What would you change about Nursing to make it better?

[RNman09]

After reading many posts here on AllNurses, I read about nurses eating their young, no respect, not enough teamwork, lazyness, not enough clinical time, Nursing shortage (yeah right),etc....So I'm asking what would you change about Nursing to make it better? You can vent, post nothing or write something maybe your idea can help another RN come up with a solution to a problem.

[nursemike, ASN, RN]

I understand the rationale for a BSN entry level. I don't agree, but it has some valid points. May I suggest, though, that the matter has been discussed at great length, and can still be, on the ASN vs. BSN thread? Perhaps it would be more useful on this thread to look at some of the other issues.

On another thread, we discussed the idea of an internship for GNs, maybe something like 6 months at half-pay, as a way of reducing the pressure during the transition from student to nurse. I'm less enamored of that than I was, at the time, but I still think something of the sort might be helpful. Maybe three months would be enough. However we do it, I think we need to find a way to let new nurses learn the ropes without getting too scarred up in the process. I doubt we can ever completely do away with burnout. Some people may just not be cut out for this life. But I think the seeds of burnout are often planted in orientation. If your first few months teach you to dread nursing, how likely are you to learn to love it. And, again, I think a supportive environment for new nurses is something we can implement immediately, without an act of Congress, that would be a big step toward improving all our lives.

[firstyearstudent]

Outside of the obvious of better staffing (ratios), the hierarchical nature of healthcare needs to change. Nurses need to practice their specialty, not just fulfill MD orders/dispense meds. Also the culture needs to improve. Nurses need to be supportive of each other and be supported by administration and other providers (doctors).

[RNman09]

i think a supportive environment for new nurses is something we can implement immediately, without an act of congress, that would be a big step toward improving all our lives.

also the culture needs to improve. nurses need to be supportive of each other and be supported by administration and other providers (doctors).

unfortunately our nursing profession has been imbued with the practice of intimidation, harassment (constructive criticism as some want to call it in some cases), and a hostile working environment stemming from threats that it might just as well take an act of congress to change this practice.

[lee1]

Have any of you ever read the book "Code Green" Money-Driven Hospitals and the Dismantling of Nursing (The Culture and Politics of Health Care Work) by Dana Beth Weinberg and Suzanne Gordon

Read why your top Nursing Administrator has problems, what happened to the politics of nursing within hospitals.

There is another book also,

Nursing Against the Odds: How Health Care Cost Cutting, Media Stereotypes, And Medical Hubris Undermine Nurses And Patient Care (The Culture and Politics of Health Care Work) (Paperback)

~ Suzanne Gordon

(Author) "It was the first week in July at the Beth Israel Hospital in Boston and a new crop of interns has just arrived in the..." (more)

Read the reviews on Amazon.com

[RNman09]

I haven't read those books but after reading some of the pages Amazon allows for reading I think I'll be buying them. The books seem interesting, thanks for sharing and suggesting those books-- lee1

[NickiLaughs, ADN, BSN, RN]

Less paperwork with the ability to focus more on the patient.

[RNman09]

The media (and some nurses) potrayal of male RN's and the Nursing profession all together. Gaylord Focker, Nurse Jackie, Hawthorne, etc...

[KParkerRN06]

less focus on cleaning up poop....more focus on using our critical thinking abilities!

[nursemike, ASN, RN]

less focus on cleaning up poop....more focus on using our critical thinking abilities!

This is not meant as a flame to the quoted post, but I wonder if it might be a reflection of one of nursing's problems. It seems to me we have something of an identity crisis. On the one hand, I certainly don't advocate we become overpaid CNAs. On the other, if we aren't about direct patient care, what are we? I have to admit, I have a prejudice, here. The practical side of nursing--passing meds, changing dressings, and, yes, cleaning poop, is what most appeals to me. Documentation, staff meetings, careplans and such are the price I pay so I can spend time looking at old ladies' butts. Well, perhaps I exaggerate, but the time I spend in rooms with patients is the food that makes the rest worth doing.

I don't want to dismiss critical thinking, and I don't mean to put words in the poster's mouth. I'm responding more to some nurses I've seen who seem to take that idea to extremes and see themselves as some sort of executives. In some cases, these have been nurses who haven't mastered the basics, but have been taught in school that they have to look at the big picture. I've been in that position at times, myself, although I think the bigger challenge, for me, was learning not to be so task-oriented that I missed the big picture. But I've also seen a few who, it appears to me, didn't want any part of the icky stuff. One guy, I recall, liked to wear a white lab coat over his nurse's uniform. He was honest in his distaste for bedside nursing, and after six months or so got a job as a DON in LTC. Good for him, I guess. Somebody has to do it, and I sure don't want to. But I think maybe that's why I tend to hearken back to my trades background when people talk about nursing as a profession.

When I was a carpenter, not many of my customers could afford architects or engineers. I did a lot of problem solving, and I enjoyed it, but most of my "blueprints" were sketched on scrap lumber, because my main job was nailing boards together. I liked figuring out how to add a porch that would be structurally sound and look good, but I had no desire to spend all my time designing porches.

So I get a little uneasy when people want to talk about the profession of nursing and standardizing the entry route, because I don't like clipboards and I have no desire to be a doctor. In truth, I don't clean much poop on a typical shift, and I rarely do baths. Most often, the aides get to do most of the fun stuff--so much so, that they don't always realize it is the fun stuff--because I'm too busy with the boring crap.

I wasn't a nurse in the days when it was a position of menial servitude, and I'm not a bit nostalgic for them. And I'm not at all sure, with the level of care patients often need, that skilled tradesperson is quite adequate a level for today's nurses. And I truly don't mean to accuse anyone on these boards of anything. But I do worry that there seems in some quarters to be a desire to redefine nursing to such an extent that it's no longer nursing. There's a school of thought that LPNs aren't nurses. I can't help but believe that those who hold that view don't really want to be nurses. What LPNs do is a big part of nursing. There are other, important parts that LPNs aren't allowed to do, but RNs can, and on the whole I think that's appropriate. Many of those things are things many LPNs probably could do, but it isn't unreasonable to want documented proof of compentency. But, to me, a role for RNs that excludes the parts LPNs do just wouldn't seem much like nursing.

[Kayartea]

Push through legislation to allow billing for nursing care. As long as paying for nurses is lumped in with the bed charge we will continue to be seen as the most expensive, most troublesome department and as not contributing to the bottom line. Nurses are the reason patients are admitted to hospital (face it, they see less of the MD while inpatient than in an office visit and nurses operate most of the specialty equipment that is the reason for admission), but no one who is not a nurse really recognizes the vital job we perform. Until nurses or hospitals can bill for our work we will never be recognized as the educated professionals we are, or treated as professionals either.

[allthesmallthings]

1) Connect my brain to the computer so that I can TRULY chart as I go! I could also automatically "look up" pt info in the computer through my brain-computer link.

2) Get out of this litigation-focused culture. Ok, this isn't really the fault of nursing or medicine, it's because of the general Western litigation culture, and I know that lots of professions have to deal with avoiding lawsuits, but I have to stop myself from rolling my eyes when I'm told to take the time to do something to avoid a lawsuit that shouldn't be filed in the first place. Seriously, this is medicine, and management tells me with a straight face to spend as much time filing bull-s as I do actually taking care of my pt? It's ridiculous that we're simultaneously told to care for pts with compassion, selflessness, and lack of judgment, yet at the same time view them as walking lawsuit bombs. Again, I know, not the fault of nursing.

[belgarion]

1) Connect my brain to the computer so that I can TRULY chart as I go! I could also automatically "look up" pt info in the computer through my brain-computer link.

Interesting idea but but you better put a filter in. I mean, do you REALLY want some of the thoughts that go through your head when dealing with certain patients to be preserved for all time?