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

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.

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.

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

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.

In one simple word:

MANAGEMENT

Too many females

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

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.

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.

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.

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)

Everyone has made some very valid and pertinent points.

I would like to add:

Lack of a cohesive nursing organization with strong leadership able to affect and speak about nursing as a whole. The media wants to quote us... but they never know where to go.

Facilities who care about nurse recruitment, but not about nurse RETENTION

Lack of funding for nursing education and the 39% of qualified BSN candidates (according to NLN) turned away last year

Dismal faculty salaries

Importing nurses from other countries instead of strengthening our nursing infrastructure

etc.

You should have more than enough paper topics by now...