I have first-hand experience with the often bizarre culture of nursing and the culture of nursing school. I'd like your two cents about seeing any improvements (or not) with respect to aspects of the profession (horizontal violence, management, hierarchy, education, patient care, anything!). I've seen my share of rigid, destructive, and petty behavior towards nurses and nursing students, but I do hope this will change for the better as the new wave of nurses enters the profession. Or, maybe not? Please share your thoughts. Thanks!
Thank you for this thread. I am amazed at the culture myself. I am trying to transition out because the nursing profession has been so unforgiving. Frankly I wonder about folks who seriously suggest that nursing is not more dysfunctional than other professions. Have they been anything other than nurses?
No, it is not getting better. Nor will it, given management's current customer service emphasis instead of good patient care.
The "dumbing down" of nurses by requiring extra signatures from everyone rather than holding accountable the few, the lack of adequate staffing, the verbal abuse by doctors/patients/families, the sleazy portrayal of nurses by the media all contribute to the idea that nurses are better-paid waitresses and in the cases of younger more attractive nurses, sexual objects to whom innuendos and advances can be made with impunity.
The minutely detailed computerized documentation, JCAHO, etc , may have started out as good ideas but have morphed into monsters.
I will retire, God willing, in six years if I can hold out til then--I am single, so have little choice--and spend most of every minute of every working day willing the time to pass quickly.
The dysfunctional behavior of nurses toward other nurses is simply the safety valve that is the only outlet for the incredible stress we live with each and every day.
The stress MUST go SOMEWHERE. You cannot take it out on patients,families,doctors or management if you want to keep your jobs. It would be nice to relieve it via exercise or some other activity but usually you are too darn tired or must fulfill other obligations at home. Few nurses really have the time and energy to care for themselves. And how many really have anyone who will care for and nurture them?
Thanks for your input, everyone! I am wondering, what does everyone think about the root of these issues? Is it burnout? Is this behavior specific to a certain age range of nurses? Is there a certain psychological 'make-up' of a nurse that exhibits destructive and even cruel behavior? Caretaking and cruelty/rudeness/ignorance/etc. are (in an ideal world) oxymoronic. Do these nurses' actions get lost in big bureaucracies and/or hierarchies? I think we live in a time in the world where we can be progressive and take on this issue. Nurses 'eating their young' was the most horrifying thing I had ever heard when I started nursing school. I know a lot of nurses might be resigned to saying, 'well, that's the way it is, we can't do anything about it'. But can a profession really be sweeping this under the rug and accepting it? I, for one, do not, cannot, and will not.
Nursing has a lot of diversity .... great, we need a lot of diversity.
However we also get quite lot of diversity we don't need.
The behaviour many of us are talking about is mainly ignorance... also emotional instability/substance abuse /psych also feature to a lesser extent.
The big problem with all this diversity is that we have let a whole lot of ignorance in with it.
I don't know how we get around this problem.
My biggest bugbear with poor nursing culture is that it often is about certain ignorant individuals. It's like the elephant in the room
Having entered the nursing workforce at age 38, I am constantly bewildered by the fact that nurses constantly seem to feel a need to beat themselves over "eating our young". There is a transition period in any job, however prestigious or menial. There is always politics if you work with other people. Perhaps if our nurses were not overworked, were well-educated (not just trained), and treated with respect, they would treat their fellow nurses better. How you treat others is often a reflection of how you feel about yourself. Many nurses do not feel good about themselves in other areas of their lives and it shows in the workplace.
The first step is to stop claiming we "eat our young" and siimply emphasize that teaching coworkers the ropes is part of our job-and giving us time to do that-a management issue.
The second step is to make our coworkers feel the respect they deserve, so they can develoop self-respect and share that respect with others. Often this again starts with management. A strong employee assistance program is also helpful.
The third step is to realize that every job has people who like to stir up others, cause problems, and not do their share of the work. Poor management will not address these issues. So we need better-educated, more effective management working on our behalf, with strong policies regarding training, well-defined work expectations, respect for work well done, and good labor-management communication.
the first step is to stop claiming we "eat our young" and siimply emphasize that teaching coworkers the ropes is part of our job-and giving us time to do that-a management issue. you can say it's not happening, but, that doesn't mean it isn't. there are those who will refuse to co-operate as it doesn't make them look better than the real good nurses. and you are expected to make the time to do this while completeing the thousands of other things assigned to you.
the second step is to make our coworkers feel the respect they deserve, so they can develoop self-respect and share that respect with others. often this again starts with management. a strong employee assistance program is also helpful.
as an individual i try to respect all my co-workers, i hope that by doing so it will be passed on. but, again not everyone does this, nor can we make them. and from what i've seen, management encourages this behavior as it "keeps us in our place" thus we are unable to improve conditions.
the third step is to realize that every job has people who like to stir up others, cause problems, and not do their share of the work. poor management will not address these issues. so we need better-educated, more effective management working on our behalf, i agree a more effective management system would go a long ways towards solving these problems, but, the cost of hiring and training this management staff would interfere with the profits, so i don't see it happening anytime soon.with strong policies regarding training, there are strong policies reguarding training in most places, still the problem is ignored.well-defined work expectations,a well defined explaination of work expectations? if my current employer had told us we were expected to work short, take unsafe patient assignments, not take breaks, spend the majority of our time playing waittress, social worker, maintaince man, receptionist, furniture mover, and plumber, i can assure you they would be unable to hire any staff. respect for work well done,very few don's ever let you know what you've done that is good. i think the reason is that if you knew how well you were doing your job, you would be entitled to larger pay raises, (which goes back to cutting into company profits) and so all we hear about is what we missed/do wrong. and good labor-management communication.i can honestly say that our management always listens to us. they don't do anything about the problems but, they do listen. so rather than asking for better communication, we should ask for better actions taken from the information given during the communication.
all in all i can't see management making the changes necessary to improve the environment we work in. as they (some not all) are not on the floor dealing with the day to day problems, they need someone who can do it for them. and so you get the back-stabber who watches your every move and runs to tattle every chance they get. at one place i worked for, they actually told me part of my job was to watch what my co-workers did & report back to them (i failed that assignment misserably). yes we need changes, but as long as we are "kept in our places" encouraged to "fight with each other", and do not stand together as a profession (or trade if you like that term better) nothing will change.
Education seems to be getting much much worse. Entry standards are too low, school requirements and standards are too low, the bar to pass NCLEX is too low. It is worse than I have ever seen it. This is what worries me about Nursing. Frankly, I think if we fixed the education issues, it would go a long way to cutting down on some of the other complaints I hear. I hope it gets better, but I don't think it will until there is some paradigm shift.
all in all i can't see management making the changes necessary to improve the environment we work in. as they (some not all) are not on the floor dealing with the day to day problems, they need someone who can do it for them. and so you get the back-stabber who watches your every move and runs to tattle every chance they get. at one place i worked for, they actually told me part of my job was to watch what my co-workers did & report back to them (i failed that assignment misserably). yes we need changes, but as long as we are "kept in our places" encouraged to "fight with each other", and do not stand together as a profession (or trade if you like that term better) nothing will change.
gentlegiver, i think you and i are saying the same thing in different ways. you are saying you have poor management and have a miserable work environment. i am sayilng in order to change, we must make our management become more professional and become accountable for the work environment. i worked in management of a large discount company before deciding to become a nurse; management in other fields is responsible for the working environment of their employees. it should be that way for nursing also. as a manager (keep in mind, i was not a nurse at that time) i made a point of being present and approachable, working with each employee regarding her/his individual needs. i expected employees to gain skills as they worked and become a resource for the newer employees. i managed the staff. as a nurse, i have worked for nine years on days (17 years total) and wouldn't recognize my vice-president of nursing if she came on the floor. my director is only available if she has criticism. i work in a small (125 bed) hospital--it shouldn't be hard for her to be available to her staff.
nursing needs professional managers, not floor nurses who aren't happy on the floor and who think they've met their goal when they move from the floor to the office. they need managers who understand that cutting staff is the easy way, but not the best way, to stay within budget. they need managers who understand how to empower good workers, encourage discouraged workers, and encourage teamwork and enthusiasm for the job. these managers must also know how to cut out the deadwood and get rid of nurses who are simply bodies on the floor. nursing, from what i have seen, has very few of this type of manager.
Gentlegiver, I think you and I are saying the same thing in different ways. You are saying you have poor management and have a miserable work environment. I am sayilng in order to change, we must make our management become more professional and become accountable for the work environment. I worked in management of a large discount company before deciding to become a nurse; management in other fields is responsible for the working environment of their employees. It should be that way for nursing also. As a manager (keep in mind, I was not a nurse at that time) I made a point of being present and approachable, working with each employee regarding her/his individual needs. I expected employees to gain skills as they worked and become a resource for the newer employees. I MANAGED the staff. As a nurse, I have worked for nine years on days (17 years total) and wouldn't recognize my vice-president of nursing if she came on the floor. My director is only available if she has criticism. I work in a small (125 bed) hospital--it shouldn't be hard for her to be available to her staff.
Nursing needs professional managers, not floor nurses who aren't happy on the floor and who think they've met their goal when they move from the floor to the office. They need managers who understand that cutting staff is the easy way, but not the best way, to stay within budget. They need managers who understand how to empower good workers, encourage discouraged workers, and encourage teamwork and enthusiasm for the job. These managers must also know how to cut out the deadwood and get rid of nurses who are simply bodies on the floor. Nursing, from what I have seen, has very few of this type of manager.
You hit the nail on the head
We have a shortage of managers with both sets of skills .... professional nursing and generic professional.
I believe a lot of the issues with poor management relate to a lack of real generic professional skill.
A lot of great nurses are promoted but they often lack the professional side ( plus the capacity)
Thank you for this thread. I am amazed at the culture myself. I am trying to transition out because the nursing profession has been so unforgiving. Frankly I wonder about folks who seriously suggest that nursing is not more dysfunctional than other professions. Have they been anything other than nurses?
yes, and I agree the culture dysfunctional. There's just too many people even here , well over 50% that have had a negative experience. that's way too high. I do agree it comes from the leadership; the horizontal aggression cannot be tolerated and I suggest a new generation of clinical managers will have more to do with that than new nurses. they have to stop rewarding people who behave that way, as one person notes, making them confidants and favorites. I don't care what their skillset may be. If they're causing turnover, they're a liability. Period. In todays times where so many hospitals are struggling to keep the door open this is a no-brainer.
kfactor
29 Posts
Thank you for this thread. I am amazed at the culture myself. I am trying to transition out because the nursing profession has been so unforgiving. Frankly I wonder about folks who seriously suggest that nursing is not more dysfunctional than other professions. Have they been anything other than nurses?