The face of nursing is changing.

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Specializes in LTC,out patient clinics, hospital.

a struggle is life and life is a struggle.

As a nurse here in North Carolina the face of nursing is changing. Management is very educated, but very short on common sense and the challenges of nurses. Companies are putting clinics under their umbrealla and calling it a business. There are more boses than patients. Over 40% of clinic patients each day have no insurance or income, how long can this last? In the mean time, we as nurses put on our fire hat and aim our hoses at the hot spots as they blaze out of control throughout the day. Can anyone relate?

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
There are more boses than patients.
I agree. There are too many chiefs and not enough Indians.

Since I have only been in nursing for less than five years, I have not seen many of the changes firsthand. However, I am bracing myself for the changes in healthcare that are certainly coming in our direction.

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Specializes in Med Surg.

I haven't been in nursing long enough to see all the changes either. I WAS in the business world for a long time. Many of the things you mention, educated bosses with no common sense, takeovers of smaller peripheral businesses, so many bosses they trip over each other, etc, have been the standard in the "real" world since WWII. I haven't seen anything in medicine as far as management that I didn't live with or participate in for a quarter century. Unfortunately, I think we will continue to see medicine become more and more about business and less and less about people.

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Specializes in LTC, Psych, M/S.

I also woonder how my hospital can keep it's doors open and provide the services they do when so many of our 'customers' are uninsured, on medicaid, indigent,ect. I do see the writing on the wall.

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sounds very scary, when money is more important then someones life It is time for something to change.

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Hate to say it, but everything is turning into revolving around the Insurance Comapanies. To many people hired to save a buck rather than provide better care. I don't want to turn this into a political debate, but got to wonder if maybe the Government stepping in and setting standards is a bad thing? Otherwise I see the Insurance Companies keep raising rates every year like they do and cut you off everytime you need to make a claim. No wonder people don't have insurance if you look at there rates. If banks can get to big and cause economic diseaster, Insurance companies are just as big with just as many lobbyist. I can't help but wonder were all these "plans" money go. Wether it be auto, health, home or life. They try to weasel there way out of anything they can. However, if you want to open a policy they will gladly pull a chair up for you and offer you coffee.

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Yes, it is about money. My mother had a stroke 7/6/04. She has since been in a nursing home. When she first got there, she could get on the bike and do pt, but she didn't like it. She gave the pt trouble, because of it. So they gave up on her, and took her pt off. She has been in bed since. Then they decided that she should be put on hospice. We, the family didn't allow that. They even wanted to put her on g-tube feeding. Well, my 84 year old father is there everyday. Feeding her. Caring for her. He doesn't get paid, but he is being the real nurse. I think that if they could have stuck with the PT, she would have been much better, but too much work, easier to get the easy ones. My dad got sick for two weeks about 3 years ago, my mom tried to get up and fell, broke her hip. We did not sue, because we understood that there are just not enough staff and the ones that are there are doing the best they can. It's been 5 years since they wanted to put her in hospice. The g tube feeding would also take off of the staff. She is on a puree diet and my dad feeds very well and she eats very well. So yeah, it's about the money. I am saying this as the patients family, although I am a nurse. It would be nice if health care would focus on the patient, instead of the money. I think most of the nursing staff try to do a good job, but there is just not enough, and too much bureaucracy. In CA, 6/10, nurses in the UC system are striking because of that. Well, yeah, I understand, from both sides of the token.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.

the current "customer service" mentality is to blame for much of what's wrong with nursing today. back when we had "patients" instead of "customers", our focus was on helping them improve their health so they could get out of the hospital, go home and resume their lives. now it seems that all we do is try to keep people happy. some people aren't going to be happy unless they get exactly what they want when they want it -- and that's not always recommended, safe or even possible.

it seems that patients and families are changing as well. people seem to be more self-centered, self-involved and entitled. years ago, you could tell your patient that you're sorry you couldn't bring her hot tea right away because someone else was coding and she'd understand. now they come right up to the bedside where you're doing cpr and whine about not getting their ice water immediately! and don't even get me started on the idiocy of some families!

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I agree, at my hospital all of our Nursing supervisors and higher ups that are making decisions haven't done bedside nursing for many, many years, I am talking pre-computer days and don't realize what a different world it is and how much longer it takes to give one med because of computers and scanning, not like the old days when you took it out and just gave it to a patient.

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the current "customer service" mentality is to blame for much of what's wrong with nursing today. back when we had "patients" instead of "customers", our focus was on helping them improve their health so they could get out of the hospital, go home and resume their lives. now it seems that all we do is try to keep people happy. some people aren't going to be happy unless they get exactly what they want when they want it -- and that's not always recommended, safe or even possible.

it seems that patients and families are changing as well. people seem to be more self-centered, self-involved and entitled. years ago, you could tell your patient that you're sorry you couldn't bring her hot tea right away because someone else was coding and she'd understand. now they come right up to the bedside where you're doing cpr and whine about not getting their ice water immediately! and don't even get me started on the idiocy of some families!

exactly!!!! it is all about customer service anymore.. those darn surveys kill me... :rolleyes:

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Specializes in NICU.

RUBYVEE!!! Said it the best!!!!!!! That's not the whole problem but I think it's more than half of the problem!!! It's turned to a customer service oriented 'business' where the patient is always right, they go home, are mailed a survey and heaven forbid any of those surveys come back and a patient has anything negative to say then you're such a bad nurse!

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Specializes in Health Information Management.

I don't have a big problem with trying to get information about patient perceptions of service, because it's only reasonable to pursue data that can have a major impact on the hospital's ability to survive. However, I have a HUGE problem with the way those opinions are typically gathered! Mail-in surveys in particular are notorious for being less than representative of the total situation. In general, people tend to bother with those types of surveys only if they've had one bad experience or a really good overall experience. Patient perceptions, even when carefully collected, are one part of a large picture. Relying primarily (or worse yet, solely!) on them to identify who is a "good" or "bad" nurse is ridiculous.

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