Is it me? What happened to nursing?

Nurses Professionalism

Published

I am at "year 6" of nursing, and I can't help but notice that nursing jobs seem to be getting worse and worse as time goes by!

When I first entered nursing, there was a big push for appropriate acuity of patients, constructive patient-to-nurse ratios, quality of care, and a big push to ensure nurses had rights in the workplace for things like lunch breaks, no pressure for overtime, and a quality-of-worklife standard.

Now that the economy went sour, it seems like all of these workplace improvements have gone by the wayside, and we are moving back into an "anything goes" mentality, where everything is piled on the nursing staff, and if you don't like it, there is the door.

Is it me? Am I just tired? Or does anyone else notice this?

I voted with my job today.

I have semi given up on hospital nursing.....

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I voted with my job today.

I have semi given up on hospital nursing.....

But I thought with your years of management experience and excellent customer service skills you were going to revolutionize American nursing.

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I voted with my job today.

I have semi given up on hospital nursing.....

What do you mean by "voting with your job"?

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Specializes in Med/Surg, Academics.

The scripting of healthcare just bugs me. I simply don't do it. I always say, "Do you need anything else?" but I never end it with "I have the time." Ever. I don't, and I'm not gonna lie, but I will group tasks because it takes less time.

I also tell the truth, and I had a refreshingly understanding patient the other day. Q4 dilaudid on the dot kind of patient. Unfortunately, every nurse and one CNA on the floor was in a code for an hour. The other CNA was told to camp at the nursing station to attend to the call bells and needs of the patients that the rest of us had to ignore.

When we were finally done, the CNA told me about my pain patient. I went in his room, apologized for the delay, and said, "I had to attend to an emergency situation."

He said, "The one lady came in here twice and never said anything. I wish she had because I wouldn't have been so upset to her."

I know not all patients are as understanding as he was that night, but I guess The Powers That Be would rather we provide no reasonable explanation so that patients like him will give us bad ratings because they received no explanation. The ones that aren't like him will give us bad ratings anyway.

Management logic confuses me sometimes.

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Preach my fellow RN.

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I'm with you on your decision. Medicine these days is questionable in it's execution of patient care and patient advocacy. I'm a former 18D, Special Forces Medical Sergeant. As such, we were trained to do procedures that you have to have 8 years of school and spend thousands of dollars on useless pre-requisite courses to get in the civilian world. In 2008, I obtained my civilian nursing license and went to work at two hospitals. Hyperbaric Technology at one and Med/Surg at the other. First two years in med surg was a great deal of fun and challenge. Heavy patient loads were not an issue when you're used to managed 2-3 or more life threatening trauma events, etc.

I was entrusted with the patient care of some of the most difficult and challenging patients. Then a rather incompetent charge nurse was moved up to the first line supervisor's position of the med surg unit. She took great pride in making sure the hospitals financial interests were covered by never calling in the back up nurse "we can handle it". I watched a patient not survive her pushes of haloperidol Q2h while not having cardiac telemetry on the patient. "We couldn't keep it on him, he flopped around too much." I was asked to come in and sit with the patient one on one but was told that I had to leave by 0230 due to hours on the clock. I left, he didn't live to see breakfast. That nurse became the supervisor.

Fast forward a year or so. The hospital is sold to a corporate ownership. CNA ratios went to 12:1 with no CNAs on duty until there were 12 patients on the floor. I arrive for my night shift and get a sketchy report on a patient that had issues. "X-ray is in there now doing a chest x-ray to rule out PE." huh?? So, I walk straight into the room and the pt. is disconnected from his IV, non-responsive, no cardiac telemetry is on him, nor in the room. Tele was ordered at 1600, 3 hours earlier. I had three other patients to see, only 1 of which I had a report on. One was a 12 year old bleeder (can't say more). Phone calls to the pt's doc and IM, orders for a contrast CT to rule out stroke. The charge THAT night was a flake that was later fired for heisting narcs. I had been raising concerns about the day shift charge nurses not correctly staffing the night shift for weeks. It was not a patient ratio issue. 5:1 at that hospital is just fine.

I made a comment to the flake charge that we should have another nurse and aid/monitor tech as we now have a guy on telemetry. She chose to call the supervisor (yep, the same flake that was promoted to supervisor and became the torch bearer for poor staffing and egotistical management practices) and say I was complaining about staffing issues. All of which were lies. I was fired that night. It gets better.

I ask the state's human rights commission to investigate practices of targetting and retribution and provide witness names and phone numbers. 1 1/2 years later I get a nice letter saying all of my claims were substantiated and found true. BUT, as I was not in a "protected" class, there is nothing the HRC would or could do. You see, i'm a white male with 22 years military service, 18 as an 18Delta. I've started thousands of IVs, many under horrible conditions, done 3 chest tubes and participated in many more, "minor exploratory surgery" to find a bleeder after chunks of metal went flying through abdomens, chests, legs and more. After 9/11, I went back and forth to the middle east doing more medicine. Spent weekends hauling wounded from helicopters at the CASH in Baghdad to overworked trauma wards. You did what you know how to do.

Since leaving that hospital 2 years ago, I have been road blocked by this "supervisor" at every turn obtaining nursing work. Several VA positions were withdrawn after a phone discussion with this supervisor. All my references, including 7 doctors (ortho, IM, OB-GYN, family practice and cardiology), several charge nurses and independant nurses as well as patients. All meant nothing as soon as that "supervisor" got on the phone.

Ultimately, i'm disgusted with the potential that poor supervisors have for destroying a career and HR sections that are so incompetent, that i'm leaving nursing (civilian) and pray for the future of patients where their lives are put on the line for budget decisions, egos, poor practices and **** poor HR staff. The nursing staff in the entire hospital has rolled over completely with the exception of 8 people who never or wouldn't dream of rocking the boat. Smile and nod, patient care be damned. It's illusionary.

What i've learned...

1. Patient advocacy is a class in a school that has little place in real practice. It has to be balanced between your career and the ego freak you have to address the patient's issue to.

2. Experience means nothing.

3. _______ nurses always get hired, _______ nurses never get fire. Explanation: I live in an area that is dominated by one particular church. They protect and guard each other like it was their money. I have seen more discrimination regarding other medical staff in favor of this particular group of people on a scale that makes the 60s pale. "Do you know so and so in Ward ___ "? "No, i'm in Ward ____, do you know so and so"? "Oh yes, he's great, we have to watch out for him." and on and on and on.

Sorry for the long story, I pray for our patients, with the future of health care (yes, doctors and nurses will be federalized and unions wiped out). If you're not healthy, get that way, your greatest danger isn't bad traffic, it may be a hospitalization.

Ghostwindrider

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I'm with you on your decision. Medicine these days is questionable in it's execution of patient care and patient advocacy. I'm a former 18D, Special Forces Medical Sergeant. As such, we were trained to do procedures that you have to have 8 years of school and spend thousands of dollars on useless pre-requisite courses to get in the civilian world. In 2008, I obtained my civilian nursing license and went to work at two hospitals. Hyperbaric Technology at one and Med/Surg at the other. First two years in med surg was a great deal of fun and challenge. Heavy patient loads were not an issue when you're used to managed 2-3 or more life threatening trauma events, etc.

I was entrusted with the patient care of some of the most difficult and challenging patients. Then a rather incompetent charge nurse was moved up to the first line supervisor's position of the med surg unit. She took great pride in making sure the hospitals financial interests were covered by never calling in the back up nurse "we can handle it". I watched a patient not survive her pushes of haloperidol Q2h while not having cardiac telemetry on the patient. "We couldn't keep it on him, he flopped around too much." I was asked to come in and sit with the patient one on one but was told that I had to leave by 0230 due to hours on the clock. I left, he didn't live to see breakfast. That nurse became the supervisor.

Fast forward a year or so. The hospital is sold to a corporate ownership. CNA ratios went to 12:1 with no CNAs on duty until there were 12 patients on the floor. I arrive for my night shift and get a sketchy report on a patient that had issues. "X-ray is in there now doing a chest x-ray to rule out PE." huh?? So, I walk straight into the room and the pt. is disconnected from his IV, non-responsive, no cardiac telemetry is on him, nor in the room. Tele was ordered at 1600, 3 hours earlier. I had three other patients to see, only 1 of which I had a report on. One was a 12 year old bleeder (can't say more). Phone calls to the pt's doc and IM, orders for a contrast CT to rule out stroke. The charge THAT night was a flake that was later fired for heisting narcs. I had been raising concerns about the day shift charge nurses not correctly staffing the night shift for weeks. It was not a patient ratio issue. 5:1 at that hospital is just fine.

I made a comment to the flake charge that we should have another nurse and aid/monitor tech as we now have a guy on telemetry. She chose to call the supervisor (yep, the same flake that was promoted to supervisor and became the torch bearer for poor staffing and egotistical management practices) and say I was complaining about staffing issues. All of which were lies. I was fired that night. It gets better.

I ask the state's human rights commission to investigate practices of targetting and retribution and provide witness names and phone numbers. 1 1/2 years later I get a nice letter saying all of my claims were substantiated and found true. BUT, as I was not in a "protected" class, there is nothing the HRC would or could do. You see, i'm a white male with 22 years military service, 18 as an 18Delta. I've started thousands of IVs, many under horrible conditions, done 3 chest tubes and participated in many more, "minor exploratory surgery" to find a bleeder after chunks of metal went flying through abdomens, chests, legs and more. After 9/11, I went back and forth to the middle east doing more medicine. Spent weekends hauling wounded from helicopters at the CASH in Baghdad to overworked trauma wards. You did what you know how to do.

Since leaving that hospital 2 years ago, I have been road blocked by this "supervisor" at every turn obtaining nursing work. Several VA positions were withdrawn after a phone discussion with this supervisor. All my references, including 7 doctors (ortho, IM, OB-GYN, family practice and cardiology), several charge nurses and independant nurses as well as patients. All meant nothing as soon as that "supervisor" got on the phone.

Ultimately, i'm disgusted with the potential that poor supervisors have for destroying a career and HR sections that are so incompetent, that i'm leaving nursing (civilian) and pray for the future of patients where their lives are put on the line for budget decisions, egos, poor practices and **** poor HR staff. The nursing staff in the entire hospital has rolled over completely with the exception of 8 people who never or wouldn't dream of rocking the boat. Smile and nod, patient care be damned. It's illusionary.

What i've learned...

1. Patient advocacy is a class in a school that has little place in real practice. It has to be balanced between your career and the ego freak you have to address the patient's issue to.

2. Experience means nothing.

3. _______ nurses always get hired, _______ nurses never get fire. Explanation: I live in an area that is dominated by one particular church. They protect and guard each other like it was their money. I have seen more discrimination regarding other medical staff in favor of this particular group of people on a scale that makes the 60s pale. "Do you know so and so in Ward ___ "? "No, i'm in Ward ____, do you know so and so"? "Oh yes, he's great, we have to watch out for him." and on and on and on.

Sorry for the long story, I pray for our patients, with the future of health care (yes, doctors and nurses will be federalized and unions wiped out). If you're not healthy, get that way, your greatest danger isn't bad traffic, it may be a hospitalization.

Ghostwindrider

Exactly. You see things true.

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I agree 100% with you. Nursing in books and before graduating seemed like one of the best jobs anyone could have. Higher pay, good hours, respect and feeling rewarded all the time. jejej big shock in the real world......I've graduated in May 2011 and have only been practicing for a total period of 7 months, and already planning how to get out of nursing. Don't get me wrong, I love nursing, I really do and feel was meant for this career. I care so much about my patients, love giving meds, teaching and explaining, doing dressings, IVs, IM you name it. I love learning and learning something new everyday, but the amount of paperwork we have to go through and been constantly vigilant because someone can come and sue us or turn our licenses to the state....when my intentions are never to harm a patient drives me nuts and makes me reconsider this career. This is the reason why I see intelligent people move up the ladder and not stay on the floor, so they don't have a lot to risk since they are not doing the patient care one-one. I know and often think that studying to be an ot/pt/st would have been better. It saddens me, because bad nurses...YES with bad intentions are left on the floor....AND NO i'm not generalizing.....I'm talking about the ones we know do wrong on purpose, but look good on paper.

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Sigh, there are over 700,000 members on allnurses. I would think we could make changes for the better. Yep, I am still a dreamer. Just not sure how long I can keep my dream alive.

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I think the downturn began with the disappearance of those cute little nursing caps.

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Have said this before and shall continue saying so: allot was lost in the nursing profession when whites, caps and tons of nursing history and culture was flushed down the loo in favour of remaking nursing as a "modern" *medical* profession.

If it weren't for the "modern medical" aspect of nursing as it is today, I wouldn't have changed my career for it. Wearing white dresses and caps so I can be the doctor's secretary and a healthcare waitress is not why I decided to become a second-career nurse.

I do feel your pain about many people treating nursing as a means to a paycheck and that connection, empathy, and altruism falling (jarringly) to the wayside. Honestly, I think it's an internal problem--the nursing industry, and it is being influenced by society. I am about to graduate in May--my school has ditched its traditional program and is implementing two accelerated programs. People are whizzing through school and becoming nurses within less than two years. Everyone wants "it" yesterday. Medicine/health care is nothing but a money-making business--all of it. That is blatantly obvious.

Change has to come from within the system, and the ones to do it are the people speaking up.

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If it weren't for the "modern medical" aspect of nursing as it is today, I wouldn't have changed my career for it. Wearing white dresses and caps so I can be the doctor's secretary and a healthcare waitress is not why I decided to become a second-career nurse.

I do feel your pain about many people treating nursing as a means to a paycheck and that connection, empathy, and altruism falling (jarringly) to the wayside. Honestly, I think it's an internal problem--the nursing industry, and it is being influenced by society. I am about to graduate in May--my school has ditched its traditional program and is implementing two accelerated programs. People are whizzing through school and becoming nurses within less than two years. Everyone wants "it" yesterday. Medicine/health care is nothing but a money-making business--all of it. That is blatantly obvious.

Change has to come from within the system, and the ones to do it are the people speaking up.

What field is not looking for a paycheck? Please advise.

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