Is nursing "care" a thing of the past?

[AnneBlunnRN]

I have been tossing up whether to vent or not about this, but I'm sick of having it go round and round in my head so here goes...

A friend and colleague recently underwent major knee surgery in a private hospital. her post surgery care was absolutely atrocious and very concerning.

No PCA post op and due to persistent vomiting did not receive any relief from oral meds day 1 post op until 10pm that night when she was finally given one shot of s/c Morph. at one point she was so desperate she truly consdered asking for her vomit bowel back so she could retrieve the meds.

she was left for 3 days with out a wash and her husband had to change her vomit stained gown after >24 hours. the only time a washer came near her was when her husband was there to do it- and once when she insisted they wash her back when the badpan overflowed!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!! Other colleagues and I have encouraged her to write a letter of complaint but she is now so "over it" she just wants to put this humiliating experience behind her.

I i wish I could say this was an isolated incident but my mother was a patient in the same hospital and was left on a commode, day 1 post major hip surgery, without access to either toilet paper or a buzzer for more than an hour. After calling out for attention she tried to get herself back to bed, upsetting the commode in the process. Being of "that generation" she did write a letter of complaint, but given my firends recent experience, it didn't make much of an impact.

What is going on? What has happened to basic nursing care? What about respecting the patients dignity, comfort? I am distraught!

for those of you of my generation you may remember a "film" we watched during our training... "Mrs Jones wants a Nurse". Whilst this was in many ways a parody of the demanding patient, the values and practices that it encouaged us to embrace will always be valid, as patients are still, most of them anyway, human beings with the same fundemental needs!

Are we now in a situation where all Nurses have to go through an operation themselves whilst training. ala William Hurt in The Doctor, to understand the importance of good nursing care and value the importance of the basics like mouthcare, post op washes and adequate pain relief? What has happened to empathy and compassion? Is this symptomatic of the "academisation"(is there such a word?) of nursing. Enough of Nursing theory and a little bit more of the Practice. Something I have alwys kept in the back of my mind is how would I feel and what would make me feel better?

How would you go about making sure that this does not happen again?

[kcmylorn]

Stop sending nurses to these BSN programs. Chalk up one point for diploma schools of nursing!! But the BSN's know how to Google, facebook, tweet, power point and Excel! And basic nursing has been replaced with stupid phrases like"nurse driven", "that being said" and "issue".

Sadly enough also gone are: not writing letter of complaint, writing to congressmen, senators or the pres., challenging an incorrect bill, standing up for what someone knows is an injustice .

[linearthinker, DNP, RN]

Maybe it's because I have only worked with BSN prepared nurses in recent years, but somehow I don't think education is related to what is clearly an understaffed unit.

As to your final question, I suggest you find out who is on the health and human services committee at your state assembly and right to them requesting minimum staffing standards be addressed in the legislature.

[snoopy29]

The post is entitled "is nursing care a thing of the past?" and quite simply my answer would have to be no. I have been nursing for over 25 years and although much has changed, generally nurses do what they do because they care and want to make a difference. Sadly there are always going to be examples of appalling care but on the whole most nurses I know would be suitably horrified by the tale above and their practice consistently reflects that they want the best possible care for their patients.

Yes training methods have changed but I believe that nurses worldwide aim to give their patients the best possible care they can. Just my thoughts.

[Flo., BSN, RN]

This has nothing to do with education and everything to do with staffing. That unit was dangerously understaffed.

[AwayWeGo]

This has nothing to do with education and everything to do with staffing. That unit was dangerously understaffed.

I agree with above poster. This has nothing to do with BSN vs ADN education. The unit sounds like it was chaotic and understaffed.

[sweetER]

Stop sending nurses to these BSN programs. Chalk up one point for diploma schools of nursing!! But the BSN's know how to Google, facebook, tweet, power point and Excel! And basic nursing has been replaced with stupid phrases like"nurse driven", "that being said" and "issue".

Sadly enough also gone are: not writing letter of complaint, writing to congressmen, senators or the pres., challenging an incorrect bill, standing up for what someone knows is an injustice .

Wow. I think targeting BSN nurses is really uncalled for. I am a BSN nurse, but the nurses I work with are about 70% ADN because we have an ADN program in town where most of them went. I respect them immensely, and I don't view either one of us as better or worse than the other. We all end up having to perfect and apply the things we learned during school to our particular job situation after school is over. As for my particular school, they focused a great deal on hands on learning and being able to work independently, so mine and my colleague's school experiences were probably very similar.

I worked as a tech before graduation, and occasionally nurses would help clean and toilet patients, but it was largely the techs' responsibility. If we were short a tech and two or three patients needed help at the same time, they might have to wait longer than they should have had to. It sounds like a bad case of understaffing in this particular scenario, and I don't think education had anything to do with it.

[martymoose, BSN, RN]

it's called understaffing. lots of bean counters feel one tech can take care of a whole floor- and the nurses can add 2 more pts to their assignment of 8 already

[ZippyGBR, BSN, RN]

Stop sending nurses to these BSN programs. Chalk up one point for diploma schools of nursing!! But the BSN's know how to Google, facebook, tweet, power point and Excel! And basic nursing has been replaced with stupid phrases like"nurse driven", "that being said" and "issue".

Sadly enough also gone are: not writing letter of complaint, writing to congressmen, senators or the pres., challenging an incorrect bill, standing up for what someone knows is an injustice .

or perhaps look at the standards of Nurse education and the preparation for practice ...

There is no reason why Nurses can't be both academically credible and competent in practice. Look at the UK ( and the rest of the EU) where there is the 4600 hours requirement for pre-registration programmes of which 2300 is spent in clinical practice and the balance earning your degree ( which from 2012 for the whole of the Uk will be an honours degree rather than the current arrangements where you can earn a Diploma of highereducation worth either 2/3rds or 5/6ths of the degree and then 'top up' post registration ).

In continues to surpise me from the descriptions given by students, ward staff and instructors/ leacturers/ teachers about how little both in duration and actual involvement Student Nurses in the USA do on their clinical prlacements.

[katy12345]

I recently was with my father in a hospital ER following a fall in his ALF. He fell after being given phenergan by a staff physician. My father is 90 years old. He fell and cut open his head with 8 staples put in. He bled and bled and bled some more. No one came in to see him after the night shift came on. No one. I had to beg for x-rays to be taken. At one point I pressed the nurse button because Dad had to go to the bathroom and he won't let me his daughter handle his member. A nurse came on and basically said "what do you want"? I asked if they could please come and help my Dad with his urinal, and he didn't even reply. No one came. After 20 minutes I pressed again, and asked again, basically same thing. The third time, I just didn't ask and told them that they could either come with a urinal or clean up him and his bed after he pees all over himself. This is a brand new hospital. A beautiful hospital, with the laziest rudest nurses I have ever seen. Also, I left the room at about 2am to go to the bathroom down the hall. While I was in the hallway a gentleman came staggering around the corner yelling for his wife. He was clearly drugged or messed up from an accident. His face was smashed in and he had stitches over his eyes. I yelled and yelled for a nurse while holding him against the wall. I did this for over 10 minutes. Finally a security guard outside of the ER walked by the double doors and I waved him down. He came and got the man in a wheelchair and said "where does he go"?. I said I had no idea but was stunned that no one was watching him. He clearly needed someone watching him or to be restrained. I did what I thought I should do. I called the hospital administrator the next day and told them the story. I thought they would take a report or something, they didn't. And they wouldn't even admit my father. unreal.

[babyNP., APRN]

Stop sending nurses to these BSN programs. Chalk up one point for diploma schools of nursing!! But the BSN's know how to Google, facebook, tweet, power point and Excel! And basic nursing has been replaced with stupid phrases like"nurse driven", "that being said" and "issue".

Sadly enough also gone are: not writing letter of complaint, writing to congressmen, senators or the pres., challenging an incorrect bill, standing up for what someone knows is an injustice .

I take offense at that. I worked very hard to get my BSN and I am a good nurse. I work in a NICU and I am constantly running around anticipating my patient's and parent's needs. There are many days that I stay late in order to make sure that my patients needs are well-attended to instead of passing along to the next shift. One of my patients needed to go down to fluoro for an exam so that he/she could eat over the weekend, otherwise he/she would have to wait until Monday and continue to NPO. On my way to lunch, I personally went down to the scheduler and asked her/him if we could fit my patient in. We did manage it--right during the last couple of hours of my shift. I could very well have said no. But I knew how important it was to this family not to waste another weekend of their child being NPO (the mom was of the very anxious type). Even though I left work a half-hour late to catch up on charting (while my awesome co-workers fed my other baby), I walked out of there knowing that I did a great service to this patient and her/his family.

So no, my BSN does not make me less of a nurse and I do not spend my time on social media sites while at work. Please do NOT generalize!

[Sugarcoma, RN]

I am appalled that a post op surgical patient experienced such horrific pain control. Why would anyone be getting oral pain medication the post op day of a knee surgery? uncontrollable n/v? I would not even try an oral med knowing full well the pt. would get no relief if they are just vomiting it back up. I would push the iv med slowly, try diluting it, try another med etc. This does sound like a case of understaffing to me. A nurse with an unsafe ratio does not really have time to think, wether it be an ADN or BSN RN, even with such a blatantly obvious issue such as the pain med one you posted above.

What happened with your mother is just poor practice. ANYONE who puts a pt. on a toilet whether they be RN or PCT should know that you absolutely make sure the pt. has 1-tp to wipe with and 2-a way to signal you if needed. This could also be related to understaffing but at the end of the day those actions of securing a call light and giving a roll of tp should be automatic.

Please encourage your friend to write that letter!