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One would think that the threat of having their certification pulled would do it - well it was the JCAHO Guidelines that precipitated the changes they have made. What I find most distressing is how some regulatory body has to legislate and demand improvements. One would think it a moral obligation to do what is best for patients. Once the outcomes and statistics are out - and there are first hand experiences of physicians actually woriing on the wrong site - why wouldn't an organisation NOT do the right thing. These questions are only rhetorical - Money is the bottom line, taking time our takes time away from the chargeable OR time, and it may make a physician late, or it might make some doctor mad, who then makes like miserable for first line staff and worst of all they fail to provide the best care. Worst of all the resistance to change is so deeply ingrained - the nurses who advicate for patients are labled as Squeeky Wheels, or Trouble-makers, or a pain in the but, or anal. I have even seen it where the staff who do the right thing anyway - are blamed for high turnover, low moral, and they are fingered as the ones who are causing all the trouble. I am on a soap box here - I had better stop while I am still somewhat civil. :chuckle

I am interested in what staff educators do. Also, how many does your facility have? Are your staff educators involved with departments other than nursing? What is your normal day like?

I want to leave nursing. It is not the doctors - it is the disrespect and abuse perpetrated by administrative types - managers - etc. Will I probably not - why - becasue I am dependent on my salary and the area in which I live has no real opportunities.

At our facility there is one major recurring issue - who has the power and who doesn't. It is pervasive from the top down. Why? It is called, "inbreeding." They promote from within, administration and managers support one another - staff be damned - they are supposed to do what they are told. What would I do about it? My own opinion is that very little can be done, without new blood. Retention is a problem, but working short doesn't seem to bother the manager or administration. Given a project to do, does not mean that the person would have the support needed to accomplish the goal. Most of the tie nurses are give directives, but no "power" to do it - and then get nailed because it wasn't up to parr. Yes we eat our young and don't seem to care about the old timers either. Maybe if the public knew more about what really happens in healthcare - changes could follow. There is no doubt about it - nursing is not nursing any more - at least not where I live. :angryfire

In my esperience administration, some staff, and physicians have not taken it seriously enough. What is said in meetings and prcaimed in the policy is not being done, BUT no one talks about it - staff nurses are aftaid to confront this. I believe that it is not possible to legislate ethical behavior. It is always easier to complain and grumble about "one more thing to do" or "hey - with some of our docs it will never happen." Am I distressed about it? Yes, however I think that patient education will be the best way to address this - when patients start asking - "I thought you were supposed to mark where you do the surgery?" Ther might be more compliance.

I too man developing a CE article regarding organ procurment, but depression, in my experience is only part of the picture. I did have some articles too, but they were not very helpful. I have participated in both harvesting and transplants, I can tell you that I have observed varied reactions. Good luck - I hope you get more responses - though I think they will be similar. Perhaps it is the kind of experience that raises lots of existential questions - confronting one's own mortality - questions about how we live life and how we are going to die someday. The same kind of questions come up when dealing with the subject of DNR.