What can we do to make nursing job better?

piscesguy · Dec 25, 2009

I am glad that there are people talking about how to make it better. I am a poor sucker who may be entering the field, so what do I know, but I'm glad there are people thinking like this and talking about it. Its a start.

thanrye8710 · Dec 25, 2009

Thanks for bringing this topic up. I agree with you about the staffing solution... A law mandating that will be very useful. I believe that with more man power, issues such as work loads will be resolved... But let us not deny the fact that everything today is business... It is not only the money but the balance in providing quality care. And quality of care does not depend on man power alone. The survival of a facility and the ability to provide quality care also depends on how much they earn and the budget for improving not only the facilities but also in updating the knowledge of its staff to the changes of the dynamics of nursing. We have to understand that some facilities have no choice but to limit the number of staff inorder to survive this hard economy. If every nurses will be willing to cut their salary to welcome more staffing, it would work well...but it is impossible...

As of now, my best answer to your question are: Time management, Do your best in everything, and always try to help other (like co-leagues that have hard time in finishing tasks).. Find ways to improve your simplify tasks... make your work place an enjoyable place... a happy attitude in a work place truly helps and affects others positively.. to the administrators or managers, you must recognize the contributions of each staff is performing in providing quality care. bonuses and other activities will help encourage staff to work well and at least alleviate the stress of their work load for once in a while.

It's been 3 years since i finished my BSN at my country (philippines). I haven't work yet as a RN because the processing of educational records from my country really takes time. While waiting for the GO signal to take NCLEX here, I worked in a Health Care Facility as a Patient Care Tech and I saw how hard are the work loads the nurses are doing. Most of the time it is "PAPER CARE" not patient care. I had asked my self the same question "What can I do to make the nursing job better as a Patient Care Tech and when I become a RN?"... What I did, utilized my knowledge in doing my work as a patient care tech. I did my best to render care to patients and assists nurses in any way that I am allowed to. And I always have positive attitude and always smile. I encouraged my other patient care tech to do their best and help one another. Even though I am not a RN and I think I have an Idea that would help, I would ask the permission from the assistant Director of Nursing to discuss my idea and oftentimes they listen. The result, our floor became a good one.. The stress from work lessens.. Did received positive feedbacks from patients and from the director of nursing. In less than a year from that facility, I had trained almost all newly hires patient care techs and i will give emphasized on how to make life in work easier despite of the heavy duty. Currently, I am reviewing for my NCLEX.

Love your work. Always have a positive attitude. SMILE. Do your best in providing patient care. Manage Time efficiently. If things are hard, try to improvise things and discover/apply new techniques that would help but always be mindful of the laws, scope of nursing, and the safety of patients and others including yourself.

Making a law that will limit the patient-nurse ratio will take long time to be implemented. At least for now, let's start doing things that we can to make nursing job better.

nerdtonurse?, BSN, RN · Dec 26, 2009

From my perspective in a rural hospital:

1) absolutely more staffing -- and don't just give us more nurses to take away telemetry techs, ICU techs, lab techs, etc. Look at the manhours required, and fill them by putting the appropriate person in the job, not just having nursing do everything including EVS.

2) If you have an ER, have a "fast track" -- that is, a 24 hr non emergency care room so that when you get the "cold sniffles n/v/d" group, you send them there, and keep the ER beds open for the folks with MI/CVA/HTN emergency/trauma. We're not going to fix people coming to the ER for nothing (and by that, I mean things that the average person would treat with OTC meds), so let's give them a place to go that's not an ER bed. I see a LOT of ER nurse burn out because they can't work on a really sick person due to all the non sick people who are pitching a fit about an earache.

3) Assign patients by acuity, not by open bed space or 'balancing the load across the shift'. If I've already got 2 terminal patients who will probably pass within my shift (or absolutely within the next), a screaming off the chain schizophrenic who the family wanted to have Christmas without Dad, so let's check Dad in with a complaint of "seizures", a possible new onset NSTEMI, please don't give me a person who comes in with the worst coag lab values I have ever seen because the poor demented thing couldn't remember if he took his Coumadin, so he took it again...and again...and again and is getting a gallon of FFPs. Aside from just the logistics of trying to look after really critically ill people who could have died in a heartbeat not to mention a crazy person screaming obsenities and attacking the staff that I couldn't calm down after enough Ativan/Haldol/Seroquel to calm an erupting volcano, it's emotionally taxing when you're watching two people die on Christmas Eve. And yes, that was how I spent night before last. Wouldn't it have made more sense to give one of my really critical people to someone who had self care patients, instead of me having people with neuro checks q2, restraint protocols, seizure protocols, flight risk, and a guy going into respiratory failure? I've had a day off, and I still feel worn out.

4) If I'm busting my butt for you (see #3), don't give me a bunch of BS about not clocking out on time because one of my patients was bleeding to death at the time. That's a great way to get me to never clock back in. And if I had left on time, you'd have jumped my tail about "leaving day shift in the lurch." Passive aggressive behavior should be grounds for immediate termination. And I don't mean the "you're fired" kind of termination, either.

5) If you can't give raises, give time off. Make me feel like you appreciate what we do, not stand up in a meeting and say, "any time you're not happy, remember we'll have new grads coming at the end of the semester." And yes, the person who was told that in response to question about patient safety in the ICU did quit. Wonder if they were surprised?

6) This can be a rewarding job, or a completely horrible one, based off what's gone on your prior shift. If you've had a new just off orientation 2 weeks nurse who had a bad shift (patient death, high acuity, just a bad, bad shift), give him or her a break and don't give them the most tore up people on the floor. I've seen a lot of new nurses burn out because people just kept pilling bad patients, bad families, bad docs on them, while they see the rest of the shift lounging in the nurse's station, and they don't get help and support. Don't give them a free ride, but you know if someone's had a crappy couple of shifts -- give them a break.

Finally...treat each other with the same respect and compassion we are expected to give the patients. If you want to have nurses, work as hard to keep them happy as you expect us to do to keep the patients happy. That's not too much to ask for, is it?