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)
Though I am only a student nurse, it is sad to see some of the changes in the nursing field. I have weighed the option of being a CNA in a long-term care facility rather than an LPN in the same place.
Why? Because I want to be involved in as much care with my patients as possible. I do not mind assisting with ADLs, or spending time with patients. Yes, I want to have nurse status, but I am not attracted to a job where I would mainly be med passing and charting, with no time for spending personally with the residents.
I can understand where you are coming from. Though I am trained in this day and time, a major part of me is 'old school'. I really hope this new job will work out for you. I am sorry that you had to face this.
"A machine took my blood pressure, which they then need to enter into a computer. Half their time in my room centered on fiddling with it. My family physician spends about half his time with me staring at a computer screen because he now has to enter so much data it can't wait until later."
There is no skill in this. No need for a higher degree. Let me correct this statement. There is skill but it is in using the computer, not in nursing.
Have you considered doing home health nursing through one of the Medicaid waiver programs? There is a dire shortage of qualified nurses to do 1:1 nursing for children and adults with disabilities, from the most mild to complicated situations like home ventilator use. All that documentation is handwritten the old school way. We have never been able to have enough staff in our house while our girls were alive, and I have no respite because we can't find someone willing to work to help take care of my husband who is now ventilator dependent. Thank heavens I am more than capable and more than willing, but we would give anything to have even minimal support with nursing. Try thinking outside the box with your options like other people have suggested including hospice and palliative care. The one most difficult transition we find for acute care nurses is that you need to respect that it is someone's home and they often do things differently than in the medical setting. Best wishes in this new second act of your career. (I use speech recognition, and although I tried to proofread closely, please forgive any errors. )
This is what happens when administrators don't understand what nurses do. They see a new grad as just the same as a seasoned nurse...only paid at a lower rate.
THANK YOU SO MUCH FOR THIS INPUT! All of you have helped me greatly with this transition in my life. Maybe I am not such a bad nurse after all
No, you aren't. You may not fit the Hospital floor nurse mold anymore, but there are still places where you will be able to draw on your years of experience.
I wish you luck, please let us know how things turn out. I plan on doing what I do until I reach full retirement age-that's 8 years from now.
This is what happens when administrators don't understand what nurses do. They see a new grad as just the same as a seasoned nurse...only paid at a lower rate.
I don't believe a lack of understanding is always the reason. The high level medical and nursing administrators know what nurses do, and if the CEO is also a physician, the CEO understands what nurses do. Even if the CEO is not a physician, he/she would in any case be informed by the medical officers of the organization.
I don't believe a lack of understanding is always the reason. The high level medical and nursing administrators know what nurses do, and if the CEO is also a physician, the CEO understands what nurses do. Even if the CEO is not a physician, he/she would in any case be informed by the medical officers of the organization.
Many administrators know that nurses pass meds, and start IVs. Tasks.
But many have no understanding of the critical thinking and cognitive stacking nurses do under pressure. If they did, then seasoned nurses would be seen as the valuable resources they are. There would be a value placed on retention.
CEOs are not typically MDs, and hospitalists are more and more contracted employees. The CEOs job is to run a business, and some strategize how to improve the bottom line- this month. Even if the strategy of cutting back on nursing today increases operational costs tomorrow.
Sadly, many nursing administrators adopt the mentality of the rest of the C suite after years away from the bedside and refer to bedside nurses as "they" while identifying themselves with non-nursing administrators. I'm not saying they lose their souls- I'll stop short of that statement.
In their defense, nurse managers often have to learn "keep quiet", not rock the boat, and not speak up- or their job is no longer secure.
I'm sure you are correct, that a lack of understanding is not the only reason. What reasons do you see?
I feel your sadness. I have been a nurse for 27 years, but have worked 26 years with my present employer. I have kept up with the technology and changes that my employer has made over the years. I have the "required BSN credential" for practice in my state. I say "required" because getting employment without it would be challenging. However, as a 52 year old, nurse I feel challenged to prove my skills daily. My younger coworkers seem to question me about things, and I'm often explaining my actions. Recently, I find myself spending more time with the computer and documentation than with patients. I observed one of the younger nurses who was scheduled to perform a 4 hour dialysis training spend 1 hour with the patient and the rest tinkering with the computer charting system. I didn't realize there were so many fields a nurse could complete in our EMR. Even so, I suspect, in time I will be replaced. Perhaps, I spoke up too many times. Sometimes it's not about the EMR, it about society's view of the older worker.
I'm 52 and have not spent my money foolishly, but nursing did not pay well in 1988. No unions, no pensions to protect nurses in my state back then or now. So what can a nurse do if one has devoted a lifetime to one employer? Not much, Loyalty does not pay. A nurse has more opportunities for employment if they worked shorter periods in various areas. Changing specialties in nursing is now something that has to be planned at the start of a career. There is the additional requirement for credentials and the ladders that designate a nurse as 1, 2 or three. The employment ads specify they want a nurse 1 or 2. I'm not blaming the new grads who need employment also. But, it seems, that every community college in my state has a nursing program. Then there's the mandatory on line BSN program, and few prospects for employment. So this is New Age Nursing ...
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.
I know how you feel after 20yrs of nursing myself I have decided to leave the hospital a currently am at. Younger nurses don't respect older nurses. They act like they know everything. We have had such a mass exodus of experienced nurses it is scary. The politics are ridiculous. I became a nurse to help people and pass on important information of how they can take of themselves. I am not afraid to talk about the hard stuff, but it sure does get quite at the nurses station. I have also learned over the yrs management really does not care about the work environment or work load. My old manager would make statements that she did not want to hear about how nurses felt, just do your job. Most people they hire now know nothing of team work. It's I will get to it when I am ready but the nurse is responsible if it doesn't get done. I am back in school and hope to teach nursing and teach students respect, team work, caring, compassion way. Having friends at work is fine, but being professional and what is in the best interest of patient care should supersid whether you like the people you work with not. I also feel undervalued but I know I am a very good nurse. So hang in there it will get better.
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Parakeet
144 Posts
Though I am only a student nurse, it is sad to see some of the changes in the nursing field. I have weighed the option of being a CNA in a long-term care facility rather than an LPN in the same place.
Why? Because I want to be involved in as much care with my patients as possible. I do not mind assisting with ADLs, or spending time with patients. Yes, I want to have nurse status, but I am not attracted to a job where I would mainly be med passing and charting, with no time for spending personally with the residents.
I can understand where you are coming from. Though I am trained in this day and time, a major part of me is 'old school'. I really hope this new job will work out for you. I am sorry that you had to face this.