What can I (we) do? RANT

[Lev]

I think there are so many things about nursing that have to be fixed. I got tired of bedside nursing after a year. I am so tired of the bureaucracy, paperwork, and the focus on things others than quality care. I am so sick of rude people who think they're the only ones in the world. Bedside nursing is the backbone of nursing, so I shouldn't have a love hate relationship with it.

I am so tired of the documentation, the unclear expectations, and picking up slack for other people.

The ratios are unreasonable and not safe. Especially in long term care. Why should people have to falsify documentation in order to "show" that they did something at the right time even if they didn't even do it because there are simply not enough hours in the day to do what is expected of us?

Why can't nursing be just care and not computers?

I would love to go to work, hear about my patients. Look up a couple things in the computer and then go give out medications. OK, I'll document those, but why do I have to document an assessment every shift. Why can't I just do my assessment and write the abnormal findings in a short note or something, or not at all. Aren't doctors supposed to round on patients and actually put a stethoscope to their lungs, heart, and bowels? Why can't I just turn patients, do wound care, and have my patient use the incentive spirometer without documenting it all. It's all so tedious! Why can't I round on my patients and not have to document that I rounded on them? Why do I have to be the go to person for everything? Why do I have to do secretarial work? Need a copy? Ask the nurse. Need a form filled out? Ask the nurse. Need something faxed? Ask the nurse. Need the number for McDonalds? Ask the nurse.

How many people have died in the name of customer service?

So what can we do? Here are some things I've thought of. I'm sure others have mentioned these ideas before.

We need to unite as nurses. We need to stop thinking that nurses in other specialties aren't "real" nurses and that we are only "good ones."

We need to have less focus on titles and degrees and more focus on quality.

We need to respect ourselves as professionals and act in away that is deserving of respect.

We need to stop trying to prove ourselves and just let ourselves be.

[anon456, BSN, RN]

Also lack of solid union representation.

What about states where there are no unions?

[brandy1017, ASN, RN]

A few years ago I was called into the supervisor's office for my annual performance evaluation. I got top marks in all but time management. The complaint was that I consistently clocked out late. Not too late, but about 15 minutes late on average. Because we are paid by the hour, this probably triggered the "needs improvement" factor. I told the supervisor the reason I clock out late was to make sure my charting was up to par. Most nurses on my unit already ate and charted through lunch, including me. But what I often did was chart the essential things in a timely fashion (meds, vital signs, I&Os) but save the other charting (normal assessments, position of the patient each hour, etc) for nearer the end of my day. I did this so I could give proper patient care, take time to listen to a patient or family's concerns, take time with my assessment (I have caught some pressure ulcer risks before they became actual pressure ulcers), provide hygiene care including a good shampoo of adolescent patients whose oily hair had been neglected too long, and organizing the room so my work can be more efficient, and it also gives a better impression to families when the room is organized. I told this to my supervisor, and she agreed that my priorities were in the right place. I tried to be more efficient with charting but still get out about 15 minutes late on average, and no one has said anything about it since. ;-)

Edited to add: I work pediatric critical care and step-down. Even though it's very busy and often sad, I love that I only have 2 or 3 patients at a time. It's a good area of nursing if you want to really work closely with patients and not feel too spread out over too many patients.

It's disrespectful and insulting to mark you down over 15 minutes late! That is just plain ridiculous!

[Rose_Queen, BSN, MSN, RN]

It's disrespectful and insulting to mark you down over 15 minutes late! That is just plain ridiculous!

If it were just an occasional thing, yes, I'd agree. But a consistently occurring clocking out late does speak of a need for better time management.

[Tenebrae, BSN, RN]

What about states where there are no unions?

What are the chances of being fired over a mistake?

If its fairly high, I'd say those states need unions however how to go about that I'm not sure. Our union is a national union with reps in each region

[Ayvah, RN]

If it were just an occasional thing, yes, I'd agree. But a consistently occurring clocking out late does speak of a need for better time management.

No, it doesn't. In case you missed it, she also wrote:

Most nurses on my unit already ate and charted through lunch, including me.

. This clearly speaks to lack of staffing. Its this "blame the nurse" attitude along with widespread understaffing that makes working conditions poor.