As most of you know i'm newly qualified and already i'm thinking about leaving the hospital setting and going into community. As a qualified staff nurse it is a big eye opener to what we nurses have to put up with. The other day my ward was completely full (23 bedded ward) and there was myself and one senior member of staff and a HCA. Doctors were asking us to do things, phones ringing, patients requiring tests in other departments etc......
Why didn't we get agency you may ask. Well the ward can not afford this. There was no other paed nurse available to help. With the winter season very close i am dreading it. How are we suppose to carry out good patient care? The Government need to do something .
The thing is i love my job but the conditions are so bad at times. I'm sorry to say i am seriosly thinking about going back to uni and doing my degree in Health Visiting. Do any other nurses experience this?
What is so frustrating to me is how nurses always seem to come up lacking... to the general public, to administrators, to doctors who disdain our knowledge base in comparison to theirs.
The general perception is always to the tune of nurses not doing enough....WE 'should' have done more.......does nobody notice/care we are overworked, with low morale? That we are human and can only accomplish so much in a given period of time with the resources we are provided??
Sometimes I feel like a helpless slavelaborer caught in a punitive system I cannot influence. Lord PLEASE influence my huby to get us back to a union area where I have a LITTLE say...
I feel your pain. I often find myself trying to juggle way to many high acuity patients due to not enough staff. It is scary because you jeopardize your Nursing liscense implementing unsafe practice, but when a patient is presented in the ER, (or anywhere)you can't say, "Sorry ... we have reached our safe nurse/patient ratio."
We have had this same discussion time and time again at unit staff meetings ... but nothing seems to get done. As soon as more nurses are hired, more quit - so it is just a continuation.
Guess thats why more and more nurses burn out and choose another profession (em hem) I mean vocation.
I am a hospital chief operating officer in San Diego (hey sjoe!!) and have been a RN since 1985 with many years of staff nursing experence in several clnical settngs.
In my humble opinion the root of the problem is greed. It is OK to make money and find ways to increase profits but healthcare has gone into the realm of a pathological pursuit of higher profits. The main culprit these days is the for-profit healthcare "industry" and being publicly traded on the NYSE. Healthcare is an industry that just shouldn't be publicly traded because the situation simply breeds more actions on the part of corporations to increase profits and we are experiencing the results. Higher rates by healthcare providers have caused the feds and states to try to control spending by forcing lower reimbursements and commercial insurers have followd suit. It is a mess.
Guess who is bearing the full weight of the squeeze----nurses are!! Why? You guys have said it, because nurses are seen as an expense that must be "managed." It is the idiotic (in the case of healthcare) business model that you go after cutting costs on your most expensive line item expense, in the case of hospitals that would be the nursing department.
What is the solution? Nurses being removed from he hospital payroll and paid directly by the payor. Will this happen? Probably not because it would force an major upheavel in the current system but it is possible. In the meantime nursing will have to demonstrate, with hard objective financial data, that hospitals will not make the profits they are enjoying without good quality nurses and to have that you have to PAY THEM well and treat them decently
Specializes in Med/Surg, ER, L&D, ICU, OR, Educator.
Originally posted by mattsmom81
...nurses always seem to come up lacking... to the general public, to administrators, to doctors who disdain our knowledge base in comparison to theirs.
The general perception is always to the tune of nurses not doing enough....
That we are human and can only accomplish so much in a given period of time with the resources we are provided??
...caught in a punitive system I cannot influence. QUOTE]
Nurses may well be in a punitive system but I believe we can influence it. Much of the "oppression" comes fron within the nursing department itself, that is, among ourselves. For some reason there are many directors of nursing and nurse managers that have a management style of heavy handed discipline or as the old term describes, a "battle ax" nurse. Perhaps this stems from the old traditional model of nursing education where it is about focusing on shortcomings and not necessarily on strengths, not sure. Nurses are very quick to criticize one another and point out fault. Nurses are also very quick to write up their coleagues and openly accuse them of poor practice or laziness and the like. We do not see this with physicians and a much lesser degree in other allied health professions.
As the largest number of healthcare professionals we have immense power and potential to reshape healthcare but we are not doing it in a positive way. We are reshaping things definitely. In the ranks of administration and among other allied health professions nursing has gained the reputation of being very difficult to work with, irritable, argumentative, critical, contatnly complaining and the main contributor to poor morale in the hospital. Why is this?
We are not the helpless, downtrodden victims that seems to be the prevailing attitude. If nursing (as a whole) can remove the emotion and focus on objective reality of the problems with workplace conditions and quit pointing the finger at everyone else and assigning blame then perhaps we could develop an effective plan of action to address our conerns that would bring about real change.
Hospital administrators, greedy or whatever they may be, are well aware that they must have good nurses if they want to provide good care and increase their profits. We cam actually use the very things we hate about hospital management to our advantage but we will not succeed with an attitude of anger and bitterness. We have effectively separated ouselves from the "team" and if we will demonstrate that we are "on the team" and provide objective data to show how we will contribute to making the hospital successful we will see conditions improve.
Managing a hospital is really all about sales. The administration is charged by their bosses with running a business, lke it or not that is reality. in any business you must have a product and you must sell that product. In the hopital we are primarily selling nursing care. Naturally it is in the management's best interest to have excellent nursing care. But the human element can't be ignored, if you approach management with an attitude of bitterness you will provoke resistance and likewise with management approaching nursing. For the purposes of improving working conditions for nurses it must be demonstrated on the premise of financial improvement, administration does not speak the humanistic and patient care focused language that we as nurses speak. Likewise nurses do not speak the hard financial data language that managemet speaks. Someone must give first to learn the other's language. I say we take the first step and present our ideas with objective financial data that links nursing care to patient outcomes to financial performane. I am convinced the proof is there.
This must be done on a grass roots level one hospital at a time and then we will see a snowball effect. Administrators are in a difficult position to meet the challenge of increasing profits to please the stocholders and boards of trustees that they answer to. If nursing will demonstrate how we can help administration will respond with more support. An antagonistic attitude from us will only perpetuate what we have now.
Nothing has happened to the Nursing Profession. We get treated like CRAP by senior management, the doctors kick us around and if something goes wrong it is ALWAYS the nurses fault.. Always has been; Always will be.
We are currently seeking a small payrise to keep us in line with inflation and you would think we wanted to be treated like management the way the Powers are bleating. Like the lady said it is a vocation and if we don't do it then all these unfortunate people that get ill will have no proper support
Not to be rude but what a negative, pessimistic, and hopeless attitude. Attitudes like this perpetuate the issues and will ALWAYS work to keep nursing as it is.
Specializes in LTC, assisted living, med-surg, psych.
I think ceecel.d is on the right track: If we learn to speak in language that the "suits" understand, not only might we gain some respect, we could earn a place at the table where the decisions are made.
Yes we must learn to speak the language. The attitude of being downtrodden victims is tired and pathetic. We are better than that and have more power than that.
Yeah, I think the LTC setting has declined with the Balanced Budget Act, and all of the Medicare laws, as the MDS Coordinator, I know first hand, it is all too easy to not really look at the patient as the patient, but as a dollar sign, No.......we don't want the Septic, we want the CVA.........
Recently I had a disagreement with our Social Worker about whether a resident should stay in Medicare or go to our Alzheimers unit.......(keep in mind Social Worker should especially be the resident's advocate)
This resident was very agitated, pulling her lap buddy off, taking Haldol injections, and very restless.........she wasn't going to Rug out very high either, I approached the SW and told her I felt it was in the resident's best interest to be moved to the Alzheimers unit(smaller, calmer atmosphere)
She disagreed w/ me saying that our Medicare unit didn't have very many people and our Corporate office was on them to get more Medicare residents in, I told her that I didn't care how much money we would receive, it wasn't fair to this lady to punish her, restrain her physically and chemically, if she would do better on the Alzheimers unit.........she didn't move that day, but after I pushed the issue, she was moved the next day, and guess what?
She did do better on the Unit and needed no restraints
It is so cruel, to keep these people where they don't want to be just for money, its cruel to forget about the patient and worry about the money.
When the Healthcare profession started focusing on money and not the patient or its staff, well..........that's what happened to our profession............
seems to me that in the mid eighties to mid nineties, healthcare was subjugated to the lawyers.......now , since the mid nineties, we are subjugated to the accountants...............neither which have contributed to IMPROVING healthcare
Always has been; Always will be.
mattsmom81
4,516 Posts
What is so frustrating to me is how nurses always seem to come up lacking... to the general public, to administrators, to doctors who disdain our knowledge base in comparison to theirs.
The general perception is always to the tune of nurses not doing enough....WE 'should' have done more.......does nobody notice/care we are overworked, with low morale? That we are human and can only accomplish so much in a given period of time with the resources we are provided??
Sometimes I feel like a helpless slavelaborer caught in a punitive system I cannot influence. Lord PLEASE influence my huby to get us back to a union area where I have a LITTLE say...