Nursing is becoming stupid

[canigraduate]

I have had a horrible week and I have figured something out.

The people who make the rules are stupid.

Yes, my friends, stupid.

I have only been a nurse for four years, but in these four years I have noticed some things that lead me to question the sanity and the IQ of the powers that be.

I am working for an unnamed healthcare system who is a very large employer and the people that run it are morons. The people that work in it aren't much better. And the nurses, well, they have been beaten down to the point that they just put up with it.

We have lots of hospitals in the region, but we don't have specialist coverage consistently. So, I got a patient a couple of weeks ago that had an emergent condition that needed to be treated by a specialist. But, that specialty is only covered every other week. This patient happened to come in during the wrong week. So, what did they do? EMTALA the patient? No, they put the patient in OBS with a BP that was consistently in the 80's over 40's. How is this safe?

Needless to say, I had this patient transferred to the ICU in the first 10 minutes of my shift and put a burr up the butt of the House Supervisor to get this patient transferred somewhere they could actually be treated.

Recently, I had a patient that needed a stat ultrasound. So, I put the order in. Ultrasound calls me back and tells me that I have to call the provider back and get a consult from a more acute specialty, because my doc's order isn't good enough for them to call the night U/S team in. So, I had to call a consult, completely unnecessarily. On the phone, the consultant decided to get a CT Angio instead and we cancelled the U/S. However, thinking that the consult was emergent and not just to satisfy policy, the consultant actually came to see the patient at 10:00 at night and decided the CT Angio was overkill and to do the U/S, but it could wait until morning. He was also super angry that we had called him and I got the "Why did you even call me?" angry spiel and butt-chew.

I was tempted to say, "Because we work for morons." But, I didn't.

Sometimes I really hate what nursing is turning into in the hospital. It's basically throw meds at a patient and try your darnedest to keep the hospital's policies from killing them before you can get them home. I have spent hours on the phone with docs, supervisors, consultants, managers, and family members from these FUBARs, and many more besides.

I really feel like the powers that be are out to kill the patients and make the nurses' lives hell because they are so so focused on turning a profit.

Am I just working in a bad system, or are the powers that be really putting in so many barriers that we can't care for patients anymore?

[FlyingScot, RN]

Oh Canigraduate, I'm afraid the veil has been lifted and the reality of nursing, in it's stark, naked ugliness, has been revealed to you at such a young age. It wasn't so very clear to us old-timers until the recent past and for that I count as us lucky.

[Horseshoe, BSN, RN]

I am not a religious person, but the love of money is the root of all evil.

Kind of OT, but this is one the first times I've ever seen that quoted correctly. :)

[WKShadowNP, DNP, APRN]

I made a comment to my head nurse that I am concerned that a child will get burned by our fancy new coffee machine in a second waiting room in our fast track. She agreed but said that was installed at administration's insistence. I remarked that this decision was based on customer satisfaction instead of real quality care. She told me, "You better get used to this game, especially since you're about to be a provider."

That really rubbed me the wrong way. I do NOT want to think of my profession as playing a game, nor how my upcoming role change will make me more of a player.

[No Stars In My Eyes]

When the 'important' thing (esp in LTC's) is how the paperwork looks, and the facility has hired some poor drudge whose only job is to comb each and every chart REPEATEDLY and spend HOURS cross-referencing Dr's orders, MARS, nurses notes, etc., looking for mistakes and variations so that everything can be corrected before any inspecting agency comes in.....

When nurses are mandated to tell outright lies every day by cheerfully trilling "I have time"....

When the nurse's main job is med-passing, plus being in-charge of everyone and everything, plus all the things a ward clerk used to do....and as a result it leaves no room for actual PATIENT CARE, which must needs encompass actual HUMANS with some needs that (gasp!) don't fit in and therefore AREN'T considered by the Powers That Be to be an important part of the equation....

When the facilities only look for warm bodies to be doing the work, and warm(ish) bodies filling the beds....in other words, the 'mere' framework upon which their Great Business is suffocatingly hung....

When personnel and patients are only *$$Dollar Signs$$* it's hard to see a way out of this. Because, you know, it's just not a case of nurses uniting to overthrow bad ratio policies; it's the whole damn entire 'Medicine-Is-Business' mindset....

I've seen, over all my years, the 'nursing model' change and change and change. Changes are not necessarily bad, certainly, but cumulatively many have come to mean that 'stupidity' becomes the NORM.

Some nurses are activist. Some nurses are company drones. Some nurses are subversive enough to continue patient-centered advocacy and care regardless of the environment they work in. Some nurses haven't got a clue and/or purposely take up the Ostrich Position. Bless us all. Differences between us shouldn't be tearing us apart, but they continue to; more often than not, everyone has something valuable to contribute. Wish we all could work within an atmosphere that could mesh all those pieces together into a confirming, cohesive force.

I would like to live long enough to see a good, positive upswing of trends that benefit patients and nurses, displacing the current milieu. But I don't want to live long enough to be at the mercy of the system as it is.

I don't have any answers except to agree, yes, nursing is becoming stupid; it isn't the nurses.

[WKShadowNP, DNP, APRN]

I would absolutely love to practice in the framework proposed (and implemented successfully, I might add) by Patch Adams. I just don't see how it is possible on a grand scale.

https://en.wikipedia.org/wiki/Gesundheit!_Institute

I especially adore his approach to behavioral health.

[BuckyBadgerRN, ASN, RN]

Makes me VERY happy that I work in a physician-owed clinic. The board members are shareholders, all of whom are physician's. Sheet gets done! It's a large, multi-specialty clinic, but every MD has a voice and gets heard.

[Horseshoe, BSN, RN]

Makes me VERY happy that I work in a physician-owed clinic. The board members are shareholders, all of whom are physician's. Sheet gets done! It's a large, multi-specialty clinic, but every MD has a voice and gets heard.

I also work in a physician owned facility. Of course they want to make a good living (and they do). But they are very pro patient. And have a full time RN whose job is to make sure all regulations are followed from patient care and safety standards, to adherence to all relevant rules, monitoring of adherence to established standards of care, to AAAA requirements, to nurse education to verification of licensing, etc.

[canigraduate]

I think the nursing shortage is going to come back because many nurses won't put up with this crap forever. I know I won't.

[FlyingScot, RN]

Ambulatory nursing is becoming the Promised Land!

[Wrench Party]

Management that also hasn't worked bedside in a blue moon is also stupid. Come talk to me about patient flow and my nursing skills when we're not understaffed, I get an adequate lunch break, and I'm not actually taking care of patient complications.

What planet does a person go to when they become a manager? Planet Lack of Common Sense?

[canigraduate]

What gets to me is that the decisions the administration makes do not make any sense on a day-to-day operational level.

For example, we had a unit close recently for repairs. Did they plan the reopening? Did they put back all the equipment that was stolen out of the unit while it was closed? Did they do any kind of preparation to make the transition go smoothly?

Nope. They decided an hour before shift change to reopen the unit. Nurses were scrambling around trying to find IV pumps and poles, mobile computers, and those little handheld medication administration things. So, not only did the nurses have to deal with the stress of being slammed with new admits to fill up the unit, they had to find every piece of equipment they needed.

[batesbd]

I left nursing at age 53 and got on disability feeling very used and abused. I did not renew my license at age 62. All my career, I was made to take the less popular shifts and holidays off because others had families and I did not. There was no fairness. They did not keep their promises so I stopped doing their favors. Once I stopped working I found a new freedom. I will always hate management 'til my dying day.