WARNING: THIS POST IS REALLY LONG. BUT I HOPE MANY OF YOU WILL READ IT. I THINK IT IS A VERY IMPORTANT ISSUE FOR ALL NURSES.
I haven't written a post for quite some time. My husband learned today that he has a "high grade invasive bladder cancer" from a cysto and biopsy he had done one week ago; he was originally hospitalized in acute renal failure which was reversed after one run of hemodialysis, the insertion of 2 nephrostomy tubes and a foley cath all of which he came home with on 11/3 and which I have been caring for.
During the past several years I have witnessed some disturbing trends in nursing. In a world famous MAGNET hosptital in HOuston, TX. for 6 days no nurse did a head to toe or systems assessment on my husband; no nurse did a neuro check; no nurse asked questions regarding pain or other discomfort; no nurse ever physically touched my husband. I did all of his care and I wanted to do it, but I did wonder how the nurses charted on him when the only thing I had seen ANY of them do was give him his meds in spite of the fact that he was on a telemetry floor and was acutely ill. He had been admitted because of a sudden onset of mental status changes with confusion, disorientation, visual and auditory halucinations, slurred speech and stuttering, staggering gait and weakness of the extremities, particularly the legs. The did EEG, cardiac echo, MRI and MRA of the brain and extracerebral circulation, doppler of the carotids, skull films. The only thing they did not do was a lumbar puncture and I don't know why they didn't because he was discharged minimally improved with no diagnosis. I never saw any of his labs, but I bet his CBC differential showed elevated WBC's with a shift to the right because I have often thought that he could have had West Nile encephalitis since he came down with this where the mosquitoes that carry it were prevalent and I have cared for patients with viral encephalitis and he had many of the symptoms. He gradually recovered completely after several weeks.
The point I really want to stress however is that from what I observed back then in Houston and now with nurses and Nurse Practitioners at the VA here in Arizona, I believe our profession to be at a critical juncture. Nursing is at the brink of losing its status as a profession partially due to the continuing shortage which initially brought about much needed increases in salaries but when the pay did not have the effect of bringing more competent, quality people into the ranks, desperate measures were sought to fill the vacancies left by aging baby boomers. We now can evaluate the consequences of some of the less desirable means utilized to fill the positions for competent RN's with what amounts to the equivalent of "warm bodies". Because of the current job market, former truck drivers, auto production workers and people who would never have considered nursing as a possible future job for themselves are signing up at record rates because it is a guaranteed job. People are going into nursing because they know they have a job waiting; because they can travel; because it is one of the few professions that you can start out in with an Associate Degree and I recently read that there is a push to get RN's out and working in something like 3 semesters. Many of these candidates have no realistic picture of the myriad of tasks that are involved in being a RN. Many would rather work in a sewer than touch or be touched by another living person's bodily fluids. Some people actually consider it from the prospective of the accessibility of narcotics.
Recently when my husband was in the hospital in renal failure, he told me that one of the nurses did not give him the correct dose of his scheduled pain medication. He said that when he told the nurse that he was supposed to get one more pill,the nurse replied, "Well that's what is ordered". Yet for the 2 days that he was on that unit, the night nurses gave him the correct dose, the exact same dosage and the same pills that he had been taking at home for more than one year so there is little chance that my husband was mistaken. Unfortunately, he did not tell me this until after he was discharged and I admit that right now turning in that nurse is not my top priority.
I would say for the most part that the nurses who write into this forum are the good nurses. Why? Because the bad nurses could give a rat's ass about anything to do with their job after they go home. I can hardly believe that they would spend time on their computer reading what other nurses think and say about their profession. To the bad nurses, nursing is just a paycheck. And most will get advanced degrees so they can "get away from the bedside", which is a good thing when you get right down to it.
It is so sad to me to think that all the work that thousands of dedicated nurses have done over the past 3 decades to bring nursing the respect and status of professionalism that it deserves may be lost when the public gets wind of the some of the "trailer trash" types and "gangstas" we are letting into our ranks. I can't work right now; 30 years of 12 hour shifts, most without breaks and most that ended up being 13 or 14 hour shifts, took its toll on my body. I have too many ailments to list, but right now there isn't any kind of nursing that I would be able to do. Just sitting and typing this, I have had to stop several times because of the pain and stiffness I get. Nursing is not the kind of job that everyone should do. It is a profession that you really have to desire from the heart and know that there comes with it a lot of things that most people would call "icky"; but in spite of the "icky" if you can derive satisfaction from the patient who thanks you for starting his IV because no one else could, or who remarks "You must have been doing this for a long time; I can tell just by the way you can talk and work at the same time." If you can look back and feel good because you KNOW that there are people walking around today because YOU were there to provide expert emergency care that was needed during that critical moment between life and death and no one gave you a medal or a bonus or a raise but it was enough to know that it was your hands that helped save a life, THEN YOU KNOW YOU ARE IN THE RIGHT PROFESSION. Then you know you are a "GOOD NURSE".
I know there are still good nurses out there. There was one in the ER named Manny who is young and fit and eager to learn, yet compassionate, caring, never forgetting that it is a human being in that bed. And when I read a lot of the posts in the forums, I see that you are out there and I thank God for you. Because we baby boomers are getting old and tired and we look at you because we see ourselves on the other side of the bed someday and hope that we will get one of the "good nurses". God bless you all!!
