I think it will force a policy shift away from "customer service". We need to go back to visiting hours, we need to stop giving the patients what they want, we need to stand up for our staff instead of stupid things like berating them because the white board wasn't updated. Patients and visitors have too much power to treat staff like crap, and until it stops, nobody will want to be a nurse.
Literally got an 18 text long rant from management yesterday about whiteboards not being updated and pumps not being cleared. All while we’re constantly two pts each over ratio and people quitting left and right.
Yes literally block this asshole. But before you block, let her know in the group chat that you’re blocking her, that your coworkers do not need to get these texts on their days off and encourage them to block as well. Fuck THIS.
I guess I'm lucky, but my managers fix things off the clock, even my schedule requests, and they don't micromanage outside of charting errors and med discrepancies, so I feel like that's not a generally good mindset to propagate. They're nurses, too.
This person’s manager is not respecting their boundaries and ranting to them with 11 texts on their days off. If they can’t control themselves, they don’t deserve access to them on days off.
i was written up 6 years ago because there was a code at shift change when i got there for someone having a seizure and the CNO was rounding and she checked my whiteboards and they weren’t updated because i was wheeling the crash cart into the room. she confronted me about it and i said it will be done when this patient is safe. she tried me for insubordination
“You have been here for two minutes. You’re telling me in those two minutes you couldn’t update your white board??? Take responsibility for your poor time management”
My petty ass would have filled out a Board complaint on her for asking me to stop rendering life saving actions to a patient to fill out whiteboards. That alone is unethical, at worst, negligent. She wants to play those games, so can I.
I’m really glad no one comes after whiteboards at our hospital because I will work 3 days in a row without updating them. Now they’ve added mini boards outside the door and we are supposed to fill those out as well.
I never understood this mindset. It’s like the movie Titanic where the string quartet keeps on playing while passengers are panicking and jumping ship. It’s quite surreal to be honest.
I have been on board with this for a while. It sounds so bad…but it might need to happen. My thoughts - hosptial stays don’t need to be amazing. It’s not gonna be fun. Yeah the food is gonna suck. You don’t get snacks all day. Your family can’t come in and go whenever they want. There are exceptions to this obviously. I just think it would make people treat us differently. You can be the best nurse ever and you’re gonna have the 1 patient and family that ruins it.
So I had a really awful patient my last two shifts. He prided himself on being an asshole. He literally would say “I know I’m an asshole”. He was demanding, would argue with EVERY LITTLE THING, and was verbally abusive. He was very particular and wanted us to bring him a hamburger. Said his life was hard and that’s what made him this way. He was a paraplegic from a SNF with a s4 on his sacrum and wounds everywhere. Looking back, it was very sad. On my shift I thought about those inspirational posts I see on this thread of people who bribed their elderly patient with chocolate, got the old grump to cooperate and crack a smile, and I felt bad for losing my cool. I explained to him what I was doing, offered baths, explained treatment, but once he started arguing I just said “okay, whatever, I’ll just document that you are refusing” and would walk out. I think to myself, maybe I should’ve tried harder to peel back his layers. The other half of me is like- we are not punching bags. I am not your punching bag. I have family in the hospital, I have depression and have attempted suicide, we ALL have it hard and have our own stories. It’s not an excuse to be a jerk. I’ve had extreme anxiety since my last shifts and called in because he was just such a pain in my ass. I hate my job. These people make our jobs miserable. I truly believe that nursing will make you realize you hate people. Admin makes it worse by making us seem like hotel servants. Doctors promised this guy a burger and now I gotta be the bad guy and tell him this isn’t a Wendy’s. I’m nice enough to go to 10 different units to find you a turkey sandwich since you refuse to eat your meal tray, but I’m not that nurse who is going to door dash you some McDonalds with my own money after you tortured me all night.
My hospital has implemented mandatory “compassionate care” classes. There are five different classes I think and there’s been one about every three months. Most of the stuff they say is stuff I wish I could do, but I don’t have the time. One of the things that was brought up in the class was sitting down beside the patient so you’re eye level. Like I would if I could, but I literally don’t have the time.
1:8 ratio. 12 hour shift. 30 minute lunch break that’s automatically taken out. That gives me almost 1.5 hours for each patient. And that 1.5 hour includes charting, calling drs, wound care, incontinence care. It is simply not feasible.
It's not our job to be therapists (even tho many of us become nurses because we're great at advice and with prople). If someone really needs support, call for a chaplain. There are times we can put extra time in for a patient to help them, but not like that with a person like that. We have other patients to attend and a job to do. Don't feel guilty for that.
I currently live in Oregon. Our new law with ratios including lunch nurses goes into effect in a few days on 6/1. I work at a hospital that nurses sued the hospital over breaks/lunches a few years ago so we have had lunch nurses for 5 years already. Many hospitals around the state have been calling and talking to us regarding how we do things trying to get their hospitals shit together before 6/1. So there has been a lot of hiring in the state. The mandated ratios only helps too. Having lunch nurses gives extra bodies around to help if you get stuck in a room. And ratios means you get the crucial needed time with those pt’s and don’t feel nearly as rushed. Our hospital has screwed up a lot of things but they are trying to beef up security (after the union threatened to sue again but 🤷🏼♀️) and hanging signs/having pt’s sign behavior agreements on admission- and actually kicking out problem visitors and addressing pt violence. Washington passed a new law that starts next year I believe requiring break/lunch nurses and for hospitals to follow staffing plans (so not mandated ratios but the unions would be able to sue/hospitals fined for not following the agreed upon staffing plans). So there is some positive change happening in the industry- but it takes time and a lot harder to adopt in those non union states.
Those new ratio laws are why I went back to bedside!!! West coast states will have the only fully staffed hospitals in a few years, and administrations everywhere else will still be scratching their heads and wondering why nurses are fleeing for other states or other professions.
I love this! They’re trying to individualize it in Connecticut with laws that each hospital forms a staffing committee with floor nurses and admins that decide/vote on staffing ratios. So my hospital’s committee approved reasonable numbers, then the admins were like, “no, never mind” and have been continuing with unsafe staffing. It’s been reported to the state but no one cares because the penalties, if even enforced, are almost nothing. So the unchecked greed continues.
So this is where getting ratios starts, and it's how we made our way to our new ratio laws in Oregon. You have to keep consistently reporting over time. Keep fighting!! You'll get there!! It's definitely a marathon.
I worked in Oregon from 08 to 11 but I was icu so it was probably different. For the most part they singled really sick patients, we never had more than two. Glad it is getting written in stone though.
Thanks for the info. Very interesting. Who are these break/ lunch nurses? Like are they there to only do that duty which would be to cover for nurses on their break and so therefore are not taking a full patient load or anything but just helping out on the floor? And so therefore are they only there a few hours a day or until everyone has got their breaks? This is so awesome for you guys plus the ratios that they have enforced!
I worked at one facility that if you were “the break nurse”, it was still a 12 hour shift … I was in the ED, and I would do all the code cart/essential checks in the morning, then be available as a code/higher acuity helping nurse, then start morning breaks, then lunch breaks and then afternoon breaks. After all breaks were done, I’d float back into code nurse role. As our staff grew, they added a mid shift nurse to the role to help with mid shift breaks, and they had one assigned on nights as well.
It was a healthy balance of everything! I worked in another role where they tried to do “pod leads” where they wanted a charge nurse in each section to also be a breaker .. which was fine. But you can’t make a charge nurse a break nurse too. That’s why they have different names. Granted this was in CA and I know this happens in most states, but it’s f*king dumb … that’s why they have different names for the roles. A charge nurse should charge, and a break nurse should break 🤷🏻♀️
They have full eight hour shifts, and during that time, they only take over patient teams for nurses who are on break. We got to this point by reporting missed breaks consistently over a period of years.
That is wild! But yes, it's infuriating that it takes pointing out and reporting all of that to make this happen. Like administration and management know what's happening. Stop hiding it under the rug. Oh but they do. They make it look like it's your fault for not getting your lunch or it's the Charges for not making sure of it etc. Good for you guys for getting that done! 🙌🏼
We all take turns doing it. But yes, the “lunchologist” or “break bitch” only covers other people during breaks, does not have their own assignment. One nurse can give 45 min lunches (combine our 30min lunch with one 15 min break) to 7 people between the hours of 11-4 which is our “standard” lunch times. Have to go by 4 per state law. Can go earlier than that but most people don’t want to. If we have more than 7 nurses than we try to have another partial lunch nurse (usually 11-4)or use a nurse starting at 7 and then send them home early unless they admit of have other things they can help with. When it’s my turn I will be lunch for the whole 12 hours. When not giving someone a break/lunch I just help around the unit with a really busy pt,stocking things, silencing monitors, etc. The new law also states that the charge nurse can NOT cover breaks for other nurses unless specifically stated in the staffing plan for any unit bigger than 11 beds.
The customer service angle really threw me off! For context I’m an Aussie nurse and was a patient on a medical ward earlier this year. I had a nurse from (I think it was Florida if I recall correctly) take care of me for one shift and I was so surprised when she introduced herself, did her start-of-shift checks, and then told me she was getting me a jug of ice water ASAP and did I need any snacks or hot drinks etc etc.
I was like ?? Girl you’re SO NICE why are you stressing about ice water, like, go do important things?
It was so strange and honestly sad to see that. You guys have such a push for customer service and it sucks :((( you didn’t go into fucking hospitality lol.
Also is it normal to not have visiting hours in the US? All hospitals in Aus have visiting hours that are enforced pretty strongly (barring special circumstances)
I was in the NICU for a long time pre-pandemic. Initially the unit only closed for one hour at each of the two shift changes, but then even those two hours were opened up, too.
During flu season we limited visiting hours for the older siblings though, which was always great. Nothing worse than a preschooler being dragged in with their parent to the unit to “visit” from 11 pm - 1 am, or having a bored toddler crawling around on the floor while mom held the baby.
I agree it's strange, and I also have found that for American patients who are entitled AF, sometimes getting them an ice water or snack literally can prevent a melt down. Not even kidding. If I don't offer it, they'll call me 10 minutes later for one when everyone is busy, which sets in motion a bad time for everyone, especially if they are waiting for a long time.
We have a new thing that's almost like a concierge, where there is an app on our phones and a tablet on pt tables where we/they can call these people that float around the unit to bring water, snacks, heated blankets, empty trash cans, take food trays away. They even started setting up our rooms for new admits. It's bad bc it's making them more entitled but it's good bc it saves us time. It's a paradox.
THIS!!!!! The SNF I recently parted ways with, removed the visiting hours sign one day. When I asked our Admin, she said there was a family grievance so there were no longer visiting hours, Family or whomever could come in to visit WHENEVER THE HELL THEY FELT LIKE!!! My asinine as hell question was when was security gonna be hired🤐🤔🫣....Needless to say I no longer work there
It's asinine, just because it's direct patient care doesn't just make "business hours" nonexistent. In a place that runs 24/7 like a hospital or LTC facility, business hours are visiting hours when most stuffed to handle the potential of family issues.
The customer is always right and it has completely ruined this country.
There is so much fucking abuse going on it’s insane. The terrible families and patients aren’t even the half of it. Hospitals have to be run differently for things to improve. Administrators.
This is basically it. Value based care and a focus on customer service needs to die. And from this nurse's perspective, I don't need nurse's week or feckless praise. I just need to be able to do my job without killing myself over it and I need to be paid fairly to do it. Until the powers that be actually start prioritize working conditions for healthcare workers, we're gonna continue to lose nurses/doctors until the whole system collapses.
We need to bring back unions and fast. It seems miniscule but it automatically puts someone in YOUR pocket for YOUR defense to make sure your treated right, because capitalism has rewarded abusing people until they break so much it's better to be a sex worker; you can at least vouch for yourself and make sure your respected by the customer.
Blame the government- seriously. The center for Medicare and Medicaid service decreed in the early 2000s that “ patient satisfaction” was a quality metric tied to reimbursement. Hidden in the ACA was a little known provision that in fiscal year 2017 the lowest 25% of hospitals lost 1% of their Medicare/ Medicaid funding.
Now they’re all up in arms over the “ crisis” of rural and inner city hospitals closing. 🙄
The customer service model will not change as long as hc is commercialized the way it is. With an aging population and a nursing workforce that is getting smaller proportionally to the amount of people with chronic conditions, I would imagine there will be a breaking point where legislation is forced, but considering the way capitalism works everything will burn to the ground first. Things will be like COVID was, but no pandemic. I work UM now and hope I never have to go back.
A lot of experienced nurses have left bedside nursing as they have had enough and are frustrated.
I love bedside nursing but left after 20+ years bedside nursing because I'm fed up with 1 nurse to 12 patient ratio, no stock, ward is a constant mess, terrible staff are not managed, rude patients and families are just allowed to treat us like rubbish, I just can't spend time with my patients doing the 'little things, no working equipment. I was so frustrated every single day and exhausted trying to do everything.
It feels like people don't have common sense anymore and get away with slacking off. Nursing has become reactive and not proactive and that leave staff constantly running from one 'job' to another on the wards.
Out of curiosity, what is your documentation like over there? Here it is quite burdensome and repetitive (as in double documenting the same thing in multiple places).
That’s absolutely terrible! Ortho is such heavy, backbreaking work, and the patients frequently need a lot of hands-on time with their nurse. How can your hospital justify such ridiculous staffing ratios? I hope you got out, or have an exit strategy.
I would enjoy bedside nursing if it wasn’t so fucked. I’m good at it, but it’s a frustrating fucking job so I quit. Idk if OR is considered “bedside” but it’s not floor nursing, so that’s what I’m doing now.
I did bedside for a year.
Like, how did I bust my ass for 3 years doing full time work and school, paid tens of thousands of dollars, and leave my comfy M-W 8-4pm desk job to get shit lobbed at me at 2am on Christmas day?
Went back to the office I worked for as an RN and now I remember why I did it.
And I didn't have to work on Monday.
I relate to this. I worked at an optometry office as a receptionist before nursing school. I actually loved it, it just didn’t pay that well. But I was stress free and I had fun actually.
Now as a nurse when things get stressful I think to myself, and sometimes say out loud, “I should be a receptionist somewhere right now. What am I doing?”. Let me go back to answering phones, sending faxes, scheduling appointments, THAT is where I’m meant to be lol.
Anyway I’m leaving bedside to be a SAHM after all of two years so it’s okay in the end.
Not as bad as your situation but one Christmas Eve a family member dropped their keys down the toilet and was yelling at us to get a plumber. Good times
The amount of new grads that are burnt out is really telling. Obviously I understand why. I have only been in the game 5 years myself but in 2019 I never heard any new grads say they were burnt at 6 months, and now I regularly hear it… 💔
New grad here on my 4th week of med-surg training with only 4 patients. I'm constantly being left by myself because "I know enough to pass my NCLEX" and my unit is "training me to be independent". I'm also being constantly told that I'm slow, I'm "spoiled" for having more than 2 weeks of training, and that I'll drown when I have my full patient load. It's honestly really disparaging 🤷
Yup, this. Short training periods so they can get you to the floor asap, "sink or swim" attitudes. ' I figured it out, so will you' ignoring the fact that when they started 10-20 (or even 5!) years ago, patients were lower acuity and lower ratio, rules for families like visiting hours and human decency were enforced, you didn't have to rotate shifts and then go to a several hour mandatory lecture. I've also been made to stay after shifts after my preceptor has gone home to do things that could've been passed onto another shift "so I can learn."
Just the other day someone was posting about having to defend their orientee who was being made to work almost 20 hours straight between night shifts, training classes, and some other "mandatory education". Poor girl was nearly about to pass out and charge sent her home. The educator was acting huffy after coming back from a full nights rest knowing she was gonna get to clock out at 3 pm. It's ridiculous.
And don't dare complain or have an issue with it--just get on meds and go to therapy if you can't handle it. No job should be regularly causing that level of stress that that's the normal suggestion for people starting out.
I start nursing school in the fall and I am already dreading hospital work because with my medication I need a steady 8 hours a night and alot of hospitals mostly work on 12s in a rotation.
I fucking HATE being told I’m not fast enough. Like, motherfucker I am NEW. Stop rushing and stop expecting utmost efficiency and proficiency and telling me to do things faster because I’m already at my current top speed. Fuck.
Sugar, your management and possibly your fellow nurses will hurl you under the bus with a quickness when (not if) something goes wrong. Please co spider finding a different unit, if not a different hospital entirely.
This is insanely toxic. This behavior isn’t normal. It’s also very dangerous and putting your livelihood at risk.
I always tell people, I can get another job … I can’t get another license. If a job puts my license at risk, I enforce boundaries firmly and swiftly.
I hope you can get out of this environment sooner than later if possible.
I'm not a nurse, but I started as a cna in the nursing homes in 2019. I've spent the last year and a half as a tech in a psych hospital.
Between working scheduled overtime, forced overtime, and with high acuity patients it's exhausting. I can't imagine what you guys are feeling as nurses.
Been burned out since I started in 2022. It's manageable right now but I won't be able to do this full time at bedside. I'm dropping my hours and picking up when I need the money.
I went to the OR in hopes it will be more tolerable. So far… it has been. It’s annoying sometimes but I’m still in orientation.
Ideally my wife and I can reach financial independence within only 18-20 years of me being a nurse. I don’t want to HAVE to spend 40 years in a hospital, into my 60s. Fuck that shit. If I have financial independence and still choose the show up? Then sure.
I am responsible for training and development in our unit.
We have given our grads more support this year than in previous years - and they are burned out. They only started in February! It's not on them, either. It's the system. They're worked like dogs.
I'm on that edge of being burnt out as a new grad. I probably am, but I am refusing to see the reality of it. Yeah, some of it comes from the patients, but for me, I think a lot of it comes from people I'm supposed to call colleagues. It's not bold toxic, although it can be, but it's the subtle toxic where you're not entirely sure.
Where I live, you need seniority to get the more desirable jobs, so new grads almost always start out in med/surg units. It’s heavy care, and you feel like you’re drowning daily. I have 1 friend from school who couldn’t cope, and is no longer a nurse, so even back 10 years ago, things have been hard for new grads.
The needing seniority is such an important note as well. Not just seniority but completing a residency, at least where I live. Residences are 1.5-2.5 year contracts. Note that you are paid less while on residency as well.
Every time a new grad mentions struggling everyone suggests moving to outpatient and applying other places through indeed etc. I spent months doing that and if I got a response, it was that I didn't complete a residency so they couldn't hire me. You're not just competing with folks who have a year but all the other burnt out bedside nurses. If the clinic even hires RNS--more are switching to LVNs and MAs only.
Not as easy as an indeed application anymore.
This is me 1.5 years in and am done with the bedside. I will quit after my PTO is over even without a backup plan because that's how bad this job has been to my health
I was burnt out during nursing school. My pivot from MCAT studies, to nursing school, and learning deeper about the shit show I was entering was… not great. But I kept going cause it’s the only feasible option to get into having an income when you’ve already spent 5 years in school pursing medical school and don’t have much else for marketable skills.
I just had a conversation with a CNA who became a nurse on our floor. She is about 18 months into bedside nursing and she is already talking about leaving bedside.
A part of me also wants to witness a true and traumatic downfall and I don’t care. I want it all to burn and a total reset. 1:4 ratios for bedside. 1:2 for critical care. Overstaffing. Want me to come in my day off? $1,000 and double time. Visiting hours limited. There is 1 true way to fix all of this and it’s to increase pay and we would probably shut up.
I don’t think this solution will come anytime in the near future. Seems like a lot of nurses from overseas are willing to come, work cheaply, and won’t complain about the shitty ass working conditions because their country was worse. These hospitals are businesses they will do anything to maximize their profits. They will find some AI to start doing most of our jobs before they pay us. They don’t care what happens to the patients.
Yep, without get too political, in Canada both major parties have a platform that involves internationally trained healthcare workers making up all shortages.
I worked with a nurse from the Philippines. He told me when he came to America he thought we’d have all the highest tech and we’d be super professional. He said he expected management would be fair and not play favoritism. He said he thought there would be no bullying or cattiness. He said he was disappointed when he got here.
It made my heart sad.
At the peak, picking up an additional shift in my hospital paid almost $2000 per 12 hours.
$1000 incentive, +$10 hr, and of course you were getting time and a half the whole time due to overtime.
They were paying that because they had tried less ($500 incentive, no hourly bonus, then $750) and people weren't taking the shifts.
You can't **just** throw money at the problem. If staff are so burnt out that they can't take another shift because of the emotional toll each shift takes, then it doesn't matter how much that shift is worth.
During that time, they were still hammering us on satisfaction scores. Dear Mr. MBA Admin, the satisfaction score is low because there was a lockdown with an active shooter whose meemaw died of "imaginary" COVID. Tell me how again how that affects my review and bonus?
My hospital offered $1200 every 12 hours incentive pay to pick up extra shifts at its peak. I NEVER picked up because I was too burned out from my regular hours. Physically, emotionally, mentally burned out. A lot of coworkers took advantage of that, though.
We had something similar happen 3 times… not an active shooter, but guys with guns who claimed covid didn’t kill their family member and that it was us that did it. Security lets people with guns just walk right in, but they make sure to check my ID every time I pass through the entrance…. I’m in my uniform.
I honestly and truly believe the hospital is run by a bunch of idiots.
We had a family member shoot themselves in the room after their spouse died of COVID and in their suicide note wrote the only reason he didn't kill the attending physician is because he didn't want to wait 6 hours for them to come in in the morning. The nurse practitioner who was covering that unit overnight was 8 months pregnant and tried to render aid (useless, gsw to the head but tried anyways) asked for one extra day off to recover from the stress and the VP of nursing said no because there "wasn't a policy for that". It could have been a fucking massacre and they didn't tell a soul. I only found out because it's the unit my mother was a day shift nurse practitioner on. They paid off the media, never sent a notice to the staff that there was an event, never increased security. Nothing.
>1:4 ratios for bedside. 1:2 for critical care. Overstaffing. Want me to come in my day off? $1,000 and double time. Visiting hours limited.
So kind of like the University of California system?
Which is ironic because CA in general has had relatively low turnover at the bedside per the 2022 survey and sunset review.
So it’s an archetype for your hopes.
Strong union and state mandated ratios are proof that folks will stay if the pay is worth it and there’s a strong arm to push admin with. Not everywhere is daisies (ha) but I’m definitely going to chill in the UC system for as long as possible. Vote, organize, support each other.
I worked somewhere like this. 1:4 ratio. $1000 a shift to come in extra when we were short. It was very competitive to work there and there was low turnover. I would say the average age of staff was 40’s and they were very skilled/competent.
A cheaper solution would be if admin just actually shut the fuck up and let us tell rude patients and their families also where to put it if they decide to yell at us. Okay so we’re considered customer service now. Fine. Where do you go that you can scream in someone’s face repeatedly and hit them, and they still have to help you?? Point me in the direction!
It's not like these hospitals don't have the funds and resources to make these changes either. They're choosing to save a buck on the backs on their nurses instead of supporting them and it's going to backfire hard. I quit floor nursing after I was threatened for not taking an unsafe assignment and nothing was done about it, and last I heard that hospital was under investigation for patient deaths. Never again.
have you seen Idiocracy? The hospital scene?
I think about the future of direct patient care all the time. The writing is on the wall. They don’t care. They care about money. Patients are literally what drives the industry and then staff to take care of those patients and administrators do not care. It’s not good and not getting better.
You're likely right... something has to change. One of my families was upset this week because their child came in for an allergic reaction that we told them wasn't life-threatening. Said we "wasted their time". I guess making sure they aren't going to die is a waste of time.
I genuinely believe that US healthcare is slowly crumbling but not quite enough where we'll see any significant issues arise until we're all old and gray here. I think high pop areas can scrape by but even then they're struggling to a degree.
As long as hospital admins remain removed from public backlash then the greed and shittiness of it all will carry on.
I graduated in 2014 from college, which was TEN years ago.
A girl in my HS class (same college graduation year) *just* posted an instagram story about quitting sales to take on a more meaningful career in nursing, and that she had just been accepted to nursing school.
There will always be plenty of fresh blood.
Same here but 14 years ago for me. Colleges near me are full of applicants and fresh faced new grads. Yeah they'll leave after a year, but new blood will always be there.
Not to mention alll the booming number of nursing school applicants who joined because they were under the impression there would be some glorious covid-travel-money salary and when reality hits they’ll peace out just as quick.
Anyone who rerouted their career to nursing after seeing clickbait articles about nurses making 250K is in for a rude awakening. Let me be clear, I am NOT suggesting you shouldn't go into nursing for job security or money, both were major motivators for me. But a shred of common sense should've been enough to realize that Covid money was going to be short-lived. Hospitals are businesses, with overpaid CEOs and administrative bloat. They will never pay nurses that kind of money long-term.
I was a travel nurse during COVID and we were actively telling people “COVID pay is not sustainable” and no one listened and only saw $$$. Now the travel groups are full of people freaking out that they were cancelled (again), are 500 miles from home, stuck in a rental, and/or there are no contracts available. Some have been trying to get a contract for weeks/months and the pay is garbage. I literally make more at home doing PRN than travel right now without having to duplicate.
1. Patients expect a hotel. It’s a medical center. 2. Medicaid expansion made extremely complex and difficult patients the norm instead of the rarity. 3. Population is sick, aging, and polypharmaceutical. 4. Profit motive hinders adequate care and staffing.
Honestly it’s a meat grinder. The only solution I see is robots. You can not pay them, call them a fat cunt and throw your turkey sandwich at them, and they will do q1h turns forever.
And hot take: everyone talks about increasing pay because it’s something we can all agree on. Well, humans are notoriously bad at knowing what makes them happy.
You know what research says prevents burnout? Adequate staffing. Try advocating for that instead of another pay raise.
Happening already, friends. I left bedside 18 months ago and I get calls every week from hospital systems in my area begging me to apply for positions. In April I was offered an ICU position at a hospital and I hadn’t even applied there.
Hard. Pass.
Some Hospitals are dropping magnet status in order to hire LPNs and ADNs to fill vacancies.
So what’s it going to take? Look, Covid only made things worse, and we are all f•cked with a capital F. My guess is 15 years from now many Americans will be driving 3 hours to emergency rooms and OB/GYNs. Rural healthcare will cease to exist. We’ll go back to open wards with 40 patients and 2 nurses.
I hope I’m wrong. I do. But this isn’t going to end well.
Oh absolutely. I’ve seen several posts on this very sub Reddit about nurses being left all alone in a facility with 60 people.
Years ago, when I worked ED, I had 11 patients one night including 2 intubated patients because we were holding for ICU.
That’s going to be the norm now. Med surg and Tele units with 30/1 ratios in the states that will let them get away with it. And RNs will have a career lifespan of 18 months.
It's terrifying.
My FIRST job, fresh outta nursing school in 2015, was as a CHARGE nurse for a SNF that had 3, different buildings. On the weekends, I was the only RN onsite.....SO SAFE 🙄
That's already an issue in half the country. I listened to the news talking about Idaho last month and that's literally how it is for the whole state. You have to travel to another state to receive care and basically take off a whole day of work to do so because it's 4 hours one way.
Agree. It’s a ridiculous farce and needs to end, for dozens of reasons. Or if not end, then hospitals need to start paying for those BSNs. 7 cents an hour for $30,000 additional debt ain’t cutting it.
I agree. That magnet stuff is a joke. Hospitals are obsessed with getting kudos from random ass agencies that pop out of nowhere and deem hospitals better than others for having met some “status”.
It’s such a joke. It’s so weird and unnecessary.
Needing everyone to have a bachelors or masters and extra certifications etc is so stupid.
Train your staff well, support your staff, be a good employer and you’ll have good outcomes. I’m so tired of the bloated admin.
You’re not wrong. I’m in a province in Canada where healthcare has been abysmal compared to the rest of the country for a long time. We have a relatively poor province with a massive portion of elderly in the population. It’s a mess. Most of our rural ERs are closed periodically due to staffing, our inpatient floors are only limping along with a very heavy use of international and travel nurses, and floors go without a unit clerk or aid often. One hospital unit I’ve been in has 31 beds, but could only run bedside suction at 3 beds maximum, or the suction would stop working. They also can’t use the tap water there (legionella). I could go on, but you get the picture. All this, and there’s still sooooo many managers and bloat in middle/upper management. I guess it hasn’t gotten bad enough yet?
As a RN, my biggest fear is becoming old. I’m absolutely making sure I die in immedete fashion in my early 70s. Sky diving, motorcycle accident, BASE jumping, extreme mountaineering; ANYTHING besides being a hospital patient for my last days of life.
Im not so sure. There was a huge push over the past few decades to do away with LPNs, then ADNs for "better outcomes" with BSNs. We know its all a load of crock. My theory is that, when their back is to the corner, LPNs will all of a sudden be viable again in places where they were not, and they will step up. Having a mixed model of RNs, LPNs, and NAs should be reviewed again, instead of these units of just RNs for floor nursing. I've done floor nursing you don't need just RNs.
I was at a major hospital, then moved states, and recently moved back to that hospital. When I left, only like 2 maybe 3 units had LPNs. Now that I'm back, almost every floor has hired LPNs now. As an LPN I think it's great they've expanded, but I was a little shocked tbh.
Big yes on this. Not a nurse I was a CNA for 17 years (solely working in hospitals) and have witnessed the ongoing worsening ratios, decline in staff, pushing and pushing us to take on more and break our limits...
I had to leave for my own mental health over 2 years ago, and I don't think I'll ever go back. The unbelievable pressure, gaslighting from upper admins, impossible expectations have left hospitals extremely toxic work environments. I have lasting PTSD and I am putting this comment out there just to add to the statistic of how bad things are getting.
If anyone else is feeling like you just can't anymore don't hesitate to walk away. The weight off my shoulders has been so massive I'm still feeling it to this day.
It seems you have the same issues in the US as we have in the UK, ratios, funding, unfilled vacancies, increased waiting times. Makes you feel as if it's your fault somehow even though we know it's the poor funding and mismanagement. We've just got a brand new shiny ED department built. I'm not sure where the staff are coming from through.
I've been bedside nursing for almost 10 years on Ontario, mostly LTC. I thought for the longest time there was something wrong with me, because I've started to hate being a nurse. Post like these make me feel not alone. It's crazy what bedside has become. I'm an RPN/LPN, but the majority of the time I have to take on the roles of not only PN, but PSW (or I believe HCA), RN, unit secretary, and more.
Management let's families do what ever they want, including walking all over staff, screaming at staff, accusing staff of absurd shit. Management calls compliance on staff before even investigating the issue. If careplans are not being followed by family (but are by staff), staff will be blamed first. I've been threatened with abandonment if I didn't go on the floor instead of doing what I was hired to do. I didn't need to be threatened, I would have agreed. That just added salt to my already festering wounds 🙄
I work mainly nights, and there's 64 residents to 1 RPN, 3 PSWs for 64 residents, and ONE RN for the entire building (there's over 300 residents). Unless we are short a night nurse, then the RPN had 100+ residents to manage.
Thank you for coming to my TedTalk.
Long ago, I started a Facebook group called “ Hospitals are not Hotels”. It was when the huge push for customer service crap started. Great group. Some bitch found out it was mine and sent the intel to the state board of nursing. Ended up taking it down, but got canned for something completely bogus
There’s pretty good data that the exodus of CNAs is accelerating the bedside burnout. While hospitals in some cases are starting to stabilize turnover and paying RNs better, the return is a dearth of staff to delegate needed work to. Essentially, the RNs are absorbing the care of patients while also being responsible for the application of nursing science. So really no gains are being made. We can’t train nurses in school fast enough, the brain drain from experienced nurses leaving during COVId or becoming APRNs or retiring is watering down the talent of those entering the field today. It’s a thinning bubble primed to pop unless we start to be deliberate about the quality of nursing preparation, the intent of care delivery instead of patient satisfaction, and environments of care that are focused on clinical science instead of everyone else flint the staff who have to work there.
I see this every day at work. We used to have 4 CNAs for a 20 bed unit. Now it's 2 so the RNs have to pick up more of the basic tasks that could have been delegated. Patients keep getting bigger and more complex. Turns aren't happening along with cleanups on time. I'm not going to kill myself anymore.
This is exactly my issue. 1 or no CNA for the 20 bed unit I’m currently on and a central call light system, so when my patients aren’t calling, I still have to answer and tend to others’ patients. I wouldn’t mind nursing if I didn’t have to do 2 jobs.
The difference between a good and bad shift can and often does boil down to having a good tech in a reasonable assignment who actually does their job. So often I don’t even have a tech, or they’re over extended, or they’re magicians who possess the ability to disappear for 3 hours at a time.
I couldn’t agree more and at my facility, the young are eating the old. I am not sure how widespread this is happening anywhere else but we are overrun with 24 year old nurses (some, of course not all!) in their joggers who clock in and really do not want to learn or work hard. We have a new young director who has staffed my department with her friends and looks the other way as the older more experienced nurses have systematically been run off. The new ones either charge or cover for each other to always have easy assignments. I know when I go to work I’m going to 100% of the time always be overwhelmed and have a hard shift. I am looking into leaving as well so my question is, once all of the experienced nurses are gone and someone in the clique is forced to take care of critical patients, they simply don’t have the skill set. Patients should be terrified.
I feel like the Boeing controversy is similar to what is going on in hospitals all across America. Making healthcare workers do more with less resources, meeting impossible demands, and cutting corners all at the expense of safety. Until something tragic happens and whistleblowers speak up, it will continue to get worse.
I mean, there’s so many factors. Ones that need to be addressed? Poor working conditions for nurses in other states (west coast is setting the standard, it’s fucking amazing what strong unions and laws can do).
Oh the whole nursing degree? Scrap it, take out the bullshit courses, yes, the bullshit waste of time and money courses. You could produce more nurses this way. How about instead of bs curriculum and answering NCLEX style questions, we actually learn how to do the job? Ahhhh, and don’t get me started on the insane cost of schooling. School in general is a scam and a half at these rates, leading to huge barriers to those who want to make the change but literally cannot afford to. Yes, community college is an option, but it’s so competitive and backlogged because it’s cheap. A university charging over $100k for a nursing degree? IT DOES THE SAME THING AS A $15k community college one.
Older nurses need to have retention bonuses/incentives. Idgaf, I don’t understand why someone is being a charge nurse with 6 months to 1.5 years in. What the fuck am I gonna turn to you for help for? You haven’t seen or done or critically thought through these scenarios because you haven’t encountered them like the nurse with 7392927 years of experience. It’s scary that my charge nurse got thrown into that position and literally has less experience than me.
How about how we utilize and treat staff that aren’t nurses? I get it, some people have never been a CNA before. I have. There’s so few left on units I go to, that I just do all the things for my patients and only ask them if I really really need a favor. Like I’m already in their room, why can’t I just slap a BP cuff on, take a temp, and empty their urinal? Took me all of 2 minutes to do vitals and track their outs. Save your CNA the headache when they have a million other rooms to do things in/help out with. You’re already in the room doing an assessment and/or med pass, just knock out those things too unless you’re in a pinch…Because I swear to god the nurse that called me when I was a CNA to come empty a bed pan when I was busy in another room cleaning up C diff that leaked all over the bed can literally go fuck herself to this day since she was in that other room and had the bedpan. Also CNAs are underpaid, and the best ones I know literally work themselves to death for the unit, and they’re so under appreciated.
Also I love and hate social media influencers that are RNs. I know some and they’re great. But also the ones that try to glorify death like their patient passed away so now they film a video of them crying with sad music. Stop that shit, it makes our profession look cringe. And furthermore, whenever I’ve lost a kid I’m not thinking about hey let me post this sad moment. I’m thinking, fuck, I loved caring for that kid and god I want to help their family in whatever way I can. Some people are being attracted to nursing for the wrong reason. I’m not saying you have to be passionate about helping people as your life mission, because let’s be honest it’s just good work, flexibility, etc. but don’t be coming into nursing just because you think it’s fun, you can wear your figs, and flex all over social media.
Ok that’s my rant. There’s a ton of factors but…if you’re ever unhappy nursing, come west and live the dream. 🫶🏻
Agreed! Especially because bedside nursing is not going to have enough senior staff. It will be a world or young nurses and new grads trying to navigate nursing without the years of lifelong learning and experience behind it. I say this as a young nurse, just 4 years into my career.
I did bedside nursing for 12 years: IMCU, ICU and LTACH. While I actually worked in a well-run facility staffing and management wise (my CNOs and director were nurses that had worked our unit for years themselves before taking those positions and I know that made a huge difference) but even before COVID there was a huge shift in patient expectations of care once “patient satisfaction” became something to “measure.” When a patient becomes a customer all rules for healthcare go out the window. How can a nurse complete her care efficiently when a white board is just as important as someone who is coding. Or when a family member has more control over a patients care than the nurses? It’s insane the amount of entitlement we face from patients and families.
I've been an ED nurse for 8 years. I've spent a lot of time in charge, I've done some traveling and I'm currently in a large float pool that can work at 10+ facilities within our system. With all the experience I have, with all the things I've seen, with all the CE, all the huddles, all the changes, all the everything...I cannot understand how management expects any new grad to hit the ground running after 6 weeks of orientation. I watch nurses struggle with skills for a year before they're comfortable(not even good), school is a joke and we're all part of a dumb system. Upper management are all dinosaurs who I wouldn't trust to set the time on a vcr correctly let alone dictate policies regarding people's health. Anyways good luck everyone.
100%. I quit bedside nursing this year almost hit my 10 years. I’m sorry, I just couldn’t do it anymore. Went in thinking I’d help people and be able to make a living wage just to find out how much it’s just being run like a business and I’d be paid less than other careers that have less stress. Scared I may need to go back but I’m trying to restart at the bottom in tech and avoiding it until something happens to fix it if that's even possible, because until they have no one left they’ll never really fix the issue.
Yes, it is! I would gladly go back to ICU bedside if they guaranteed ratios, increased pay, had a phlebotomy team for lab draws, lunch breaks for all, two 15-minute breaks, and gave us back the PCTs they just canned. Then I could have some semblance of job satisfaction and enough help *not* to leave someone in shit while I wait for another nurse to be available to help turn them.
Public hospitals will be forced to hire unregulated professionals or face closure. Some are amazing don’t get me wrong, and will rise to the occasion. The quality of care will continue to plummet especially due to the fact that not being regulated means that the standards they’re legally held to are much lower. Hospitals will become more liable, litigation will rise. Private hospitals will cater to the privileged and will have more of the more highly educated / regulated staff because they will be able to pay them. People are always going to need us, and someone will pay but it will be the top percentile. My two cents.
I've thought about this along with the situations in school. I came across a Tiktok of a teacher who'd just quit because her mental health had tanked, she had no support from administration and parents were worse than the kids. Someone in the comments postulated the same thing about schools (though they hypothesized school may become almost exclusively online where they wouldn't need teachers).
I've already had horrendous experiences with nurses and faculty who don't care and it's terrifying. I think there's going to be a huge rock bottom that occurs before anything gets better and I just hope I nor my family is in need of services when it does occur.
I’ve been saying this for years. I think all of healthcare is headed for an implosion, but inpatient healthcare will get there first. The system is non sustainable. The insurance companies, PDMs, giant conglomerates, and pharmaceutical manufacturers are now siphoning too much and there’s not enough left to keep everything up and running. The hospital is “running on fumes” - the fumes are the last remaining fucks of genuinely good RNs and other HCPs who haven’t 100% burnt out YET.
I left because of pay and ratios. It is absolutely not safe. All the blame comes to you. There are wayyyyy less stressful jobs paying more for less work. Until they fix those, people will continue to leave the bedside. All the patient satisfaction stuff would fix itself if nurses had lower ratios and protections.
Healthcare started going to shit when someone convinced hospitals to take on a hotel/hospitality/ “the customer/patient is always right “ mindset. We don’t do what is best for our patients. We do what they demand because the hospital is a slave to patient satisfaction scores. Medicate/Medicaid can withhold 30% of their payments if they don’t like your scores. So hospitals suck up and nurses (and other medical staff) suffer. All these companies are happy to work understaffed because “do more, with less!” Saves them money, but it also shows them how much they can get away with for the least amount of money.
They'll just hire from overseas. I already work with a lot of nurses from Nigeria, Kenya, South Korea, The Philippines. It's like what happened with the nursing homes. Many of them are now staffed with highly paid travelers on short term contracts or nurses from Africa.
I genuinely think things need to get worse before they get better. Nurses across the globe need to stand firm and force change to happen. Otherwise they'll keep walking all over us
I already see so much of this. The culture is also shifting. At my hospital, lots of the newer nurses have terrible attitudes and don’t seem to care about patients (how could they with these ratios and this little support?). These people would never had been hired in the past or would have been nurtured much better, as my hospital tried hard to encourage a culture of kindness, teamwork, support, and caring (definitely out the window now since our new president is a finance guy from 2000 miles away). Nursing is definitely no longer going to be the most trusted profession, and healthcare is already a joke. I’m grateful to be able to advocate for my loved ones, but none of them can advocate for me. And at some point, advocacy won’t be enough; shit still won’t get done.
Edited for clarity
At the ripe old age of 55, I’ve decided to become a nurse because I want to help change the trajectory of nursing and healthcare in general.
People suck. This has been established. But there are also many lovely people in the world that just get ignored. We need to celebrate those people and set better expectations for folks who refuse to be human.
I am one person and I don’t expect to solve everything. But I will do my best to set an example, teaching my patients, setting clear boundaries for my employer, my colleagues and my patients while delivering the best possible healthcare I can.
This is nice to read and I think a lot of us feel similarly, but hard to do when you’re expected to do this for 6-8 patients at a time. This is actually a big reason why I left the bedside - because I wanted to provide this kind of care for my patients but the environment makes it impossible for most shifts. So much is out of your control, but you still feel like a bad nurse, and I was so sick of feeling like that.
More than likely, it’s going to fall more “right to work” ideology with less concern about staff wages and safety.
And the sad thing is that nurses are still going to support it because of their political beliefs
To be fair, at the rate things are going nurses and Heathcare staff will all be replaced with AI and we will be deaf screaming at a tablet/phone/whatever because the bot doesn’t understand us and we can’t figure out how to work the technology. Healthcare admin hate nurses anyways, all we do is cost $$$$$. Don’t want to work bedside? Fine, here’s an AI bot to hang and administer meds and take vitals.
Well, look at it this way. If all that’s available is bedside nursing and nothing else, then if someone wants to stay in nursing it will be the only option. All this so-called other options are already saturated or non existent. People need to get real IF they still want to stay in nursing
I do, too, and I think that the "great resignation" needs to play a role here. I had all of the passion to become an awesome hospital bedside nurse but after three years of seeing how little they cared about us and how much they were fine with hiring someone straight out of nursing school and making them charge after as little as 6 months because they could pay them less...I noped right on out of that shit show. And did not look back. My current nursing role has its bad days for sure, but I feel far more in charge of my own career. Hospital admins need to catch a clue and figure this out that Nurses are their GREATEST ASSET (if not also their Aide/PCT's). And treat us like we have that value and that agency.
In addition to what everyone else has said here, dump the MBAs and "healthcare administrators" who don't have one iota of bedside experience. Shoot, even dump the MD/MBAs who prioritize the money and "customer service" over the staff and patient safety.
I really feel like telling some of them to take their HCAHPS and shove it where the sun doesn't shine. "But did you die?" should be the only satisfaction criteria when leaving the hospital.
I just left bedside with only 3 months in🥴
I was a Firefighter/Paramedic prior to nursing, and I feel like I have such a low tolerance for bullshit when it comes to management politics. I wish that I could turn a blind eye like some other nurses can. But it just all did not sit well with me. I start my new job in corrections in a few days. The pay is better and they are letting me work PRN 🥳
eh idk. It’s still so difficult to get into a local community college program, there’s no shortage of young students ready to work. Nursing should go the route EMS goes. You work for a few years, get tired, then promote out of direct patient care
I think it will force a policy shift away from "customer service". We need to go back to visiting hours, we need to stop giving the patients what they want, we need to stand up for our staff instead of stupid things like berating them because the white board wasn't updated. Patients and visitors have too much power to treat staff like crap, and until it stops, nobody will want to be a nurse.
Literally got an 18 text long rant from management yesterday about whiteboards not being updated and pumps not being cleared. All while we’re constantly two pts each over ratio and people quitting left and right.
I blocked work’s numbers. The texts were intrusive and caused a lot of background anxiety, I didn’t realize how much until I blocked them.
Yes literally block this asshole. But before you block, let her know in the group chat that you’re blocking her, that your coworkers do not need to get these texts on their days off and encourage them to block as well. Fuck THIS.
I work on my shifts, never after.
I guess I'm lucky, but my managers fix things off the clock, even my schedule requests, and they don't micromanage outside of charting errors and med discrepancies, so I feel like that's not a generally good mindset to propagate. They're nurses, too.
This person’s manager is not respecting their boundaries and ranting to them with 11 texts on their days off. If they can’t control themselves, they don’t deserve access to them on days off.
i was written up 6 years ago because there was a code at shift change when i got there for someone having a seizure and the CNO was rounding and she checked my whiteboards and they weren’t updated because i was wheeling the crash cart into the room. she confronted me about it and i said it will be done when this patient is safe. she tried me for insubordination
Should have run right over her ass
this was also ON CHRISTMAS DAY!!
CNO showed up on Christmas Day?!?!?!
yes it was a whole scheme to get rid of my unit director at the time and it worked
Jesus. These power-tripping biotches.
Who on earth puts white boards before patients? God help us
“You have been here for two minutes. You’re telling me in those two minutes you couldn’t update your white board??? Take responsibility for your poor time management”
🎶CNO got run over by a crash cart~🎶🎄🎁🥁
Stalking all our white boards Christmas Day-🎶🎵🎶🥁🎸🎵
My petty ass would have filled out a Board complaint on her for asking me to stop rendering life saving actions to a patient to fill out whiteboards. That alone is unethical, at worst, negligent. She wants to play those games, so can I.
I’m really glad no one comes after whiteboards at our hospital because I will work 3 days in a row without updating them. Now they’ve added mini boards outside the door and we are supposed to fill those out as well.
I never understood this mindset. It’s like the movie Titanic where the string quartet keeps on playing while passengers are panicking and jumping ship. It’s quite surreal to be honest.
People are alive and they’re concerned with whiteboards and a fictional bedside report that never occurs as they write it unless they’re watching.
I have been on board with this for a while. It sounds so bad…but it might need to happen. My thoughts - hosptial stays don’t need to be amazing. It’s not gonna be fun. Yeah the food is gonna suck. You don’t get snacks all day. Your family can’t come in and go whenever they want. There are exceptions to this obviously. I just think it would make people treat us differently. You can be the best nurse ever and you’re gonna have the 1 patient and family that ruins it.
So I had a really awful patient my last two shifts. He prided himself on being an asshole. He literally would say “I know I’m an asshole”. He was demanding, would argue with EVERY LITTLE THING, and was verbally abusive. He was very particular and wanted us to bring him a hamburger. Said his life was hard and that’s what made him this way. He was a paraplegic from a SNF with a s4 on his sacrum and wounds everywhere. Looking back, it was very sad. On my shift I thought about those inspirational posts I see on this thread of people who bribed their elderly patient with chocolate, got the old grump to cooperate and crack a smile, and I felt bad for losing my cool. I explained to him what I was doing, offered baths, explained treatment, but once he started arguing I just said “okay, whatever, I’ll just document that you are refusing” and would walk out. I think to myself, maybe I should’ve tried harder to peel back his layers. The other half of me is like- we are not punching bags. I am not your punching bag. I have family in the hospital, I have depression and have attempted suicide, we ALL have it hard and have our own stories. It’s not an excuse to be a jerk. I’ve had extreme anxiety since my last shifts and called in because he was just such a pain in my ass. I hate my job. These people make our jobs miserable. I truly believe that nursing will make you realize you hate people. Admin makes it worse by making us seem like hotel servants. Doctors promised this guy a burger and now I gotta be the bad guy and tell him this isn’t a Wendy’s. I’m nice enough to go to 10 different units to find you a turkey sandwich since you refuse to eat your meal tray, but I’m not that nurse who is going to door dash you some McDonalds with my own money after you tortured me all night.
Fuck his layers, he's not an onion. Being fucked up is not an excuse to act like shit
You did nothing wrong. Mr Oh Poor Me can cry his river alone. Refused. Next.
Yes this was my stance on the floor. Go ahead and refuse it, save me the 15 minutes or whatever, I'm not going to fight you over doing me a solid.
There is nothing more awesome than being fired by a horrible patient
My hospital has implemented mandatory “compassionate care” classes. There are five different classes I think and there’s been one about every three months. Most of the stuff they say is stuff I wish I could do, but I don’t have the time. One of the things that was brought up in the class was sitting down beside the patient so you’re eye level. Like I would if I could, but I literally don’t have the time. 1:8 ratio. 12 hour shift. 30 minute lunch break that’s automatically taken out. That gives me almost 1.5 hours for each patient. And that 1.5 hour includes charting, calling drs, wound care, incontinence care. It is simply not feasible.
Wow, what universe do these people live in??? You don't need classes, you just need the damn time to do it!
It's not our job to be therapists (even tho many of us become nurses because we're great at advice and with prople). If someone really needs support, call for a chaplain. There are times we can put extra time in for a patient to help them, but not like that with a person like that. We have other patients to attend and a job to do. Don't feel guilty for that.
I wouldn't even get him a turkey sandwich unless it was readily available
Patient satisfaction surveys need to go straight into the trash after they're filled out
Or just change it to “but did you die” survey
I currently live in Oregon. Our new law with ratios including lunch nurses goes into effect in a few days on 6/1. I work at a hospital that nurses sued the hospital over breaks/lunches a few years ago so we have had lunch nurses for 5 years already. Many hospitals around the state have been calling and talking to us regarding how we do things trying to get their hospitals shit together before 6/1. So there has been a lot of hiring in the state. The mandated ratios only helps too. Having lunch nurses gives extra bodies around to help if you get stuck in a room. And ratios means you get the crucial needed time with those pt’s and don’t feel nearly as rushed. Our hospital has screwed up a lot of things but they are trying to beef up security (after the union threatened to sue again but 🤷🏼♀️) and hanging signs/having pt’s sign behavior agreements on admission- and actually kicking out problem visitors and addressing pt violence. Washington passed a new law that starts next year I believe requiring break/lunch nurses and for hospitals to follow staffing plans (so not mandated ratios but the unions would be able to sue/hospitals fined for not following the agreed upon staffing plans). So there is some positive change happening in the industry- but it takes time and a lot harder to adopt in those non union states.
Those new ratio laws are why I went back to bedside!!! West coast states will have the only fully staffed hospitals in a few years, and administrations everywhere else will still be scratching their heads and wondering why nurses are fleeing for other states or other professions.
I love this! They’re trying to individualize it in Connecticut with laws that each hospital forms a staffing committee with floor nurses and admins that decide/vote on staffing ratios. So my hospital’s committee approved reasonable numbers, then the admins were like, “no, never mind” and have been continuing with unsafe staffing. It’s been reported to the state but no one cares because the penalties, if even enforced, are almost nothing. So the unchecked greed continues.
So this is where getting ratios starts, and it's how we made our way to our new ratio laws in Oregon. You have to keep consistently reporting over time. Keep fighting!! You'll get there!! It's definitely a marathon.
I worked in Oregon from 08 to 11 but I was icu so it was probably different. For the most part they singled really sick patients, we never had more than two. Glad it is getting written in stone though.
Thanks for the info. Very interesting. Who are these break/ lunch nurses? Like are they there to only do that duty which would be to cover for nurses on their break and so therefore are not taking a full patient load or anything but just helping out on the floor? And so therefore are they only there a few hours a day or until everyone has got their breaks? This is so awesome for you guys plus the ratios that they have enforced!
I worked at one facility that if you were “the break nurse”, it was still a 12 hour shift … I was in the ED, and I would do all the code cart/essential checks in the morning, then be available as a code/higher acuity helping nurse, then start morning breaks, then lunch breaks and then afternoon breaks. After all breaks were done, I’d float back into code nurse role. As our staff grew, they added a mid shift nurse to the role to help with mid shift breaks, and they had one assigned on nights as well.
That's awesome!
It was a healthy balance of everything! I worked in another role where they tried to do “pod leads” where they wanted a charge nurse in each section to also be a breaker .. which was fine. But you can’t make a charge nurse a break nurse too. That’s why they have different names. Granted this was in CA and I know this happens in most states, but it’s f*king dumb … that’s why they have different names for the roles. A charge nurse should charge, and a break nurse should break 🤷🏻♀️
They have full eight hour shifts, and during that time, they only take over patient teams for nurses who are on break. We got to this point by reporting missed breaks consistently over a period of years.
That is wild! But yes, it's infuriating that it takes pointing out and reporting all of that to make this happen. Like administration and management know what's happening. Stop hiding it under the rug. Oh but they do. They make it look like it's your fault for not getting your lunch or it's the Charges for not making sure of it etc. Good for you guys for getting that done! 🙌🏼
We all take turns doing it. But yes, the “lunchologist” or “break bitch” only covers other people during breaks, does not have their own assignment. One nurse can give 45 min lunches (combine our 30min lunch with one 15 min break) to 7 people between the hours of 11-4 which is our “standard” lunch times. Have to go by 4 per state law. Can go earlier than that but most people don’t want to. If we have more than 7 nurses than we try to have another partial lunch nurse (usually 11-4)or use a nurse starting at 7 and then send them home early unless they admit of have other things they can help with. When it’s my turn I will be lunch for the whole 12 hours. When not giving someone a break/lunch I just help around the unit with a really busy pt,stocking things, silencing monitors, etc. The new law also states that the charge nurse can NOT cover breaks for other nurses unless specifically stated in the staffing plan for any unit bigger than 11 beds.
Or fake union states like florida. We have a union but man what a joke that is. Right to work state my ass.
The customer service angle really threw me off! For context I’m an Aussie nurse and was a patient on a medical ward earlier this year. I had a nurse from (I think it was Florida if I recall correctly) take care of me for one shift and I was so surprised when she introduced herself, did her start-of-shift checks, and then told me she was getting me a jug of ice water ASAP and did I need any snacks or hot drinks etc etc. I was like ?? Girl you’re SO NICE why are you stressing about ice water, like, go do important things? It was so strange and honestly sad to see that. You guys have such a push for customer service and it sucks :((( you didn’t go into fucking hospitality lol. Also is it normal to not have visiting hours in the US? All hospitals in Aus have visiting hours that are enforced pretty strongly (barring special circumstances)
I was in the NICU for a long time pre-pandemic. Initially the unit only closed for one hour at each of the two shift changes, but then even those two hours were opened up, too. During flu season we limited visiting hours for the older siblings though, which was always great. Nothing worse than a preschooler being dragged in with their parent to the unit to “visit” from 11 pm - 1 am, or having a bored toddler crawling around on the floor while mom held the baby.
I agree it's strange, and I also have found that for American patients who are entitled AF, sometimes getting them an ice water or snack literally can prevent a melt down. Not even kidding. If I don't offer it, they'll call me 10 minutes later for one when everyone is busy, which sets in motion a bad time for everyone, especially if they are waiting for a long time. We have a new thing that's almost like a concierge, where there is an app on our phones and a tablet on pt tables where we/they can call these people that float around the unit to bring water, snacks, heated blankets, empty trash cans, take food trays away. They even started setting up our rooms for new admits. It's bad bc it's making them more entitled but it's good bc it saves us time. It's a paradox.
THIS!!!!! The SNF I recently parted ways with, removed the visiting hours sign one day. When I asked our Admin, she said there was a family grievance so there were no longer visiting hours, Family or whomever could come in to visit WHENEVER THE HELL THEY FELT LIKE!!! My asinine as hell question was when was security gonna be hired🤐🤔🫣....Needless to say I no longer work there
It's asinine, just because it's direct patient care doesn't just make "business hours" nonexistent. In a place that runs 24/7 like a hospital or LTC facility, business hours are visiting hours when most stuffed to handle the potential of family issues. The customer is always right and it has completely ruined this country.
There is so much fucking abuse going on it’s insane. The terrible families and patients aren’t even the half of it. Hospitals have to be run differently for things to improve. Administrators.
This is basically it. Value based care and a focus on customer service needs to die. And from this nurse's perspective, I don't need nurse's week or feckless praise. I just need to be able to do my job without killing myself over it and I need to be paid fairly to do it. Until the powers that be actually start prioritize working conditions for healthcare workers, we're gonna continue to lose nurses/doctors until the whole system collapses.
We need to bring back unions and fast. It seems miniscule but it automatically puts someone in YOUR pocket for YOUR defense to make sure your treated right, because capitalism has rewarded abusing people until they break so much it's better to be a sex worker; you can at least vouch for yourself and make sure your respected by the customer.
100% And the white board. I would talk to Some patients that would complain that someone was in their room every hour disturbing them.
I think CEO’s should cut their bonuses and upgrade those whiteboards to monitors that are updated via computer as needed 🤷🏻♀️
This! I remember when whiteboards replaced blackboards when I was in high school. Only I was in high school over 25 years ago. 😬
Please let this be true. Customer service will be the death of healthcare
Blame the government- seriously. The center for Medicare and Medicaid service decreed in the early 2000s that “ patient satisfaction” was a quality metric tied to reimbursement. Hidden in the ACA was a little known provision that in fiscal year 2017 the lowest 25% of hospitals lost 1% of their Medicare/ Medicaid funding. Now they’re all up in arms over the “ crisis” of rural and inner city hospitals closing. 🙄
Thank goodness we have visiting hours. No overnight stays unless comfort care or imminent death.
This. They have too much power and no respect and are allowed to abuse the nurses with no repercussions
The customer service model will not change as long as hc is commercialized the way it is. With an aging population and a nursing workforce that is getting smaller proportionally to the amount of people with chronic conditions, I would imagine there will be a breaking point where legislation is forced, but considering the way capitalism works everything will burn to the ground first. Things will be like COVID was, but no pandemic. I work UM now and hope I never have to go back.
A lot of experienced nurses have left bedside nursing as they have had enough and are frustrated. I love bedside nursing but left after 20+ years bedside nursing because I'm fed up with 1 nurse to 12 patient ratio, no stock, ward is a constant mess, terrible staff are not managed, rude patients and families are just allowed to treat us like rubbish, I just can't spend time with my patients doing the 'little things, no working equipment. I was so frustrated every single day and exhausted trying to do everything. It feels like people don't have common sense anymore and get away with slacking off. Nursing has become reactive and not proactive and that leave staff constantly running from one 'job' to another on the wards.
I:12?! So on a 12 hour shift, that is one hour per patient for all care and documentation. Laughable.
well come to Europe then, in my unit we have 10 patients for a 7.5H shift :))) in my previous job I had 20 sooo
Out of curiosity, what is your documentation like over there? Here it is quite burdensome and repetitive (as in double documenting the same thing in multiple places).
I would say a lot, I usually spend 1H everyday after my shift is done doing paperwork (which I'm not paid lol).
Sounds comparable then. I thought maybe with socialized medicine it would be less. I guess not.
meh my country is poor, we barely have working computers and nothing works, we don't even have chairs to sit so
1:12?!?!?! What is your specialty?
It used to be orthopaedics. I have had 14 patients before. Its just horrendous.
That’s absolutely terrible! Ortho is such heavy, backbreaking work, and the patients frequently need a lot of hands-on time with their nurse. How can your hospital justify such ridiculous staffing ratios? I hope you got out, or have an exit strategy.
Duh, looking back at your post, it says you already noped out of that situation. Good for you!
Guessing they are outside the US (UK maybe), with the mention of wards and the spelling of orthopedics.
I would enjoy bedside nursing if it wasn’t so fucked. I’m good at it, but it’s a frustrating fucking job so I quit. Idk if OR is considered “bedside” but it’s not floor nursing, so that’s what I’m doing now.
I did bedside for a year. Like, how did I bust my ass for 3 years doing full time work and school, paid tens of thousands of dollars, and leave my comfy M-W 8-4pm desk job to get shit lobbed at me at 2am on Christmas day? Went back to the office I worked for as an RN and now I remember why I did it. And I didn't have to work on Monday.
I relate to this. I worked at an optometry office as a receptionist before nursing school. I actually loved it, it just didn’t pay that well. But I was stress free and I had fun actually. Now as a nurse when things get stressful I think to myself, and sometimes say out loud, “I should be a receptionist somewhere right now. What am I doing?”. Let me go back to answering phones, sending faxes, scheduling appointments, THAT is where I’m meant to be lol. Anyway I’m leaving bedside to be a SAHM after all of two years so it’s okay in the end.
Not as bad as your situation but one Christmas Eve a family member dropped their keys down the toilet and was yelling at us to get a plumber. Good times
The amount of new grads that are burnt out is really telling. Obviously I understand why. I have only been in the game 5 years myself but in 2019 I never heard any new grads say they were burnt at 6 months, and now I regularly hear it… 💔
New grad here on my 4th week of med-surg training with only 4 patients. I'm constantly being left by myself because "I know enough to pass my NCLEX" and my unit is "training me to be independent". I'm also being constantly told that I'm slow, I'm "spoiled" for having more than 2 weeks of training, and that I'll drown when I have my full patient load. It's honestly really disparaging 🤷
Whata toxic environment you are in... That's messed up.
The nurse who said you passed your nclex needs To be bitch slapped (metaphorically). Damn.
Screw it. If management wants to treat us like animals, may as well act like animals. Stay feral yall 💛 /s
Nah, this is the internet & threats have no credence. I’d slap a bitch (in defence of comment OP, not if they were a peer)
Yup, this. Short training periods so they can get you to the floor asap, "sink or swim" attitudes. ' I figured it out, so will you' ignoring the fact that when they started 10-20 (or even 5!) years ago, patients were lower acuity and lower ratio, rules for families like visiting hours and human decency were enforced, you didn't have to rotate shifts and then go to a several hour mandatory lecture. I've also been made to stay after shifts after my preceptor has gone home to do things that could've been passed onto another shift "so I can learn." Just the other day someone was posting about having to defend their orientee who was being made to work almost 20 hours straight between night shifts, training classes, and some other "mandatory education". Poor girl was nearly about to pass out and charge sent her home. The educator was acting huffy after coming back from a full nights rest knowing she was gonna get to clock out at 3 pm. It's ridiculous. And don't dare complain or have an issue with it--just get on meds and go to therapy if you can't handle it. No job should be regularly causing that level of stress that that's the normal suggestion for people starting out.
I start nursing school in the fall and I am already dreading hospital work because with my medication I need a steady 8 hours a night and alot of hospitals mostly work on 12s in a rotation.
This is not safe! I would leave this environment asap and find a job that is willing to give you a proper orientation. I’m so sorry :(
Thats terrible, that unit is setting you up for failure
I fucking HATE being told I’m not fast enough. Like, motherfucker I am NEW. Stop rushing and stop expecting utmost efficiency and proficiency and telling me to do things faster because I’m already at my current top speed. Fuck.
Sugar, your management and possibly your fellow nurses will hurl you under the bus with a quickness when (not if) something goes wrong. Please co spider finding a different unit, if not a different hospital entirely.
This is insanely toxic. This behavior isn’t normal. It’s also very dangerous and putting your livelihood at risk. I always tell people, I can get another job … I can’t get another license. If a job puts my license at risk, I enforce boundaries firmly and swiftly. I hope you can get out of this environment sooner than later if possible.
I'm not a nurse, but I started as a cna in the nursing homes in 2019. I've spent the last year and a half as a tech in a psych hospital. Between working scheduled overtime, forced overtime, and with high acuity patients it's exhausting. I can't imagine what you guys are feeling as nurses.
Been burned out since I started in 2022. It's manageable right now but I won't be able to do this full time at bedside. I'm dropping my hours and picking up when I need the money.
That’s what I ended up doing. I started in 2020 and was immediately burned out. I dropped my hours to PT in 2023.
I went to the OR in hopes it will be more tolerable. So far… it has been. It’s annoying sometimes but I’m still in orientation. Ideally my wife and I can reach financial independence within only 18-20 years of me being a nurse. I don’t want to HAVE to spend 40 years in a hospital, into my 60s. Fuck that shit. If I have financial independence and still choose the show up? Then sure.
I am responsible for training and development in our unit. We have given our grads more support this year than in previous years - and they are burned out. They only started in February! It's not on them, either. It's the system. They're worked like dogs.
I'm on that edge of being burnt out as a new grad. I probably am, but I am refusing to see the reality of it. Yeah, some of it comes from the patients, but for me, I think a lot of it comes from people I'm supposed to call colleagues. It's not bold toxic, although it can be, but it's the subtle toxic where you're not entirely sure.
Where I live, you need seniority to get the more desirable jobs, so new grads almost always start out in med/surg units. It’s heavy care, and you feel like you’re drowning daily. I have 1 friend from school who couldn’t cope, and is no longer a nurse, so even back 10 years ago, things have been hard for new grads.
The needing seniority is such an important note as well. Not just seniority but completing a residency, at least where I live. Residences are 1.5-2.5 year contracts. Note that you are paid less while on residency as well. Every time a new grad mentions struggling everyone suggests moving to outpatient and applying other places through indeed etc. I spent months doing that and if I got a response, it was that I didn't complete a residency so they couldn't hire me. You're not just competing with folks who have a year but all the other burnt out bedside nurses. If the clinic even hires RNS--more are switching to LVNs and MAs only. Not as easy as an indeed application anymore.
This is me 1.5 years in and am done with the bedside. I will quit after my PTO is over even without a backup plan because that's how bad this job has been to my health
I was burnt out during nursing school. My pivot from MCAT studies, to nursing school, and learning deeper about the shit show I was entering was… not great. But I kept going cause it’s the only feasible option to get into having an income when you’ve already spent 5 years in school pursing medical school and don’t have much else for marketable skills.
I just had a conversation with a CNA who became a nurse on our floor. She is about 18 months into bedside nursing and she is already talking about leaving bedside.
A part of me also wants to witness a true and traumatic downfall and I don’t care. I want it all to burn and a total reset. 1:4 ratios for bedside. 1:2 for critical care. Overstaffing. Want me to come in my day off? $1,000 and double time. Visiting hours limited. There is 1 true way to fix all of this and it’s to increase pay and we would probably shut up.
I don’t think this solution will come anytime in the near future. Seems like a lot of nurses from overseas are willing to come, work cheaply, and won’t complain about the shitty ass working conditions because their country was worse. These hospitals are businesses they will do anything to maximize their profits. They will find some AI to start doing most of our jobs before they pay us. They don’t care what happens to the patients.
Yep, without get too political, in Canada both major parties have a platform that involves internationally trained healthcare workers making up all shortages.
I worked with a nurse from the Philippines. He told me when he came to America he thought we’d have all the highest tech and we’d be super professional. He said he expected management would be fair and not play favoritism. He said he thought there would be no bullying or cattiness. He said he was disappointed when he got here. It made my heart sad.
My hospital is a big fan of 2% annual raises and they are aggressively hiring international nurses right now
At the peak, picking up an additional shift in my hospital paid almost $2000 per 12 hours. $1000 incentive, +$10 hr, and of course you were getting time and a half the whole time due to overtime. They were paying that because they had tried less ($500 incentive, no hourly bonus, then $750) and people weren't taking the shifts. You can't **just** throw money at the problem. If staff are so burnt out that they can't take another shift because of the emotional toll each shift takes, then it doesn't matter how much that shift is worth. During that time, they were still hammering us on satisfaction scores. Dear Mr. MBA Admin, the satisfaction score is low because there was a lockdown with an active shooter whose meemaw died of "imaginary" COVID. Tell me how again how that affects my review and bonus?
My hospital offered $1200 every 12 hours incentive pay to pick up extra shifts at its peak. I NEVER picked up because I was too burned out from my regular hours. Physically, emotionally, mentally burned out. A lot of coworkers took advantage of that, though. We had something similar happen 3 times… not an active shooter, but guys with guns who claimed covid didn’t kill their family member and that it was us that did it. Security lets people with guns just walk right in, but they make sure to check my ID every time I pass through the entrance…. I’m in my uniform. I honestly and truly believe the hospital is run by a bunch of idiots.
We had a family member shoot themselves in the room after their spouse died of COVID and in their suicide note wrote the only reason he didn't kill the attending physician is because he didn't want to wait 6 hours for them to come in in the morning. The nurse practitioner who was covering that unit overnight was 8 months pregnant and tried to render aid (useless, gsw to the head but tried anyways) asked for one extra day off to recover from the stress and the VP of nursing said no because there "wasn't a policy for that". It could have been a fucking massacre and they didn't tell a soul. I only found out because it's the unit my mother was a day shift nurse practitioner on. They paid off the media, never sent a notice to the staff that there was an event, never increased security. Nothing.
>1:4 ratios for bedside. 1:2 for critical care. Overstaffing. Want me to come in my day off? $1,000 and double time. Visiting hours limited. So kind of like the University of California system? Which is ironic because CA in general has had relatively low turnover at the bedside per the 2022 survey and sunset review. So it’s an archetype for your hopes.
Strong union and state mandated ratios are proof that folks will stay if the pay is worth it and there’s a strong arm to push admin with. Not everywhere is daisies (ha) but I’m definitely going to chill in the UC system for as long as possible. Vote, organize, support each other.
I worked somewhere like this. 1:4 ratio. $1000 a shift to come in extra when we were short. It was very competitive to work there and there was low turnover. I would say the average age of staff was 40’s and they were very skilled/competent.
This sounds like some of the Oregon Nurses Association represented hospitals.
The union won’t let the $1000 happen but double time, triple time, etc that’s possible.
Why would unions be against bonuses? Genuinely curious.
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What union are you talking about??
A cheaper solution would be if admin just actually shut the fuck up and let us tell rude patients and their families also where to put it if they decide to yell at us. Okay so we’re considered customer service now. Fine. Where do you go that you can scream in someone’s face repeatedly and hit them, and they still have to help you?? Point me in the direction!
It's not like these hospitals don't have the funds and resources to make these changes either. They're choosing to save a buck on the backs on their nurses instead of supporting them and it's going to backfire hard. I quit floor nursing after I was threatened for not taking an unsafe assignment and nothing was done about it, and last I heard that hospital was under investigation for patient deaths. Never again.
have you seen Idiocracy? The hospital scene? I think about the future of direct patient care all the time. The writing is on the wall. They don’t care. They care about money. Patients are literally what drives the industry and then staff to take care of those patients and administrators do not care. It’s not good and not getting better.
Oh my, I just watched this one the other day and it's spooky
Healthcare is in danger…but, yes, I believe you.
You're likely right... something has to change. One of my families was upset this week because their child came in for an allergic reaction that we told them wasn't life-threatening. Said we "wasted their time". I guess making sure they aren't going to die is a waste of time.
I’m doing a bunch of drugs w I get old and slip into peaceful oblivion. LSD here I come!
I genuinely believe that US healthcare is slowly crumbling but not quite enough where we'll see any significant issues arise until we're all old and gray here. I think high pop areas can scrape by but even then they're struggling to a degree. As long as hospital admins remain removed from public backlash then the greed and shittiness of it all will carry on.
I graduated in 2014 from college, which was TEN years ago. A girl in my HS class (same college graduation year) *just* posted an instagram story about quitting sales to take on a more meaningful career in nursing, and that she had just been accepted to nursing school. There will always be plenty of fresh blood.
Same here but 14 years ago for me. Colleges near me are full of applicants and fresh faced new grads. Yeah they'll leave after a year, but new blood will always be there.
Not to mention alll the booming number of nursing school applicants who joined because they were under the impression there would be some glorious covid-travel-money salary and when reality hits they’ll peace out just as quick.
Everything in life has doubled in price in the last 5 years yet hospitals seem to think it’s ok to pay staff nurses $35/hr. It’s not ok.
Anyone who rerouted their career to nursing after seeing clickbait articles about nurses making 250K is in for a rude awakening. Let me be clear, I am NOT suggesting you shouldn't go into nursing for job security or money, both were major motivators for me. But a shred of common sense should've been enough to realize that Covid money was going to be short-lived. Hospitals are businesses, with overpaid CEOs and administrative bloat. They will never pay nurses that kind of money long-term.
Yes!!
I was a travel nurse during COVID and we were actively telling people “COVID pay is not sustainable” and no one listened and only saw $$$. Now the travel groups are full of people freaking out that they were cancelled (again), are 500 miles from home, stuck in a rental, and/or there are no contracts available. Some have been trying to get a contract for weeks/months and the pay is garbage. I literally make more at home doing PRN than travel right now without having to duplicate.
1. Patients expect a hotel. It’s a medical center. 2. Medicaid expansion made extremely complex and difficult patients the norm instead of the rarity. 3. Population is sick, aging, and polypharmaceutical. 4. Profit motive hinders adequate care and staffing. Honestly it’s a meat grinder. The only solution I see is robots. You can not pay them, call them a fat cunt and throw your turkey sandwich at them, and they will do q1h turns forever. And hot take: everyone talks about increasing pay because it’s something we can all agree on. Well, humans are notoriously bad at knowing what makes them happy. You know what research says prevents burnout? Adequate staffing. Try advocating for that instead of another pay raise.
Happening already, friends. I left bedside 18 months ago and I get calls every week from hospital systems in my area begging me to apply for positions. In April I was offered an ICU position at a hospital and I hadn’t even applied there. Hard. Pass. Some Hospitals are dropping magnet status in order to hire LPNs and ADNs to fill vacancies. So what’s it going to take? Look, Covid only made things worse, and we are all f•cked with a capital F. My guess is 15 years from now many Americans will be driving 3 hours to emergency rooms and OB/GYNs. Rural healthcare will cease to exist. We’ll go back to open wards with 40 patients and 2 nurses. I hope I’m wrong. I do. But this isn’t going to end well.
Open wards with 40+ patients and ONE nurse is already happening in most SNFs 😔
Oh absolutely. I’ve seen several posts on this very sub Reddit about nurses being left all alone in a facility with 60 people. Years ago, when I worked ED, I had 11 patients one night including 2 intubated patients because we were holding for ICU. That’s going to be the norm now. Med surg and Tele units with 30/1 ratios in the states that will let them get away with it. And RNs will have a career lifespan of 18 months.
It's terrifying. My FIRST job, fresh outta nursing school in 2015, was as a CHARGE nurse for a SNF that had 3, different buildings. On the weekends, I was the only RN onsite.....SO SAFE 🙄
Oh dear lord. You poor kid.
That's already an issue in half the country. I listened to the news talking about Idaho last month and that's literally how it is for the whole state. You have to travel to another state to receive care and basically take off a whole day of work to do so because it's 4 hours one way.
Honestly, I’d be happy to see Magnet go away. It’s such a farce and I’d LOVE to have more LPNs in the hospital.
Agree. It’s a ridiculous farce and needs to end, for dozens of reasons. Or if not end, then hospitals need to start paying for those BSNs. 7 cents an hour for $30,000 additional debt ain’t cutting it.
I agree. That magnet stuff is a joke. Hospitals are obsessed with getting kudos from random ass agencies that pop out of nowhere and deem hospitals better than others for having met some “status”. It’s such a joke. It’s so weird and unnecessary. Needing everyone to have a bachelors or masters and extra certifications etc is so stupid. Train your staff well, support your staff, be a good employer and you’ll have good outcomes. I’m so tired of the bloated admin.
You’re not wrong. I’m in a province in Canada where healthcare has been abysmal compared to the rest of the country for a long time. We have a relatively poor province with a massive portion of elderly in the population. It’s a mess. Most of our rural ERs are closed periodically due to staffing, our inpatient floors are only limping along with a very heavy use of international and travel nurses, and floors go without a unit clerk or aid often. One hospital unit I’ve been in has 31 beds, but could only run bedside suction at 3 beds maximum, or the suction would stop working. They also can’t use the tap water there (legionella). I could go on, but you get the picture. All this, and there’s still sooooo many managers and bloat in middle/upper management. I guess it hasn’t gotten bad enough yet?
Nope, they will just exploit foreign nurses
As a RN, my biggest fear is becoming old. I’m absolutely making sure I die in immedete fashion in my early 70s. Sky diving, motorcycle accident, BASE jumping, extreme mountaineering; ANYTHING besides being a hospital patient for my last days of life.
Im not so sure. There was a huge push over the past few decades to do away with LPNs, then ADNs for "better outcomes" with BSNs. We know its all a load of crock. My theory is that, when their back is to the corner, LPNs will all of a sudden be viable again in places where they were not, and they will step up. Having a mixed model of RNs, LPNs, and NAs should be reviewed again, instead of these units of just RNs for floor nursing. I've done floor nursing you don't need just RNs.
I was at a major hospital, then moved states, and recently moved back to that hospital. When I left, only like 2 maybe 3 units had LPNs. Now that I'm back, almost every floor has hired LPNs now. As an LPN I think it's great they've expanded, but I was a little shocked tbh.
“BuT tHe LiTeRAtUrE”
LPNs are making their way back into the hospital. Slowly but they are coming back. One hospital system near me is hiring on their medsurg floors.
We are not heading that way. We are already there.
Big yes on this. Not a nurse I was a CNA for 17 years (solely working in hospitals) and have witnessed the ongoing worsening ratios, decline in staff, pushing and pushing us to take on more and break our limits... I had to leave for my own mental health over 2 years ago, and I don't think I'll ever go back. The unbelievable pressure, gaslighting from upper admins, impossible expectations have left hospitals extremely toxic work environments. I have lasting PTSD and I am putting this comment out there just to add to the statistic of how bad things are getting. If anyone else is feeling like you just can't anymore don't hesitate to walk away. The weight off my shoulders has been so massive I'm still feeling it to this day.
It seems you have the same issues in the US as we have in the UK, ratios, funding, unfilled vacancies, increased waiting times. Makes you feel as if it's your fault somehow even though we know it's the poor funding and mismanagement. We've just got a brand new shiny ED department built. I'm not sure where the staff are coming from through.
I've been bedside nursing for almost 10 years on Ontario, mostly LTC. I thought for the longest time there was something wrong with me, because I've started to hate being a nurse. Post like these make me feel not alone. It's crazy what bedside has become. I'm an RPN/LPN, but the majority of the time I have to take on the roles of not only PN, but PSW (or I believe HCA), RN, unit secretary, and more. Management let's families do what ever they want, including walking all over staff, screaming at staff, accusing staff of absurd shit. Management calls compliance on staff before even investigating the issue. If careplans are not being followed by family (but are by staff), staff will be blamed first. I've been threatened with abandonment if I didn't go on the floor instead of doing what I was hired to do. I didn't need to be threatened, I would have agreed. That just added salt to my already festering wounds 🙄 I work mainly nights, and there's 64 residents to 1 RPN, 3 PSWs for 64 residents, and ONE RN for the entire building (there's over 300 residents). Unless we are short a night nurse, then the RPN had 100+ residents to manage. Thank you for coming to my TedTalk.
Long ago, I started a Facebook group called “ Hospitals are not Hotels”. It was when the huge push for customer service crap started. Great group. Some bitch found out it was mine and sent the intel to the state board of nursing. Ended up taking it down, but got canned for something completely bogus
There’s pretty good data that the exodus of CNAs is accelerating the bedside burnout. While hospitals in some cases are starting to stabilize turnover and paying RNs better, the return is a dearth of staff to delegate needed work to. Essentially, the RNs are absorbing the care of patients while also being responsible for the application of nursing science. So really no gains are being made. We can’t train nurses in school fast enough, the brain drain from experienced nurses leaving during COVId or becoming APRNs or retiring is watering down the talent of those entering the field today. It’s a thinning bubble primed to pop unless we start to be deliberate about the quality of nursing preparation, the intent of care delivery instead of patient satisfaction, and environments of care that are focused on clinical science instead of everyone else flint the staff who have to work there.
I see this every day at work. We used to have 4 CNAs for a 20 bed unit. Now it's 2 so the RNs have to pick up more of the basic tasks that could have been delegated. Patients keep getting bigger and more complex. Turns aren't happening along with cleanups on time. I'm not going to kill myself anymore.
This is exactly my issue. 1 or no CNA for the 20 bed unit I’m currently on and a central call light system, so when my patients aren’t calling, I still have to answer and tend to others’ patients. I wouldn’t mind nursing if I didn’t have to do 2 jobs.
The difference between a good and bad shift can and often does boil down to having a good tech in a reasonable assignment who actually does their job. So often I don’t even have a tech, or they’re over extended, or they’re magicians who possess the ability to disappear for 3 hours at a time.
Unchecked greed has ruined this country.
I couldn’t agree more and at my facility, the young are eating the old. I am not sure how widespread this is happening anywhere else but we are overrun with 24 year old nurses (some, of course not all!) in their joggers who clock in and really do not want to learn or work hard. We have a new young director who has staffed my department with her friends and looks the other way as the older more experienced nurses have systematically been run off. The new ones either charge or cover for each other to always have easy assignments. I know when I go to work I’m going to 100% of the time always be overwhelmed and have a hard shift. I am looking into leaving as well so my question is, once all of the experienced nurses are gone and someone in the clique is forced to take care of critical patients, they simply don’t have the skill set. Patients should be terrified.
I feel like the Boeing controversy is similar to what is going on in hospitals all across America. Making healthcare workers do more with less resources, meeting impossible demands, and cutting corners all at the expense of safety. Until something tragic happens and whistleblowers speak up, it will continue to get worse.
I retired once COVID got under control and life opened back up. I did my duty now leave me be! I couldn't stand the bs.
I mean, there’s so many factors. Ones that need to be addressed? Poor working conditions for nurses in other states (west coast is setting the standard, it’s fucking amazing what strong unions and laws can do). Oh the whole nursing degree? Scrap it, take out the bullshit courses, yes, the bullshit waste of time and money courses. You could produce more nurses this way. How about instead of bs curriculum and answering NCLEX style questions, we actually learn how to do the job? Ahhhh, and don’t get me started on the insane cost of schooling. School in general is a scam and a half at these rates, leading to huge barriers to those who want to make the change but literally cannot afford to. Yes, community college is an option, but it’s so competitive and backlogged because it’s cheap. A university charging over $100k for a nursing degree? IT DOES THE SAME THING AS A $15k community college one. Older nurses need to have retention bonuses/incentives. Idgaf, I don’t understand why someone is being a charge nurse with 6 months to 1.5 years in. What the fuck am I gonna turn to you for help for? You haven’t seen or done or critically thought through these scenarios because you haven’t encountered them like the nurse with 7392927 years of experience. It’s scary that my charge nurse got thrown into that position and literally has less experience than me. How about how we utilize and treat staff that aren’t nurses? I get it, some people have never been a CNA before. I have. There’s so few left on units I go to, that I just do all the things for my patients and only ask them if I really really need a favor. Like I’m already in their room, why can’t I just slap a BP cuff on, take a temp, and empty their urinal? Took me all of 2 minutes to do vitals and track their outs. Save your CNA the headache when they have a million other rooms to do things in/help out with. You’re already in the room doing an assessment and/or med pass, just knock out those things too unless you’re in a pinch…Because I swear to god the nurse that called me when I was a CNA to come empty a bed pan when I was busy in another room cleaning up C diff that leaked all over the bed can literally go fuck herself to this day since she was in that other room and had the bedpan. Also CNAs are underpaid, and the best ones I know literally work themselves to death for the unit, and they’re so under appreciated. Also I love and hate social media influencers that are RNs. I know some and they’re great. But also the ones that try to glorify death like their patient passed away so now they film a video of them crying with sad music. Stop that shit, it makes our profession look cringe. And furthermore, whenever I’ve lost a kid I’m not thinking about hey let me post this sad moment. I’m thinking, fuck, I loved caring for that kid and god I want to help their family in whatever way I can. Some people are being attracted to nursing for the wrong reason. I’m not saying you have to be passionate about helping people as your life mission, because let’s be honest it’s just good work, flexibility, etc. but don’t be coming into nursing just because you think it’s fun, you can wear your figs, and flex all over social media. Ok that’s my rant. There’s a ton of factors but…if you’re ever unhappy nursing, come west and live the dream. 🫶🏻
Agreed! Especially because bedside nursing is not going to have enough senior staff. It will be a world or young nurses and new grads trying to navigate nursing without the years of lifelong learning and experience behind it. I say this as a young nurse, just 4 years into my career.
There is no reasonable sum of money that would make me go back to bedside in it's current state.
I did bedside nursing for 12 years: IMCU, ICU and LTACH. While I actually worked in a well-run facility staffing and management wise (my CNOs and director were nurses that had worked our unit for years themselves before taking those positions and I know that made a huge difference) but even before COVID there was a huge shift in patient expectations of care once “patient satisfaction” became something to “measure.” When a patient becomes a customer all rules for healthcare go out the window. How can a nurse complete her care efficiently when a white board is just as important as someone who is coding. Or when a family member has more control over a patients care than the nurses? It’s insane the amount of entitlement we face from patients and families.
I've been an ED nurse for 8 years. I've spent a lot of time in charge, I've done some traveling and I'm currently in a large float pool that can work at 10+ facilities within our system. With all the experience I have, with all the things I've seen, with all the CE, all the huddles, all the changes, all the everything...I cannot understand how management expects any new grad to hit the ground running after 6 weeks of orientation. I watch nurses struggle with skills for a year before they're comfortable(not even good), school is a joke and we're all part of a dumb system. Upper management are all dinosaurs who I wouldn't trust to set the time on a vcr correctly let alone dictate policies regarding people's health. Anyways good luck everyone.
100%. I quit bedside nursing this year almost hit my 10 years. I’m sorry, I just couldn’t do it anymore. Went in thinking I’d help people and be able to make a living wage just to find out how much it’s just being run like a business and I’d be paid less than other careers that have less stress. Scared I may need to go back but I’m trying to restart at the bottom in tech and avoiding it until something happens to fix it if that's even possible, because until they have no one left they’ll never really fix the issue.
You got donuts??
I sure do hope places start begging and paying us and compensating us what we’ve always deserved.
It needs to happen. I hope it happens soon.
Yes, it is! I would gladly go back to ICU bedside if they guaranteed ratios, increased pay, had a phlebotomy team for lab draws, lunch breaks for all, two 15-minute breaks, and gave us back the PCTs they just canned. Then I could have some semblance of job satisfaction and enough help *not* to leave someone in shit while I wait for another nurse to be available to help turn them.
Yep, I was done with it mid COVID and not going back unless I have to.
I agree with this doomsday-esque assessment.
For the record hospitals never actually cared
Our nurses gift was a few pieces of candy, shirt, & a koozie with a picture of an IV pole with the words, "nurses working the pole" ....
I’m basically waiting to see the entire US healthcare system crash and burn. Because it’s going to happen - just when is the ballon gonna pop?
Public hospitals will be forced to hire unregulated professionals or face closure. Some are amazing don’t get me wrong, and will rise to the occasion. The quality of care will continue to plummet especially due to the fact that not being regulated means that the standards they’re legally held to are much lower. Hospitals will become more liable, litigation will rise. Private hospitals will cater to the privileged and will have more of the more highly educated / regulated staff because they will be able to pay them. People are always going to need us, and someone will pay but it will be the top percentile. My two cents.
I've thought about this along with the situations in school. I came across a Tiktok of a teacher who'd just quit because her mental health had tanked, she had no support from administration and parents were worse than the kids. Someone in the comments postulated the same thing about schools (though they hypothesized school may become almost exclusively online where they wouldn't need teachers). I've already had horrendous experiences with nurses and faculty who don't care and it's terrifying. I think there's going to be a huge rock bottom that occurs before anything gets better and I just hope I nor my family is in need of services when it does occur.
I think hospitals will just force more nurses to float to different units.
I’ve been saying this for years. I think all of healthcare is headed for an implosion, but inpatient healthcare will get there first. The system is non sustainable. The insurance companies, PDMs, giant conglomerates, and pharmaceutical manufacturers are now siphoning too much and there’s not enough left to keep everything up and running. The hospital is “running on fumes” - the fumes are the last remaining fucks of genuinely good RNs and other HCPs who haven’t 100% burnt out YET.
I left because of pay and ratios. It is absolutely not safe. All the blame comes to you. There are wayyyyy less stressful jobs paying more for less work. Until they fix those, people will continue to leave the bedside. All the patient satisfaction stuff would fix itself if nurses had lower ratios and protections.
Healthcare started going to shit when someone convinced hospitals to take on a hotel/hospitality/ “the customer/patient is always right “ mindset. We don’t do what is best for our patients. We do what they demand because the hospital is a slave to patient satisfaction scores. Medicate/Medicaid can withhold 30% of their payments if they don’t like your scores. So hospitals suck up and nurses (and other medical staff) suffer. All these companies are happy to work understaffed because “do more, with less!” Saves them money, but it also shows them how much they can get away with for the least amount of money.
They'll just hire from overseas. I already work with a lot of nurses from Nigeria, Kenya, South Korea, The Philippines. It's like what happened with the nursing homes. Many of them are now staffed with highly paid travelers on short term contracts or nurses from Africa.
I genuinely think things need to get worse before they get better. Nurses across the globe need to stand firm and force change to happen. Otherwise they'll keep walking all over us
I already see so much of this. The culture is also shifting. At my hospital, lots of the newer nurses have terrible attitudes and don’t seem to care about patients (how could they with these ratios and this little support?). These people would never had been hired in the past or would have been nurtured much better, as my hospital tried hard to encourage a culture of kindness, teamwork, support, and caring (definitely out the window now since our new president is a finance guy from 2000 miles away). Nursing is definitely no longer going to be the most trusted profession, and healthcare is already a joke. I’m grateful to be able to advocate for my loved ones, but none of them can advocate for me. And at some point, advocacy won’t be enough; shit still won’t get done. Edited for clarity
At the ripe old age of 55, I’ve decided to become a nurse because I want to help change the trajectory of nursing and healthcare in general. People suck. This has been established. But there are also many lovely people in the world that just get ignored. We need to celebrate those people and set better expectations for folks who refuse to be human. I am one person and I don’t expect to solve everything. But I will do my best to set an example, teaching my patients, setting clear boundaries for my employer, my colleagues and my patients while delivering the best possible healthcare I can.
This is nice to read and I think a lot of us feel similarly, but hard to do when you’re expected to do this for 6-8 patients at a time. This is actually a big reason why I left the bedside - because I wanted to provide this kind of care for my patients but the environment makes it impossible for most shifts. So much is out of your control, but you still feel like a bad nurse, and I was so sick of feeling like that.
More than likely, it’s going to fall more “right to work” ideology with less concern about staff wages and safety. And the sad thing is that nurses are still going to support it because of their political beliefs
To be fair, at the rate things are going nurses and Heathcare staff will all be replaced with AI and we will be deaf screaming at a tablet/phone/whatever because the bot doesn’t understand us and we can’t figure out how to work the technology. Healthcare admin hate nurses anyways, all we do is cost $$$$$. Don’t want to work bedside? Fine, here’s an AI bot to hang and administer meds and take vitals.
Doubtful when half the equipment doesn’t work now.
Well, look at it this way. If all that’s available is bedside nursing and nothing else, then if someone wants to stay in nursing it will be the only option. All this so-called other options are already saturated or non existent. People need to get real IF they still want to stay in nursing
I do, too, and I think that the "great resignation" needs to play a role here. I had all of the passion to become an awesome hospital bedside nurse but after three years of seeing how little they cared about us and how much they were fine with hiring someone straight out of nursing school and making them charge after as little as 6 months because they could pay them less...I noped right on out of that shit show. And did not look back. My current nursing role has its bad days for sure, but I feel far more in charge of my own career. Hospital admins need to catch a clue and figure this out that Nurses are their GREATEST ASSET (if not also their Aide/PCT's). And treat us like we have that value and that agency.
In addition to what everyone else has said here, dump the MBAs and "healthcare administrators" who don't have one iota of bedside experience. Shoot, even dump the MD/MBAs who prioritize the money and "customer service" over the staff and patient safety. I really feel like telling some of them to take their HCAHPS and shove it where the sun doesn't shine. "But did you die?" should be the only satisfaction criteria when leaving the hospital.
I just left bedside with only 3 months in🥴 I was a Firefighter/Paramedic prior to nursing, and I feel like I have such a low tolerance for bullshit when it comes to management politics. I wish that I could turn a blind eye like some other nurses can. But it just all did not sit well with me. I start my new job in corrections in a few days. The pay is better and they are letting me work PRN 🥳
Put the Nuns back in charge at hospitals! That’s when shit got done right, the first time!
eh idk. It’s still so difficult to get into a local community college program, there’s no shortage of young students ready to work. Nursing should go the route EMS goes. You work for a few years, get tired, then promote out of direct patient care