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 Equipment is outdated, broken, or non-existent.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

[WCSU1987]

Old hospital I worked at was 1 nurse to 6-8 patient's. There was one PCA and three if lucky to 2 non skilled nursing tech's. Basically we were the eye's and ears of the nurse's.

Current unit each nurse has 3-5 patient's. Two non skilled nursing tech's and one PCA.

[c.strong]

I do not know which state you work in I worked in Texas for most of my career 40+ years. I really empathize!! It never got better. Now it is brutal. Administration knows that the majority of nursing are single moms who cant quite or protest, because they soon find themselves on the list for :Poor performance" if they do protest. I have been in your shoes, multiple times but with 10 patients. I find that being a nurse became just a High-paid maid, with the same kind of respect and the same find of easy dispensability. Administration knows we will work in despicable conditions because we have too, So why hire more nurses. There is not a nurse shortage, Why hire more when 1 will do the work of 3. I am now 70+ years and have had to retire, I am thankful I can live on my social security. I have no idea how this delema can be mended. I do know it is really brutal at this point in time. As a new nurse in the 70's it was bad, I had hoped we could improve..... It got worse.

[Katie-in-charge51, BSN, RN]

Seasoned nurses are worth their weight in gold! They have developed an intuition that tells them when something is just "not quite right". They catch Doctors' and other staff's errors, and have no problem bringing this to their attention-all in the name of protecting their patient! They don't care who yells at them, because they will do whatever it takes to get the orders they need for their patients. You can only hope and pray you will have one of these tough, smart nurses caring for, fighting for, and protecting you!

A seasoned nurse with all the scars and stars that come with it!

[dstevens55]

I am also concerned about nurse to nurse bullying, or horizontal violence. This type of environment is also something we as nurses need to say: No More! No more disrespect. No more unkindness. No more lack of support. We are all in this together, so we better make it nice. And if a bullied nurse gets so stressed that she/he makes a mistake, the person bullying will also be held accountable. The bullied nurse will not be the only person left holding the bag! Isn't this more fair?

[Sensibility, BSN, RN]

A couple of things that have caused a breakdown in the above model are the supposed available charge nurse without patients. I have been in situations where I am running at top speed and this person is busy doing nothing but personal junk.

I have also been marginalized. And you will not believe why. I am one of the few white English speaking Americans. And I am a Christian. I do not support certain lifestyle choices. I have never once spoken of this at work. It doesn't matter because people know instinctively. The tides have changed to where people such as myself are treated at times extremely disrespectfully.

[Healerforlife]

The Hospital I used to work at, "Laid off" 32 nurses from the float pool. Their excuse was that the previous year, we didn't have a very high census r/t the Flu season and cuts needed to be made. No explanation was given for HOW they decided who got laid off. Interesting that ALL of the nurses had more than 10 years experience at the Hospital. Not only were they our BEST most experienced nurses They also commonly got paid the most money. Some of my best friends were cut from the family after many many years of dedication and hard work heartbreaking.

My own story is pretty brutal too. I was fired after 15 years. I was never written up once in that time. But one night, I came in and found that my Charge nurse was sending herself home and making me in Charge with 7 patients, and only 2 other nurses would each have 6 pt.s each on 34 bed Trauma Unit on a Sat. night. So yeah , I got upset, and asked "whose idea is this?" I was told nobody was in the ER, yet 30 minutes later we were called with 2 Hip fractures. ( Tell me they were not in the ER 30 minutes earlier) Well I refused the admits as it was unsafe. One that we were supposed to get was a Rapid Response where they went. I still feel that patient would have died, because we would have been too busy to notice. Well anyway, I was put on a "Performance Deficiency" as I complained about being treated unfairly. This states that you can basically do anything to be fired. A patient who used 40 mg of morphine in 8 hours, ( stoned out of her mind) said she didn't think I wanted to take her to the bathroom. ( I, not my tech, charted her bathroom times 7X) as I took her. BUT that was it, I was done. 15 years down the drain the Performance deficiency is the new Loophole to fire nurses. They have staff sign a "Standards of Behavior" and ANYTHING can be construed as breaking it. HR, even told me at my exit, that walking down the hall without a smile could be considered a "Negative attitude"

I will never work in another hospital after how I was treated. I now work in a small Dialysis clinic. I am making 2 dollars more than I did in the Hospital, I would have retired from before. But you know what? Everything happens for a reason, and Thank God I made it through and couldn't be happier. Awful how nurses are treated these day. Will always have a sore spot on my heart after 15 years of devotion, but ah well.

[BeenThere2012, ASN, RN]

Look up Senate act S.864 and support it.

[nutella, MSN, RN]

It is mostly due to the fact that healthcare and healthcare decisions are financially motivated from all sides. Since that does not result in better care - only higher costs with more profit margin for the top Medicare is now moving towards "value-based care". Well meant but still poorly executed in most places as administration still seems to think that quality care comes with low staffing and processes in place that do not work. A punitive environment is the result of attempting great scores and numbers through compliance that is anxiety driven.

I do not agree with administration burning out nurses and not changing the way we deliver care. Everything is constantly changing, constant multitasking, everything is interacting. Collaboration and teamwork is more important than ever before.

I have worked in different hospitals and in the community in different areas. It is the same problem everywhere. Less reimbursement but increasing technology and more tests = more costs and with bundled payments it becomes more difficult to break even or have profit.

Nurses are the group that will suffer forever before they speak up. A lot of folks in nursing have some kind of martyr thing going on - they need to feel that they are essential, needed - and will work more and more without speaking up until everything is down the drain.

Administration knows that nurses put up with almost anything so there is no need for changing anything.

Have you guys noticed that nowadays patients hardly ever get out of bed and get walked, transferred into a chair and so on - unless they are surgical, in which case the surgeon ensures that this is happening. There is no time to do that anymore and patient get other problems related to it.

I have worked in major "best hospital" and only one of them was actually good to nurses and valued nurses. Unfortunately, the drive was 1.5 h one way. Now I work at a community hospital with Magnet status and I enjoy it so much! Nurses are valued, understood, take part in decision making, have input into the budget and so on and forth. Is it perfect? No - of course not. There are also things that need improvement. But it is a work climate in which a nurse can thrive. And guess what - because it is not a punitive environment nurses do not seem to have the same anxiety as nurses in the punitive places that are so "best hospital".

Nurses here do not seem to have a Florence Nightingale complex but they genuinely care about patients and are not afraid to advocate. Physician/ NP and nurse interaction seems to be mostly ok and collaborative / respectful. Once in a while there is somebody who is "off" but because most people here behave most of the time, people forgive each other when they say something in high stress moments that is not so nice. Nurses do not seem to leave easily and a lot of younger nurses have worked here also for a while.

[Steffy44]

#5 & 6 will be the biggest two reasons that will make me leave!

[BeenThere2012, ASN, RN]

#5 IS THE MOST CONCERNING AND FREQUENT, by my experience. All the issues are important, but 5 puts patients at big risk and the nurses' licenses as well. The repercussions of this are multiple. Lost wages, loss of confidence, loss of family stability and on and on.