My RANT on the state of Nursing in my neck of the woods

[anRNinICU]

my "rant" on the state of nursing in my neck of the woods:

in the past year or so, i feel like i constantly have to be on the defense, defending myself and my work to the manager and coordinator. it has become such a punitive work environment, and this has already caused me some serious health problems.

never in my 23 years in the workplace have i felt my job was threatened until the past couple of years. it feels as if someone is always waiting for me (not just "me" ...... "me" =nurse) to "slip up" and then discipline me for it. this creates added stress in an already stressful environment, which then increases the chance of mistakes and omissions. nitpicking, threatening, and tearing people down are actual factors that create an error-filled work environment, not the opposite desired effect of having an error-free environment.

we have even recently been told that we must always speak positively of our workplace, and that those with negative attitudes will be disciplined. (not gonna mention the threats of lay-offs at every opportunity... despite the fact that our institution has over 200 vacant rn positions) the words "you will be disciplined" are very rarely omitted from blanket emails and other communications from the manager. come on now! do you really think that a bunch of grown women and men are going to take kindly to this?

staffing is good sometimes and horrible other times. there are some days where you may be working with only one or two other 'regular staff' and the rest have been sent by the resource staff or come from other units through bidshift. many of these nurses (including some of the more recently hired regular staff) obviously haven't a clue how to take care of icu patients and just go through the motions hoping that nothing bad happens during a given shiftso no one notices their incompetence. it appears that those in management turn their heads to incompetence when the regular and icu-competent staff can clearly see it for what it is.

the newer nurses (three-years and less experience) are being placed on pedestals as if they can do no wrong; last year's new grads are precepting our current new grads while the more seasoned rn's are cast aside like week-old bread. very inexperienced rn's are being placed in charge nurse roles, and many of them don't even have the basic icu skills mastered yet. it is as if the knowledge and wisdom that has been gained from decades of experience pose some sort of threat to management and/or administration.

if a crisis happens in the unit, the more seasoned nurses are often left to rescue the patient for the pedestalized newer nurse, literally. you can imagine the hostility that is created here, yet the "seasoned nurses" just keep marching along like good little soldiers, taking a beating along the way, and pretending to like it.

i feel like i am no longer allowed to use my nursing knowledge, judgment, and wisdom because of all of the black and white rules that have been imposed, and i have no sense of autonomy for fear of being disciplined. many of these rules are said to have been mandated by administration due to cms, jcaho, and the likes. critical care nurses are supposed to be able to think critically and to recognize and act upon variances in the patient's condition to prevent crises. it seems that administration would prefer to have robots that they could program to do everything the same way and at the same time, without ever questioning if what is being done is really going to help or to harm the patient. patients and health crises are not one-size-fits-all. it seems we are forgetting the human aspect of nursing.

the bottom line is: nursing, especially critical care nursing. is not black and white, but many shades of gray; and when you try to take something that is gray and make it function like it is black and white, it causes system failure, and that is where i fear that we as nurses at my hospital are headed today.

our staff used to be happy and worked great together as a cohesive team. management and administration have created such a punitive and hostile environment, (perhaps unknowingly), that it seems no one is happy with their jobs anymore. it has become one scary place to work.i am normally a very optimistic person who is committed and loyal to my workplace and to my co-workers. i am quickly losing this optimism, commitment, and loyalty because of the bureaucracy that has decided to see just how hard they can make it on the nurses who are caring for our patients. the patients whose lives we save, whose families we comfort and reassure. the patients who are the reason we are all here in the first place. feeling this way saddens me deeply.

is this just at our place? or is it universal?

staff note: font size changed from 1 to 3 for easier reading.

[TakeOne]

Could this be reposted in a larger font, please??

[eriksoln, BSN, RN]

I imagine it is universal, but thats just my opinion.

My manger too loves to throw the "I have a line of applicants for every position. The line goes out the door and down the street to the next hospital. If something is not to your liking, please, feel free to explore other options. And just to let you know, I'm tired of people saying they are tired or don't feel like being at work today. I'm going to start accommodating people's wishes."

Here is the part you may like though:

Turns out, that "line out the door" or applicants she talked about.........well, she don't talk about it anymore. lol. Turns out that line was chalk full of people who only thought they wanted to work there. A few quit on her before the first day, a few saw the conditions on the unit and didn't come back after their first day and others found something in the mean time. She still can't get people to work the night shift.

To be completely honest, these hard times in the past couple years have motivated me. I am now motivated to be sure I am not relying on nursing my entire career. I will be going out and learning a trade or something else to do when I am older. I am not going to waste my money on a BSN. I'd much rather put my money into something that will release me from nursing. Nursing will become something I do on the side. There are too many older nurses how worked at one place 30 years who were laid off for ticky tacky reasons and are now unable to find work. Not going to happen to me.

[ChristineN, BSN, RN]

Wow. That sounds terrible. I have two staff jobs and neither of them are like that. However I did leave a job earlier this year where good nurse's were being reprimanded, even fired, while incompetent nurses continued to get promoted, further their education and take care of pts. I would start searching for a new job.

[Mulan]

Sounds familiar.

[Mulan]

To be completely honest, these hard times in the past couple years have motivated me. I am now motivated to be sure I am not relying on nursing my entire career. I will be going out and learning a trade or something else to do when I am older. I am not going to waste my money on a BSN. I'd much rather put my money into something that will release me from nursing. Nursing will become something I do on the side. There are too many older nurses how worked at one place 30 years who were laid off for ticky tacky reasons and are now unable to find work. Not going to happen to me.

What are you thinking of doing?

[eriksoln, BSN, RN]

What are you thinking of doing?

The options are endless. An associates in accounting is my first thought. I wont make the same as a nurse, but being a book keeper has a certain......advantage in sanity lol.

I've considered bus driving too but not sure that's the best option.

Plumbing has been a thought at times but, IDK if its a good idea to get into that in my advanced years. I'd be a laborer and end up with a really bad back.

IDK. I'd have to give it more thought.

I've even considered working in a youth home as a staff member.

[Scarlette Wings]

wow, i so entirely understand where you are coming from! i wonder sometimes if it is just a matter of money, it is cheaper to hire in new nurses and new grads than it is to keep older ones who have worked their way up the pay scale system and just beginning to make the wages that nurse's should make at the onset. i see the same thing happening in a great many areas, not only speciality care. a hospital around here just laid off about thirty or 40 employee's yet one nurse i remember from back when i worked at the place is still there.

that nurse was very manipulative back then and i doubt that leopard has changed any spots. i was just always thankful i didn't work the same unit and could endure the shift and stay busy when that nurse was floated our way. it is almost as if the nurses that are kept are retained for the wrong reasons.

nursing instinct and wisdom come with experience and that takes years, not just months. nurses specialize and are as focused and trained in their area of expertise as physicians are now. the equipment and procedures are complicated and unique to every area and nurses can no longer just "show up" and "be a warm body with a license" and yet there seem to be some that always manage to survive any nursing lay off or downsizing. i have noticed that many that are retained are related to someone in the healthcare "system" in the local area though.

overall, i'm with you and i don't understand it either.

[oramar]

Could this all be about money? You say there are unfilled positions but could it be that unfilled positions mean more jingle in the pockets of management? Could it also be that the poor treatment of older, experienced and better paid nurses is an attempt to thin out the ranks and again lower cost? Can't help but wonder.

[AZblabnurse]

Being a new Grad that looks at the job boards everyday, possibly every few hours. If they have lines out the door to take your spots, then why do they post, re-post, re-post and re-post the same ICU jobs over and over again. Maybe the managers are not in the great spot that they think they are.

At least that is how it is in Phoenix. I wish it were cheaper to hire a new grad, because we are not seeing it :). I have had about 15 interviews over the last 6 months. 35 New Grads going for 5 spots is not very good odds.

Maybe it is time for the managers to actually hire some STAFF.. Wow that is a novel idea.

[roser13, ASN, RN]

If you could possibly change the font size of your post, you could get responses from nurses over 40 too!

Sorry to ask for an accommodation - I'm old

[JB2007, ASN, RN]

I am only 37 and after reading at work all day I just can not read that font size. My poor eyes just can not take it.