We've all seen the effects of the recession. If not in our own professional lives, then in the neighborhood at least, or maybe on this board with all the new grads looking for work or nurses who planned on retiring but could not because their spouse got laid off.
When the recession hit, I noticed a difference in the attitudes of hospital admin. and management. It was as if, after years of resentment and having to hold their tongue, they breathed a sigh of relief and started speaking their minds. Managers bragged about having more applicants than they could deal with. Hospital admin. began strutting about the hospital with their chests pumped out like rosters, daring anyone to disagree with their new money saving tactic (which was usually to freeze wages, cut ancillary staff and make their duties nursing responsibilities). In short, with jobs so difficult to find, we are down, and we are being kicked while we are down. Hospitals see us as a profession as being vulnerable, and they have certainly applied to boot to our throats and are doing everything possible to keep us there.
In the past, when a situation I found myself in was dangerous, I would resolve it as best I could and then let management know what the problem was. "Three fall risks climbing out of bed all at the same time, on opposite ends of the assignment, and no aid to help watch them. I'm surprises there was not a fall. Bed alarms won't avert a fall, because alarms were sounding off in one room while I was getting the other one back in bed. I couldn't just stop and run to the new alarm every time." Not being critical or pointing fingers, just letting them know there was a problem.
Lately, when you bring issues to your manager/admin., you are basically greeted with a "I have a meeting to be at, if you find the work conditions so bad, have fun finding a new job. And BTW, empty the trash out of the public restroom on your way out."
Easy to see, after a year and a half of this, nurses are finding themselves having to choose between poor work conditions and being jobless. I know more than my fair share of nurses holding onto positions they hate just to make a living. I must admit, on more than a few days, I am one of them. I go to work and, on a daily basis, am placed in a situation where only the most generic care is possible. "Service" is an illusion, simply getting meds passed and avoiding a code takes the extent of my nursing skill. I try to figure out anything, something, I can do differently rather than treat my pt's like numbers/things on an assembly line, but it just is not possible under the conditions my hospital has become comfortable with.
The longer this goes on, the more I find myself thinking/acting like one of the nurses I used to make fun of. Pt's want this/want that and I simply don't have time for it. I don't even make an effort anymore. Pt's try to converse with me, have a discussion with me, and I turn my back and walk away, I don't even have time to explain that someone needs me NOW and I can't talk right now. I've even had a few days so bad, other nurses are asking me for help with this and that and............sorry, I don't even have my cart checks complete, whatever your pt wants will have to wait until they are done.
We even have a nurse so fed up with the whole thing, they have gone a step further than I. She had the assignment I described above, with all the fall risk pts, and she simply gave up half way through the shift. "If they fall, they fall. I've done all I can do. Maybe then they'll stop taking the aid off the unit to save $50 anyway."
I don't support her attitude, but at the same time, I can certainly sympathize with it. I certainly hope I don't get that bad, but things are not going to improve on the unit any time soon. They are, on a daily basis, taking away everything/anything that could make our jobs easier. You have to be F. Nightingale just to keep people alive, forget about compassion or "5 star" service.
:pMaybe we should create a support group for nurses or something.
Really what happened to America that in the wealthiest country in the world we have so many people working under the threat of losing their jobs & knowingly doing far less than satisfactory care, & this is widespread now. I know, we are lucky we are not in Pakistan or Zimbabwe, but really that's besides the point. We are the wealthiest nation n the world. This should not happen (& BTW things aren't that bad in many so-called Third World countries as we are led to believe from TV images. I've been to many...)
There is a level of arrogance in management in America that is not present in many countries, probably a result of at-will employment laws, absence of unions (altho' they are far from perfect) & we are a hopeful, optimistic people who think bad times are only temporary, but I wonder...the results of globalization, immigration & technology may result in changes in our work situation, employment opportunities & economic strength we have not experienced before. While healthcare cannot be outsourced like manufacturing or accounting, as more people flock to healthcare jobs as 'recession-proof(?)" there will be oversupply, & frankly, America cannot survive as an oversized hospital with deep unemployment & recession everywhere.
Specializes in Peds/outpatient FP,derm,allergy/private duty.
"Maybe we should create a support group for nurses or something. "
Under the circumstances that you cite, that would likely be called a union:lol2:
I would not dismiss this idea out of hand, if it weren't for the evidence of our propensity for turf protection and the factions in nursing emphasising our differences more often than our common challenges.
Since the recession and the recent huge influx of new grads into the market I have seen a very different attitude my the management at my place of employment. Whereas before there was at least an effort to be seen as supportive of the nursing staff, all pretense in this regard has been dropped, replaced by the "don't let the door hit you in the @ss on the way out" style of management. Though we suspected strongly that this was the reality all along, the unmasking of such is still really discouraging.
Heard at a recent conference, "if you don't care to do things the way we tell you to, there are four or five people who come in here every day who would be happy to have your job". Gee, hugz to you, too!! Should I laugh? Cry? I'm not sure yet!
So far I haven't had apathy toward the patients set in, but I'm in a comparatively low-stress area now-- and not dealing with people who would be so crass as to strut their stuff so brazenly when the job market became more favorable to the 'buyer".
Specializes in burn ICU, SICU, ER, Trauma Rapid Response.
When the recession hit, I noticed a difference in the attitudes of hospital admin. and management. It was as if, after years of resentment and having to hold their tongue, they breathed a sigh of relief and started speaking their minds. Managers bragged about having more applicants than they could deal with. Hospital admin. began strutting about the hospital with their chests pumped out like rosters, daring anyone to disagree with their new money saving tactic (which was usually to freeze wages, cut ancillary staff and make their duties nursing responsibilities). In short, with jobs so difficult to find, we are down, and we are being kicked while we are down. Hospitals see us as a profession as being vulnerable, and they have certainly applied to boot to our throats and are doing everything possible to keep us there.
*** YES! That is EXACTLY what I have observed as well. The second the hospital I worked for found themselves with more RNs applying than they had jobs for (and of course the Magnet recert was over) EVERYTHING changed. That program the hospital had to help pay for BSN or MNS? Gone. Health and dental insurance premiums? UP. Raise? Not this year and don't hold your breath for next year. Bedside nurse led leadership and practice counsel? No more.
Oh, by the way the culture survey is coming up, if the nurses makes managers look bad we are going to take one of your days off away each month for 6 months! (seriously they threatened us with that, we were going to spend one day a month in a mandatory "team building" workshop, in addition to regular shifts).
I left and now work for the government in a VA hospital where, while things change slowly, the rules, policies and benefits are as close to being written in stone as can be found today.
Ok here's my ideas. I have learned to think differently, because I am a union nurse. I believe in the power of many united because we have changed things like this.
Now I used to put up with alot of this, but I have learn to change myself. It is extra work, and definitely extra time, but hear me out.
First off I no longer lie to patient when they ask, "WOW it sure seems as if there are less staff now a days. I remember there was a lady who would come pass water and chop my food for me every meal. ". I don't dismiss it like I used to. I say, "Mr./Ms. pt. I will do everything I can to make sure you get what you need to get well. When you go home you will get a survey from the hospital that asks your opinion about your care. Would you mind taking a minute to tell our hospital that you noticed the lack of staff. Sometimes an administrator will come to your room and ask. Please let them know also. Now what can I do for you to make you comfortable right now." I also tell then realistically, when I will be back, even if it means in 2 hours.
Second. If I don't take a break, I no longer suck it up by clocking out only to resume my other duties. It is a violation of labor law to not give someone a break. If your kids were not allowed to go to lunch, even after you paid, until they finished their school work, you would raise hell. Why do we martyr ourselves?
I also don't clock out to do competencies. If it means I have to stay over to do them, then I stay on the clock. And as a matter of fact, so do my other union coworkers. If one person refuses, because they don't want the "conversation" from the boss, then we other nurses talk to them. (This one maybe harder for non union nurses, I understand it is scary because I used to work in hospitals like that.)
I use restraints more than I used to. Have to, to keep people safe. Vest more than the wrists, and only when we have no CNA's. I will try to get the family in to sit with Mom or Dad, but I have to tell them that even with that, they can ask for a vest to secure them by the waist.
I also ask them if they can visit at meals to feed their family member if they need help eating. Not everyone can, but some actually just change their visiting routine. It also helps them to be involved since I am giving meds around meals, I can educate while they are there. I can also watch their technique to give them tips on preventing aspiration. And yes I honestly tell them if they ask about CNA's. the same as I tell pt. I will do my best, but let admin know.
Document your staffing, keep notes on horrendous days and who you notified. Encourage others to do the same so if there is ever a problem you can defend yourself. Unless you are unionized. Then just keep filing disclaimers. They will protect you if indeed it was staffing that created a patient safety issue.
You could not write this better. Our hospital changed recently staffing ratios for worse. I work per diem and make good money. In the meantime I am finishing bachelor degree in nursing. I know it will only get worse in the hospitals everywhere I go, so there is no sense to even try to change units or hospital. I will try to find a job in government or VA hospitals or outpatient something. Luckily, our management is not the worst, at least I like our boss. But I know things will only progress for worse in healthcare. Our hospital of course does not hire new grads.
AmaurosisFugax
84 Posts
Really what happened to America that in the wealthiest country in the world we have so many people working under the threat of losing their jobs & knowingly doing far less than satisfactory care, & this is widespread now. I know, we are lucky we are not in Pakistan or Zimbabwe, but really that's besides the point. We are the wealthiest nation n the world. This should not happen (& BTW things aren't that bad in many so-called Third World countries as we are led to believe from TV images. I've been to many...)
There is a level of arrogance in management in America that is not present in many countries, probably a result of at-will employment laws, absence of unions (altho' they are far from perfect) & we are a hopeful, optimistic people who think bad times are only temporary, but I wonder...the results of globalization, immigration & technology may result in changes in our work situation, employment opportunities & economic strength we have not experienced before. While healthcare cannot be outsourced like manufacturing or accounting, as more people flock to healthcare jobs as 'recession-proof(?)" there will be oversupply, & frankly, America cannot survive as an oversized hospital with deep unemployment & recession everywhere.