Is there any help for this old nurse lost in new age nursing??

[coolnurseclub]

I have been a med surg nurse for 20 plus years. I worked at the same hospital for 20 of those years. I was terminated because I simply cannot keep up any longer. I have accepted and learned CPOE. med scanning,computerized charting, etc. BUT...I cannot go completely "paperless" and always chart in "real time" . ( just to mention two out of many gripes).

The last year of my employment at this facility that I loved and grew up with, changed administration when 2 new hospitals opened in the area. During that time most of us "older" nurses (highest paid) either mysteriously left or retired early after years of employment, all being replaced by new grads. No offense to new grads, you are very much needed and have been trained in the new ways.

I feel like an old dog being kicked to the curb. I am a good, caring nurse. Spent "too much time with my patients". Forgot twice to document if smoking cessation education was given and no flu and pneumonia vaccine status documented. That won't happen again!

So what if I was trying to keep my patient from coding trying to get a transfer to ICU all by myself while all the docs and charge nurses and supervisors were at their morning meetings and not responding to pages "in a timely manner" sooooo... I didn't chart or give all my meds in that "timely manner" many times and have been doing the same since I was a new nurse. That is fact and I'm sure many of you will agree you've had to do the same.

I guess I just don't know how to be a nurse any longer. Can anyone relate to this?

I don't know what to do. I can't retire (lost most of it in the '90's) and had to live off the rest when I lost my job. Its a dog-eat-dog world out there and new nurses are in demand. I am 53 years old and never thought the career of my dreams would end up this way.

I do start a new job in a LTC facility next week. Maybe this will work out. I'm too old and poor to go back to school now.

My greatest advice to all you new nurses is, hang in there and take good care of me when I need you, and start putting in a lot for your retirement right from the start. I truly have been traumatized to the point I feel incompetent and I know that is not the case.(PTSD)

Please help me guys! I need feedback!

[donnakhamm]

Despite being behind in my email, I had to read this email chain. I am an older nurse (23 years on the job--15 on the floor--yep, Med-Surg with a pinch of ICU) but came to nursing at the age of 40. So, I think I qualify as a COB. I started with a BSN, got my Masters in Nursing Informatics and now work as a Systems Analyst. Notice, the nursing adjective is not included here. I work for IT, but, once a nurse, always a nurse.

Change has been such a part of our culture, and until recently, healthcare was immune to it. Healthcare is trying to catch up, and the process is less than orderly. Nursing has not taken a seat at the table as they should have--and it shows.

I heard several times that the electronic charting does not reflect the quality of nursing. I guess you need to define quality to be sure, but patient outcomes and patient satisfaction scores should reflect nursing quality. A lot of what folks consider niggling detail are really attempts to record, in a retrievable fashing, information that is important to the care of the patient. At the same time, if done correctly, it can also measure patient acuity. You can 't complain that nurses are over-worked (of course--we can see that!) without some data. Don't be afraid to capture this. The linens didn't get changed....hmmmmm...do you have codes for as to why it wasn't done?

Everyone in healthcare is being asked to do more in their jobs--being tasked with working to the maximum limits of their training and licensure. Think of the things that RNs have traditionally done--and love them--that could be done by a CNA? RN jobs are changing, whether we are ready or not. I agree, there are many different avenues for nurses--it is important that we find the path that is best for us.

I regret that anyone feels that they are no longer useful or qualified for their jobs. If that occurs, I would look to two things. 1. Leadership who is not aware of how important it is to grow and encourage your staff, and 2. Nurses who are unwilling to try and change. The economy has disrupted the plans of many baby boomers like myself. We have to find a way to adapt.

[Natkat, BSN, MSN, RN]

I'm really sorry to hear that. I am an Informatics nurse and am over 50. I left the floor when the computers started to infiltrate the hospitals in 1998. I was a pioneer!! The other thing is I'm a contractor so I don't work in a clinical setting. I can tell you that computers are not the end all be all yet. I think we were better off with paper if you want to assess the patient and patient care.

Computers are to assist in litigation which is where everything is focused now. Computers have a long road ahead of them if they are to be efficient and SAFE in the patient setting. My first choice would be not to work in a clinical setting in the technology age. I'm very skilled in computer technology but I don't think it has any place in patient care. Computers make it too easy to "check the box".

If we are to make HIPAA so important, why do we still have shared rooms? That is a HIPAA violation as far as I'm concerned. If you step back and look at this big picture, it's not about the patient anymore. The patient's are lucky to get out of a hospital alive. It scares me to death to think about what our future holds as an aging society. When the young nurses get to be our age, they'll understand. I'm not sure how a person can say they got into nursing for the "patient care" or the "patient". It surely wasn't for the money. They don't pay nurses nearly enough for the liability they are faced with. You can't base a salary on that! I don't even understand why anyone wants to go into the medical field anymore. I'm thankful that I have the education so I can be an advocate. If I were you, I'd look to an office environment where you can maybe do some patient education. Working in a LTC facility is sure to break your heart. Where ever you work just know you'll make a difference to the patient, not the facility. It's sad but true.

i quoted some of the highlights. I could have written this. I feel the same way.

I love technology. I dove into using computers as soon as they became widely available. I took my first user class in 1981. I worked for 15 years as a medical transcriptionist which is a huge help with charting. I can puke out a note like it's nothing. If the software spins me into purgatory I can troubleshoot my way back out of it.

However - the way it is being applied to healthcare is ridiculous. It is enefficient and dangerous. You spend so much time clicking on boxes and reading pop-up messages that you don't have your eyes on your patient. It's frustrating when your patient wants pain medication and the stupid AccuDose won't read your fingerprint, or you can't scan your patient or the med or there's a warning on the screen that you have to answer. Meanwhile the patient is howling, the family is upset and everyone thinks you're stupid because you can't just give them their medication.

I I don't think it's futile. I believe what we are going through is a difficult birth. I believe that over time they will figure out a way to make the technology more seamless. The generation after us has used computers since they were toddlers and have a better instinct for making things work well together. It'll be too late for us, but eventually they will develop ways to make charting easier. I was talking to someone who studied technology where there is some kind of reader on the patient so that when you go into their room the computer recognizes their ID and you don't have to scan meds or click on boxes. Their information comes up on the screen and you can see all their labs and test results, the highlights of their history and their care plan.

I am hopeful that it'll get better. What makes me sad is al the patients who will get hurt because it's not working so great yet, and as always, it will be the nurses who get the blame for a system that has too many flaws.

Meanwhile, I wish they could come up with make telemetry wireless. I get so tired of untangling the call light, the oxygen tubing and the tele wires all day long.

[dvrn49]

I know what you are going through.After 30+ years of nursing I was "encouraged" to retire.Was allowed to come back and work 2 days/week.That didn't last long,now working 4 hours/week.I am 66yo and still would like to work PT,but it's almost impossible to find a job at my age.Sorry for your situation,but I know I'm not alone.

[bldlpn]

LTC can be physically challenging for an older nurse. Have you considered home health? As a private duty home health nurse I have ONE pt to care for, not 12 - 15- 35 -??? I drive to one house and stay there the entire shift. For much of that shift I am monitoring my pt, not actually intervening. I am paid for what I know as well as for what I do...

(BTW-- I am 65 years old)

Best of luck with your search!!

[Sue Barton fan]

I am a 1976 BSN graduate. I have had many great jobs but lost a super good job in behavioral health with awesome benefits ; the details don't matter because I did receive unemployment, I had grounds for a law suit but chose to just walk away and my integrity remained intact. What did I learn? 1. It's really hard to find a new job at my age. 2. I also can not afford to retire, so I need to keep plugging away. I have to realize that my supervisors now will likely be half my age and I figured out a way to make that work. 3. I discovered sites like this and I feel more connected to nurses of all ages and perspectives than I ever did before; I love reading these comments [although right now I am job searching so I didn't have time to read too many responses to your situation]. 4. I work for an agency right now and so far I have staffed Wellness Clinics, a hospice home care and the county correctional facility. 5. I did learn that I can not do floor nursing or skilled nursing facilities and most have moved to the new technology anyway, so there's no escaping it. 6. I, like one other poster, did enjoy working hospice but I had to learn how to chart on a lap top and I mastered that in about 3 1/2 weeks. Hospice, though, had really changed from my days in the 90's when it was all end-stage cancer. Just brace yourself for a lot of dementia, CHF and COPD. It was not my cup of tea but I am glad that I gave it a try. In conclusion, by the grace of God, I hope to work until age 70. I have already met some pretty awesome nurses in their 70's and they have inspired me to keep plugging away. Good luck and I wish you the best.

[Sue Barton fan]

Although it is illegal to online search for age of an applicant, I have no doubt that my age [61] was the reason I was not called for most jobs. I had a relative in HR and he admitted that it was easy to just use the white pages web site if you have a name and address [which we all have to put on our applications, right??!!]. And, on the other end, he admitted to age discrimination with his company's older employees and he worked for a major international corporation. So, age discrimination is REAL!

For me, an unexpected opening came my way through my brother's friend, who ran a temp agency, but that was a real fluke! I also signed up with any employment assistance program that I could find through our state unemployment agency, and we were told that anyone could utilize their services, not just folks collecting unemployment. The agency work that I found is not bad but I did need to take some online competency tests. I had been out of nursing for 11 years, so I really had to study to prepare for those tests. And, I have to work, I don't have enough to retire. I wish you luck but keep plugging along!

[nurseactivist]

Age discrimination is real and should be fought against at every level. I worked really hard through 40 years of nursing to adapt to change. At my last job, all documentation was computerized. What I find sad as someone who was reading computerized records was that check lists and no narratives gave me no real sense of the patient. Again, I encourage those still working to include those descriptive words that do more than just CYA.

[ScottJohns]

I turned 61 yesterday and I currently work in ICU and have for the past forty years. I'm a bit of a nerd and I like the evolving technology. Some of the technology is good and some of it is bad. You need to understand that some of the new EMR programs are good and some of them are just plain awful. Some hospitals provide teaching related to EMR's and some don't. Were you ever offered a class? It is ridiculous that some power to be thinks you can chart in real time. It's just not possible and any working nurse knows this. Perhaps you were just a victim of upper management dusting off their spreadsheets as they push for increased profits. If they can pay someone less to do the same job you do why would they keep you around? It's about the money, not you. I see this happening everyday in other fields of employment. You are not alone. Just put this behind you and go out and find another job because you are an excellent nurse.

[qnmimi]

I hear you, and see this in practice every day. As an RN with 28 years experience, and as a member of a team that supports nurses, and does emergency management, I see, and get to "clean up" the issues with patients that nurses sometimes have unknowingly allowed to occur because of all the time needed to e-chart on a lot of information that although may be important for compliance issues, just don't allow eyes on the patient where they belong. I do chart reviews personally on our patients who experience a code blue, and you know what? our charting by exception just don't tell an adequate patient story. Layers and layers of issues from management are pushing nurses into being a super data collector, not the nurse our patients need to keep them safe. Nursing assistants although valuable, just are not the person to be doing most of our hands on patient care. We nurses need to find a way to reinstate the integrity of our licenses, and in my practice the buck stops with me, not management.

[Spidey's mom, ADN, BSN, RN]

Meanwhile, I wish they could come up with make telemetry wireless. I get so tired of untangling the call light, the oxygen tubing and the tele wires all day long.

I've said that many times as I stood bedside untangling lines and tubes.

[donnakhamm]

Meanwhile, I wish they could come up with make telemetry wireless. I get so tired of untangling the call light, the oxygen tubing and the tele wires all day long.

What always amazed me was multiple IV lines and ICU nurses. It would seem that every shift the nurse would come in, completely rearrange the pumps and tubing (along with a few lines) and then felt set for the day. At shift change, the next nurse would come it, and rearrange it to her taste! Now that nurses have to chart what lines are feeding into which ports in the EHR, maybe this happens less?

[OHNBJL]

I've also been a nurse do 35 years. We now have EMR that I positively think distracts from patient care. But I deal with it because I have to. I can understand your pain but regardless wherever you go EMR is now in effect. Fortunately at my facility we still keep paper documentation. The manager agrees that when the computer shuts down we would be unable to care for patients. I wish you the best of luck in your new job. Patient care will always be my priority also but the EMR is unfortunately the now essential for a accessibility and billing