Student nurse dismayed by bedside nursing attitude

Purple_roses · Jul 9, 2017

It's because nursing isn't just about getting your hands dirty and providing great patient care. It's feeling like you can't provide your personal best care because you have way too much to do; it's staying an hour late to finish documentation; it's calling pharmacy, lab, and everyone else to remind them of what you asked for literally 5 or 6 hours ago. By the end of your shift, you're literally exhausted. I'm a new nurse, but every single shift last week was ******* insane. I'm dreading going back.

chris21sn, BSN, RN · Jul 11, 2017

Personally, school is very different from having a real job. And unless you have the experience of working a full 36hr weekly shift, with 6-8 patients, it would only be right of you to be respectful of the ones who do. Criticizing and pretending you know their perspective is not a way to understand their side of the table. Respect! And experience is key.

RNGummy40 · Jul 15, 2017

Dear New Gal,

I think the answer to your last question includes a lot of factors. Students entering nursing may want a good paying job, fewer work hours, respect in the work they do, ability to be challenged in skill, the option to socialize with others, or they may have no clue. The virtue of taking care of another human being may not be their first priority when entering the nursing practice, a sad thought. New nursing students may have a complete academic plan in their heads and that includes as few back bending moments over a patient as possible. Some nursing students may hate the site of blood, fecal matter, vomit, or snots and seek a position after graduation away from those colorful moments. Some students may have none or minimal bedside experience before entering nursing school.

The day's of Florence are in the past. I was very surprised to read that teaching compassionate care in nursing has increased and that nursing programs around the world have had to adapt to the cultural change. When I went to nursing school, the focus was on critical thinking, but now that includes compassionate care? In my opinion, the indirect forms of communication have minimized the human experience and interactions needed to learn and maintain compassionate thinking and behaviors.

Med-Surg nursing is hard work!!! GOD BLESS my fellow nurses! It is total care, with high capacity, and high acuity. The nurse to patient ratios are high, the involvement in team dynamics are high and turn over between admits and discharges can play like a ping pong table. The balance of managing patients care is at times difficult with the expectations of charting, and the expectations of the patients. Hospitals are now focusing on a customer service approach which can be a conflict with medical care. A nurse may be expected to take on the role of house keeper, fireman, bodyguard, chef, hair stylist, or plummer. Questions as to who is right frequently comes up: Is it the patient, doctor, management, or nurse? The answer to these questions can create headaches during your shift and unfortunately, responses are not always given in logical non biased terms, but illogical and biased. Education is not always consistent or available depending on your facility, which magnifies the headache.

You are correct, that nursing is about giving the best possible care. The struggle with nursing is providing the best care under safe conditions for the nurse and the patient. Decisions are not always made by nurses, or even by doctors. Med-Surg nursing a great foundation for clinical practice.

Jwrnsktr · Jul 16, 2017

I loved bedside nursing, when I actually nursed the patient and not the electronic chart. EMR has taken our attention away from the patient and put it into maintaining pages and pages of charting with scores of drop down boxes. Impersonal to say the least. Time consuming and burdensome. Add to that initiatives imposed by people who haven't been in the field for decades if at all....and you have nurses who are always wishing they could do more for the patients who come in with high expectations. Some floors, some hospitals are so short staffed and yet, the nurses always seem to make it work....sacrificing their meal breaks, and their health! Unless you get personal satisfaction from a job well done, don't continue in this career path. The pay seems to depend on the region of the country you work in. When I moved from NY to NC 12 years ago, I took a $15/HR pay cut, and didn't get a raise for ten years because of my casual (per diem) status. Think before you leap! Good luck!

CherylBishop · Jul 16, 2017

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Jul 3 by cleback
The main disatisfier for me is feeling like the middle management of healthcare sometimes and having different "higher ups" with competing priorities telling you what to do. Have to keep the patient's 100% happy all the time, but why are you calling the on-call doc for a different pain management plan? A diet order? Pffttt all that can wait 12-15 hrs until the morning rounds. Practice at your highest level of education but clean rooms after discharges because we let go all of our housekeepers. It's no win sometimes. Honestly, if all I wanted to do was make a difference in someone's life, I could have volunteered at a nursing home and work a much less stressful 9-5.

I have worked in nursing homes for the last 24 years. If you think it's 9-5 and much less stressful you are NUTS. 12-16 hour days. Family members and administrators up your hind end all the time. Anywhere from 25-50 patients that you are responsible for. And are also responsible for the nursing assistants that work under you. I'm not saying your job is any less stressful, so please don't say mine is.

Editorial Team / Admin · Jul 16, 2017

I have worked in nursing homes for the last 24 years. If you think it's 9-5 and much less stressful you are NUTS. 12-16 hour days. Family members and administrators up your hind end all the time. Anywhere from 25-50 patients that you are responsible for. And are also responsible for the nursing assistants that work under you. I'm not saying your job is any less stressful, so please don't say mine is.

The poster you were quoting was referring to volunteering, which yes, is going to be a lot less stressful than a nursing position.

JoannieO · Jul 16, 2017

Extremely well said! Love the part where you say : "While bedside might be the 'core' of nursing, you can provide the best care possible in many different areas, it doesn't necessarily have to be bedside." In my 45+ years of experience, I worked at multiple places of employment. My very last job was in occupational health nursing, prior to my retirement in 2016, and I loved it. There I was the manager, clinician, and secretary: I did provide nursing care onsite to manufacturing and engineering employees in the Defense industry, and I had a master's level degree in business/ computers; 2 lower levels in nursing. So bedside nursing can be OUT OF THE HOSPITAL: in schools, in teaching, in the community (visiting nurse) or in occupational/wellness health nursing. What this new nurse describes about the other nurses sounds like burnout from the current workforce of "too much to do, with no staff or time to do the work !"

SandraCVRN · Jul 16, 2017

Im not stressed lol....ok i guess I could have worded what I truly meant better. As far as bedside nursing goes, what is it about it, that makes nurses dislike it the most? From what I gather it is the patient to RN ratio

In my opinion it's not that they/we hate bedside nursing we hate all the things that don't allow us to be the kind of nurses we went to school to be. We want to take great care of our patients but we have:

Too many patients

Patients that think they are in a 5 star hotel

Families that think you should also wait on them hand & foot

Not enough ancillary help

Charting, charting, charting

Administration breathing down our necks with scripted care

I think you get my point. Most of us thought the way you do when we first started out. I remember thinking what are these nurses griping about their pay (a new grad made at least double what I was making with 15 years experience as an oral surgery assistant) now I realize we don't get paid half of what we should. Good luck in your new adventure.

SandraCVRN · Jul 16, 2017

My reasons for strongly disliking bedside nursing were multiple, and some were compounded by others. I worked two different floor jobs before coming to the OR. Both were the same patient populations: neurosurgery/neurology progressive/stepdown and floor, with a variety of patients on our units because we could put nearly everyone on tele. The interpersonal situation on each unit was vastly different. My first unit? I could count the people I could trust to help me on one hand (very scary as a new grad). The politics were unbearable, and there were a lot of issues in that facility that scared me. My second unit? My coworkers would pitch in and help. Made all the difference. The interpersonal and work unit culture issues were far worse than the workload in my first job.
I had anywhere between 3 and 7 patients, depending on my acuity mix (in general less patients if higher acuity). On my second unit, we had LPNs, no big deal, except that RNs had to cosign some things, handle care plans for the LPNs they were "paired with", and handle the tasks requiring RN licensure (IV push meds, etc). Our LPNs would pretty reliably take tasks from us, that wasn't the issue. The workload, in terms of the types of patients we cared for was a challenge. I learned a LOT, literally a TON.
I decided a year or so in, that the floor wasn't for me. I had offers and could have went to the ED or an ICU. I went to the OR in a different facility, being offered a potentially once a career opportunity. I've been here for several years. I've learned more than I ever imagined I'd learn. I like having one patient at a time, though when things are crazy in my environment, well, it's a totally different kind of crazy (and hard for me to explain). I have the best relationships with surgeons and anesthesia providers, the teamwork is wonderful.

I worked an ortho/medical floor right out of school. It was great, good setup, great teamwork etc. then moved and had a chance to get back into the OR. I had been a private scrub for an oral surgery group before nursing school. Been on the heart team for the last 11 years except for a 7 month stint back to the floor because I missed regular patient care. When I got in trouble for not getting a blanket for a pt wife while I was doing a stat ekg for current chest pain I went right back to the OR. We bust our behinds & it wears me out more physically but I don't think I could ever go back to the floor.

HawaiianDreams · Jul 16, 2017

Let's see...endless pushback from management with no support. Very critical patients with astronomical nurse to patient ratios. Nursing is more government reimbursement forms and "customer service" so needless to say I despise nursing.

Silverdragon102, BSN · Jul 16, 2017

Closing for staff review

Silverdragon102, BSN · Jul 17, 2017

Reopening this thread. Some posts have been moved from view, please remember what the poster is asking and maybe read posts before posting something that can be interpreted as a violation of the Terms of Service of the site.