Why do nurses tolerate bad workloads and bad work situatitons?

UM Review RN, ASN, RN · Nov 4, 2006

...
My question is:
WHY DO NURSES PUT UP WITH THE PATIENT OVERLOADs, UNREALISTIC ADMINISTRATIVE PAPERWORK and UNNECESSARY OVERTIME resulting from not having enough time to finish your work during the shift that you have agreed to work????
Why don't we as a professionals just "get together" on some level such as within a specific Unit, specific hospital or even at the State or National level and REFUSE to take 5 or 6 patients (or whatever the number of patients that is creating the work-overload).
There has got to be a way to get the the hospital administration or state/national healthcare officials to put an end to the unrealistic/overload of work.
As long as nurses continue to KILL THEMSELVES to accomodate the unrealistic work load demands put on them by administrators..........the over-work will continue.
I don't understand why we all get on this website and "whine" about how bad things are and how overworked we are ...[all of which is absolutely true!!]........ and yet we "slug passively along" and allow hospitals and managers to overcommitt us to handle unrealistic patient loads, often on extremely acute patients !!!
Has it ever occurred to any group of nurses within a Unit to "JUST SAY NO ???" I don't mean 'say no' and walk off the job or anything like that........but I do mean, grab that nurse manager / Dir of Nursinng and officially demand that additional staffing be added and patient:nurse ratio be adjusted ??
It seems to me there are many stratagies that could be used to improve the shabby work situations faced by so many hospital nurses!!!
Would be very interested in hearing your opinions on this subject !!

First question:

We put up with it because we are no longer autonomous; we are employees. We have no choice, we have no say. Anyone that thinks she has a say about what we do is kidding herself. Those who protest are fired, and in some cases, blackballed.

Second question:

The only way I know of that nurses have successfully "gotten together" and changed things is through the CNA (California Nurses Association, a union) and even the union relied heavily on nursing research that showed that high patient loads contributed to patient mortality.

Third question:

Refer to answer #1.

Sad but very very true. If you are a "troublemaker" you will be dismissed. They will find a way, believe me.

Long Term Care Columnist / Guide · Nov 4, 2006

And if they don't find a way to outright fire you, they will harass you and "write you up" and call you on every tiny omission or infraction until you give up and quit. Having a union doesn't always help, either; mine didn't do a thing for me when I was going through this, probably because the reps were too rushed and overwhelmed with their own workloads to be able to help another drowning nurse.

I think human nature also works against us, preventing us from getting together to solve this fast-growing problem of what I call "nurse abuse". It's that herd mentality: we see a member of the herd being shunned (the reason doesn't matter), and as they grow weaker, we start shunning them too---not only because we naturally want to be counted among the strong and healthy, but also because we're afraid the same thing might happen to us.

I have no idea how to deal with this problem in hospitals; all I know is, it's going to take some VERY high-profile deaths and egregious cases of patient neglect before anything is done about the "nursing shortage", and even then, nurses will take the brunt of the blame. As the shortage becomes more acute, the public MIGHT start looking at hospital administration and for-profit healthcare as the principal issues, but only if a large number of nurses "go public" with their dissatisfaction..........and that usually happens only after they are no longer working for a particular facility, or working in nursing at all.

RNKay31 · Nov 4, 2006

Yes, what Angie said is so true, we have to bite our tongue and put up with all the BS

EmerNurse, BSN, RN · Nov 4, 2006

Sadly, Marla's right. The public (or hosp admin) won't "learn" once mortality really starts going up. Why? Because the individual nurse caring for that patient will be branded and blamed, NOT the system he/she is attempting to work in.

Why don't nurses band together and demand a better situation? I think some of it has to do with the need to put food on the table. Since anyone willing to speak out is eventually "escorted out", few are willing to make waves. Instead, they eventually leave nursing altogether. Easier than butting their heads against places like DFW where you may be blackballed in the entire area!

Mutter.

emmycRN · Nov 4, 2006

I've said it before on this site and I'm going to say it again now. Nurses put up with poor working conditions because nurses throughout the history of the profession have accepted the steriotypical "self-sacrificing angel" perception of nursing. We have convinced ourselves that it is our duty to put up with anything they throw at us in the name of "patient care". I am a firm believer, however, that we cannot effectively take care of others until we address the problems inherent to our profession.

Even though it is extremely difficult, I plan to stick with nursing and be an advocate not only for patients but for nurses. It will take a long time and a lot of re-education of the public and ourselves to change our situation. A set of circumstances that has developed over hundreds of years cannot be expected to change overnight.

scaredofshots · Nov 4, 2006

Some things that make you go hmmm....

1. Why do we park in driveways and drive on parkways?

2. Do Lipton employees take coffee breaks?

3. Can I yell "movie" in a crowded firehouse?

4. Can you be a closet claustrophobic?

5. How do a fool and his money GET together?

6. Why does Hawaii have interstate highways?

7. How is it that a building burns up as it burns down?

8. If a train station is where the train stops, what is a workstation?

9. If nothing ever sticks to Teflon, how do they make Teflon stick to the pan?

10. If the pen is mightier than the sword, and a picture is worth a thousand words, how dangerous is a fax?

11. If the police arrest a mime, do they tell him he has the right to remain silent?

12. What hair color do they put on the driver's licenses of bald men?

13. What was the best thing before sliced bread?

14. Why do banks charge you a "non-sufficient funds" fee on money they already know you don't have?

15. Why do they put Braille on the drive through bank machines?

16. If Barbie is so popular, why do you have to buy her friends?

17. If you get cheated by the Better Business Bureau, who do you complain to?

18. What are Preparation A through Preparation G?

19. In a country of free speech, why are there phone bills?

20. Did Washington flash a quarter when asked for ID?

21. How come there aren't B batteries?

22. If the post office has machines that can sort snail mail at 1000's of times per minute, then why do they give it to a little old man on a bike to deliver?

23. How do "Do not walk on the grass" signs get there?

24. Why do black olives come in cans and green olives come in jars?

25. Before they invented drawing boards, what did they go back to?

26. How is it possible to have a civil war?

27. If all the world is a stage, where is the audience sitting?

28. If love is blind, why is lingerie so popular?

29. If the #2 pencil is so popular, why is it still #2?

30. Why is the alphabet in that order? Is it because of that song?

31. If I melt dry ice, can I take a bath without getting wet?

32. Crime doesn't pay...does that mean that my job is a crime?

33. How do they get the deer to cross at that yellow road sign?

34. How do you know that honesty is the best policy until you have tried some of the others?

35. How do you throw away a garbage can?

36. How does a thermos know if the drink should be hot or cold?

37. How does the guy who drives the snowplow get to work in the mornings?

38. Do you realize how many holes there could be if people would just take the time to take the dirt out of them?

39. If a word in the dictionary were misspelled, how would we know?

40. If you're in a vehicle going the speed of light, what happens when you turn on the headlights?

41. What happens to an 18 hour bra after 18 hours?

42. Why didn't Noah swat those two mosquitoes?

43. Why do hot dogs come 10 to a package and hot dog buns only 8?

44. Why do tourists go to the tops of tall buildings and then put money into telescopes so they can see things on the ground close-up?

45. Why is it that bullets ricochet off of Superman's chest, but he ducks when the gun is thrown at him?

46. Why is it that night falls but day breaks?

47. Why is it that you must wait until night to call it a day?

48. What if the Hokey Pokey IS what its all about?

49. When your pet bird sees you reading the newspaper, does he wonder why you're just sitting there, staring at carpeting?

50. What happened to the first 6 "ups"?

Tweety, BSN, RN · Nov 4, 2006

Very good question.

Sometimes I wish we would all band together, but as I'm sure you see we don't always get along and agree.

We've been very vocal about our work environment, and they have over the years strived to make changes, but it seems in financial hard times, like they claim we're having now they backslide.

I put up with quite a bit because I get a paycheck every two weeks and it's called "work" and I choose to work there. Mind you there are problems. One of the reasons I'm getting my BSN is to hopefully have options as I age.

emmycRN · Nov 4, 2006

Some things that make you go hmmm....
1. Why do we park in driveways and drive on parkways?
2. Do Lipton employees take coffee breaks?
3. Can I yell "movie" in a crowded firehouse?
4. Can you be a closet claustrophobic?
5. How do a fool and his money GET together?
6. Why does Hawaii have interstate highways?
7. How is it that a building burns up as it burns down?
8. If a train station is where the train stops, what is a workstation?
9. If nothing ever sticks to Teflon, how do they make Teflon stick to the pan?
10. If the pen is mightier than the sword, and a picture is worth a thousand words, how dangerous is a fax?
11. If the police arrest a mime, do they tell him he has the right to remain silent?
12. What hair color do they put on the driver's licenses of bald men?
13. What was the best thing before sliced bread?
14. Why do banks charge you a "non-sufficient funds" fee on money they already know you don't have?
15. Why do they put Braille on the drive through bank machines?
16. If Barbie is so popular, why do you have to buy her friends?
17. If you get cheated by the Better Business Bureau, who do you complain to?
18. What are Preparation A through Preparation G?
19. In a country of free speech, why are there phone bills?
20. Did Washington flash a quarter when asked for ID?
21. How come there aren't B batteries?
22. If the post office has machines that can sort snail mail at 1000's of times per minute, then why do they give it to a little old man on a bike to deliver?
23. How do "Do not walk on the grass" signs get there?
24. Why do black olives come in cans and green olives come in jars?
25. Before they invented drawing boards, what did they go back to?
26. How is it possible to have a civil war?
27. If all the world is a stage, where is the audience sitting?
28. If love is blind, why is lingerie so popular?
29. If the #2 pencil is so popular, why is it still #2?
30. Why is the alphabet in that order? Is it because of that song?
31. If I melt dry ice, can I take a bath without getting wet?
32. Crime doesn't pay...does that mean that my job is a crime?
33. How do they get the deer to cross at that yellow road sign?
34. How do you know that honesty is the best policy until you have tried some of the others?
35. How do you throw away a garbage can?
36. How does a thermos know if the drink should be hot or cold?
37. How does the guy who drives the snowplow get to work in the mornings?
38. Do you realize how many holes there could be if people would just take the time to take the dirt out of them?
39. If a word in the dictionary were misspelled, how would we know?
40. If you're in a vehicle going the speed of light, what happens when you turn on the headlights?
41. What happens to an 18 hour bra after 18 hours?
42. Why didn't Noah swat those two mosquitoes?
43. Why do hot dogs come 10 to a package and hot dog buns only 8?
44. Why do tourists go to the tops of tall buildings and then put money into telescopes so they can see things on the ground close-up?
45. Why is it that bullets ricochet off of Superman's chest, but he ducks when the gun is thrown at him?
46. Why is it that night falls but day breaks?
47. Why is it that you must wait until night to call it a day?
48. What if the Hokey Pokey IS what its all about?
49. When your pet bird sees you reading the newspaper, does he wonder why you're just sitting there, staring at carpeting?
50. What happened to the first 6 "ups"?

How is this relevent to the discussion?

Tweety, BSN, RN · Nov 4, 2006

How is this relevent to the discussion?

Technically it's not. I can't speak for the poster, but they are probably saying that the original question is something like those questions.....things that make you go hmmmmmm............but don't ever really have an answer.

llg, PhD, RN · Nov 4, 2006

Nurses throughout history have said "No" in many ways. Some have switched jobs until they found one they liked well enough to stay. Others have left nursing altogether. Others HAVE grabbed that manager/administrator and expressed their dissatisfaction -- and have either been punished in some for being a trouble maker or been ignored or been told that the hospital did not have the resources to fix all the problems immediately, but was working hard to try to improve them.

Some nurses have had the courage and committment to healthcare take on the responsibility that comes with accepting a leadership role. They do their best to improve things one day at a time. They learn that many or our big problems are complicated and will require great effort, great wisdom, and great sacrifice (by a lot of people, including nurses) to solve. They learn that many of the solutions will require large sums of money -- and that the general public does not want to pay more for health care. They learn that for every nurse who has an idea that might help, there are 10 others who do not agree and who will not cooperate with those ideas.

Anyone who wishes to better understand why the difficult working conditions persist within nursing should roll up their sleeves and start trying to solve those problems. With time, study, and experience as a problem-solver will come the better understanding -- and hopefully the skills to make things a little better.

llg

Sheri257 · Nov 5, 2006

The only way I know of that nurses have successfully "gotten together" and changed things is through the CNA (California Nurses Association, a union) and even the union relied heavily on nursing research that showed that high patient loads contributed to patient mortality.
Sad but very very true. If you are a "troublemaker" you will be dismissed. They will find a way, believe me.

I don't think that's always true. Maybe things are different here in California but I've personally seen nurses pitch a fit when they tried to break ratios or give them additional patients that they felt they couldn't handle. As far as I know, they didn't get fired for it.

Nurses are very assertive here. Maybe it's because there are a lot of union hospitals here. And, the RN's can have ten jobs the next day if they want to so they have a lot of leverage. It's very difficult for mangement to fill those positions when they leave.

The union also helps, I think, in other ways besides ratios. A friend of mine is a new grad and they tried to make her charge when she just wasn't ready for it. The union put a stop to that real quick.

:typing