War on Nurses

[dareese, MSN, RN]

Wow-what a shame!  Hospitals are missing out on great nurses if this is a trend nationwide.  Are other hospitals across the country similar in this practice?

[Jralax]

Coming from an existing health care worker shortage previous to covid was already a problem we had from the start. We then proceeded to burn our candle from both ends with government planned health care worker shortages. Our situation feels somewhat deserved. 

[159Nursesrule, ADN, BSN, CNA, EMT-B]

I am Faculty at a private-for-profit college; I teach in the LVN program, either 12 months full-time or 15 months part-time nights.  Both programs are fast-paced.   Students are actively engaged in Theory/ Clinical Learning Lab, Simulation Lab, and Clinical sites.  We encourage our students to stay actively involved in all aspects of their education, and one focus is critical thinking versus task performance.  The college also has an LVN-ADN program, BSN and MSN programs.  The college is rapidly expanding to different states/locations.   Due to a faculty shortage, we have students waiting to attend; the pay isn't competitive with PRN positions in the industry, so many candidates walk away.     So how about improving our income also.  

Another aspect would be recruiting from the high schools; many districts already have agreements with local colleges for students to attend college-level courses and receive credit.  Make it mandatory for colleges to accept those courses if they meet the state accreditation standards.

[dareese, MSN, RN]

Appreciate your weighing in from an educational perspective.  Excellent points!

[Guest1030824]

On 1/10/2022 at 9:17 AM, KalipsoRed21 said:

Also I feel the New Grads RNs being hired are getting shafted due to education needs but lack of personnel to train. We all know a new grad BSN is not floor ready. The last place I worked they tried to give a 3 week old new grad her own team; with a heparin drip, only 3 RNs on the floor (including the new grad) with 6:1 ratio. No charge or resource RN. No way anyone was going to have time to help the new grad. I filled out a safe harbor for before even taking report. Response I got was: “Well the New Grad didn’t complain.” ? Really?! That poor baby is new….if you tell her she should jump infront of a car because it is in her scope of practice and her duty as a nurse; she would probably believe you. That’s why new grads are scary and why we shouldn’t be *** putting them at risk. Because my facility didn’t take that complaint seriously I wrote a letter to state reporting the hospital. I got a message from state basically saying “Thanks for sharing your concern. These complaints are not punitive, nothing is going to happen to the facility, but we will bring this up to them and TJC (who is paid by hospitals to make sure they are safe…tell me how that is effective?). It is all smoke and mirrors and we are the sacrificial lambs. 

I started out in Med/Surg as a new grad and there were not enough staff to train me. I followed a nurse around for 2-3 weeks and learned very little hands on skills. She had 7-9 patients and had zero time to really train me.  I started out with 3 patients which was nice, but I got a lot of pressure to increase my patient load every day. I basically had to teach myself when I started out as a new grad. I got bullied a lot because of being new as well. I really believe the toxic worked environment is fueled by the already overly stressed out staff. I got burned out after 2 years and left in 2017. Took two years off which I regret. I didn't feel confident enough to look for another job. I finally applied again in 2019, and it was the same old stuff. The training was awful, and I was bullied so bad. I only lasted four months this time. Two years later, I'm now sitting at home unemployed and lacking the confidence to interview. I am so sad because I love bedside nursing. I know I am not the only nurse that wants to return to bedside after time away. It's not that we don't have enough new grads to train, but we are lacking the staff that can train them in the hospital setting. Hospitals are losing their current experienced staff which further adds to the shortage. New grads are getting burned out quicker because of their training , and leaving the bedside within a 1-2 year time period. The nursing shortage is coming from various avenues. Pouring in new grads will further add burden to experienced nurses burning them out faster because of the already high to nurse patient ratio. The hospital I was at got rid of their nurse educators which was not a good idea in my opinion. Instead of utilizing them, they let them go. Why not use nurse educators to train nurses while they are on the floor? I have had plenty of classroom educational opportunities but little hand on training on the floor. I know we are supposed to get this while in school, but the teacher was so stretched that many of us fell through cracks. They did not have simulation labs while I was in school either. I can go on and on, but it basically comes down to funding. Hospitals don't want to spend the money to train new grads, and schools don't want to hire enough teachers. It starts at the top. 

 

 

[toomuchbaloney]

1 hour ago, CinLeo42 said:

I’m a BSN nurse with a two year gap and it has been hard for me to return to the bedside because hospital’s are asking for recent experience.  Hospital’s do have programs for new graduates with less than six months experience. I know I am not the only nurse looking to return to bedside. Hospital’s can increase staffing by offering training to nurses looking to return to the bedside. 

Hospitals have long been willing to sacrifice that promised training and support because other concerns take priority. 

[Gratefulbutnotstupid, ASN, LPN, RN]

As a nurse who started as an aide, then a LPN through a hospital based LPN program before becoming a RN I can see your ideas clearly.

LPN school required me to do intense academic classes followed by intense hands on practice.  The program was one year Sept 8 to Sept 8.  We went through the Summer and days were 8-9 hours.  5 days for vacation at Christmas and part of New Year day off.  My practicum was in hospital and with the hospital staff.  Our help was enormous.  We passed po meds, gave injections and hung IVs ( First antibiotic had to be hung by the RN. No IV pushes or other meds).  The IVs the LPN couldn’t give could be monitored by them and reported to the RN if needed.  As a LPN I also started IVs, gave daily hygiene care, ambulated patients etc.

Turn the coin.  As a RN, I usually got 14 to 15 patients with a LPN to assist.  The LPN took vitals, passed linens, ice water, assisted the patient bathing and passed the medications they were permitted to pass.  They also did ambulating etc.  As a RN, I did the assessments, IV pushes, and all other RN duties including overseeing the LPN.  It was doable.

My mother went to a three year diploma school (through all summers) for her RN.  The students eventually were staff as they continued to learn.  She had to go through all departments and specialties, be the Supervising nurse for a certain time period, scrub in to 25 minor and 25 major surgeries and so on.  They were integral in the functioning of the hospital.

Starting these kind of programs with immediate pay while learning would be a win win.  Students get training, hospitals get staff.

Enjoyed your article, good ideas.  Sometimes you have to go back to move forward.

[Guest1030824]

1 hour ago, 159Nursesrule said:

I am Faculty at a private-for-profit college; I teach in the LVN program, either 12 months full-time or 15 months part-time nights.  Both programs are fast-paced.   Students are actively engaged in Theory/ Clinical Learning Lab, Simulation Lab, and Clinical sites.  We encourage our students to stay actively involved in all aspects of their education, and one focus is critical thinking versus task performance.  The college also has an LVN-ADN program, BSN and MSN programs.  The college is rapidly expanding to different states/locations.   Due to a faculty shortage, we have students waiting to attend; the pay isn't competitive with PRN positions in the industry, so many candidates walk away.     So how about improving our income also.  

Another aspect would be recruiting from the high schools; many districts already have agreements with local colleges for students to attend college-level courses and receive credit.  Make it mandatory for colleges to accept those courses if they meet the state accreditation standards.

Why are they recruiting from high schools when there is a shortage of faculty staff already? You are right, teachers need to be paid more and the student to teacher ratio needs to be ideal. Schools are giving teachers way too many students to teach especially at the bedside. 

The list of students waiting for the nursing program will increase, and students may walk away because of this long wait which is counterproductive. Correct me if I am missing something.  It all boils down to funding. Where can schools and hospitals getting the money? The higher ups are not willing to adjust their pay. How is the government helping?  This is where the focus needs to be. Hospitals say they don't have enough nurses but there are enough. It's just there way of trying to take the focus off the real problem. Schools use this tactic as well to increase their bottom line. The healthcare system is in trouble because nurses are leaving the bedside due to various reasons caused by the system. Mainly, it is a shortage of unfair allocation of funds.

[DallasRN]

I've only scanned most of the replies so my thoughts may be redundant.  Nonetheless, so many of the comments are similar to those made back in the early 80's when I started nursing.  However, things are different now.  Two years ago, nurses all over the US (and world) were thrown into situations they were totally unprepared for yet most stood shoulder to shoulder attempting to provide care for people dropping like flies all around them.  Retired nurses re-joined the work-force - maybe just to provide "clinic" relief for those more up-to-date on clinical skills.  I knew several of those nurses myself.  Nurses were called heros.  Given standing ovations.  Offered free pizza.  Everywhere I went, I saw signs posted across lawns of nursing home facilities - Heros Work Here.  And two years later?  For those nurses who oppose vaccines?  They are shown the door.  After working through the worst of the pandemic.  (and no, I'm not an anti-vaxxer but I do appreciate others opinions and concerns).

In the interim, nurses have found they can leave the dangers (yes, dangers) and frustration and sheer exhaustion of the hospital environment and go to work in a big box store and make almost as much per hour in some locations.  Leave hospitals where they are often treated like the proverbial "hand-maiden" by patients and some physicians. No night shift, no holidays, no 12 hour exhausting shifts. Here in my area - Amazon (a job for young/strong people) pays up to $23/hour, EXCELLENT benefits (insurance and PTO), lots of available OT if one chooses, double time on holidays...and little health risks.  Certainly no legal risk as those nurses face every shift - in great part due to staffing issues coupled with increased accuity.

Finally.  Go back and read so many posts from newer nurses just now entering the work-force.  Complaining about having to work holidays, nights, w/e's.  I read these comments and just shake my head...what did you think you were getting into?  How did you get through school not knowing you were entering a 24/7 profession?  

By fast-tracking/doing the things you mentioned the profession will be diluted.  As it stands, there are abundant opportunities for would-be nurses to go into other fields - law, engineering, IT, even medicine - opportunities not available 30-40 years ago.  We need to clean up the profession from the inside.

[Terri Holland RN]

Sounds like a wonderful detailed plan to current staffing solutions. Would only add one very important other point. The option for 8 hour shifts. This would allow for Nurses raising kids to work and balance family life which makes for happier and more pleasant team and staff. The goal here should be options for better life balance.  The best quality of care for patients is having a range of talented Nurses of all age range verses relying on constant change of travel Nurses. Fast track training, hiring LVN’s and more ADN’s is an excellent goal but also creating better life balance and work flexibility is crucial.  

[jeron]

I'm in Australia and were already at breaking point in our Health System since Delta arrived. I'm ex-military and became a student nurse now aged 47 and as USA,Canada,UK,Australia all share covid-19 discoveries and seeing how detrimental to all Nurses,Doctors etc has taken it's toll they continue to ignore any pleas for help or to change the system to ramp up extra Nurses,Assistants to combat this. RN Training can be done as a 2 part system taking your model of Hands on Practicle Learning with the theory being done via online from the Universities which would inject thousands of Students into Hospitals, Aged Care and Residential to alleviate the crisis. Paying students,Supplying the tools of the Nursing Trade free to students also would see larger number of intakes.The amount of experience a student would receive is 100% more than they we do only completing set amounts of hours to pass a particular practicle module.I learnt in 2 hours Manual BP Taking Accurately and Nurse planning within 2 weeks from RN's. I've spent on my own time 1 month purely observation in ED with special premission and I now have far greater knowledge,understanding and less hesitation once I complete my training to be able to hit the ground running faster than my other student classmates so I believe your method can be put in place without too much complication at all. Will they do this or even consider it "NO" as there are too many Lawyers and people ready to sue the Government,Hospitals and facilities at the slightest chance that someone fails in the position causing serious injury / death. Our societies have become corrupt where governments and Lawyers,Big Pharma are making money and not caring about the consequences of the people and the dire need for change are just continuing to band-aid the situation in the hope getting everyone vaccinated who can be and everyone complying to make our communities as safe as possible and ride out the pandemic just like the days of Spanish Flu as an example. I hope someone listens and adapts but until then many doctors,Nurses will either change positions to less stressful positions or leave the profession as they are now placing everyone else in harms way and not enough experienced people to help Students who do Graduate able to forget half of what you learn in University only to be replaced with actual ways and proceedures used in a real working hospital and not just in the classroom. Can't wait to graduate and get the opportunity to come to the US and learn more... 

[Terri Holland RN]

Australia I’ve read and watched on documentaries is suppose to have the most efficient healthcare system.  How do you think that will compare to US systems which is still for  profit? Most hospitals even teaching facilities have to make a profit and staffing shortages are not always priority.