Nurses Fight Back! Why Some Hospitals are Despicable

[allnurses]

This article was written by a member on allnurses in response to reading the article

Hospitals Firing Seasoned Nurses: Nurses FIGHT Back! . Due to the controversial and emotionally charged nature of the article, she is afraid of retribution if her hospital administrative staff should read this article and link it back to her. So we offered to publish it for her anonymously. Please add your comments regarding this issue negatively impacting nurses and the healthcare system.

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Sue, a new nurse three months into her first job, had a rough assignment, along with every nurse on the floor that day. A wing of 25 beds - and 24 of them filled, there were only 4 nurses - including the charge nurse. Sue barely had time to do an assessment more than open the door and check to see if her patient was breathing. If they talked - they were breathing - and that had to be good enough. The doctor was rounding and wanted to talk to her. Bed 8 needed pain meds and bed 10 needed to get off of the toilet. Would have been great if they had a tech working that day, but that is just fantasy. She still had not taken vital signs or opened her charts to see what meds were needed by 8 am.

Overhead, a Code blue was being called. As Sue ran to assist, she passed by room 11 and her patient screamed out that she had fallen out of bed. The IV pole was lying on the floor next to her and her iv site was bleeding...she was on a dopamine infusion. Sue stops in her tracks to help her patient, a 200-pound female who tried to move from the bed to the chair without calling for help but tripped on her IV tubing. Undecided if she should immediately restart the IV while her patient was still lying on the floor, or try to move her up to the chair without help, Sue wanted to scream in frustration. It was only 7:30 am.

Sadly, this is an example of nursing that should not ever be imposed on anyone, much less a new nurse who has no experience to draw on. Hospital administration who expect to have success by cutting corners and hanging the staff out to dry are at high risk for increased turnover rates, high morbidity/mortality, and disgruntled employees.

10 Reasons Nurses Believe Some Hospitals are Despicable

1. Nurses are under...or not... appreciated.
2. Equipment is outdated, broken, or non-existent.
3. Doctors are coddled to and they are allowed to treat nurses disrespectfully.
4. Improvement suggestions are ignored by management and are not appreciated.
5. Understaffing units and placing nurse licenses at risk with a high/unsafe workload.
6. Unit directors do not lend a hand to help out on the floor when everything is in chaos.
7. Benefits are decreased, pay increases are decreased or not given, and retirement is bleak.
8. The hospital takes better care of administration than it does the staff caring for the patients.
9. Nurses have no support system within the hospital, do not have mentors, nor trust other nurses within their unit.
10. Creating an environment of "us vs them". Nurses are written up by management for things beyond their control due to the heavy workload. Yet, management does little to ease the load of their staff.

Understanding why some hospitals are despicable paints a clear picture of how NOT to manage a hospital, and lends credence to creating a hospital workplace that succeeds. The comparison from one environment to another is striking. Hospitals that succeed place a lot of time and money into proper training of their nurses and value the staff. Take a look:

Anna was a graduate nurse who landed her first job at a local hospital. While waiting to take her board exam, Anna was started in a Pathway Program with other new nurses at the hospital that lasted 6 months. During the first week, the hospital prepared the graduates to take their NCLEX exam with an intensive review.

After the nurses passed their boards, they spent days in Pathway training in classroom training. This included going over hospital policies, safety issues, guidelines, and best practices for hospital patients. Over the next 6 months, they worked on different units with mentors, trained on medication administration, the computer programs used for patient charting, and completed the hospital computer education curriculum. The program instilled the hospital values and mission in the training. Nurses were not "eaten" by the staff, but supported and encouraged.

Anna, along with the others in her program, then graduated and started on the unit they were hired for full time. She had an assigned mentor who she could approach at any time if she had any concerns in caring for any of her patients. The workload at the hospital was acceptable and did not overburden the nurses. In the unit where she was assigned, she found the charge nurses started off the day without an assignment so that she/he could help the other nurses with discharges and admissions, and if need be, could take on a patient or two during the shift. Anna learned the value of teamwork.

Additionally, Anna found she could increase her hourly pay through ambition. Pay raises are attainable through yearly evaluations, gaining continued education certifications, and through continued college education degrees. A reimbursement program for continued education was available. Overtime bonuses and pay during "crisis" seasons when the hospital was overflowing was offered. The hospital gives back to their nurses through yearly bonuses, PTO, Nurse Appreciation Week, and recognition of achievements.

Anna asked her mentor, "Is everyone here this nice?" She also told one of her family, "It is really hard to get a job in this hospital, no one ever wants to leave and work someplace else."

This is true. When hospitals want to become great, administration must realize it is nurses who are the foundation of care, understand what it takes to move a nurse from a graduate nurse to a strong, experienced nurse, and what it takes to keep them.

Hospitals that succeed value those who can create a trusting relationship with patients; who have time to educate and provide quality care for them (decreasing readmission rates); and create positive outcomes -in many ways - even through death; and who have the power to define in action the value and mission of hope and healing many hospital's claim they have.

Nurses, let your voice be heard - stand up for what you believed in when you decided to become a nurse. Be the leader of change in your hospital, be the compassionate, caring, daring, brave nurse you know you are meant to be!

Share your comments here, and join the movement -

STAND YOUR GROUND!!! LET YOUR VOICE BE HEARD!!!

[Chisca, RN]

[h=1]If you want a picture of the future of nursing, imagine a boot stamping on a human face—for ever.” George Orwell -1984[/h]

[c.strong]

This article is so true. This sums up a lot of the almost 50 yrs I spent as a Reg Nurse. And is not getting better. I am grateful I had a job all those years but it was not a happy place except for about 10 sporadic years In other jobs not connected with hospitals....for the most part it was a job as a high paid maid.... with all the lack of respect , the work and the lack of support that goes with being a maid

I did my best to never leave a pt with out pain med for more then 10 minutes, clean up pts when no CNA was available of just refused to do that job. Handle disgruntled families, other nurses, lab techs, impossible Dr's non cooperative Pharmacists, blaming Persons from administration down to the housekeeper who could report you for any infraction that they could spin. I loved nursing I did not like the baggage that came with it

[BuckyBadgerRN, ASN, RN]

This is OP's first post. S/he is not telling us anything that we don't already know!!!

[Nurse/Advocate]

This is OP's first post. S/he is not telling us anything that we don't already know!!!

If you will look at the initial post, you will see that this was posted for another member.....who is actually a long-time member. She/he posted in order to get discussion on the issues that you and others are already aware of. And as far as this being my initial post (as the one who posted this for the member), I have been a member here for a very long time.

[RedScrubs]

I am an EMT Certified LVN who was working as an ER tech in a small for profit hospital, while finishing my prerequisites for RN. The job description given to me was very casual, but in writing. The things that I was doing seemed to continually get stretched. Splinting with orthoglass, irrigating wounds, dressings that weren't dry (neosporin thrown in for the purpose of padding the bill),etc. When a nurse asked me to d/c an iv, I told her that it was outside my scope of practice. I kept getting radiology coming up and asking my to d/c ivs and reconnect them on return. I went to my department head to confirm, as it seemed quite the norm and he said he would follow up. In the meantime, I pulled up corporate policy, versus the documentation I was given for my job description and it aligned with no duties other that comfort measures, vital signs, etc. Nothing that required skills so much. I knew, as EMTs, we were trained for prehospital splinting only, and I told the man in the interview that I didn't have any splinting skills. The coworkers training me were emts and had been splinting for years. They still didn't look correct and I didn't trust the training as a competency training. Even if I were working as an LVN, I would only have been able to use preformed splints. There were constant standard of care problems, (which I view as training problems) Long story short, I was given a brand new job description that described all of these things and was told that I had been given this description earlier, upon hire. I am certain this isn't so, and my coworkers were given the same job description simultaneously, saying they had turned it in to HR and it had been lost. I wound up quitting because the people relying on the cheating for bonuses were the same people that were supposed to maintain compliance. They asked me to report anything to them that I had done outside company policy, agree to not whistleblow, and report to them any events outside standard of care. I told them I needed to speak with an attorney first. I could go on and on about being out of there and feeling like I woke up from a nightmare, but I had some really wonderful coworkers. Even some of the one on the bonus program were fine, they just had to go along to get along. I need to do what my legal minimum is to protect myself. Do

I need to report this to anyone? I keep thinking about the things that go on, and the good nurses have no control. They put (less than 90days) new nurses on the psych patients and give one sitter to three one to ones, etc.(Which is a safety issue for everyone and medicare overcharging) I'm just trying to survive this bad situation as unscathed as possible, with an implied threat. There is no way I can think of to make it better for anyone by reporting anything. I figure I'll volunteer in the area and try to give back that way. I really had hoped this tiny desert crossroads hospital would be a positive experience. I did learn by researching what was wrong. I really expected excellence in a small hospital. Wow. I was wrong. I continuously have flashbacks about the nonsense. Not nursing care at its finest by any means. Fall risk is a fall risk is a fall risk, whether in the ER or Med Surg or SNF. Vital sign machines are basic equipment. Pillows are standard equipment for seizure precautions and miscarriages. I wish I knew how to make it better.

[Julie Reyes, DNP, RN]

Anna asked her mentor "is everybody nice here?"

And her mentor answered "YES"

:roflmao::roflmao

.

i have seen it happen time and time again where i work. It happened to me as well. I love where I work - everyone is all about caring for the patient, working as a team, supporting each other, we all have each other's backs. From administration - all about the patient and employees - and you can see this all the way through the hospital, from the employees to the contractors who work here, to the volunteers. I think that is one of the reason our hospital always wins "The Best of the Best" places to work in our city. and seriously - it IS hard to get a job here, because no one ever leaves!

I wouldn't even know what to do at Sue's hospital!

[Julie Reyes, DNP, RN]

This is OP's first post. S/he is not telling us anything that we don't already know!!!

Sure - this is a hot topic - we know what is going on, but what are the solutions? I think that must be the point. Do you have any suggestions or thoughts?

[Thachik_109]

I myself can relate to the new nurse thrown in and undertrained feeling with lack of enough staff to patient ratio. I hate how as a nurse, just because you have gone to and finished school, you are expected to know how to jump in and take on any medical situation without the training and molding we so deserve! It's a scary thing and huge weight to have the responsibility of someone's life in your hands let alone multiple lives at once. We need those seasoned nurses to season us. It seems that support staff with extremely important responsibilities are the ones who are treated like crap. Take the time to train and provide good mentoring programs and it will pay off in the end!

[alanchhith]

I really like this article because it feels like there are nurses out there in other organizations that are going throught he same thing. I used to work in a place where the nurses are valued and work well as a team with the support of their leaders. where I am now, the hospital is smaller and they are cutting cost, with outdated equipment or not available resources to help the nurses. As new nurses are hired, more experience nurse get cancelled or resigned. As time passes, the newly hired nurses are becoming disatisfied with the working condition and lack of support. They too are leaving at an alarming rate.

Fixes need to be done but the corporate of the for profit hospital leave little to do anymore than what they are doing now. Sad situation.

[NextGen]

I found out the hard way that if you complain to a manager about just about anything, you are tagged as "not being a team player". Not being a team player has become the euphemism for complaining about anything in the hospital environment.

After working in corporations for 20 years, I followed my heart into nursing. I enjoy bedside care. But is has been disappointing to find that managers are more worried about "managing up" than the care of patients on their unit.

As long as no one steps up and voices their concerns, nothing will change.

[CHESSIE]

I really like this article because it feels like there are nurses out there in other organizations that are going throught he same thing. I used to work in a place where the nurses are valued and work well as a team with the support of their leaders. where I am now, the hospital is smaller and they are cutting cost, with outdated equipment or not available resources to help the nurses. As new nurses are hired, more experience nurse get cancelled or resigned. As time passes, the newly hired nurses are becoming disatisfied with the working condition and lack of support. They too are leaving at an alarming rate.

Fixes need to be done but the corporate of the for profit hospital leave little to do anymore than what they are doing now. Sad situation.

It is not just "for profit" hospitals that have the issue that you eloquently describe.

I worked for a "non profit hospital," and retired over ten years ago. This "non profit" hospital, and all hospitals in the county, were under the "umbrella" of the same Health Care System, and had the same issues with dangerously short staffing, little or no mentoring of new RNs, rapid turnover of personnel, and too many administrators, directors, and other corporate elite. There was no competition from other hospitals in the vicinity.

Add to that conundrum, small, well run practices were strongly "encouraged" to join this Health Care System or face "punishment" from said Health Care System. One knowledgeable physician was no longer the head of a department that he had successfully managed for years, when he decided and told the administration that upgraded equipment was needed. When this needed state of the art equipment was not purchased by the hospital/health care system, he purchased his own state of the art equipment and opened his own very successful practice. Six months later, the hospital, out of necessity, and due to competition, did purchase the much needed equipment.

Competition breeds excellence and lack there of breeds mediocrity.

[Traceyhigh]

DON's and managers who have maintained their licenses should have to take a typical (I.e., full) assignment monthly. That way they would get a first hand look at our daily experience.