What would you change about Nursing to make it better?

southernbeegirl, BSN, RN · Dec 21, 2009

Are these two quotes not contradictorary? Put down newer nurses who want to pursue higher education...whatever it may be and then the next quote you want to say "not put down someone else's motives" for being a nurse? What give you the right to input your opinions on someone else's future goals and aspirations?
Who's to say the new nurse may not be a great CRNA, midwife or ER nurse once they get experience under their belt? Everyone has to start somewhere in life...Remember you were once a newly graduated nurse w/no experience as well.

i think you missed the whole point of ruby's post

RNman09 · Dec 21, 2009

I would also change the "client and customer service" idea hospital administrations have come up with. It is a hospital and in hospitals you go to get care when ill.

Ruby Vee, BSN · Dec 21, 2009

are these two quotes not contradictorary? put down newer nurses who want to pursue higher education...whatever it may be and then the next quote you want to say "not put down someone else's motives" for being a nurse? what give you the right to input your opinions on someone else's future goals and aspirations?
who's to say the new nurse may not be a great crna, midwife or er nurse once they get experience under their belt? everyone has to start somewhere in life...remember you were once a newly graduated nurse w/no experience as well.

go back and read my post again; you're obviously missing something. i wasn't putting down new nurses who want to pursue higher education; i was saying that perhaps they need to master the basics first. and that someone who is trying to help them master the basics isn't "eating them" by giving them negative feedback, but rather attempting to help them to become a great nurse by getting good experience under their belt.

General E. Speaking, RN, RN · Dec 22, 2009

Get a nurse friendly computer system for charting. We are not computerized so until then I would like ONE fold out sheet that follows the patient from the ER or OR to the floor so I do not have to search for the answer or sound like an idiot when I ask the same question that the ER nurse just asked 30 minutes ago.

I would like to pay the CNAs better. Some of them work their tails off and I would like to keep them around. They are invaluable and enable me to be a better nurse.

I would like a rolling Pyxis that goes down the hall so I do not have to keep making trips back and forth all day long. Better yet, I would like the pharmacy to fill locked boxes in each of the patients rooms with all their meds.

I would like to allow only so many doctors at the nurses station at a time. I want a roped off area (like at the movies) where the docs are waiting their turn. Also, a max of 3 orders at a time- if you must write more then you have to go back and get in line.

Implanted chips in the patients with all their data/hx so I can wave a wand over my patients head (like they do to check pacemakers) and get the info I need. Hopefully this will stop the 45 minute heated debate that goes on (while trying to do an admission) between cousin Bertha and Uncle Ebner about what kind of surgery Momma actually had 4 years ago or what that little green pill is that she takes 4 (or is it 3?) times a day...

(The last ones are a fantasy... hey! a girl can dream, can't she?)

Wise Woman RN · Dec 22, 2009

1. Get rid of the Joint Commission.

2. Let nurses be nurses.

3. Put the reins on Medicare's power.

4.Require that any documentation that is done on any given procedure, action, or response to same be only written once.

5. Provide clearly written information to patients and families that a hospital is NOT a spa or hotel.

6.provide administrative support to reinforce all of the above...

LOL

skittlebear · Dec 22, 2009

The biggest thing I want to see change (on top of a list of others) is to allow nurses the ability to do a job without the extra BS. I can't seem to figure out why new paperwork is developed and adm thinks it is better.
For example, hourly rounding. It is not a part of the permanent chart (at least not at our facility )and I already chart that I have seen the pt or done some care on the permanent charting anyhow, so why would I need to initial and fill out another paper. Yes I hear it is to reduce falls. It is just paper, nothing magical. You can fill it out without actually seeing the pt too.

:yeah:I could not agree more with that!

I would also like to see a better nurse to pt ratio...especially in nursing homes. 1 nurse to 30 patients or more is downright scary if you want my opinion. I haven't heard of a nursing home yet in my area that has an acceptable nurse to patient ratio.

belgarion · Dec 22, 2009

go back and read my post again; you're obviously missing something. i wasn't putting down new nurses who want to pursue higher education; i was saying that perhaps they need to master the basics first.
i agree that new nures should learn to crawl before they take off running.
and that someone who is trying to help them master the basics isn't "eating them" by giving them negative feedback, but rather attempting to help them to become a great nurse by getting good experience under their belt. [/quote
the problem is that many of these nurses who are trying to "help" through negative feedback have no clue as to how to provide constructive criticism. their "help" turns into a lecture, the main theme of which is how stupid the young nurse is. instead of "helping" them. they are trying to destroy their confidence. i think this is where the "nurses eat their young" comes from. just an opinion based on obseravation.
]

Not_A_Hat_Person, RN · Dec 23, 2009

Act more like cops! Think blue wall! I always see nurses looking to throw other nurses and staff under a bus! I am not saying big mistakes should be cover up. However we should look out for each other and if we see something coming down the line that does not look right help your brother and sisters out before they get jammed up!

When did the blue wall become a good thing? There's a reason people trust nurses more than cops.

It's ridiculous to chart everything in three diferent places, especially now that computer charting is becoming the norm.

Yes! At my job, PRNs have to be documented in 3-5 places (PRN sheet, pain flow sheet, narcotics sheet, chart, communications log).

My suggestions:

Get rid of rotating shifts.

Mandatory semester or summer practicums for nursing students.

A national nursing license.

More new grad mentoring by experienced nurses.

A professional uniform; not a white dress, hose, shoes, and cap, but some equivalent to a doctor's white coat. Different uniforms for non-nurses.

RNOkie · Dec 23, 2009

I would like to loose the totally useless care plans. I have never understood their value in the first place. (except for taking up valuable time that would be better spent in other areas, like, oh i don't know, SAVING A LIFE")

patrice meursault · Dec 23, 2009

There are a few things I would like to see change.
2) Mandate a bachelors degree as the minimum requirement for all entry nurses.
3) Cut out all the additional educational titles seen on name badges. Ex: Gaylord Focker RN BSN LMAO ACLS BLS CCRN ACRN CDDN CWOCN CRRPTC. Really, is all this crap necessary? I have always found it annoying. How about Gaylord Focker RN.
4) Get rid of all the waste of time classes (cultural diversity, theory etc) and fill that space with some science that will ACTUALLY BENEFIT YOU in the real world of nursing. Unfortunately, the BSN programs tend to fill their students with more of this useless crap than the ADN programs.

Wrong on the BSN theory. Nursing went downhill once the diploma schools started closing. A few classes in art history or ukranian egg decorating does not make you a better nurse. And the theory of having a BSN will improve the image of nursing is hogwash too.

We are our worst enemies. We are a dysfunctional lot and we ourselves are responsible for the plight we are in.

Why cannot we organize and become a unified voice. We could become a powerful lobbying organization and actually have a say in policy on a governmental level and also setting standards of practice.

Instead we bow to JACHO and other State regulations that only interfere with patient care and actually take nurses away from the patients as we fill out silly form after silly form.

Then those nurses with the numerous letters behind their name will call for meeting after meeting after meeting, to come up with another stupid committee after stupid committee to create more needless paperwork. Those in the high heel brigade look out for themselves and their jobs (God forbid they have to touch a patient) and are so far removed from reality that they have no clue or have forgotten what the nurses in the trenches are going through.

That is what i would change.

RNOkie · Dec 23, 2009

i went to school for x number of years to become a nurse, i do my job competently and present myself professionally. so stop trying to mandate what color of scrubs i wear to work. (if the problem is that ancillary staff who don't do actual patient care are also wearing scrubs and the patient cannot tell them from the nurse, mandate what the ancillary staff wears -- or doesn't wear.)
throw the press-gainey business away with the trash, and return our focus from "customer service" to "patient care" where it ought to have been all along. this business of pillow fluffing and beverage fetching while someone else is coding is ridiculous, and the management types who pander to this sort of craziness at the expense of safe nursing don't have a clue. perhaps they should be finding jobs in the customer service sector and let us get on with the business of health care.
new nurses need to understand that it is not their "right" to "follow their dream" of being a crna, nurse midwife, er nurse or whatever if they cannot master the basics of nursing. people who give them negative feedback aren't merely trying to backstab them or eat them -- many of those people are genuinely trying to help them.
let's reinstate and enforce visiting hours. we had them for a reason, and it was a good reason. for everyone that complains that it is their right to be at granny's bedside to ensure that her nurses do a good job of pillow fluffing, hand holding and tear-soothing, i explain that it they're sitting there, that's their job, not the nurse's. when you're sitting at granny'd bedside, confine your complaints to the legitimate ones. (hint, it might be something like "granny couldn't breathe and the nurse didn't do anything because she was fetching a diet coke for the patient in the next bed." and not "granny had to wait twelve minutes for her tea because all the nurses were in the next room watching some old guy get shocked.")
as nurses, we all understand about cultural diversity and let us not be ethno-centric. but let our patients also realize that we, as americans, have our own culture and the nurse that inadvertently violates your customs may be a perfectly fine nurse out to save your father's life, not a whore out to soil his person with her touch. and there are some customs i absolutely cannot respect, however non-pc of me that might be. do not expect to backhand your wife across the mouth in my presence because in my culture, the culture of the country whose soil you've chosen to be standing on, that's a crime.:yeah::yeah::yeah:
and finally let us all worry about our own motives for become nurses, and not put down someone else's motives. i don't care if joe's in it just for the money as long as he helps me lift and turn and clean up my patient when he's working beside me, and leaves my patient clean, comfortable and the work complete when i follow him. nor do i care that sue's motive was a calling as long as she's there to help when i need her, lets me know when she needs help in a timely fashion and doesn't bore me or waste my time blathering on and on about her calling and how god has put her in this place so she can convert the sinners.
i'm sure i'll come up with more, but it's late and i really should be attempting to sleep.

oh my!!!, ruby vee, you truly are my hero!!! i wonder if we are long lost cousins or something because you took the words right out of my mouth. :yeah: :yeah::redbeathe:redbeathe

Multicollinearity, BSN, RN · Dec 23, 2009

1) BSN minimum entry (FYI, I have an ADN)

2) Safe nurse-to-patient ratios based upon evidence

3) Wave magic wand to fix behavioral problems with the passive-aggressive/unprofessional nurses