What do you think are the current major problems in nursing?

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Hello: I am a pre-nursing student taking my nursing theory class, and I must write a paper about what nurses think the major problems are in nursing today. So feel free to be as honest, open, and detailed as possible, and help me to get valuable information to write an educated paper. Thank you.

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Specializes in icu/er.

the constant battle trying to provide safe and honest care to patients in a enviroment that is constructed to achieve the maximum amount of profit for less than maximum and sometimes less than the minimum amount of resources.

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Specializes in ICU, CCU, Trauma, neuro, Geriatrics.

The primary issue that frustrates me the most about nursing is the lack of autonomy. We are expected to know nearly as much as the doctors but cannot function in a private practice setting as we rely on a physicians license for orders to treat a patient. Nurses don't have the tight knit respect and support for others in their profession that I would like to see.

On the positive side, we can go home and leave work behind us, physicians are responsible 24/7 for patients they take into their practice.

A general lack of respect from many patients which usually turns out to be a lack of education on what nursing really is. If your primary education about nursing is what you see on TV then you probably won't think much of your nurse.

Lack of knowledge and respect from nurses toward nurses, if a nurse doesn't work in the same area of expertise as you and wants to learn in a new position or is pulled to a very different type of unit there is limited support. Generally nurses become catty and start standing in groups talking about the "stupid" nurse with 23 years of ER experience but doesn't know a darn thing about discharging an orthopedic patient to home. Maybe break up the chat session and offer to discharge that patient and maybe in return she might suggest a better way to deal with one of your problem patients.

New nurses don't usually get adequate orientation, a 6 to 8 week 1:1 is good, but don't just dump that nurse to grovel on her own at that point. It is going to take at least 2 years to organize your routine and bring your critical thinking skills up to independance level. Proper teaching of the teachers is the key here, I don't usually see that. If you have 4 or more years of experience you can orient in many facilities with no further training. The in-hospital nurse educators don't have anything even close to current bedside experience; if you are going to offer me continuing education you had better have a good idea of what I do on a daily basis and what I need to continue to care for my patients.

Last but not least, facilities pushing the experienced nurses out of the way instead of utilizing them. This is one of the stupidest cost-effective measures I have seen so far in the health care system.

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Low staffing levels, higher acuity patients, older patients, obeser patients, shorter stays r/t reimbursement levels, legislators ruling health care decisions.

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Specializes in CMSRN.

Unbalanced nurse:Pt ratio's. Harder to perform requirements of job and also a risk on license when something is missed.

Also the silly requirements of nurses that represent that we are there to provide convenience (like a hotel) and not care to our pt's.

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Specializes in ICU, Psych.

In one simple word:

MANAGEMENT

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Specializes in CRNA.

Too many females

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

1. The lack of respect from doctors, patients, family members, coworkers, managers, and society

2. The increase in accountability for patient outcomes, without the corresponding increase in salary

3. The fact that new nurses are churned out into the workforce every 6 months, further saturating the job market for nursing

4. The general consensus that nurses are warm bodies who simply fill shifts

5. The low workplace morale that can often be observed at many healthcare facilities

6. The low self-esteems and passive aggression of some nurses

7. The increase in lateral workplace harassment

8. The public's very outdated perception of the nursing profession

9. The fact that there is a myriad of different ways to become a nurse (LPN, ADN, BSN, MSN, Ph.d)

10. The female domination of the nursing profession

11. The desire for hospital administrators to maximize profit margins, without regard to nursing staff or patient safety

12. The practice of recruiting new nurses, rather than the retention of highly experienced nurses

13. The expectation that nurses can "do it all" while working understaffed, and lacking supplies

14. The lack of integrity of some members of the interdisciplinary team (i.e., the admissions rep who will allow anyone to be admitted if the insurance is good)

15. The expectation that the nurse is also the customer service rep, bellhop, concierge, waitress, clerk, messenger, courier, pillow fluffer, and receptionist

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all of the aforementioned barriers, are real and very pervasive.

but in these past couple of weeks, i've noticed something even more concerning.

so many nurses are TIRED.

our souls have been sapped and our bodies, broken.

we are so very burnt out.

and it's all r/t what has been mentioned.

these past wks, more than ever, i have seen nurses breaking down, in emotional, mental, spiritual and physical exhaustion.

i do everything not to cry, when i see this.

where's my adrenaline when i need it?

i can tell you, it's not where it used to be.

lately, i have barely been getting by, only by 'doing'...

and not feeling, not reacting, not relating.

in some, there is numbness.

in others, there is despair.

so my question is, HOW do we face the challenges of nurses in healthcare, if the conditions that we meet, are killing us slowly, ea and every one of us.

there's so much to fight for,

and very little to fight with.

what then???

leslie

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1. Nurse patient ratios are to high. 1-7 or 8 or more is too high for the reality of nursing care today. These ratios and higher worked years ago because the acuity of the patient population was less and the expectations for what medicine was able to do was less. If a diuretic and lanoxin would not fix a heart it just didn't get fixed. There were monitors in intensive care but nowhere near a med surg floor.2. Administrators who at one time years ago worked as a bedside nurse think they still know what the bedside nurse faces today. Unfortunately they know how it was then but not now.3. Rapid turnover of the patient population. At one time in the not to distant past hospitals had a discharge time. If the patient was not out by discharge time they were charged for another day. There was rarely a discharge after that time(maybe 11am or noon). Now we are discharging almost 24/7 to home or nursing facilities. Makes all shifts busier.4. In a lot of hospitals charge nurses and "head nurses" have been done away with and there is no one for the nurse who is so busy she can't keep up to fall back on for help because all the nurses are usually in the same boat. Management sees those nurses as not pulling their weight but they could do sooo much to relieve some of the pressure and make all nurses life easier.

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Specializes in Medicine.

The way nurses are portrayed in Hollywood absloutely drives me nuts. No wonder why our patient's don't know a thing about "real" nurses because on Grey's Anatomy, House, Scrubs, ER, it's the Doc's that do everything. :banghead:

How nurses preech to our patient's to be healthy, yet many are extremely over weight, smoke, eat horrible food that our patients and doctors leave us, do nothing to keep our mind and BODY healthy.

How we are expected to wipe the dr's butts when they do something wrong and WE have to point it out to them, and make multiple suggestions regarding the plan of care.

How we are expected to watch our patient's be absloutely miserable to us because the Dr won't let them leave, but treats the doc with the up most respect. (I just had a pt with a 60 beat run of Vtach and couldn't understand WHY he couldn't go home?!?!)

How we are expected to take verbal/physical abuse, sexual remarks and other inappropriate events and not "judge" these people.

That is just some of the things that are wrong within the world of nursing. I agree with everyone elses statements.

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Specializes in Flight, ER, Transport, ICU/Critical Care.

Overall:

Lack of RESPECT.

From -

patients

families

visitors

the public

administration

doctors

ancillary staff

other nurses

AND lack of self-respect for ourselves at times (it is hard to look in the mirror at times, with all the "compromises" I've had to make to keep doing this job)

;)

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