So Far it has been Disappointing

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Specializes in Emergency Room.

I went into nursing because I am people person and enjoy medical science. I am not the type of person that can stay behind a desk. Nursing gives me the ability to end my work day knowing I do not have more tasks in my inbox undone.

I graduated in August 2009. I landed my first job in September of 2010. I currently work in the emergency room. I work for a very large hospital system. The frustration and the amount of energy and time to just land my first job took a toll. But nothing compared to my introduction to the reality of nursing

Nursing orientation was one day. We went over a lot of information very quickly, because the hospital reduced the budget. Since I was a new nurse I had to attend the nurse residency program, which I was very excited to attend since I had been out of school and clinical s for a year. Nurse residency lasted 9 weeks long and gave us very little information that would actually help us as new nurses. My first 2 weeks at the hospital I was scheduled to work in the ICU with a "clinical coach". I have never had any critical care exposure previously. Here I am walking into ICU, with no computer training, no equipment training, no training on the electronic medication dispenser. I had been out of RN clinicals for a year and totally new to this hospital system. Again because of the cost all this training was eliminated. There was no personalized evaluation of what each new graduate needed.

The software they use is antiquated and made you less productive. There was one tech on the entire ICU floor. I knew less than nursing students who has been doing clinicals in this hospitals system for months.

I then begun my 6 week orientation in the emergency room. I have researched and spoken to ER nurses on allnurses and other places and the consensus is a 6 month long orientation with a preceptor would be more appropriate. Again, this minimal 6 week orientation was because of budget constraints and the need to get a warm body out there to fill in the staffing holes on the schedule. I have survived the orientation process because thankfully I had a good preceptor and I do have very good critical thinking skills. The acuity levels run across the entire spectrum, from a runny nose, chest pain, and a shattered ankle. 4 to 1 nursing ratio hopefully with a tech that actually does their job.

The shifts I work are variable meaning I have to work days and nights and many weekends. I am 47 my body cannot deal with the constant changing between days and nights.

Very few of the emergency room physicians that I work with do their job because they enjoy it. I hear them mainly speaking about the vacations they can take and their more expensive toys they can purchase and being financially secure. I guess the same can be said about most of the more experienced nurses I have spoken to.

What is really disappointing is that you can go back 5-10 years on allnurses and read about the same complaints over and over again. For the most part nothing is nursing has changed. They are some small advances, nurse to patient ratios being mandated and good nurse residency programs etc...

Nurses either end up searching for a unit or a position where they can actually enjoy themselves on the job, whether it be NICU, PACU, or the OR. Nurses end up advancing their education as soon as possible to get away from the stress filled unsafe units they work on. They also end up just working part time to have free time and less time on the job.

I do not look forward to going to work, but I tolerate it because I need a home and to feed my family. I am already focused on moving on to the OR where I can have a steady schedule. Since I had to attend the nurse residency program I am required to work a full year at this hospital system.

I see why nurses end up leaving the so called prestige of hands on care and run to clinic positions that are less stressful.

Obviously it is not the same for every person who enters nursing but I do think its time for change. I do envy nurses who land their first job and enjoy it so much they end up staying for most of their career.

Nurses need to finally become united in order for change to begin. Hopefully this will eventually happen.

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Specializes in Nursing Professional Development.

What is really disappointing is that you can go back 5-10 years on allnurses and read about the same complaints over and over again. For the most part nothing is nursing has changed. They are some small advances, nurse to patient ratios being mandated and good nurse residency programs etc...

So ... why do you think nursing students continue to ignore the well-documented facts of nursing when they create pie-in-the-sky fantasies about their future nursing careers? Why do new nurses continually say the were surprised by the realities? ... or that the career is harder than they expected?

The fact that the job is tough and demanding is no secret. But still, students seem to ignore those warnings as if in some denial -- thinking "That can't happen to me. My life as a nurse will be wonderful."

As long as people graduate ... then leave once they get a taste of the real world ... the problems are unlikely to be solved.

How can we best stop people who aren't going to stick with it and work to solve to the problems from using the limited valuable resources of a nursing education?

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Specializes in Emergency Room.

I agree nursing students believe this fantasy and nursing schools help feed this fantasy. I would like to help solve the problem, but nothing cannot occur unless all nurses can agree that broad changes need to be made. The IOM report on the future of nursing is a great opportunity. We as nurses can't afford not to take advantage of this opportunity to voice our opinions on the future of healthcare and nursing.

Clearly nursing leadership is lacking for these problems to persist year after year. The ANA just offers opinions with no real grass roots action being taken place in each state. We no longer need studies and data to know what the problems are, these are well documented.

I know how I want to practice nursing, its a matter of finding a place that will actually allow me time to assist my patients. We, including myself have to create those type of working environments that will allow us to practice nursing in a way that will benefit the patient. Until this occurs we are all just hamsters spinning the wheel.

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OP, I share your frustration! What to do though?

Should we all become active members in our local ANA and report back to each other for ideas and support so maybe we can do our own little part in change? Spearhead a letter-writing compaign to nursing publications? Brainstorm and come up with a 500-page reform plan that ends up as a doorstop? I hate to just complain about the problems and not do anything to help change it, but it can be difficult to figure out where to put one's limited energies that are already being stretched by so many various competing needs of life. Not to mention the internal conflicts within nursing about what exactly nursing is and where it should be going!

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Specializes in Emergency Room.
OP, I share your frustration! What to do though?

Should we all become active members in our local ANA and report back to each other for ideas and support so maybe we can do our own little part in change? Spearhead a letter-writing compaign to nursing publications? Brainstorm and come up with a 500-page reform plan that ends up as a doorstop? I hate to just complain about the problems and not do anything to help change it, but it can be difficult to figure out where to put one's limited energies that are already being stretched by so many various competing needs of life. Not to mention the internal conflicts within nursing about what exactly nursing is and where it should be going!

Doing something is better than nothing which has clearly what has been occurring for years now. I think if we start a discussion among our fellow nurses regarding this issues we can get them involved and care again about a career they are also disappointed in. I intent to lead and start discussions. Though we must remember change cannot begin unless we change ourselves as individuals. The days of silent voices, martyr-ism and self sacrifice must end. We must not allow physicians, medical directors, and Administrators to have the only say on how nursing should be practiced. Nurses are health professionals and we deserve and must demand a seat at the table to discuss how to provide quality affordable health care for out patients.

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Specializes in Cardiac step-down, PICC/Midline insertion.

I have been lucky enough to work for a hospital with strict nurse:patient ratios, and the hospital itself was designed basically the way the nurses wanted it to be. It was designed to support a working environment for nurses to actually be the health care professionals that they are....not just warm bodies running like dogs all day. It is a partially physician owned hospital. Basically 50/50 between the physicians and a state hospital. We are a huge success. Oklahoma Heart Hospital. Google it. If every hospital was the way this one is....nursing would be the fantasy that it is supposed to be. I love my job. I never have to search for the equipment I need, I always have help, techs are available for most of the dirty work/showers, and I give all my meds on time most of the time. Seriously. They weren't pulled @ 0700, scanned @ 0900 & actually given @ 1000-1100 like you have to do at other hospitals to "be on time". It is soooo safe. I have never been in a sketchy situation where I felt like my license was in jeopardy because I didn't have the resources that I needed.

I honestly think giving this place more publicity and getting ANA involved and pushing other hospitals to follow the blue print that we have would help A LOT. It may just take nurses to go on strike at other places. And I'm not even kidding about that. Somebody has to wake up and realize that nurses are the bread and butter of the hospital. When nurses can't be the bread and butter, patient care suffers. And people die because of it. Refuse to work at a place that jeopardizes patient safety and they have no choice but to change. I have quickly realized in my 2 years of nursing that the worse the hospital is.....the more new grads you will see. That's because the experienced nurses have gotten the hell out of there for the sake of not only their nursing license, but their sanity as well! Once they wear out a batch of new grads, they get more. And the vicious cycle continues. I say STRIKE!!

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It's great to hear about a place with such a supporting environment (enough working equipment available?! techs available to help out when needed?! next you'll be saying you are able to spend more than 15 minutes with each and every patient each shift! and that physicians don't insult you for calling based on hospital policy!)

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Specializes in Cardiac step-down, PICC/Midline insertion.

Here I work what would be the "floor" at any other place. I have 3 patients. So yes....I spend...at least a couple hours with each pt a day. If needed. And our doctors are very polite on the phone...we have the few who do get ***** on the phone, but most listen to what you have to say and then they tell you what they want done and actually wait while you repeat it back to them. The patients have room service...meaning that they order what they want when they want, and it's actually something that is appropriate for their diet. So there is no passing of the trays....which in my opinion should NEVER be a nursing duty. I have time to EDUCATE my patients about all of their meds and their condition, and about any procedures that they are having done....and answer questions that they have. We actually have too much equipment if anything....and it all works. A pyxis is avaible for every 8 patients...so no waiting in line to pull meds. Pharmacy mixes all drugs and get this...does the math for you and puts it on the label. There is a tech for every 8 patients. Each room has it's own bathroom and shower. DREAM job. Definitely. It does exist. Don't lose hope!

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Specializes in Family Nurse Practitioner.

Although I got what I considered a very short orientation before being tossed in the charge nurse role I loved my first nursing job and continue to love nursing. I didn't think it was going to be a walk in the park but most days I really enjoy my coworkers, my patients, the wages and the job itself. If I didn't I would find another place to work or another career.

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Kudos, I agree, if nurses do not unite, they will keep telling us we need experience to get experience, they will pay us what they want and we cant do anything about it. They will hit us with cut backs, down sizing etc and leave us with no where to go but nursing homes. I am tired of the system. They say if you are not part of the solution you are part of the problem, well if anyone could figure out a solution to this, Id be more than happy to get on board. Ive been stuck in situations that werent safe, put my license on the line etc..why cause I have children to feed and need to work. I am now in school working towards my masters...there has to be a better way to make a living than kissing butt and putting my life and license on the line.

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Specializes in ICU,LTC,HOSPICE,HOMEHEALTH.
:confused: Wow!! This sounds like a terrible hospital. Unfortunately, its not nursing itself, it is the horrible working environments and conditions that exist in nursing, particularly in acute care nursing that make it like this. Poor working conditions have existed since the days before Florence Nightingale in the hospital setting, particularly because the hospital is not run and controlled by nurses. This will likely continue to be the case until nurses regain control of the acute care setting. However, if one reads Florence Nightingale's work her ideal for the profession of nursing was that ultimately nursing would return to caring for patients in the home and community setting which is where nursing is currently headed. It is here I believe that Nightingale saw that nurses would have the most power and widespread opportunities to effect more change through health promotion, teaching patients how to manage and maintain chronic illness at home, health policy formation, case management and advanced practice nursing. Do not despair acute care nurses, there are a plethora of opportunities outside of the acute care setting to affect change and find your niche and have a healthy work-life balance and still make a decent living. I also find that Magnet run hospitals tend to really practice and adhere to the shared-governance model and nurses have alot of say in what goes on in these hospitals. If at all possible I would try and get on in one of these. I have had good experiences with Magnet hospitals and they are a stark contrast to acute care settings where nurses have no voice. I believe that this is the model Nightingale would be proud of. Its not perfect, but it is an excellent start. Rule of thumb, don't despair in finding your niche in nursing, hospital nursing is only one aspect of nursing and does not define the nursing profession, do not work somewhere which would violate your conscience and would not put your own parents or kids in, let alone your dog. It may mean sacrifice such as a long commute, undesirable working hours, or even a change in specialty or practice or furthering and advancing your education,or possible relocation. But you will have more peace of mind, feel good about what you are doing and have a more positive outlook and prevent burnout. No nurse should feel powerless or helpless continually. :redbeathe
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I also find that Magnet run hospitals tend to really practice and adhere to the shared-governance model and nurses have alot of say in what goes on in these hospitals. If at all possible I would try and get on in one of these. I have had good experiences with Magnet hospitals and they are a stark contrast to acute care settings where nurses have no voice.

Glad to hear about your experience with Magnet run Hospitals. Sorry to say not always consistent in our area.

I had a family member in a Magnet hospital for heart surgery. In the CCU post op, excellent care and

top notch. My family member was moved to the step down unit and invisible care.

Floor so short of nurses, no one shows up for a light. I go out into the floor, and can not find

a nurse, or unit secretary. Where is the "Magnet nursing care"? My family member did very well medically and was d/c 3 days later to home

after triple bypass surgery.

Discharge planning done moments before d/c. This from a major teaching hospital, very disappointed in

how what is advertised is not reality. I have just heard they have increased the workload for

nurses again here...

Botton line- now that healthcare focused on business and dollar bills, patient care continues to

decline in many but not all hospitals.

As long as you keep the merry go round of experienced dissatisfied nurses (but well paid)

leaving, you can replace them with new inexperienced baseline salary nurses...and give them less staff members to work with.

How sad:crying2:

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