Every unit has them. The nurses who, at any level of licensure, have been with the facility for a number of years. Depending on how small your Town is, those nurses who know patients and their histories well. Who know the family dynamics, know when the patient is not "themselves", how to convince a patient to do what they want them to do for the patient's benefit. It is a level of compassion and caring that only can come from years of experience. A day in which if you can keep a patient warm and dry and happy that their nurse "gets" them, and all will be ok.
NursesAnnouncementsArchiveArticle
Then in comes the Management team. They tear apart the way that is better for the patient's peace of mind, instead, to have a nurse become more efficient. Everything based on a number, a graph.
A de-personalization to the point of monotone scripting of basic communication. Because at the end of the day, they could care less is Mrs. G doesn't take her lasix because she doesn't want to be up all night peeing (where one could assume that the prudent nurse would speak with the MD about changing the time of the med to see if that works), they would like you to diurese the patient, and get them the heck outta the unit.
Patients as numbers or little dots on graphs are a new concept to a number of nurses who have been in this field for any length of time. Managers that don't want any direct patient care and will let the nurses struggle as opposed to lending a hand is a new concept.
There was a day that every code, every rapid response, the manager and sometimes even the DON would be right there. Because the mindset was on good patient care. Nurses who had a sterling nursing practice. That when a patient was admitted to the unit, they were understood, the communication was careful and individual, the the nurse was really working towards a common patient oriented goal, as opposed to a unit or facility goal.
Some facilities are working so hard to become "better" than the next facility by hiring BSN's only, phasing out those who don't fit that mold, and making them into everyone says the same thing to the same patient day after day. Don't care if you understand it, but gosh darn it, I am leaving you in capable hands!!
More education is not a bad thing. A BSN is a worthy goal. But just because someone has a BSN doesn't make them a better or worse nurse than another lower licensed nurse with years of experience. And it is sad to see nurses who are hired purely due to their degree, who are then taught that nursing is all about graphs and numbers.
Stick to the script, check off the boxes, stop elaborating, we don't care. We want the patient to assume you are kind and helpful, but you don't really need to be that way, just act as if you are. But you have 8 patients. Go in, report at the bed, don't forget to play up the oncoming nurse, don't really care if you believe that person to be a good nurse or not, but you must convince the patient that they are, smile, act interested, but don't show any individualized compassion. That doesn't get us paid. You don't need to connect to patients. They are not really people, they are numbers. And the goal is to act as if they are VIP's so that they will check off the appropriate boxes on the survey.
It is sad that facilities have come to this. That a nurse, regardless of degree or experience in other realms of nursing, can find themselves in a facility that employs this type of practice. That nurses who have a history with a facility are not valued for their knowledge, but corrected and sometimes fired for and individualized approach to patient care. It is such a direct conflict to how and what the nurse is in practice, that most move on to an alternate position. But the saddest part of that is, that's not their loss. Move on, who cares, there's 10 more applicants who will take your place tomorrow. Too bad, so sad. And I believe it IS too bad. And very, very sad.
