Is it like this everywhere now?

37 minutes ago, Young_Torso said:

The real kicker about this is that there's never a solution on their end.  The answer ultimately always boils down to "you need to do better" without any specifics as to how. 

If you're in management/administration and the only direction you can give is "start doing better," maybe it's time to start looking in the mirror. 

Don't you know that we have to work on our time management skills? Maybe an in-service will help.

1 hour ago, sarolaRN said:

Don't you know that we have to work on our time management skills? Maybe an in-service will help.

The answer is always more charting, my friend. More carting solves everything, according to management. 

On 5/17/2019 at 9:14 AM, panurse9999 said:

Thats nice that you are still in touch with every single one of your ADN classmates to know for sure they are working in hospitals. Ask them if management did to them what is happening here, forcing them to be in school at their own cost, to get the BSN, or be terminated. (which basically means working full time and attending school part or full time). Thanks. 

Speaking for my hospital (just outside of Chicago), we hire ADN RN's and DO NOT require them to return for a bsn. It is encouraged, but I know at least 2 dozen ADNs who have been working there for 5-15 years and have no plans of returning for a BSN.  My hospital does however offer significant tuition assistance if you choose to go back to school. 

I’m a nurse x 11 years. I have done cardiac, ER, travel, coordinator, and now home health nursing. Yes, it is more important to pay attention to what your paper work says than what you actually do at 100% of the places I’ve worked. And I’ve worked a more facilities than most. Some are more reasonable, but even the best ones still didn’t allow me to get done on time or always have ratios that allowed optimal patient care without me running around like a chicken with my head cut off.  Even now in home health where I am suppose to work 8am to 4:30pm and I only see one person at a time, my people are often to far spread out in terms of mileage or to many to fit in an 8 hour period. And in home health you kind of HAVE TO see your patients before 4:30 or you can’t get MD orders because that’s when MD offices close. So you are left to spend 2-4 hours on a good day doing charting after you get home.....and in a lot of instances not getting paid for it because it is salaried or paid per visit. 

Which is why all those student nurses/nurses who are like, “If you don’t love nursing anymore you should quit. People deserve kind and caring people to be their nurse. It’s a calling and it isn’t for everyone.” are so freaking annoying. I have never really ran across a nurse who hated people, but I have ran across a lot of nurses who hate having a career that mislead them into believing they were going to help people and instead spend more time documenting than providing care.

17 minutes ago, KalipsoRed21 said:

I have never really ran across a nurse who hated people, but I have ran across a lot of nurses who hate having a career that mislead them into believing they were going to help people and instead spend more time documenting than providing care.

This.

6 hours ago, KalipsoRed21 said:

 

Which is why all those student nurses/nurses who are like, “If you don’t love nursing anymore you should quit. People deserve kind and caring people to be their nurse. It’s a calling and it isn’t for everyone.” are so freaking annoying. I have never really ran across a nurse who hated people, but I have ran across a lot of nurses who hate having a career that mislead them into believing they were going to help people and instead spend more time documenting than providing care.

In and out of various jobs over 20 years in this field, in a market saturated area that has always had more nurses than available jobs, and you are correct. What I have seen is a rigged set-up where corporations are able to fully exploit the workforce, with more and more and more tasks/ charting, because all they want is to maximize reimbursement levels. When you see the insane amounts of tasks/ charting/ check boxes always in an upward trajectory (never decreasing) over months and years, one begins to question wether I am a nurse, or just a billing whore for the bottom line. 

As far as SNF work, where this is rampant, I see a mix of nurses who walk away, creating a revolving door of nurses lasting less than 3 months on the job. But nothing ever changes, because there is an endless supply of new nurses always willing to take the job, even with toxic conditions and low pay. The corporate conglomerate nursing home chains have us all right where they want us...desperate and willing to be whores for the bottom line, but never actual nurses who spend time with the patient. 

On 5/16/2019 at 4:43 PM, Forest2 said:

A nurse friend of mine had the day from hell at work the other day.  He was telling me all about it. Patients moving, discharging, admitting and too many patients from the get go.  Just chaos all day.  Then he gets a call a couple of days later asking about a personal belonging of a patient that was missing, he didn't get the inventory sheet done on admit.  So they are looking for this one item. He said he didn't feel that doing the  inventory had a very high priority when insulin was past due and patients were asking for water and to go to the bathroom and admissions had to be done.  So I guess the jist of it, he is being told this must be done, MUST on admission.  I don't like what is happening to nursing, can't the nurse set priorities anymore?  Is everything an absolute MUST?  How are nurses supposed to get anything done that is important if inventory sheets are listed as a high priority?( just an example).  I think the world has gone crazy sometimes.  He says there are signs all over the place that the hospital is not responsible for valuables and families are to take them home. He did not unpack for her, her family did.  So he thinks he may get fired for this.  Seems a bit much to me.

He also said that most of the nurses don't change dressings, do actual assessments, etc, but chart that they do it because it is a must, because the work load is more than a human can handle.  It is really scary to be a patient in a hospital I think.  I wonder if it is like this everywhere?

Hospitals decided to add Hotel features. "Need good reviews. Need more customers."

Guess who is responsible for the blunt of that force?

 

Nurses. 

On 5/17/2019 at 4:29 AM, hherrn said:

My theory is that nursing tasks should be like a balanced budget.  Like my budget, not like the federal budget.  If I decide to do one thing with my money, I understand that there is something else I won't be doing, as I will run out of money.  Time is no different, as no matter what you want, there are only going to be 60 minutes in every hour.

So- feel free to add a task.  But either remove one of equal time value, or make a couple more efficient.  But, if you think about your last two years, consider what tasks have been added, and what tasks have been removed.  It is literally impossible, so stuff is either being faked or done to a substandard level.

While working in the ICU, I was asked what I thought of the new flowsheet.  (somehow there is always a new flowsheet.) I asked my boss if she had decided what I should stop doing.  I got the same quizzical look I often get from my dog- "I know those words somehow relate to me, but I can't really put it together."  I explained in simple terms that at that point, my shift was already full of tasks.  The only way to add a task would be to remove a task, or to do some of my existing tasks less diligently, and I would like her input on what to stop doing.  She changed the subject.

I like analogies.  I would like one day to go into an administrator's office with a pitcher of water and a glass, and explain the the glass is my 12 hour shift, and the water represents tasks.  I would put the glass on the desk, ideally on top of some critical paperwork, then fill it to the brim with water.  "As you can see, my my shift is full to the top with tasks.  Take this pitcher, and lets see what happens when you add something to a container that is full."

Many administrators possess at least basic intelligence.  They can perform basic tasks like getting dressed, starting a car.  Some can even do higher level stuff like using a check book and baking cookies.  I have seen some do complex stuff like planning a vacation, coordinating lodging, food, transportation and entertainment.  How they can miss some of the most basic concepts is beyond me.

Yes!  Somehow there is ALWAYS a new flow sheet!

On 5/17/2019 at 11:08 AM, panurse9999 said:

I won't do it either, yet I see and hear both nurses and CNAs getting their arses ripped because all of their assignment check boxes were not checked off that shift, and that is not acceptable....what is not acceptable is the forced falsification of charting that exists in dozens on SNFs . 

Exactly this. I missed a daily charting that includes a set of VS on a very bad no good day. Must have been 3 or 4 days later the DON came to me expecting me to complete it.  I am pretty sure I never did those VS that day and I am even more sure that if I had there's no way on God's green earth I would remember them 4 days later.

It seems like it, the other day I got called in for a complaint from a surgeon who was mad I gave one of his surgical patients a medication that was ordered by a hospitalist. I had to explain myself why I was not out of line for giving 0.25 of Xanax to a pt for having clear anxiety. 

7 minutes ago, Wrestler133 said:

It seems like it, the other day I got called in for a complaint from a surgeon who was mad I gave one of his surgical patients a medication that was ordered by a hospitalist. I had to explain myself why I was not out of line for giving 0.25 of Xanax to a pt for having clear anxiety. 

Do you consider resigning?

12 minutes ago, Wrestler133 said:

I had to explain myself why I was not out of line for giving 0.25 of Xanax to a pt for having clear anxiety. 

Nope.

"It sounds like Dr. Surgeon's concern would be best discussed with Dr. Hospitalist. I cannot answer for Dr. Hospitalist." [Thank you, good-bye.]