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?

[blackribbon]

Our floor has implemented "bedside reporting" because the patients are happier. Ummm...there is a lot that needs to be said at report that can not be said at the bedside...even down to very appropriate things like test results that the doctor has not had time to tell the patient about yet. For me, it meant that the dayshift did not report that one of my young adult patients had a violently angry dad and he almost had to call security on him during the day shift. Can I was completely blindsided when he called up screaming at me while I was trying to deal with an emergent issue and had several very needy patients that I also was caring for.

[Jules A, MSN]

Because there aren't any other options in my area unless I want to make a specialty change and take a pay cut. So, until I win the lottery, I'm pretty much stuck.

While I feel for you and agree its a lousy position to be in I'm not willing to accept that. If I needed to move, change specialty or work extra hours at a reduced rate I am unwilling to compromise on my need to be moderately happy where I work, feel somewhat appreciated and have the support to provide safe patient care.

FWIW I was somewhat traumatized by years of complaining from my Mother who was one of those nurses who worked in an area with only 2 other hospitals within 2 hours all owned by the same entity who was miserable with her employer and supervisors for 30 years yet refused to move, return to school or change specialties because she loved the actual job she did, was friends with her coworkers and had become complacent. She was near brilliant and excellent at what she did it was a waste.

[Jules A, MSN]

Drives me up the wall. Why I left a job, once - I was over the unit culture of making assumptions that then would impact patient care. And the patient getting medical help in the future.

Kudos I wish more people would take a stand with their feet.

I continue to assert that if we as nurses refused to work in unsafe positions with absurd staffing ratios for crap wages things would have to change. This would require that we were willing to be uncomfortable for a while as things are upset and sorted out. Unfortunately I think too many are just not financially stable enough to be able to do this.

[xoemmylouox, ASN, RN]

Kudos I wish more people would take a stand with their feet.

I continue to assert that if we as nurses refused to work in unsafe positions with absurd staffing ratios for crap wages things would have to change. This would require that we were willing to be uncomfortable for a while as things are upset and sorted out. Unfortunately I think too many are just not financially stable enough to be able to do this.

It wouldn't work because these schools are pumping out new grads to fill all of those empty spots. Until that situation slows down, nothing will improve for us.

[Adele_Michal7, ASN, RN]

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?

I could not agree more. It is so frustrating. Where I work is cracking down on OT lately. Getting asked, "Well, why aren't you clocked out on time and ready to go?" makes me want to scream.

Do you REALLY want to ask that question? Cuz I think you don't. Sigh.

[Bob Loblaw]

All the above are reasons for a national RN's union. Granted unions come with their own demons, but one of the few hospitals in my state with a union started to go on strike because of PT ratios and when it came down to the wire, ratios were reduced and more staff hired. Strength in numbers.

[nurseprnRN, BSN, RN]

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.

There. Is. No. Nursing. Shortage.

There are plenty of nurses looking for work.

The only reason there's a nursing shortage on the floors is because the powers-that-be pay shareholders more than staffers and they won't hire more of us.

[Jules A, MSN]

All the above are reasons for a national RN's union. Granted unions come with their own demons, but one of the few hospitals in my state with a union started to go on strike because of PT ratios and when it came down to the wire, ratios were reduced and more staff hired. Strength in numbers.

I have never understood the resistance from nurses with regard to unionizing. Very foolish, imo.

[Nurse SMS, MSN, RN]

..........

[Dacatster, ADN]

In the process of leaving a place because of the insanity. I commute a decent distance not to take the stupidity. Luckly a position by my house opened up, I will be paid the same. Even if the work enviroment is bad, at least I will closer to home. I do believe it will be better though.

[BostonFNP, APRN]

I had to run over to the hospital to do a late afternoon admission yesterday and I overheard the floor nurses talking, and it made me think of this thread, and part of the overall problem: the nurse was on the phone giving report to a SNIF about a patient that was on the way out the door with transport when the ED called up to speak to the nurse to give report on the patient coming up to take the bed. The unit coordinator told the ED nurse that the M/S nurse would call her right back she was just finishing up another report. Less than two minutes later the nursing manager is on the floor to talk to the M/S nurse because the ED nurse called to complain that she "wouldn't take report" and the ED is "very busy".

A big problem is money, we all know that, too few nurses (and other providers) to give quality care because nurses are the hospitals biggest expense.

The second problem is that nurses don't stand up for each other. Physicians may disagree with each other, and may get upset with each other, but they also would circle the wagons and protect their own, and this includes physicians that have gone into executive/administrative roles. Nurses need to be doing the same thing, from floor nurses to deans, start circling the wagons on these things.

[Jules A, MSN]

The second problem is that nurses don't stand up for each other. Physicians may disagree with each other, and may get upset with each other, but they also would circle the wagons and protect their own, and this includes physicians that have gone into executive/administrative roles. Nurses need to be doing the same thing, from floor nurses to deans, start circling the wagons on these things.

This is the single biggest difference I have found as I crossed from nursing staff to medical staff and could not agree with you more. Nurses need to stop picking each other apart and unit to demand safe, respectful, well compensated working conditions and if they are not achieved they need to refuse to continue working at these unsafe hospital systems.

I know it takes effort but we need to take control of our lives, take control of our finances and treat our career like the business it is.