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Discussion

Top 5 Nursing Problems

Hey everyone,

I need some help. I am curious to know what your would rate as your top 5 areas of difficulties as a nurse. This can relate to while you were in school, after school, and beyond! :)

I'm doing this for my college thesis and am struggling to narrow my scope. I have heard things such as endorsement, expensive books, continuing education and comparable programs. I would greatly appreciate your help!!

Thank you!!

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    • Experts

    You might have to narrow it down to nurse vs nursing student. The problems are very different for each group. But here's one that can apply to both: For nurses it's the ubiquitous poor staffing ratios. For nursing students it's not having a clinical instructor available when doing clinicals. Students are getting farmed out to staff nurses who are already ill-equipped to handle additional workload.

    Hospitals and nursing homes don't want to pay nurses. Schools don't want to pay instructors. So both nurses and students are getting short-changed. (And that's not even considering the poor patient.)

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    • Author

    Oh wow, that is difficult. Staffing issues are serious. If there aren't enough faculty to teach nurses, I see that adding to the current shortage :(. If there were a service to be provided that would help, do you think visibility into programs and jobs would be helpful? Or visibility into clinical placement? Also, has anyone tried to juggle family life or a job while in school?

    Thank you for your help! I appreciate all of your insights!!

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    There is no nursing shortage. Just ask new grads how long it's taking them to get work. The shortage of direct care RNs in facilities is a budgetary decision-- i.e., they're deliberately not hiring enough RN staff.

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    1. Staffing

    As patient become sicker in the acute care setting, bedside nurses have to provide complex and often physical and mental taxing interventions. As an ICU nurse when I am tripled, the level of care that I can render is severely diminished compared to having two patients or even one when clinically warranted.

    2. Education

    I am all about increasing education. However, having employees sign contracts to attain X degree by X amount of time is a little ridiculous. If hospitals are going to dictate educational requirements of hired staff then tuition assistance has to be on par with the amount of tuition courses are costing.

    3. Administration

    Upper management has unrealistic expectations regarding thru put and outcomes. They place a heavy burden on staff with scripting and documentation that removes the nurse from the bedside.

    4. Students

    I enjoyed my time as a nursing student, because our clinicals were small (5 students at most) and our instructor had time to review things and answer questions as they came. Lately I have noticed that instructors seem to dump their students in the ICU to "Shadow" a nurse. I don't mind having students, but if they don't want to learn it makes things difficult for me and the patient.

    5. Documentation

    There is way too much documentation, so much so that I spend a large portion of my day charting. Gone are the days of charting by exception, it appears that with the clicking hospitals want you to go chart happy and click on every possible box there is.

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    • Admin

    Staffing/scheduling. There's either too many and people get sent home or not enough and it's crazy and people end up working in specialties they aren't oriented to. In the OR, we have 1:1 ratios. A nurse can't cover 2 ORs and each OR must have a nurse in the room whenever there is a patient. It's like there's no effort to make sure that days off for those working the weekend or not working 5 shifts per week are distributed so that they aren't all off at the same time.

    Management. Right now I'm dealing with a management regime where favoritism is rampant and my specialty team is definitely not among the favorites- we're being targeted to the point of we're having a discussion about filing a grievance with HR. Many are already applying and interviewing for jobs elsewhere.

    Decreased hours and income. As a result of above management issue, there is a small group of us finding ourselves being told to go home early or not come in at all multiple times in a two week pay period. No work = no earning of vacation time = using vacation time faster than earning it = time off without pay. I'm on my own with no one else contributing income, so I'm struggling as I've taken an average of $500 a month in a pay cut.

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    • Author

    Thank you so very much for your insights. I really appreciate it.

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