I didn't realize how many patients one nurse gets. Even when some are acute, some hospitals still keep piling on the patients on a regular basis rather than hiring extra staff. In the search for short-term profits, the hospitals ignore the studies showing higher rate of errors & even moralities when staff is overwhelmed.
I also did not realize how little time the nurse did what I considered was nursing care. At least half the time the nurse is at the desk, doing documentation, calling doctors, straightening out pharmacy mistakes, calling family, doing more documentation, and trying to keep track of aids. When in the room with the pt, some shifts the nurse only has enough time to do a quick assessment, ask pain level, and hand out meds because she has 6 patients to see in that hour. I don't understand why in nursing school they bother to train us on communication, alternative pain management, the psych variable, educating family, and other things -- when some nurses on the med-surge floor don't even have time to pee before having to zoom into the next room to give out meds. (And can someone tell me why ALL patients have their meds due right at 8am? Wouldn't it make more sense to schedule half at 8 and half at 9 or 10, when pt load is 6+ per nurse?)
It's also frustrating to have to listen to the corporate B.S. about top quality care at their facility, how they're magnet status, blah blah blah -- and walk onto a floor where the first THREE dinemapp machines are broken, two of the computer terminals are down, the single pulse-ox unit was lost weeks ago, and there is absolutely nobody assigned to equipment maintenance. They want us to be "customer service reps" to meet any need our pt or pt family has, but they give us 5 high-maintenance patients and a nurse's aide who hides in the closet to TXT her friends. How can we take the time to really show each patient is special if you're treating us like cogs in a giant machine, geared to run as fast as possible?
And a personal pet peeve: school trains us on proper nutrition. But then we work in facilities where they think it's ok to serve over-processed, over-salted, inappropriate foods. Fresh vegetables are unavailable and most dishes are full of fat (esp saturated fat). Why are we serving diabetics a meal of Wonder (white) bread, instant white rice, and a deep fried hunk of factory-farmed high-fat meat? And patients learn from this bad example how to eat.