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 Equipment is outdated, broken, or non-existent.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!!!

[CHESSIE]

Twenty five years ago, our local paper employed an investigative journalist. She "dug deeply" into some nasty issues regarding our local hospital, and it ended up having the CEO dismissed. For a while staffing improved along patient care and retention of nurses. Then, the parent company of this one hospital bought out the two competing hospital, one in a town thirty minutes away and one in our city. Soon the other hospital in our city closed. The parent company started buy out private practices and tried, as it had in the past, to buy out another hospital, north of our city, to no avail. Sadly, due to poor management the, very needed, hospital in the city north of our city was forced to close within only a day's notice, and it has yet to reopen. The parent company of the local hospital has taken over the OPDs, EDs and expanded the X-ray services, and is still buying all the private practices that it can. This monopoly is causing this one health care group to be the "only game in town." Sadly, lack of competition breeds dissatisfaction, complacency on the part of administration and mediocrity.

We could use another investigative journalist.

[NursesRmofun, ASN, RN]

Twenty five years ago, our local paper employed an investigative journalist. She "dug deeply" into some nasty issues regarding our local hospital, and it ended up having the CEO dismissed. For a while staffing improved along patient care and retention of nurses. Then, the parent company of this one hospital bought out the two competing hospital, one in a town thirty minutes away and one in our city. Soon the other hospital in our city closed. The parent company started buy out private practices and tried, as it had in the past, to buy out another hospital, north of our city, to no avail. Sadly, due to poor management the, very needed, hospital in the city north of our city was forced to close within only a day's notice, and it has yet to reopen. The parent company of the local hospital has taken over the OPDs, EDs and expanded the X-ray services, and is still buying all the private practices that it can. This monopoly is causing this one health care group to be the "only game in town." Sadly, lack of competition breeds dissatisfaction, complacency on the part of administration and mediocrity.

We could use another investigative journalist.

I know what you mean about monopolies! In the case of your town it is *very bad....I agree! In my town (which is fairly small), we have only two groups for one specialty for many miles around. For some specialties, many people travel 2 hrs. to get to a specialty doc for that expertise. It is not good. In bigger cities, you can have your choice or 3-4-5 or more groups for one specialty and sometimes 2, 3, 4 separately run hospitals. I miss that! :/

[target98765]

""Why do they eat their young? Just a little devil's advocate on that thought. Some (a few?) new nurses believe they actually are better than experienced nurses because they are some combo of "fresher" and "less bitter". When a new nurse comes with that attitude AND/OR comes with an attitude of "knowing it all", it can be difficult to those orienting them or working with them...that second one makes me nervous. If a new nurse comes with a lot of energy and is willing to learn, I am one of the nicest old bats around! lol ""

Hey, I could be a millionaire right now if I had a dollar for every time a brand new RN said "I KNOW" with a slight attitude. The RNs just out of school know without a doubt that they are "better trained, know more and much more qualified" to care for patients than I do, a 20 year nurse. Apparently, I have been fumbling around the last 20 years doing this job called nursing that I know nothing about. And, let's face it, you can lead a horse to water but you can't force it to drink!! I would NEVER set anyone up, but if you made your bed you need to lay in it.

[wanttonurse7]

wen to a meeting the other day and all the directors/big wigs in the company basically, were feeding us BS about patient care. how can we do better jobs as nurses, etc... unfortunately, the undertone of the meeting was about "HOW TO SAVE THE HOSPITAL MONEY."

[brandy1017, ASN, RN]

""Why do they eat their young? Just a little devil's advocate on that thought. Some (a few?) new nurses believe they actually are better than experienced nurses because they are some combo of "fresher" and "less bitter". When a new nurse comes with that attitude AND/OR comes with an attitude of "knowing it all", it can be difficult to those orienting them or working with them...that second one makes me nervous. If a new nurse comes with a lot of energy and is willing to learn, I am one of the nicest old bats around! lol ""

Hey, I could be a millionaire right now if I had a dollar for every time a brand new RN said "I KNOW" with a slight attitude. The RNs just out of school know without a doubt that they are "better trained, know more and much more qualified" to care for patients than I do, a 20 year nurse. Apparently, I have been fumbling around the last 20 years doing this job called nursing that I know nothing about. And, let's face it, you can lead a horse to water but you can't force it to drink!! I would NEVER set anyone up, but if you made your bed you need to lay in it.

Surprisingly, I've only encountered one new nurse that had the superior attitude and looked down on us older nurses. Happily she didn't stay long, but moved on and out of state. I hear she is now a low level supervisor to which I can say I feel sorry for the nurses working under her, especially the experienced ones if she still has that same attitude. Good luck to them!

[rrtfl]

Im an RRT, and Im so glad to find nurses sharing their stories who feel the same way I do. I'm speaking up. I cant really say what Im working on quite yet. Could I use your story? or refer to it at least? Its already on the internet, but I wanted to ask you out of courtesy and respect. I have been struggling to get feedback from nurses because at work its taboo to talk about this type of stuff. So, glad I found this page!

[catsmeow1972, BSN, RN]

I will agree on the issue of new grads acting like they know it all. I personally have been of the opinion that if someone has been a nurse (or worked in that hospital for a day longer than I than he or she has more experience than I and should be respected as such.

[angeloublue22, BSN, RN]

I was a brand new nurse and my first job was ICU psych. I had 2 days of training. The first day, the nurse who was supposed to train me that day refused right there in front of me. She had only been their for a month. The 2nd day of training was a blast. The third day of training, I was training another nurse who got hired the same time I did. That was just the beginning. I stayed at that job for 3 years and I don't know why. Well, I do. The patients and my coworkers were amazing. You had to be amazing there. It was either sink or swim. Management didn't get it. They were putting all these new nurses on the floor and only giving them 1 to 3 day trainings, then putting them in charge of a 24 bed psych unit. Only 1 in 10 hires stayed more than 3 months. We all asked for management to provide more training. I even offered to set it up and be a mentor. Of course, that was a no go. Apparently, warm bodies are better than warm, skilled bodies.

[Nurse Beth, MSN]

Thanks for sharing a great article. I think many (not all) hospitals have a paternalistic, old fashioned way of managing and nurses are not treated as professionals. Sadly, nurses just get used to it and accept it, like the frog in hot water.

Many nurses work in settings where there are punitive measures, lack of understanding about what nurses do, unsafe workloads, lack of ancillary support...on and on.

I agree we have to keep talking about it, raise awareness, and stand together.

[Barnstormin' PMHNP]

Just a quick thought that had occurred to while reading this excellent and appropriate thread. I believe it will extremely difficult for nurses to unite as our basic structure, which is state based, encourages divide. I know states have their own legislation etc but really, how can we be a united voice when there are 50 voices? There needs to be a universal, nationwide license system with a nationwide BON. We are all pulling in different directions and really do not have a visible leadership structure, the US government works in this manner, and as bad as it is can you imagine it if we had no central government to steer the ship so to speak.

I too, have worked in terrible places and now work in the best place I have been so far, but even now we are suffering an acute staffing crisis which has just become extremely severe.......do you think we can get a float nurse to come help out or a tech? No. As an inpatient psych unit we are the ugly stepchild of the facility and the floats are assigned to med surge and ICU/ER first. The attitude is "Screw the psych people, they don't do anything anyway."

My 2 cents worth.

[lsvgsdawn]

This is true. As a new nurse just past my one year mark I go in to work in the morning just praying I won't have maximum patients. I went the other day and 6 patients right at report. One who just started getting a blood transfusion and needed vitals before I could even finish getting my report on the others( and no vitals machine anywhere to be found cause techs hide them and I can't find the techs), one who started pushing his light for IV pain meds right after I got report on him( still have to do vitals and get my other reports and outgoing nurse does not even offer to give it before she leaves) 5 of the 6 were accuchecks( have to make sure they are covered before breakfast-and 4 needed insulin... And night techs forgot to get blood sugar an a few) oh and look I am getting a 7th from the ER who don't call report and the patient just arrived to her room( screaming dementia patient who is a fall risk they put in the back hall cause that's the only bed they have for isolation) and I haven't even been given her sbar from ER to know why she is even there! By the time I did vitals,gave insulin, and did a very quick assessment on my new lady I barely if at all had time to look over labs and still have to do admission paperwork on the new lady. Oh wait she is contact and has some wounds on her bottom. So I ungown and have to go hunt the camera down in another unit, and then regown and go back in to take photos. The camera snaps one picture and the battery dies! Ungown go find batteries. Come back... Gown up and finally get the pictures! Hang on cause now my guy with blood hanging needs his second unit! Omg this is why I am already planning my exit... Just don't think it's any better somewhere else:(

[CHESSIE]

I am happily retired, but a former neighbor was a new BS grad and thrown into an untenable situation, such as you describe. She, willing, admitted that her clinical knowledge was lacking although she pulled straight As, and was up to the minute academically. She hope that she would be assigned a mentor, none was forthcoming, due to low, dangerously low staffing. She lasted six months, and now works in an ambulatory surgical center that is not associated with the hospital, and was assigned a mentor, and has, happily, been employed in the center for over two years.