What happened to professionalism in nursing?

[NursebirdRN]

I have been a nurse for 14 years and have seen a striking and scary decline in the professionalism in nursing care and standards. I work at a very prestigious and award winning magnet hospital in Texas. New nurses ( and nurse managers) are so cocky and act like they are above the rules. Our nurse managers cannot even pitch in to do pt care if needed either due to laziness or lack of skill- I think it's both. My unit in particular is small and has a lot of problems. There is a lot of arguing, no one wanting to work, patient complaints, racial division and so much more. I have been to management, contacted the anonymous hotline to share things such as racism, nurses not providing adequate patient care, false documentation- not actually performing assessments but documenting them before a patient is even seen. I have been interviewed by human resources a few times and was honest about the happenings on our unit but feel like no one actually cares because nothing has been done. Managers joke and laugh with the problem nurses and it appears that those few nurses get away with everything such as coming in late numerous times, calling in sick and posting on social media the activities that they are doing after calling in. I love my job. It's a unique opportunity and that's what is holding me there however it's definitely affecting my mental health. I feel almost panicky going to work daily. I have no idea what else to do! Please help.

[Davey Do]

Yeah. I hear you, Nursebird. And, welcome to AN.com!

Sometimes I think the times have changed, and then other times I think it may be me.

In adhering to the belief that my happiness is not a result of what others say or do or what goes on around me, that my happiness comes from being at peace with myself, I adhere to my own standards. I believe my standards meet or excel those of my place of employment.

Besides, I cannot change another person. I can only change my perspective.

The best to you, Nursebird!

[HouTx, BSN, MSN, EdD]

Can you transfer to a different department with a more mature & positive culture? I find it shocking - in today's world - that any organization would turn a blind eye to charges of racism. That's not an organization in which I would want to work.

[Pangea Reunited, ASN, RN]

I have been a nurse for 14 years and have seen a striking and scary decline in the professionalism in nursing care and standards. I work at a very prestigious and award winning magnet hospital in Texas. New nurses ( and nurse managers) are so cocky and act like they are above the rules. Our nurse managers cannot even pitch in to do pt care if needed either due to laziness or lack of skill- I think it's both. My unit in particular is small and has a lot of problems. There is a lot of arguing, no one wanting to work, patient complaints, racial division and so much more. I have been to management, contacted the anonymous hotline to share things such as racism, nurses not providing adequate patient care, false documentation- not actually performing assessments but documenting them before a patient is even seen. I have been interviewed by human resources a few times and was honest about the happenings on our unit but feel like no one actually cares because nothing has been done. Managers joke and laugh with the problem nurses and it appears that those few nurses get away with everything such as coming in late numerous times, calling in sick and posting on social media the activities that they are doing after calling in. I love my job. It's a unique opportunity and that's what is holding me there however it's definitely affecting my mental health. I feel almost panicky going to work daily. I have no idea what else to do! Please help.

Is it possible that you're too involved with what other people are doing? I don't care which co-workers call in sick, or why. I don't worry about when they do their assessments on their patients. And I'm certainly not monitoring their social media in an attempt to trip them up.

My advice would be to address issues that affect you, directly, and not worry about the other stuff. A co-worker who's consistently late and causes you to have to stay late would be a legitimate complaint, for example.

It sounds like you want to be in complete control of this unit, but that's not your role. Your constant and varied complaints probably make you seem like more of a problem than someone who's trying to solve a problem.

[jadelpn, LPN, EMT-B]

I am sure that back when you began your career, the expectation was that you were a professional nurse, with patient care being the #1 priority above all else. Managers to DON who would take the time to come onto the unit if needed, to brainstorm about how a patient could function going forward--a true team.

Now, doesn't matter how many bells, whistles, and the like a facility has. Healthcare is a business. The business is making the most profit for the least amount of output. Schools seem to be teaching new nurses how to be business people, and not so much on the clinical aspect of things. Just because one can discuss Evidence Based Practice until the cows come home doesn't mean that a nurse is in any way, shape or form ready to practice it. That is why they keep the nicer of the crusty old bats around--to teach enough so patients don't die on anyone unless they are supposed to.

They really don't seem to care if you actually touch a patient (ewwwww, you have to TOUCH people?!?!?!) as long as boxes are checked. And that you are extraordinarily lovely to patients. And use key phrases and words so that those little surveys are filled out correctly (to get the most bang for the buck).

I think back to my first DON, who is at this point I am sure is turning over in her grave at the state of nursing practice today. Once a nurse manipulates a patient into how they are going to fill out those surveys, you really just have to sit in front of a computer and check boxes....oh and run around to fluff pillow.....x about 8 or so, as even if one is "super nurse" there is that pesky medication pass thing....

[TheCommuter, BSN, RN]

I think our work environments are heavily influenced by the types of nurse managers who oversee the operations. After all, the bottom is affected by the top.

If management allows a lack of professionalism, it pervades all aspects of the unit.

[llg, PhD, RN]

It sounds like you want to be in complete control of this unit, but that's not your role. Your constant and varied complaints probably make you seem like more of a problem than someone who's trying to solve a problem.

I totally agree with this. The OP's observations may be 100% accurate and her unit may indeed have a bad problem with its culture. But the OP needs to think about what her role is in this situation. If she wants to be a "mover and a shaker" to fix everything, she probably needs to advance in her career to a position with more authority.

We can't control everything in life -- and we need to realistically assess our situations and make realistic choices about our responding to things that we don't agree with.

How does the classic "Serenity Prayer" go?

"May God grant me the strength to change the things that I can change ...

to accept the things I cannot change ...

and the wisdom to know the difference."

Doesn't it go something like that? It's very applicable in this case.

[NOADLS]

OP, it sounds like everyone is having a good time except for you.

[gonzo1, ASN, RN]

I hear you Nursebird and feel your pain. I work on a really small unit too. It seems like the nurses rush through all required pt care tasks in order to get back to FB or Amazon as quickly as they can. There's a lot of sleeping too. It used to piss me off to the point that I went and got the same job at another institution and wow, it's the same exactly.

I'm at least ten years older than the next oldest nurse so there's a little bit of a generation gap maybe.

At one job I had the CEO walked through the unit ( a big unit) and reported to our director that not one nurse looked up at him as he was going through, or acknowledged his presence. He said everyone was reading a book, or playing on the internet or their phone. Consequently phones and internet usage was ordered to stop. It didn't, but people did start looking to see who was walking by at least.

I finally stopped paying attention to what other nurses were doing, for the most part and just do what feels right to me.

Of course if the racial problems are directed at you, or you are hearing them directed to someone else you have to speak up about that.

[paidmydues]

Honey leave the unit and/or the hospital. No job is worth the damage to your physical and mental health. Find something that works for YOU.....

[Cab411]

I worked at a facility for 9 years 2 years towards end of my employment management was absolutely awful. They hired a bunch of new big wigs and everything in the facility went under. The moral was down census was low people were being overworked CNAs were being forced to work overtime lots of calls to the state it was pretty bad. Plus I was supposed to get wound certified promised by my administrator two years prior and it never happened. I finally took a leap of faith and left and found a new job. I found a company that believes in supporting their employees and believes inpatient care Above All Else. I forgot what it was like to work for a company and have co-workers with such love and compassion for nursing and for the patients and their families. I feel so blessed that I left and I feel blessed that I found this new job and a new company that completely rocks. Sometimes it's just a sign that it's time to move on.