand the importance of having all "I"s dotted and every "T" crossed, but when will the physicians be held accountable? I can't be chasing down physicians when they forget to check the correct box especially when it has little or nothing to do with a patient's outcome. That's not my job. We nurses are stressed, afraid, furious, and just plain depressed as a result of these added responsibilities. We already worry about our patients even after quitting time. After leaving work, many of us call back up to the floor or unit checking on our patients. We are genuinely concerned about them, but it is very obvious that management's agenda is not the patients. Whatever management's agenda is becoming our agenda, right? WRONG! I'm here to take care of patients, not physicians.
There are so many nurses, YOUNG, fairly new nurses, that I know that started their nursing careers with a clean bill of health. They are now on antidepressants, benzos, blood pressure meds, and others due to the stress and unhappiness. Nursing has gotten away from patient care. It's about making money for the organization which is about making the physicians happy. If that means being stripped of our dignity, we are to do what it takes. I feel as though it is second nature to provide excellent care to our patients. WE have saved many lives anywhere from observing changes in our patients to discovering mistakes made by others (physicians) and correcting them or directing attention to the oversight. I wish they would let us do OUR jobs and provide care and management can run up behind THEIR "customers". If we can keep those two jobs separate, that would be great.
We are a vital part in patient care, but yet, we are so underappreciated and taken for granted. We make a positive impact in many lives, but we are the first ones cursed out because someone is having a bad day. Not only are we unappreciated, but we are very disrespected, and in many occasions, we are unfairly belittled and we are just supposed to accept those words because "it's part of the job." I'm done accepting it. I'm reminded every day there are replacements waiting in line. I'm reminded that any fool can do my job. I don't want a pat on my back every time I do a great job, just acknowledge that I am a vital part of the team. I understand human resources has a stack of nursing applicants on their desks. I just don't have to be reminded of that everytime all my paperwork isn't on the chart (because I'm still working on it), or if I come back from lunch two minutes late.
I am not cut out to take jabs and low-blows without throwing them back. I have so many responsibilities that I take on from the time I punch the clock to the time I punch out and I refuse to be disrespected by someone with a title because I happen to not move fast enough or I am having to clarify an unclear and, most of the time, an unfinished or incorrect order. I'm helping YOU out!! We genuinely worry and care about our patients that it often consumes us. When a patient codes or expires, we are crushed. I once had a patient who got stuck at least 15 times by various staff members, including physicians, to get IV access. The patient took those sticks like a champ, but I still went home and boo-hooed because I hated to see him go through that. We hurt when our patients hurt. On top of carrying out our responsibility as nurses, we are holding in so much emotion associated with our patients.....yet we get very little to no respect. Don't get me wrong, there are some physicians that I'm in contact with whom are polite and value my opinion and I do appreciate them. Of course, I'm not always right or may not make the most intelligent statements, but they acknowledged my voice. Again, I don't want a cookie. I just want to be acknowledged as a professional.
I understand customer service includes dealing with angry, rude, and the dissatisfied. But when I have poured my heart, soul, and emotion into my job and my customers and I am still allowed to be mistreated and insulted, then that becomes a problem. I feel I have no rights as a nurse. Who is protecting me? Who is my voice? Who is standing in my defense?
So at this point, it's time for me to bow out from the nursing profession gracefully and while in good standing with the organization, my family, and myself before I am forced out or OD on my meds(or somebody else's). My family, happiness, health, dignity, and peace of mind is worth leaving. They tell me Costco employees never leave.
I completely understand your frustration. You are so right how we are constantly making sure the doctors don't "accidentally" kill the patients. I think there's even a facebook page called that. Nurses we do so many jobs and get no credit or appreciation for it. However, I think your talents are not being used in the best environment. I'm assuming you work in a hospital? Have you tried considering Home Health? I hate when people just assume that nurses only work in hospitals. You work normal hours and might have to work a weekend once a month or be on call. But you have 4-6 patients (depending on your agency), rarely have to deal with doctor crap and politics. You get to call the shots and the doctors will actually thank you because you are keeping the patient out of the hospital. You are kind of an extra set of eyes and ears for the doctor to keep tabs on the patient, but you are not having to cross all his Ts and dot all his Is. You get to make your own schedule. You get to form relationships with your patients and their families. They appreciate you! They thank you! There's a lot of paperwork yes and there's a lot of driving, but it was one of the most rewarding jobs I ever had. Administration isn't breathing down your neck, you rarely see your coworkers maybe once a week for a meeting or a joint visit with Therapy. I really encourage you to try this avenue. You can do peds, elderly, hospice, etc. You could also try private duty but the pay tends to be a bit less and they might not have something fulltime. I really encourage you to just give it a shot. Who knows, you just might love it!
Yive said:in Nursing school... we are taught to be empathetic and that nursing is not a job, it's a career.I want to be able to call nursing a professional career and not just a job.
In my opinion, the difference is this:
A job is a singular engagement, performing a defined set of duties, for a specific employer.
A career is a series of jobs.
QuoteSo, what sort of mindset must I have to continue Nursing?
One which can derive satisfaction from things which aren't dependent on other people be they patients, physicians, or bosses.
For me, it's a combination of practical items like pay, benefits, and job security along with satisfaction that I generally bring something more to many patients than simply being competent in my skills, judgment, and time-management... something which is unique to me, my personality, and my life's experiences.
The former, though, is my primary motivation and sustains me sufficiently in the absence of anything else.
rhernandez748 said:That would be impossible for me and frankly just sad.
If your response is directed to me, I suppose I am just fortunate to be able to compartmentalize so easily.
I've worked a ton of jobs, both professionally and otherwise, prior to my 4 nursing jobs and I've got the perspective granted by 50+ years of living.
I find it not sad at all. In fact, I find it liberating.
It's not about pleasing doctors either. It's about pleasing Press-Ganey. The administration bows to them. It's also not about "what you do." It's about what you chart. I've been in nursing for 37 years. I still "only" have a diploma. I'm so glad I'm at the end of my career rather than the beginning. I do get attached but on my terms. I cover holes in MD care because it's what's right. My hospital is no longer having ED nurses call handoff. We get notified we are getting a patient, have 30 minutes to read some crappy online kardex. It's a recipe for disaster but it's to save time,code for churning more patients through the mill. I could go on and on. Oh, Costco employees on the west coast start at just about the same salary as a graduate nurse....
I understand exactly what you are saying. Years ago, we would have "VIP" patients. Those who donated lots of money to the hospital, physicians and their families, top administrative people. I didn't care for the "VIP" designation. I believed then, as I do now, that all patients should receive the same care. Eventually, that idea caught on. I haven't seen a VIP patient in years.
Now, we are supposed to strive for high patient satisfaction scores. CMS bases the amount of their reimbursement on these scores. So, if a patient who comes to the ER on a regular basis (we aren't allowed to call them frequent flyers anymore) with dental pain doesn't get the drugs he is asking for, he is not happy and I get dinged. It doesn't matter that I can't prescribe what I give him. It's my fault that he gets ibuprofen instead of dilaudid!I get to take the verbal abuse from the patient, then administration reviews the chart and I get to go to a meeting to discuss what I could have done to make the patient happier. Heaven forbid I roll my eyes! That results in a three day suspension!
I am so thankful that I am near the end of my career, rather than the beginning. I love what I do, my coworkers are my second family, but people who don't know what nurses do need to stop telling us how to do our jobs!
I agree that it isn't healthy to go home day after day crying about our patients, but certainly believe there should be a few days we shed a tear with patients and or family when there are difficult circumstances.
I absolutely believe nursing is a calling and a mission. It is a job too, but I have met a dozen or so nurses who I would never want caring for me or loved ones because they are lacking compassion and give crappy, slow, sub-standard care, etc. There are non-patient care positions that are available which these folk should be doing instead.
CareerStudent10
6 Posts
As someone who left a job at Costco in Outside Marketing to pursue a career in nursing, I would have to say that the the grass may not always be greener on the other side. This is actually my first post here as I am a long time reader. I have worked in human services for many years and began working at Costco on a contingent basis over one holiday season for a bit of extra money. Inside of one year I had been hired in part time, full time and then promoted to a clerk position. I had worked at three different warehouses and excelled in marketing/membership sales. I left my job with the local community mental health agency as well as my part-time position with a local school district in their post-secondary autism program. I was working full time for an excellent company (costco) in which I was guaranteed a raise every 1000 hours worked and ultimately received up to $4000 of a biannual bonus based on years of service. At this point I had seen many employees who made an excellent living with no options outside of Costco. One of my direct managers was a mechanical engineer by trade who had left the industry as a result of economic downturn. He began working as a forklift driver for Costco and never returned to his chosen field. I had met many talented young people who began working at Costco in college and never left because they made a decent living at Costco. In terms of income my previous position would have topped out at about $25 hr with time and a half on Sundays each week but no real over time. I am currently in nursing school and my present employer starts entry level adns at 27.96. I feel that Costco is an excellent company and I would still be there if it had not been for the opportunities I have had to work in inpatient psychiatric treatment and begin my nursing program. The dilemma for Costco employees is that their only option for a career change is within the same company. No other grocery store will pay you $25 to run a register. As a nurse you have many more options. If you don't enjoy the position you are in, you have the ability to change it. I have heard of Costco termed "The golden handcuffs" from employees. This is in reference to the fact the people hope to do other things with their lives/careers but they end up staying at Costco. Now make no mistake, I love Costco and I greatly enjoyed working there for the time I did. I still shop there weekly and purchase the majority of my household items there. It seems as though the question of whether or not an individual is satisfied in their current role has to with perspective. I know that when it was December and filled with hundreds of holiday shoppers, I was working in the warehouse waiting for the day to end. Oh and pushing carts in a snow storm... not the most fun I've had. In my current role(s) as full time mental health technician and full time nursing student I am busy to say the least. I have been assaulted by patients more times than I can count and I have had issues with clinical staff and physicians at times. However, I am currently doing what I love. I understand that the population I serve needs people to advocate for them. I understand that my choice to work in psychiatric treatment is not for everyone. My wife-who is also in nursing-works in the medical intensive care for the same health system. She has a job that i have no desire to do at this this point in my career. She in turn has no desire to work in behavioral health. This is the beauty of the profession of nursing. I hope that you are able to find a career that you truly enjoy whether it is inside or outside of nursing. It is great that you have empathy for your patients. I would encourage you to work to define your patient/practitioner relationship in a manner that allows you to continue to perform your daily responsibilities. Providing high quality care is vital to the treatment of our patients.