What do you think is a major problem in nursing?

CrunchRN, ADN, RN · Mar 9, 2005

TriageRN -

I am so sorry about the situation you faced. I totally agree that nurses undermining each other is one of the most disheartening things about the problems. You have my total sympathy - at least you know where you stand and her true colors. You always sound like a really great nurse in your posts which I have enjoyed and followed for some time. Keep it up!

caroladybelle, BSN, RN · Mar 9, 2005

Yes, I understand that they have gotten rid of CNAs, and instead of hiring educated, licensed Certified Nurse Aides, they are hiring people off the street calling them by catchy titles like "patient care technicians", "patient specialists", and other creatively contrived labels. How lovely. I would think professional nurses would be appalled.
So hospitals and Medical facilities are under staffed and you prefer not to have the help of licensed and educated nursing support? I assume by your comment that you prefer to be working with unlicensed individuals that have not had any formal training in patient care. Choice! Isn't that something?!

That's a rather naive assumption of you.

Actually, ma'am, have you heard of the phrase "all RN staff" or "all licensed staff"? That is where I work, and would prefer to always work, given a choice.

No CNAs, no "patient care techs", no "nurse techs", no orderlies. No unlicensed or "certified" care staff.

A hospital/unit staffed only with well educated licensed (not "certified")personnel, all responsible fully for the care that they give, doing their own baths and vitals and answering their call lights.

An interestingly, magnet status - for some reason the staff is more fulfilled and there are less problems with shortage and turnover.

Some of us are darn proud of our education and our bed bathes and skill with putting in an NG or putting someone on the bedpan. My vitals are done manually by me. And on night shift, I put together my own charts.

No dealing with the us vs them attitude...from either side. Or tacky petty passive aggressive behaviors. And the patient's seem much happier. At least two of these facilities rank in the US News top 15, for at least two years in a row.

So I suggest you take the 'ya'll couldn't manage with us doing the bathes and the vitals" and dump it in the trash where it belongs. Plenty of us on this BB, professional nurses clean our own patient's fannies....and prefer it that way.

Primary Care Rocks!!!!!!!!!!

allamericangirl · Mar 9, 2005

You know ... NO ... I have NEVER heard of such a facility before ever.... but then, I'm just a 58 year old stupid beginner, and have only had the experience of going to three, maybe four hospitals before in my entire life. So, yes, I guess I am naive. Aren't you fortunate to work in such a fantastic place and aren't you patients fornunate to have access to such a wonderful place. I don't think the my assumption is all that naive, however, considering that a facility like yours is the exception and certainly not the rule.

I have just finished my first session of classes, and will be taking the national exam for CNA, Home Health Aide. I hope very much that I will be able to find a job as a CNA so that I can use my income to begin the next phase of my education. There are some hospitals that prefer to hire folks off the street rather than hire someone who has had some training.

By the way, I don't think that a snooty attitude toward CNAs is a good thing, since they are a needed componet in health care, except in the exceptional cases, like yours. Perhaps you were able to start at the top of the heap, its difficult to tell by your demeanor in your post, but many have to start at the bottom, and some, by choice, or by circumstance never move up the nursing ladder.

Here I see a lot more cuting down and cutting out of qualified personnel than full staffing of all RNs. Count your blessings. Have a nice day too!

That's a rather naive assumption of you.
Actually, ma'am, have you heard of the phrase "all RN staff" or "all licensed staff"? That is where I work, and would prefer to always work, given a choice.
No CNAs, no "patient care techs", no "nurse techs", no orderlies. No unlicensed or "certified" care staff.
A hospital/unit staffed only with well educated licensed (not "certified")personnel, all responsible fully for the care that they give, doing their own baths and vitals and answering their call lights.
An interestingly, magnet status - for some reason the staff is more fulfilled and there are less problems with shortage and turnover.
Some of us are darn proud of our education and our bed bathes and skill with putting in an NG or putting someone on the bedpan. My vitals are done manually by me. And on night shift, I put together my own charts.
No dealing with the us vs them attitude...from either side. Or tacky petty passive aggressive behaviors. And the patient's seem much happier. At least two of these facilities rank in the US News top 15, for at least two years in a row.
So I suggest you take the 'ya'll couldn't manage with us doing the bathes and the vitals" and dump it in the trash where it belongs. Plenty of us on this BB, professional nurses clean our own patient's fannies....and prefer it that way.
Primary Care Rocks!!!!!!!!!!

caroladybelle, BSN, RN · Mar 9, 2005

I don't think the my assumption is all that naive, however, considering that a facility like yours is the exception and certainly not the rule.
By the way, I don't think that a snooty attitude toward CNAs is a good thing, since they are a needed componet in health care, except in the exceptional cases, like yours. Perhaps you were able to start at the top of the heap, its difficult to tell by your demeanor in your post, but many have to start at the bottom, and some, by choice, or by circumstance never move up the nursing ladder.

Your naive assumption was the idea that I prefer untrained personnel to CNAs. It was assumption that you made along with the one that, "nurses can't do without CNAs to do the dirty work". And it was without any basis given my post.

We can. We do. And we will continue to give great care with or without ancillary personnel. Especially if they come in with the inaccurate assumptions that you carry.

Ancillary personnel can be a great help and provide awesome teamwork. Or it can be a hindrance. But until CNAs carry the same legal burden as RNs, I will prefer working primary care.

And these facilities are becoming the rule more acute care settings, and less the exception.

Carolina

PS . I did work as a nurse intern. And while I believe that I did an excellent job, I still firmly believe that every patient deserves to have only licensed personnel working with them.

PDCNurse · Mar 9, 2005

I spend most of my day doing redundant paper work. There is no reason for writing the same information on the same chart 4 different times. If the people who came up with this stuff had to use it, there would be some changes.

I really get angry when I can't do the kind of patient care I should do because the administrators are trying to save a buck. They don't care if someone dies as long as they don't have to pay for more staffing. Someone better wake up and smell the coffee--nurses are getting stressed out and leaving the profession.

Health care facilities should be a nurturing place to work. If employees don't feel appreciated, the quality of work they do decreases. A pat on the back and a thank you would be nice once in a while. Hire the best people you can and get rid of the dead wood and the envionment will improve.

NurseFirst · Mar 11, 2005

Someone mentioned passing a message from one doc to another? Yikes! That's just a communication disaster waiting to happen! If someone wants to say something to someone, I refuse to be the medium; after all, if the receiver of the message has questions (which is often), I don't have the answers, and have to refer them back to the sender. Easier, faster, all the way around, if sender and receiver communicate directly. Now, granted, a CNA coming to tell me that my patient needs me...that's appropriate--because it is not the full message; it is a "meta-message" -- the patient needs me for some reason, which they will tell me when I see them.

BTW:

CMAs do NOT work under an RN's license, they work under the physician's license.

NurseFirst

Jenny99 · Mar 11, 2005

Hi Everyone,

The biggest major problem in nursing without question is the "territorial battle" that has gone one for many years now between the different educational levels in nursing. From Master degree nurses on down to the LVN/LPN - including the CNA's, it even flows through to the nursing educators and the cirricculm that is taught in the various school settings.

This territorialism is the basis of why nurses and the nursing profession have the problems they do today

The views of various facitlites and hospital administration is another thing totally and left for another day to discuss.

Jenny99 :)

NurseFirst · Mar 11, 2005

YOU THINK YOU ARE BETTER THAN THE AUAs BECAUSE YOUR NAME TAG SAYS RN, PLEASE GET OFF YOUR SOAP BOX :angryfire :angryfire :angryfire

sound of siren in the background

sound of siren slightly louder

sound of siren coming closer

sound of siren right near by

sound of siren stops

a bunch of firepersons get out...hoses ah, um, a'firin...

***** SPLASH *****

AHHHHHHHH.....So much cooler now!!!

NurseFirst

Student Nurse

RN34TX · Mar 12, 2005

Hi Everyone,
The biggest major problem in nursing without question is the "territorial battle" that has gone one for many years now between the different educational levels in nursing. From Master degree nurses on down to the LVN/LPN - including the CNA's, it even flows through to the nursing educators and the cirricculm that is taught in the various school settings.
This territorialism is the basis of why nurses and the nursing profession have the problems they do today
The views of various facitlites and hospital administration is another thing totally and left for another day to discuss.
Jenny99 :)

Well said!!

In LPN/LVN school I was told to explain things in simple, easy to understand, non-medical terms when delegating tasks to the "non-licensed and non-professional" personnel, even though when I took my CNA course we were taught and were expected to know many of the correct medical terms.

Then in RN school I was told that LPN/LVN's are taught to perform tasks but really don't understand the reason and science behind it and not to expect too much from them. Oh yes, I also was told not to let LPN/LVN's be allowed to do too much because they will take over RN jobs.

There's your territorialism!

God knows what they are going to teach me this fall in BSN school.

Tweety, BSN, RN · Mar 12, 2005

God knows what they are going to teach me this fall in BSN school.

The one and only time in real life I heard a slur about ADN nurses was from a BSN nurse who essentially said the same thing. "An ADN can add the postassium to the IV fluid (back in a day we used to do our own additivies to IV fluids), but it takes a BSN to know the reason why. :rotfl:

I've ben an ADN RN for 15 years and am now working on my BSN. They are very respectful, but make it very clear the only "profressional nurse" is and should be a BSN. So perhaps that's how they'll present it to you. Then they go and describe what a professional and profressional nurse is. Good luck in BSN school!

allamericangirl · Mar 12, 2005

That is sick, sick, sick. How could any educator be so petty and small minded? I doubt that doctors are taught to watch out for the nurses or they will have their jobs. Well, that certainly explains a lot about the attitudes shown by some of the newer RNs around here. They have been taught to look down that nose. Oh, my, my, my. How sad and ignorant.

Well said!!
In LPN/LVN school I was told to explain things in simple, easy to understand, non-medical terms when delegating tasks to the "non-licensed and non-professional" personnel, even though when I took my CNA course we were taught and were expected to know many of the correct medical terms.
Then in RN school I was told that LPN/LVN's are taught to perform taks but really don't understand the reason and science behind it and not to expect too much from them. Oh yes, I also was told not to let LPN/LVN's be allowed to do too much because they will take over RN jobs.
There's your territorialism!
God knows what they are going to teach me this fall in BSN school.

RN34TX · Mar 13, 2005

That is sick, sick, sick. How could any educator be so petty and small minded? I doubt that doctors are taught to watch out for the nurses or they will have their jobs. Well, that certainly explains a lot about the attitudes shown by some of the newer RNs around here. They have been taught to look down that nose. Oh, my, my, my. How sad and ignorant.

Most of my instructors did not carry that kind of attitude, those were a few isolated incidences, but my point is that it only takes one remark of a respected and admired nursing instructor to a very impressionable nursing student to spark that kind of attitude.

As far as attitudes of your newer RN's where you work, just keep in mind that many new nurses (all levels) are full of fear and self-doubt and often try to compensate for it by appearing confident and knowledgeable, they particularly do not want to show any self-doubt or perceived weakness in front of those that they feel are "lower rank" than they are.

It can be a humiliating experience for the new RN who feels that just from graduating from their RN program that they should automatically know more about everything than an LPN and then come to find that they are often needing help and guidance from the experienced LPN those first few years and maybe a lot longer than that.

I'm not trying to excuse the behavior, I'm trying to make sense of it myself because I'm still dealing with it as well.

I work with a 22 year old new BSN who never had a job at all prior to working in our ICU. She resents being corrected, advised by, and dependent on her CCRN co-workers and talks down to the unit clerks and techs. All of them try to keep her from sinking and help her even though she doesn't see it that way. I try to be patient and I'm actually thankful on her behalf that she didn't end up in one of those arrogant ICU's where the experienced nurses would eat her alive. She has no clue how bad things could be for her because she doesn't know anything else.