Why my patient quit nursing...

[FireStarterRN]

I worked a nightshift last night (no I didn't call in sick). One of my patients was a non-practising RN. She was my age. We had a discussion. I asked her why she quit nursing. She got her nursing license back in the late 70's.

She told me that as time went by the government and regulators started making it harder and harder to actually take care of the patients. She said that back in the 70's it was present, but it didn't interfere with patient care. She just lost her desire to work in the profession. Now she does part time work as a medical transcriptionist.

I totally agree with her, this is the major factor for burn out for me personally. I'm tired of the government making a one step process a 5 step process. The computerization of everything is making my job more difficult, and if the Joint Commission throws one more inane rule down my throat, I'm quitting.

I recently went to half time, thank goodness for my husband's income. But more and more I'm starting to think "How can I get out of nursing?" even though I love many aspects of it.

[EmmaG, RN]

Oh boy, are you right on that one! :angryfire

There's "customer service", and then there's being a damned doormat.

Arg. That really sticks in my craw.

(what's a craw, btw )

[pagandeva2000, LPN]

there's a zillion regs in ltc.

my concern is with bedside nursing becoming progressively more stressful, many will leave to work in those areas that don't involve the floor.

to add to our existing shortage, there will be another shortage on top of that.

and that's exactly where it's headed.

leslie

Very true. It seems to me, now that most nurses may give a year or two of time on the floors; but they cut out because of the horrors of patient care making it difficult, if not impossible to really be a patient advocate. When I first became a nurse last year, I was assigned to work in the clinic I worked in previously as an aide. I was to do 6 weeks of med-surg first. In the beginning, I was surprized that they would place a brand new inexperienced nurse in the clinics so early (but, I admit I was and still am happy about it), but after those 6 horrific weeks up there with constant order changes and lack of supplies, I ran and didn't look back. I wanted to work overtime to gain nursing skills, but at the moment, I really think I can do without it.

[leslie :-D]

I told him he should have asked that ignorant woman how she'd feel if it were HER mother or father sleeping on the floor, or being granted the right to fall and break a hip--- or worse.

And it's ignorant fools like that who are telling US how to do our jobs. That is what ticks me off.

the problem with siderails (being considered a restraint) is many will try and climb over them.

i've seen sev'l snf's that have mattresses at the bedside.

bed alarms are supposed to be the saving grace.

leslie

[pagandeva2000, LPN]

I told him he should have asked that ignorant woman how she'd feel if it were HER mother or father sleeping on the floor, or being granted the right to fall and break a hip--- or worse.

And it's ignorant fools like that who are telling US how to do our jobs. That is what ticks me off.

Most of the time, the toads making the decisions are the furthest away from real patient care.:angryfire

[FireStarterRN, BSN, RN]

the problem with siderails (being considered a restraint) is many will try and climb over them.

i've seen sev'l snf's that have mattresses at the bedside.

bed alarms are supposed to be the saving grace.

leslie

Yes, actually the latest data points to the fact that siderails don't prevent falls but make them worse. However, the inspector saying that "The patient has a right to fall" shows that she/he hadn't even been educated on the rationale behind the new guidelines...

[EmmaG, RN]

the problem with siderails (being considered a restraint) is many will try and climb over them.

i've seen sev'l snf's that have mattresses at the bedside.

bed alarms are supposed to be the saving grace.

leslie

I understand about the rails; he indicated they couldn't use any rails. Bed alarms have their place, but I see too many administrators placing too much faith in them. They're only as good as the staff's ability to get to the bedside in time to avert the fall.

As far as sleeping on the floor; that just seems so degrading. More so than a roll belt IMO.

[EmmaG, RN]

Most of the time, the buttholes making the decisions are the furthest away from real patient care.:angryfire

I'd love to see the feds declare that JCAHO accreditation is no longer a requirement for Medicare reimbursement.

[crissrn27, RN]

The "right to fall" thing really is an accepted term with surveyors. I heard it before I left LTC 3 years ago, and I'm sure it continues today. Stupid.

[ktwlpn, LPN]

Several years ago, I talked to a friend who had left the hospital to work in LTC. He told me that they had started putting mattresses on the floor so that when a patient rolled/climbed out of bed, they only 'fell' a few inches. They did so because the state inspectors informed them they could not use siderails or restraints. (even the tray on a geri-chair was now a no-no) He said one of the inspectors told him that the residents "have the right to fall". No wonder our healthcare system is going to hell in a handbasket.

yep-They have the right to fall,the right to refuse meds,the right to be as non-compliant with their care-plan as they possibly can.BUT when the inevitable consequences start to occur you had better have reams of documentation showing that you constantly educated the resident regarding those consequences. .:deadhorse Yes-we have low beds-we are restraint free.So a resident in a low bed can't rise up to a standing position and fall from a greater height.Instead they just skitter all over the floor in the middle of the night-usually in a puddle of BM or urine. Lacks dignity,don't you think? However the 98 yr old arthritic old gal does not have the right to refuse PT,OT and restorative ambulation because she's tired and everything hurts. According to the state we have to fix her....and drag her down the hall at least 5 times a week even if it's for 10 ft at a time.They look at the quality controls such as ambulation,bowel and bladder function,adl performance etc-when a resident decides the staff are there to wait on them hand and foot you better be able to prove it was their choice and not something you did or failed to do...It's really ridiculous...I don't like it any more.

[EmmaG, RN]

Oh boy, are you right on that one! :angryfire

From their website:

For more than 20 years, Press Ganey has been committed to providing insightful information that allows our more than 7,000 health care client facilities to continuously improve their performance.

Yep. That's about when it all started to go in the *******.

[bethin]

This is why I'm not going to nursing school. I work as a CNA on med surg and see the nurses running ragged and never seeing their patients. I wanted to be a nurse to be with the patients and not behind a computer. If I wanted to sit in front of computers all day I would be a computer tech. I'm sick of seeing management not standing behind aides or nurses and only thinking about money and satisfaction ratings. Money and ratings are not nursing. I think management should be required to work so many hours a month on a floor to see their stupid timely rules in action. Maybe then there wouldn't be so many. A nurse told me last week that if she could she wanted to turn back time to the late 70's. She said then nursing was about the patient and not the government. She explained to me how she could take 10 patients and give great care because there wasn't triple charting and 100 hoops to jump through.

[nursemary9, BSN, RN]

Well, I've been doing this for more then 40 yrs.

You can't believe the changes I've seen in that time--& I must say that most are not for the better.

All these rules & regulations!! For every one thing you do, there are 5-6 pieces of documentation--computer & also paper!!

When we got the computer, we were told--no more paper charting!!

NOT TRUE--now we do the computer AS WELL AS paper charting!!

Go Figure!!

I'm tired of it all & hope that I can soon say Good-Bye!!

I still LOVE nursing but hate all the rest; you all have said it all--I won't repeat.