Quote from ukstudent
That was well written and so very very true. However, part of the problem with burnout is the fact that nursing is powerless to change any of the causes of burnout. Lateral violence is a symptom, not a cause in my mind.
Adequate staffing, adequate supplies, adequate time with patients are all controlled by upper management.
Being that we are the largest collective group of healthcare workers in the nation, is it really true that we are powerless or have we been led to believe that this is so?
Let me tell you a story. Once upon a time while I was working with a group of students, we noticed a physician going from isolation room to isolation room wearing the same personal protective gown. He would walk up to the nursing station in the gown and stand there while writing orders. He would then head off to the next patient's room. So much for preventing the spread of infection! Infections, our little gifts to our patients, result in untold numbers of deaths in our country every day and that we would do even one to cause harm to a patient is unforgivable. Having the expertise and and yet still making the wrong choice is egregious. One nurse asked the house supervisor if she was going to say something to him. Her response was, "No way." This is one of many examples I could give of the perceived powerless of nurses even to the extent that it affects our ability to effectively advocate for the safety of our patients. Certainly I'm not arguing that nurses do not feel powerless, but I am concerned that we aren't fighting harder (collectively) to change this which is not to suggest that I know the right solution.
Do you have any thoughts around how we, as a profession, could make a more dramatic statement or impact?
I definitely agree that lateral violence is a symptom of the larger problem which I wholeheartedly believe to be burnout. I hold that everyone has the right to a satisfying and rewarding career path and am concerned that, over time, our current system has taken away this right.
I'd love to hear more of your thoughts.
Another thought, has the cost of caring
grown so enormous in terms of the disease complexity of our patients, paucity of insurance reimbursement, increased supply costs, and other factors, exceeded our ability to sustain a significant profit in healthcare? Are administrators fighting a losing battle in trying to sustain and increase their bottom-line with the most concerning result being staff burnout and patient injuries?
There are many interventions that we perform as nurses which are impossible to bill for and also difficult to quantify in terms of time. For example, I was once told that a good ED triage nurse can finish his or her assessment in 10 minutes or less. This is true in many cases; however, but this does not account for the fact that our patients are getting older and sicker and it has taken me at least this long to accurately transcribe the med list of many patients not to mention their heath, social, and surgical history! If I don't copy the med list down accurately, I risk the safety of my patient and also the wrath of my employer because most hospitals are hyperfocused on the Medication Reconciliation process which must start at the point in which the patient hits the door. However, I also risk condemnation for taking too much time to do what is asked of me and for the the sake of the patient. In theory, Medication Reconciliation is of critical importance because so many harmful errors have occurred as a result of mistakes in the reconciliation process. However, giving us another paper to fill out and not allowing us additional time is the way of healthcare and things aren't looking up. As it becomes more difficult to turn a buck and sustain a profit, look for mass-casualties among the nursing staff.
Is it possible that administrators believe nurses to be lazy individuals who without constant oversight and PUSH, would choose to read magazines and surf the net? While I have seen more than my fair share of nurses doing more socializing than patient care, my hope is that this is the exception and not the rule. As for myself, I have so little time to do what I love that I am highly motivated with the small amount of time I'm allowed. Again, the case of the "lazy nurse" is what I believe to be a yet another symptom of a much more concerning plague, and that is, burnout. "If we can't effectively do the job we'd like to do, then why bother?" becomes the theme and mantra for some. Frustration breeds anger. Anger breeds resentment. Resentment breeds apathy (some may mistaken this for laziness).
As always, these are just my thoughts and I could certainly be wrong. I'd love to hear the insights of the rest of the community.