On: The death of bedside nursing (and why it should matter to everyone…)

This picture looks old and grainy because it is. That is me in nursing school, almost ten years ago (I’m screaming internally). Sit down because I am about to get serious with you and let you in on a scary reality that most nurses know but don’t talk about.

The face of nursing is changing. It has been. It is not a good thing.

A family member was recently admitted to the hospital. I accompanied her to get her settled on the floor and in doing so met her nurse, who was being trained by another nurse  (we will call her Mary). Mary and I got chatting and she explained that she trained for a period in my unit during her nursing education. Upon discussing this she mentioned shadowing a nurse that had been on my unit a short period of time and had left. From my calculations she shadowed a nurse who had been working on my unit for 1-2 years (who was already gone) and that had made her a staff nurse for approximately 1 year or so. Subtracting a generous 12 week orientation, Mary (who has been practicing independently for a liberal approximation of 8-10 months) was now in the process of training brand new nurse.

Do you see a problem here?

This revolving door of nursing is creating problems for patients, cost increases (for everyone) and problems for those of us who do decide to stay at the bedside. Nurses are leaving in droves and novice nurses are teaching more novice nurses. According to the RN Work Project, a study performed over 10 years to track career changes among new nurses, 17.5% of new nurses left their position within a YEAR of starting a new job, 33% within two years and 60% within eight years.

What does that mean to you? That means there is a high probability of you getting a pretty “green” nurse when you walk into a hospital. You might notice that half the staff look like they just graduated college, which sometimes is true. (Scary right?)  However, just because you have an older RN it doesn’t mean that they have experience, much of the workforce is second degree nurses and you can’t trust the age to tell you about level of competence.

This matters. Statistically speaking experienced nurses help patient outcomes. This means that there are less hospital acquired pressure ulcers (bed sores), infections, etc. with a staff of experienced nurses. This study concluded that increasing experience (to an average of 5 years) and clinical hours (6 hours a day to 7 hours a day) could lower incidences of hospital acquired pressure ulcers by 11.4%, and falls by 7.7%.

What does that mean? It means $$$$$$. Experienced nurses would save hospitals money because as it stands now, hospitals aren’t being reimbursed by Medicare and Medicaid services (CMS) what they consider “hospital-aquired conditions” like pressure ulcers over a Stage II. To you non-nursing people, this means when you get a bed sore that opens up and becomes difficult to heal, its considered preventable so CMS isn’t paying for it.

Now in ways these things are preventable, just like urinary tract infections from urinary catheters, however the way to prevent those things is to have STAFF. Competent, experienced nursing staff and adequate support staff like nursing assistants to help. Pressure ulcers are preventable if you turn patients, if there aren’t enough staff on hand to do the turning, they become less “preventable”.

This is an issue not because nurses are aging out, not because of “nursing shortages” but because of the hospital environment. Nurses are overworked, understaffed. Units with a high census and acuity take a toll on even the most experienced of nurses. Patients are heavier both literally (in weight) and with more comorbidities. We have modalities to keep the most critically ill patients alive for inordinate amounts of time and these are only small parts of the cause of the bigger problem.

Money is the driver for much of the issue and we are doing more, quicker, with less support than ever before. We are required to work long shifts without breaks, hold our bladders, skip lunches and keep going. We are required to work weekends, holidays, nights, long stretches of 12 hour shifts that become 14 hour shifts. We get berated, verbally and physically assaulted, accused of withholding pain medication, letting food get cold. We are literally breaking our backs- some estimate the average nurse lifts 1.8 tons per shift. Why would you stay at the bedside?

So people leave. They go to a clinic, become visiting nurses, go back to school, pull back their hours or just stop working. Who would blame them? Advanced education means a bigger paycheck and better hours. No double knee replacements at 60 or slipped disks at 35.  Why would you stay?

New nurses look cost-effective initially, lose a nurse with 12 years of seniority to gain someone who will be paid at an entry-level rate sounds like cost savings but unfortunately this isn’t the reality. Once they finish orientation, they stay a short time and then move on to school or burnout and leave the bedside altogether. This is not cheap. According to The Costs and Benefits of Nurse Turnover: A Business Case for Nurse Retention “Recent studies of the costs of nurse turnover have reported results ranging from about $22,000 to over $64,000 (U.S.) per nurse turnover”.

More importantly,  more than cost, there is something to be lost when good, experienced nurses leave the bedside. Institutional knowledge, experience gained from years within an organization are lost and with it the patient experience suffers, or worse. In a study done of Pediatric Cardiac Intensive care unit patients (discussed here), that included 38 hospitals and 20,407 patients, they concluded that “the odds of death significantly increased when the percentage of RNs with two or fewer years of clinical experience was 20 percent or more” and going further to recommend that “pediatric ICUs should have no more than 20 percent of their staff with less than two years’ experience.”

Layman’s terms, patient mortality and outcomes have a lot to do with how long your nurse has been doing his or her job.

Nursing is a lot more than bedpans and med passes, there is a lot more that goes into the minute-to-minute decisions that aren’t taught in a classroom  or on orientation. In teaching hospitals this is even more important. Residents coming onto the floor are fresh out of med school and honestly depend on experienced nurses to be their double-check at times, nursing being the last line of protection to the patients. If the nurses are new and the prescribers are new, it can spell disaster for people in the beds. You’ve all seen the Scrubs meme where the nurse speaks to the more experienced physician saying “Doug wanted me to give this patient five hundred thousand milligrams of morphine. I thought I’d check with you before I kill a man.” This is funny because its true. Mistakes happen, you want the person giving you or your husband or wife or child to recognise the error before giving the medication.

There are so many of us devoted to this career. Who want to see it succeed. I want to work alongside a staff of experienced, dedicated staff whose priority is the patient above all. I have had the pleasure of working with some phenomenal experienced nurses throughout my career and have seen newbies blossom into some of the most amazing nurses I know. I want people to stay and for patients to get the care they expect to in the hospital (minus the expectation of dinners for their extended families and five extra pillows- I don’t work at the Hilton).

Retention is key, I want to stay at the bedside and I know many that do. The face of the bedside doesn’t need to keep changing. Management and hospital administrations need to play a more active role. Hospital administrators need to address this hemorrhaging of experienced staff, through better ratios, staffing, schedules for better work-life balance, and retention projects.  Spend the money allocated for hiring bonuses on your experienced staff and you won’t need to keep hiring. It will be more cost effective and more importantly, patient outcomes depend on it.

 

 

 

 

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474 Comments Add yours

  1. Snowball says:

    What an exemplary article! Having just lost my father after 3 weeks in a famously accredited hospital where I had to literally beg them to shave him after 4 days and being told the razor wasn’t good I had to contact the nurse manager to get basic nursing care done! Where are the preceptors? I moved on to home visiting after27 years of backbreaking work but my goal is to volunteer in a hospital if I remain healthy enough to do so! The caring difference no longer exists! Don’t get me wrong there are a handful of caring nurses left but something is getting lost in translation!

    1. Anonymous says:

      I think you missed the point.

      1. Jen Kyer says:

        I think caring is there. We just don’t have time to do it anymore.

      2. anonymous says:

        Oh Snowball, you missed the point of the article.

      3. Anonymous says:

        Most hospitals won’t let you shave patients anymore anyway. Too high of a bleed risk with all the blood thinners since some would rather give you a shot than encourage walking.

    2. Anonymous says:

      I agree, I think you missed the point of the article. Shaving…

  2. Reblogged this on Living to serve and commented:
    Eye-Opening Truth of Bedside Nursing

  3. Teresa Forsyth says:

    I’ll try to keep this comment brief – 2009 my husband had a mild heart attack, transferred to Johns Hopkins University. As a nurse, I knew what to watch for, generally. The scheduled surgery went great, the SICU was marvelous. However, when he was moved to the regular medical floor, he received NO attention. One day an RN came in once at 9a, once at about 5p, both for medications. (I can’t report night activity.)Additionally, his room and bathroom floors were filthy. I bathed him, shaved him, fed him, watched his IV site, maintained his I/O, changed the linen on the bed, and literally, literally washed the floor which was black with dirt. Looking out the Johns Hopkins window to enjoy the view, I looked down and there were about 20 housekeepers sitting on a concrete planter, smoking cigarettes. The number #1 Hospital in the nation? I hope it’s improved.

    1. Anonymous says:

      It hasn’t sadly.

  4. Stephanie Hunt says:

    Thank you ! Why I had to leave my 28 year job !!!!! Stephunt9@aol.com

    1. Jen Kyer says:

      Sorry to hear that. It’s a shame.

  5. Lori Reaves, RN, BSN says:

    Unfortunately, this is not a new problem:

    – During my father’s hospitalizations in 1999 (CABG), he would never have been ambulated, bathed, or had his bed changed if my retired-RN mother hadn’t been there.

    – When he had an abdominal aneurysm repair 5-6 years ago, the surgeon wrote orders to d/c his IV, catheter, and NG tube. When he returned 2 hours later, none of it had been done. How many patients did his ICU nurse have? One, my dad. And don’t even get me started on the “bath” he had to give himself 24 hours after surgery with an 18″ incision. They didn’t even give him a call light, and of course, he couldn’t call for help because he’d just been extubated.

    – When my husband developed CHF a few years ago, he was admitted to be dried out. They drained >6 liters of fluid off him. I finally went home the night before he was discharged, thinking he was safe. Wrong. I came the next morning to find a half-full bag of IVF hanging. It was the 2nd bag. When I turned the air blue expressing my displeasure, my husband said he had questioned the order, but the nurse said… are you ready for this? “Because the doctor said so.” She didn’t even question the order! He spent an extra 1.5 days in the hospital because of it. And you can bet I didn’t go home.

    These are only 3 of the many experiences we’ve had in the last 20 years as my family has experienced strokes in a 28 y/o, multiple heart attacks, breast cancer, miscarriages, and more. The frustrating part is that when I tried to get a clinical job again (about 10 years ago) after raising my children, no one would even interview me. When I dropped into one hospital to see if I could find out why, they actually admitted that they would hire a new grad in ICU before they’d hire an experienced nurse and update her on the new drugs/protocols. I wasn’t trying to get into a new specialty. I was trying to go back to the area I’d worked in previously. Blows my mind.

    1. Jen Kyer says:

      It’s frightening. I don’t know what is worse, to be aware of the problems or totally clueless. I swear they hire the newbies because they don’t understand how bad the situation is. We have something to compare it to. They don’t.

    2. Joan Leck says:

      Hi Lori,
      I totally agree with your statements. My heart bleeds for “good bedside nursing.” Take care,
      Joan Leck RN Class of 1970 BHSN Bayonne NJ.

  6. Jim says:

    Do you have references for your numbers? I’d like to use them for school.

    1. Jen Kyer says:

      All the studies are hyperlinked. You can see them that way.

  7. Anonymous says:

    EVERYONE SHOULD READ THIS Including the stupid hospital administrators. When people start dying and the lawsuits start rolling in perhaps they will take notice

    1. Anonymous says:

      No they literally told me that’s what they have insurance for

    2. Shawna says:

      Yes, as a nurse of 16 years in an OR (doing mainly cardiac surgery ), I can tell you that administration is a big problem. I mainly 1st scrub hearts now. Most of our long term RNs scrub and circulate. 1st scrubbing hearts is a very unique skill that requires critical thinking and the ability to stay calm and alert under extreme pressure . Once you develop this skill, turnover is very very low. I was recently told that I would be replaced in this role. They intend to replace me and many others with scrub techs. A scrub tech on average makes half of my hourly wage. I am insulted and very concerned for our cardiac surgery program. Let me say, I work alongside two fabulous scrub techs who also scrub hearts. It is not the degree that makes you able to have the skill set to scrub hearts, people either have the talent necessary to do it, or they don’t. But for administration to flippantly disregard the years of experience and talent of RNs scrubbing these very challenging cases is just ignorant. Talent, experience, and skill is being completely disregarded in health care settings across the board. And, it all comes down to the Almighty dollar!

      1. Jen Kyer says:

        I’m so sorry. I’m really sad that they don’t see the risk associated although I’m not surprised. These “cost savings” will end up costing more in the end but they don’t see it that way. I’m sorry. I’m also really interested in hearing more about this role. I’ve never even heard of it! Find me on Facebook (Jen Kyer) if you have time. I’d love to just hear about it!

    3. Teri says:

      Unfortunately, it’s cheaper to settle lawsuits than fix the problems😞

    4. Edward Sillery says:

      They are not concerned about the lawsuits. Administration writes protocols that are impossible to follow exactly with the staff and time allowed. This way when there is a lawsuit their lawyer gets on the stand, points out they had protocols in place but the nurse did not follow them, therefore making the nurse, not the hospital liable.

  8. Those today in colleges do not get the training at the bedside to be a good nurse. The excuse is they are training for management and that the nurse will get their training by the hospital that hires them. Then what are they going to college for? We have lost with this attitude on the so called better education. They need to go back to the basic 3 year hospital training we had before. Learning to write research papers and statistics is not basic nursing. . The patient suffers the most. Loved being a patient with a foley in and it hadn’t been emptied all night When calling for help, they told me it was removed yesterday and that just walk into the bathroom and go. They think the trick is to just write it in the chart and it is so because it is in black and white on computer. There isn’t any real discharge instructions either. They tell you the homecare nurse will do that. By then it is too late for that family of the patient or for that matter the patient. BRING BACK THE REAL NURSING 3 YEAR HOSPITAL TRAINED NURSE. THEY ARE DYING OFF .

    1. Jen Kyer says:

      As a college trained nurse I’m really proud of the science background I received. That being said the majority of my bedside training came from the bedside. I think with quality bedside training they can complement each other but the two year track to grad school nurses are not helping the situation I agree.

      1. Anonymous says:

        I completed my RN in a 2 year program and felt much better prepared than some of my BSN prepared counterparts. I had more actual bedside training and less research based curriculum to go through. After practicing for 10 years I returned to school and completed my BSN then my MSN as an FNP. I’ve had nurse managers tell me they’d rather hire 2 year prepared nurses over 4 year new grads because of the increased bedside training.

  9. smarterwiser says:

    Reblogged this on smarterwiser and commented:
    This is the nursing reality of 2017! Great post & one point!

    1. Jen Kyer says:

      Thanks so much!!!!

  10. Nursing is one of the few fields that as you progress in career, one moves away from the bedside. My career trajectory has not been traditional, I’m sorry that my time at the bedside as a Nurse was so limited. Would you like to offer your thoughts on a recent post on a related topic? http://bit.ly/EHRNurseWorkflow

    1. Jen Kyer says:

      I’ll check it out. I don’t think moving from the bedside should be the case. It seems to be the trend to the patients detriment unfortunately. Looking forward to reading your article.

      1. Anonymous says:

        I think​ a strong bedside foundation should be a pre-requistite to move forward or to even go back to graduate school. I’ve only been a nurse for 8 years and I’m ready to be done with the bedside, so I am now looking to go back to graduate school. Bedside​ care is getting more and more difficult with patients getting sicker and sicker. You discharge one patient and before youre even close to being caught up youre getting an admission or transfer. I think new nurses are being shown in a bad light, a lot of “nurses eat their young” comments here. A lot of stories of family members being neglected so it seems, were any of these concerns brought up to nursing management? If so what happened and what were the outcomes? When you have a 6 patient assignment and have to proritize care, I am always forever grateful for the patient that has a family member or members that are there willing to help. If you want to be there for your family member but don’t want to participate in their care and you aren’t getting what you need from the nursing staff then you have to speak up. As far as the others with concerns about nurses not questioning doctor’s orders, questioning comes more easily​ with more experience. While this article is written well and it’s really spot on for bedside care, I feel the comments are just bashing brand new nurses left and right, its kind of sad.

      2. Jen Kyer says:

        I agree it’s a problem above the bedside. I don’t place blame on the newer nurses at all. It’s the environment. Like I said, why would you stay? The new nurses aren’t wrong for leaving I think some of us that have stayed are crazy. Administration and corporate mindsets are to blame above all else. I know some phenomenal nurses that are and have been great right out of the gate.

      3. Anonymous says:

        Older nurses and New nurses get bashed by each other every day. We are all very good at criticizing each other. The powers that be have made it more difficult to be a nurse at the bedside and No one wants to be there any longer. Nurses want to be more educated and go on to being away from the bedside and often they become critical of those that are still there, forgetting how difficult this work can be on every level. When the ANA and the powers that be made it required to have a BSN to work in hospitals they’ve created a monster in my opinion. Being one who has worked in almost every area in the course of my career I am now required to go back to school after 30 years of experience. They say that nursing care is better with more edu but that is not what I’ve seen. Some of the best nurses I’ve worked beside had less edu. Experience is no longer valued and the numbers on hospital infections and malpractice has not changed in years. Hospitals over see themselves which is a conflict of interest. So the info that everything is honky Dory is false. When nurses spend a fortune on education they don’t feel that they should put up with being treated like children and generally continue on to get more degrees to get off the floors. All the little niceties that admin does to make nurses think they are valued is ALL BS and nurses know it. We are not stupid! Problems will continue until hospital start addressing REAL issues with real solutions and not until. It’s very unfortunate that hospitals are all about making money. Our whole healthcare system is so flawed it’s probably beyond fixing. Big Pharma, Insurance companies and lobbies in Washington are the cause of high fees. Care that only the top 10% can afford in a country where people can go bankrupt because they get sick. Something is seriously WRONG with this system!

      4. Jen Kyer says:

        I’m not sure why nurses are required to go back to school if they’ve been practicing. It seems crazy.

      5. Jen Kyer says:

        Experience should be valued. I hate the requirement of nurses to get BSNs to continue. It should just be the standard going forward. This requirement is just silly and stupid. No one needs a statistics course or a ethics course to be a good nurse. That being said BSNs coming in bring some good to the bedside as well. The hospitals need to value the diversity, let us all work together and teach each other and have the support to do it.

  11. Anonymous says:

    Nursing became a nightmare for me after 30 years of bedside nursing, so I left the field.

    1. Jen Kyer says:

      Thanks for your hard work and I’m sorry. I’m sure you have a ton of knowledge that went with you.

  12. Terri says:

    I am approaching 40 years of being a bedside nurse and will retire next year. Many of us forget that nursing is or should be a calling that we love and respect. I can honestly say that I have never been burned out, and I have seen almost every difficult situation there is to see and I still love it. Every profession has difficult challenges but at least with nursing we see lives saved and lives changed. Keeping a positive attitude and an attitude of continuous learning is key. We are blessed in our hospital as we recruit well, train well and even encourage moving on if that is someone’s dream. Our patients get safe and excellent care because we mentor until a new nurse is confident and ready and we support seasoned nurses if they find floor nursing challenging. I have been at my current hospital for 31 years and I would not change a thing. Nursing is a blessing, don’t forget that and don’t forget those experiences we have with patients, at the beside, that we will not get anywhere else.

    1. Jen Kyer says:

      I’m glad you feel this way. I want to come work where you work! We do make a difference, I unfortunately feel my experiences have been less frequently positive than I would like. Thanks for reading and your positive perspective.

      1. Anonymous says:

        I can’t believe your story. Never burned out. What type of floor did you work. Ob??
        I too worked 40 years. I’ve mentored prayed gently guided interns . I’ve started out with 7 patients 3 discharged 3 new admits and through in a team. Then drive home running through everything to make sure I did everything
        When I started we had 36 patients 2 of us on the floor. No iv pumps counted drops didn’t have premixed meds. Counted pills to order how many we re needed to last over the weekend.
        I loved it but as the write States nursing needs some help. Forget Obama care. Have skilled experienced nurses to care for the patients cost effective care and knowledge nurses to care for and be profitable to their employer. Every hospital administrator should be mandated to read her article and sign off as we have to for every repetitive memo we read. Yeah for nursing and those who love it and TAKE care of patients. But not to leave out computers. Those that come into the room spend 88% of their time looking at a screen not a patient. My last petpeive.

  13. Britt says:

    What do you expect to happen? Where would you like the “green” nurses to go exactly??

    1. Jen Kyer says:

      I’d like them to stay. I’d like retention for nurses at the bedside. So that “green” nurses get experience and experienced nurses stay.

      1. JS says:

        I think you should write part two of this article. Put down your thoughts and ideas for how you would improve the problem not just state the problems that exist. I see one maybe two solutions suggested in this article for problems. As one of the nurses who did leave the bedside for management and administration, these are areas that are daunting to swing the pendulum the other direction. Now after 20 years returning to clinical care through FNP care delivery I don’t think this is a negative aspect of our profession. One of the greatest attributes of nursing is our ability to advance our education and reach patients (and other nurses) on a number of levels in a variety of settings with our experience.

      2. Jen Kyer says:

        I think retention is key for nurses that want to stay at the bedside. There are some of us. I’m not discouraging advanced degrees at all. They’re a huge part of the system and necessary. All I’m asserting is that that shouldn’t be an obvious next step because of burnout/stagnant pay/pore schedule options. I want people to become APRNS and managers because they want to not because they feel forced into it for other reasons.

      3. Briana says:

        That isn’t going to happen. If experienced nurses stay, there’s no room for green nurses, even though I agree with what you said here. It’s about money though.

        I have no intentions of staying in bedside nursing for longer than it takes me to earn my DNP and go after the position that I truly want. Some people see that attitude as not being fit to be a “real” nurse. I just see it as a natural progression in my degree and chosen field. I chose nursing because of all the different pathways I can take it, not to be held back or to be told I’m part of the problem with lack of bedside nursing. Out of my cohort that I just graduated with, I would say at least 75% do not want to be long term bedside nurses. Half had already applied to MSN or DNP programs along with myself last August.

        I think an alternative solution to the bedside nursing dilemma is to STOP weaning out LPN’s in the acute care settings.

      4. Briana says:

        “I want people to become APRNS and managers because they want to not because they feel forced into it for other reasons.”

        Maybe I am wrong and only going on my limited experience, but it seems as if feeling forced to due to burn out or whatever, is not the main reasons why nurses are leaving bedside, at least not new ones. BSN and ADN schools all over the US push for students to continue their education and further their degrees. The face of nursing is changing. I think it is a good change, because look at the studies out there, most recently, one by Kavanagh and Szweda (2017) that found out of 5,000 new nursing graduates who passed the NCLEX, only 23% of new grads to be “practice ready”. New nurses need more education and clinical hours but they (mostly) want the higher autonomy and positions that come with more education.

        I just know that I saw a big difference in the way newer nurses think than those who graduated a decade or more ago.

    2. Martha says:

      I want to work at your place of employment also.

  14. Nursing needs to go back to team nursing. Having been an RN for over 40 years and an LPN for 14 years before that. Having to be an in patient frequently because of MS . I have experienced the declined of bedside care first hand. It is cost in loss of life and increase in healthcare cost due to lack good,safe prudent nursing care! 3yr nursing program was the best . LPN at the bedside also followed by an aide. Not by a 6 week CNA that comes in takes your vital signs and leaves! No one should ever be left alone in hospital today alone . Question everything!

    1. Jen Kyer says:

      I wonder why hospitals haven’t looked to employ LPNs more. It seems like a wasted opportunity to help deliver more consistent care.

      1. Stacy Stats says:

        As many look to strive for “magnet” status, sadly they leave the LPN option completely out. Hospitals want more BSN and MSN prepared nurses to make them “look better”. Not always the answer!

        I am a military nurse and 9/10 times you have a nurse with less than 2 years experience training a new grad. We have high turnover, but we know that if we train a nurse good, they move on to another military facility to grow and develop further on the skills we’ve shown them.

        Being a nurse 11 years, I see it as a generational problem. Most young people look for the instant gratification (bonus) and jump facility to facility looking for the best deal. Not thinking about their retirement or long term plans.

        TOTALLY love my profession and now being a CNS, but always looking for ways to help empower, intrigue and ignite that education, pursuit of personal development in my nurses to help retain.

      2. Jen Kyer says:

        So true. I wish it wasn’t the case. Something has to give. Otherwise it will only get worse.

      3. R D says:

        Because LPN function under the auspice of the RN …they only collect data they do not assess and their education is not as stringent as that of an RN. An RN has to delegate tasks to an LPN and then is responsible for the folllow up to make sure the task was completed.

      4. Jen Kyer says:

        I could use an LPN for things like wound care, ambulation of patients, etc. CNAs are busy sitting with patients or covering lunches for secretaries where I work. There’s plenty of work to be done.

      5. Anonymous says:

        I beg to differ. I was an LPN who was educated and worked thru levels of nursing, later becoming an RN. LPNs are trained in assessment and are very good at it. In fact, my education gave me MORE experience as a bedside nurse in LPN training than the RN program. By getting rid of LPNs nursing is cutting it’s nose off to spite it’s face. These are some of the best nurses I’ve had the pleasure to work beside. Far more skilled than MANY Rns I’ve worked with.

      6. Jen Kyer says:

        I admittedly don’t know much about the skills or role of the LPN as I’ve never worked with any. I am sure that there are thousands of wonderful LPNs. I think it’s a role that is warranted and important and could help RNs.

  15. Mike Doherty, MD says:

    When did nurses get forced to turn into data entry clerks…and WHY do they put up with it! Where is your professional dignity ?!?

    1. Jen Kyer says:

      Amen. Why I write in a nutshell.

      1. R D says:

        We don’t have a choice…those in high administrative levels dictate our practices without regard to the reality of patient care. Unions only support “bad employees ” . The things that they should focus on nurses and patient care issues, how many weeks of vacation and time off ….not concerned!

      2. Jen Kyer says:

        I’ve never worked in a unionized hospital but that seems true of most administrations.

  16. R D says:

    This is not a nursing problem this is an administrative problem! When your told your staff is valuable but those above continue to do nothing to show them the are valuable….it will continue to happen. In my case I keep asking how much does it cost to train an ICU nurse? It really doesn’t matter because all the bean counters care about is HPPD yet don’t look at the increase in acuity and the number of sitters that is also included in those numbers! NSI do not appear immediately they take time to take a dive and patients in the meantime are not the focus of care but nurses just trying to get through their shift and check all the administrative boxes! Hospitals can’t run without nurses, we are valuable,….show us!

  17. Arleen Schmidt says:

    I recently retired from nursing after some 40 odd years. ..I was proud to be a nurse and do bedside nursing. Over the years my position may have changed but I never forgot why I was there, the patient. …I worked as a staff nurse. ..assistant head nurse…IV team. ….supervisor. …and finally staff development. ….I taught NA training classes and supervised clinical care. ….I worked in a hospital, LTC , and retirement community. … last position 20 years. …yes nursing has changed. …for better or worse. ….I have my thoughts. …

  18. Anonymous says:

    Excellent article. I was told when I was a practicing RN when I ask for more help that I had just gptten a raise. Yhat was not what I needed.Hopefully the big guys will wake up!

    1. Jen Kyer says:

      Insane. Like how we get umbrellas instead of adequate staff.

      1. anonymous says:

        yup…umbrellas,pizza,and tshirts…get a clue people. not helping us!!!!and if you are night shift?forget it. they do things for them at 11am but you will never see them come to night shift at 11pm and serve dinner…meetings at 11am or so…but do they ever have them DURING night shift? no. you have to either stay later or come back or come in on your day off. admin would NEVER come to a mandatory meeting.done g at 2am but they sure expect you to come to a 2pm one!!!

  19. Karin Graham says:

    My sister, hospital RN, Med/surg for 35 years, saw changes coming back in late 80’s, early 90vs as she worked at Tulane University Hospital. She told me: if you love someone DON’T leave them alone in a hospital! And it proven true from then on. Ive caught wrong meds being guven another patient bag of fluid being hung, etc, I sadly, mistakenly went to school at 55 yo and got my RN. I was onboarded to orthopedic floor fresh iut if school by giving me from 6-8 patients and expecting me to run with it… A day shift! I saw tough army nurses of 15 years with tears d/t stress and frustration, RNs w/30+ years crying. The things we were expected was inhumane and throw the tantrum throwing doctors bc we interrupted their dinner = crazy. I ended up with a stroke… Neurologist said it was stress. I quit nursing and am in school taking my time for a publuc health degree. Out of my class of 25, more than 1/3 if us are not in nursing and that many more planning to quit in next 3-5 years. Its sad that doctors are part of the problem.

    1. Jen Kyer says:

      I’m so sorry about that. I’m glad you’re finding a better role in public health.

  20. Warrior nurse says:

    Excellent article & very accurate dipiction of what it is like to be a bedside nurse. So many of them are choosing to go on for graduate programs like CRNA or NP. I have been a critical care nurse at a level I trauma center for the past 17 years & an RT for 7 years before that. I have seen many changes at the bedside. Some were patient focused, but many were financially motivated with little regard for patient incomes & nurse retention. I hear more often than ever new nurses being discouraged by the environment & the culture of nursing that they are surrounded by. Until the attitudes of administrators change we will continue to see a decline in this once highly regarded, highly sought after profession. I love making a difference in my patient’s lives. I am a clinician still providing bedside nursing care due to staffing challenges. We are frequently floated, tripled with critical patients & are constantly being told by the bean counters to do more with less. I am often so tired at the end of my 12, or more like 14 hour shift, that can hardly keep my eyes open & my feet hurt so bad I can barely walk. If I do get to eat breakfast it is after 11, lunch usually after 5, if at all, & I don’t drink much because I don’ t have time to pee. Does this sound like a career that any sane person would subject themselves too? I don’ t think so. I don’ t know how much longer I can keep on keepin on. The real victums are the patients who are no longer being cared for by the experienced seasoned nurse. They are being “practiced on” & being cared by those that, are doing the best they can do, but are not adequately trained & quick on the road to burnout themselves. I loved this article. I felt like the words were coming from me. Yes, LPN’s have their place in the medical field, but most go on to become RN’s or get out of the field all together. The focus of the article is the decline & deterioration of the nursing field & more specifically the experienced bedside nurse. I am very saddened & disheartened by what I see & pray that there are more nurse WARRIORS out there that can intervene & change this discouraging trend.
    Sincerely,
    A warrior, a bedside nurse.

    1. Jen Kyer says:

      We are definitely experiencing the same thing. Thanks for your comment. I’m sorry this is the state of things but I’m glad that people like you continue to give it all for the patient. Thanks- your warrior RN friend.

  21. Des says:

    I definitely understand where you are coming from in your article, but it does hurt my heart a bit that it seems that the tone is being set that a new nurse cannot be a good nurse. Yes, of course experience is the best teacher but that does not mean that a new nurse would essentially kill you or ignore you. So many of these comments read as if that’s what people truly feel. And they are not there to run anyone out, they just want a job like anyone else. I just wish we could support one another more and come together to see real changes made.

  22. Anonymous says:

    Great article! I would agree it is an administrative problem. The focus has shifted from patient care to being all about the money. Yes, healthcare is a business but without patients, nurses, MDs,CNAs, housekeeping, etc. there is no business. The new nurses being trained by other new nurses is disaster waiting to happen. New grads aren’t getting the training they need or deserve. Those who go to nursing school busy their butts to get that degree and by not allowing these individuals the training and guidance that they need from experienced nurses administrators are setting them up for failure… it is more with less ,yet work at the top of your license but make a mistake , and administration steps in and cuts the newbie off at the knee because “as a nurse you should know better” … but really if you don’t give them the guidance and training they need what do you expect. It’s so disheartening to watch a profession like this being destroyed by administration. Do more with less but be flawless. It’s like trying to put a fire out with gasoline… it just doesn’t work!!

    1. Jen Kyer says:

      In my experience they’re not getting guidance and the response to failures is more red tape for all and less remediation for the mistakes or investigation into the cause. Why was a wrong med given is rarely asked (too heavy an assignment, no support, family members interrupting care) it’s more like here everyone do a checklist that you double check your meds. There can’t be learning without understanding the stresses and coping with them at all.

  23. Heather says:

    A very good article and and agree with a lot of the content but what is disappointing is that one huge problem in nursing, especially for the “new nurses ” that compromise their training is the whole eating our young. Nurses eating their young is a very real problem and because of how I have seen ( and we all know it happens to frequently) new nurses treated by the experienced nurses it quickly breaks down trust and then you have new nurses that don’t want to even come to you with questions, they’d rather just figure things out on their own. How do we expect these new nurses to grow and learn and be excited about developing into great nurses when they enter a work force that notoriously treats them like outcasts. I was fortunate as a new grad that I had amazing preceptor that were constantly teaching me and taking every opportunity to show me something new and expose me to things I needed to work on. I honestly learned more as a new nurse on my unit due to these amazing experienced nurses that broke the mold and treated me as an equal and not just the ‘new nurse that shouldn’t be in an ICU ‘ . Because of them I always felt comfortable coming to them if I had a question or encountered something I was unsure about. And I learned! Because of them I made a vow that I’d be good and do my best to respect and help new nurses that came in after me. We are training the future of healthcare.. the new nurses today could be the ones taking care of our family tomorrow and we need to STOP eating our young and help them grow, cultivate them, make them feel like they are important. We change the experienced vs new nurse mindset and we will see huge improvements. And if people deny their is a huge problem in this area then they have to ask themselves… are they are part of the problem??

    1. Jen Kyer says:

      I agree. This is a huge internal issue. I however feel that for some this may be due to institutional pressures on the “older” nurses and veiled burnout. I think nursing in-fighting detracts from a system that is set up against us and if we band together real change can be made.

  24. Eve wright says:

    I was an RN Fl for 33 years retired in 2000 and went to massage school for the exact reason to save ME

  25. JANET says:

    Nurse administrators in my hospital do not value the older nurse. We have a new manager and basically everyone over age 45 got poor evals last year. Very discouraging…guess who comes in extra when the unit is short, serve on committees and constantly precept our young new nurses? Administration should be looking at accommodations to keep aging nurses are the wisdom they hold.

    1. Anonymous says:

      So True, and care is suffering because of it. Nurses no longer care about making sure patients get a bath or get fed. It’s pretty pathetic. My 84 year old mother was in John’s Hopkins recently. It took her 6 days to get a wash cloth after asking numerous times. She also looses weight every time she goes in because of the poor coordination of tests. No one cares about patients any longer. Health care is in the toilet.

      1. Jen Kyer says:

        I disagree. I want to give good care but I’m spread too thin most of the time to get tasks done. I think that’s how most of us feel sadly.

      2. Jen Kyer says:

        I’m saddened you feel that way. I know I care too much. I wish I had the time to give the care I want to all the time. We do care. We’re just asked to do too much. I promise.

  26. Pat Bruce says:

    After actively working in nursing for 52 years I am appalled by nursing today. Unfortunately they will NEVER go back to the 3 year nursing school nurses. (We were TRAINED – NOT EDUCATED.) Give me hospital TRAINED nurse ANY day! We were taught to clinically assess and respond to the situation. In the mid-60’s a great instructor, Katherine J. Bordicks, showed us first hand how to respond to a crisis situation. She observed that one of our patients was going into septic shock – before his doctor did, and perused the doctor to begin antibiotics. He recovered, but would have almost certain it died if she had not intervene! She is truly one if my nursing heros!!
    In the 50+ years I have seen a decline in care of patients – but if it is charted, it was done – or so the lawyers say. But I also have seen a decline in the quality of nurses produced. With the advent of more scholarships, etc. The pool of high quality has been diluted. Smart women are becoming architects, lawyers, and other fields. Much different than in the 1960’s when if your family could not afford to send you to a traditional college you usually had the options of becoming a hairdresser, a teacher (1 year teaching certifice) or a hospital based nursing program. It cost $350. the first year (to pay our tuition to the community Jr. College ), $150. The second year (to pay for our affiliated hospital fees (Peds, psych and communical diseases). The last year was pretty much ‘slave labor’s, as we were often in charge and treated much like general employees + having classes, too. But we graduated and were able as new grads to face many unfamiliar crises. GOOD NURSING CARE is the same under almost all situations.
    I strongly believe that new nurses should have a one year, rotating (through ALL areas in the hospital) preceptor ‘class’ before they take boards. I think the current BAN programs DO NOT prepare nurses for the reality of Today’s bedside nursing. I strongly feel that that is one of reasons that nurses leave the field.
    I also believe that people in general believe that they should not have to work that hard at any job!! One persistent problem is what do you progress to after years of VERY HARD WORK?? There is little reward for people who do work many years@ There are no “perks” for being a good nurse. It puts me to mind of a phrase my mother used to say, ” When I get to heaven I’ll have a bale oh hay waiting for me for being a jack- add for all of these years.

    1. Jen Kyer says:

      BSN programs do have some clinical on each hospital floor but due to regulations are not allowed to pass meds (without a preceptor present) put in IVs or do other things at all. It’s a shame but it’s all liability driven. The problem (in my humble opinion) is more related to the dehumanizing of the nursing position due to task priorities and high acuity and turnover of patients. I love working hard. I want to work hard. I want to be able to care for my patients though. Not just see them a few times for tasks and sit for 40 minutes charting or doing one of the hundreds of non nursing roles I’m required to do to get my job done (stocking, chasing down meds that haven’t been delivered, etc).

    2. Jen Kyer says:

      Thank you for your service to the profession. One of my mentors was a hospital trained nurse. She was phenomenal. Thanks for reading.

  27. Anonymous says:

    Jen, you wrote a very good article! I felt what you wrote about 5 years ago! I remember having a charge nurse with less experience then me giving me a high acuity case load, not because she was being mean but cause she had no clue what she was doing. She has worked beside for maybe a year then made charge for the most of her nursing career. Then of course, she got her Masters and now has some sort of a desk job and not bedside . So really she has no clue just how stressful it is to be a bedside nurse. Of course you also have the one year nurse who becomes a preceptor and really has no clue how to do bedside nursing without a another person. Yes I know I am preaching to the choir.
    However, getting my BSN after working as an RN for 6 yrs renewed my passion for nursing. I don’t ever think that education is bad. I do think that it is a administration issue and fully believe that they do not care! There some very good nurses out there. New grads and old nurses and if it wasn’t for them we’d have people dying left and right. What we need is more honest writers like you to get the conversation going and then maybe just maybe we can have some changes! Thank you for what you ar doing and keep on doing it!

    Oh and please for the love of God no more CNAs that think because they are going to go to nursing school (no where in the near future) they are already RNs. Today I had a CNA/tech with 10 yrs experience and who teaches CNAs tell me to draw a blood sample from I line I was giving a NS bolus for a BS check. He said he was thinking about the patient notstuck. Yeah good point, (insert eye role) never mind I was wrecking my brain trying to think why he was diaphoretic and getting lethargic. Of course he was offended when I told him a stick was going to yield more accurate sample. Another example of not knowing what they don’t know.

    Ok…..done bitching 🙂

    1. Jen Kyer says:

      I’ll keep writing if you keep reading. Thanks so much!

    2. Jen Kyer says:

      Thanks for reading. I’ll keep writing if you keep reading lady!

  28. Mark Schrider says:

    A strong clinical ladder system would help. I did the research, tried to get the ball rolling, but it went NOWHERE. Why? Hospital administration isn’t interested in spending the money (short-term) to derive a concrete long term benefit for patients, nurses and, the bottom line.

    1. Jen Kyer says:

      I’m part of clinical ladder program but now I think it’s having to work down to allow people to “move up” because they fulfill even the most basic of requirements.

    2. Jen Kyer says:

      I don’t think they’re as beneficial as they seem.

  29. Peggy says:

    I graduated from a BSN program in 1988. I was charge nurse the first night after I passed boards. I had never started an IV. I have worked in a variety of nursing fields. I never liked working in the hospital bc every hospital I worked at except a Catholic one was about money. The administrators certainly wanted you to do a good job but would not provide the staff to do so. Yes, young nurses are eager and willing but don’t have the experience necessary to take care of very ill patients. I’ve worked with LPN’s who were some of the best nurses around, contrary to my BSN program teaching. More experienced nurses move on to administrative jobs bc they have seen how hospitals treat them. I had a child in 2004. Suddenly I was on the other side. I don’t care if I ever have ice in my pitcher! But put the side rails up on my 2 year old!!! I used to pray my child in the NICU would get a caring nurse on the night shift when I couldn’t be there bc I had to go back to work.Fortunately we have had more good experiences than bad. I had some of the best nurses when I was pregnant and had to deliver at 28 weeks. It’s scary bc the schools, I believe teach them but how can you give adequate care to 12 people when you are doing the IVs for 24 and also getting vital signs and getting ice for pitchers! Lol. Happily retired.

    1. Jen Kyer says:

      It’s crazy isn’t it?

  30. Jay Hanig says:

    I know I hit the trail at age 56 after 18 years of bedside nursing. I would rather drink toxic waste than go back.

    1. Jen Kyer says:

      Great analogy 😂😂😂

  31. Lori Starkey says:

    Thank you, for this long-over-due article. I was a bedside nurse for almost 18years on a very busy med/surg unit in my hometown. I’ve seen many changes in those years. What I don’t understand is why the administration has never figured this out on their own. It’s not rocket science. It’s not complicated. It’s about doing the right thing, for the patient and the experienced nurse. Limit nurse-patient ratios, decrease shifts back to 8 hrs/day and focus on quality. Kudos to you!

    1. Jen Kyer says:

      It is simple. I wish they’d pay attention.

  32. Terry says:

    The more degrees we get the more they micromanage us. It has not helped. And like all teachers nurse educators get paid very poorly compared to bedside nurses. It is the healthcare as business mentality that ruins healthcare. I have been a nurse for 43 years and would not recommend it to anyone nowadays.

  33. Anonymous says:

    I received my AS nursing degree at 29 after working as a medical assistant for 4 years. I’m 38 now and have 9 years as an RN as well as my medical assistant experience. I had already earned a non-nursing BS degree in my early 20s so I had no intention to go back to school. Unfortunately my hospital as well as many others have insisted that all RNs have BSN degrees…they don’t recognize my previous BS degree. So why waste my money with another BS degree?? They don’t allow ASN nurses to precept new nurses so they have new nurses teaching new nurses. I feel like I get treated horrible because I lack a few initials after my name. I attempted to compensate for my lack of BSN by getting my CCRN, CEN, TNCC and ENPC. Yet the hospital continues to not allow non BSN nurses in on the decision making or precepting because somehow my years of experience and certifications are not equivalent to a class in nursing leadership! So, so long hospital, I’m in a FNP grad program because I love clinical nursing and I was perfectly happy at the bedside until you failed to treat me with the respect my patients and I deserve.

  34. E says:

    Fresh newly-minted BSN grad here… found this post and all the comments from experienced nurses informative and helpful. While this should be a time of great excitement for me, I can’t help but feel significant apprehension as I pursue a med-surg career. So many of the experiences mentioned here I’ve already experienced… missing breaks and meals, holding my bladder, feeling like a pill/task robot, not being able to bathe all patients. I had thought maybe it’s because I’m a new nurse (and believe it will get better), but I realize there are a lot of systemic and administrative issues beyond my control as well. Having fewer experienced nurses to ask questions of also doesn’t make the job any safer or easier. I want a long career in med-surg doing my best for patients, but realistically not sure how long before burnout.

    1. Jen Kyer says:

      You are who I hope this fixes for most. It could be better. It should be. We don’t need to be martyrs for the job but we should love what we are doing which it seems like you do. I hope things change to keep good people like you doing good work. Hang in there.

    2. Brenda Atkinson says:

      E,
      I have a lot of respect for any nurse that wants to be a med-surg nurse. The amount of patients they get is unsafe (7-8) and they are the heaviest patients usually. Hang in there there is a lot of good about being a nurse and you will find a group of co-workers that work well together helping each other and makes it better. Enjoy the experience you are learning now because some day you will be teaching new nurses.
      Good luck!
      Brenda

  35. Randy says:

    ” We have modalities to keep the most critically ill patients alive for inordinate amounts of time and these are only small parts of the cause of the bigger problem.”

    Yes this would make your job easier. Some of these critically ill patients need to JUST DIE! Fortunately for them, YOU don’t get to make those decisions. I’m not sure what else was written in your article. After that paragraph, nothing you have to say means anything to me.

    1. Jen Kyer says:

      Sorry this upset you. I’ve seen people tortured beyond anything you can imagine in the name of a “miracle”. It’s not only completely inhumane but mentally and physically draining for not only the family but the caregivers and expensive when all the people caring know we are literally torturing someone to delay a painful, horrible death by minutes or days. Sorry. Don’t know if you’re an ICU nurse or not but you don’t know what we can do in the name of science and medicine. It’s not all miraculous.

  36. Anonymous says:

    The writer implies leaving the bedside for Home Health is the lighter path…HH requires just as much experience and dedication…I’m almost 30 years in working in all different areas…the other side of the coin is having RNs that have been in their positions for 25-30 yrs resistent to change keeping the organization from moving forward in all areas.

    1. Jen Kyer says:

      I’m not implying that at all. I’m talking about anything outside of bedside. Not implying that those positions are easier or require anything less than bedside nursing. I’m just saying the loss at the beside has a ripple effect to everything. Horrible in-hospital teaching will effect outpatient care and home care and honestly direct patient care at the RN level is being watered down because of bad environments everywhere. I also don’t believe just because a nurse has been in a position 25 years he or she will keep an organization from “moving forward”.

    2. Brenda Atkinson says:

      I have done Home Health Nursing and really loved it ! It is just you and your assessment and teaching skills out there. You are responsible for trying to make your patients safe at home, set up community services, recomment other services such as PT, OT, MSW, HHA. The physician really gets to know you well because thecgoal it to stay out of the hospital. It was one of the most rewarding jobs i ever had. But when I wanted to get back into hospital nursing they would not even consider it as experience. If anyone does not mind driving it is an excellent job.
      It is NOT an easy job at all!!!

  37. Matt says:

    It is ALL about staffing. Always has been. Properly staff and the issue will resolve itself. However the suits will not listen, they think they know better and they do not. I could run a facility, it’s logistics, it’s finances better than them, most of us who are reasonably intelligent and experienced can. Example; Why is a 3:1 ratio in ICU allowed…ANYWHERE? It can not be defended, rationalized or explained. When a concept as intuitively obvious to anyone as this with half a brain is lost on them the only rational explanation that remains is corruption.
    And there you have it.

  38. Mary w says:

    Iam one of those experienced nurses and soon to retire ,partly because of all the things in this excellent article I can’t stand to see the destruction of the nursing profession as I’ve known and loved it ,

  39. Anonymous says:

    I’m proud to say I work for a company that cares about retention….but I agree completely with acuity of patients in my field I don’t think the staffing levels are as great as they could be, we definately need some regulations on this topic.

  40. Anonymous says:

    Nurses have to unite and then force hospitals to listen . I was a nurse for 45 years and worked ER and ICU. I am 74 and cry when I see what is going on. The sad truth is women do not stick together and fight. This has been going on for years. Good Luck

  41. Anonymous says:

    Great article… I was asked to leave after 40+ years of nursing. was at a critical Hospital with 23 beds for 4 years….they wanted to hire a new grad from the home town area and she was much cheaper than my salary and she knew more than half of the hospital people working there…so I was laid off and it’s hard to find a decent job when your at the top of the pay scale and over 50… sad but how do you fight city hall. At this hospital they had a great turn around, the new grads would get the one on one training and then leave for a bigger hospital and better pay. YES go back to 8 hour shifts. I saw the 12 hour shifts being abused by the nurses. I witnessed nurses sitting at the desk reading, on the internet and cell phones (11-7 shift) and trading shifts with other nurses to work 3 12’s together so they could get a longer period of time off. Then when they returned they had to get back into the groove all over again… not good

  42. Anonymous says:

    So what would be the solution here? Keep aging nurses on the floor? New nurses provide a totally different spin to nursing care, a fresh pair of eyes. At some point we all were new nurses and being a newbie doesn’t mean that the nursing care will be poor. We must provide new nurses with the support and foundation they need. Bedside isn’t for everyone and sometimes it takes a nurse 1.5 yrs ok one floor and 2 yes on another floor before they figure that out.

  43. Rachel says:

    This is the problem with nursing. You have a lot of older nurses who think they are better than the younger more novice nurses. Many times once you have at least 3 yrs of exp. nurses seem to forget that they were once young nurses as well. So what do you suggest? Have an entire nursing career filled with older nurses? Not going to work. I do agree that some nurses are becoming preceptors too fast however. Bedside isn’t for everyone and it’s okay to leave the bedside to go into a different soeacialy and then move forward to your MSN or DNP. Many NO programs are taking nurses with only a year of acute hospital experience. You can be at the bedside for 10 years and then go into a different soeacily and not know a damn thing. That’s the beauty of nursing you don’t have to get comfortable and you can move around and challenge yourself.
    I’m not sure where you got your stats from, but even if the stats show more experienced nurses help hospitals save money and decrease patient issues, experienced nurses just don’t drop out of the sky. We have to give young nurses a foundation and a good upbringing. In this field.

  44. Rachel says:

    *specialty* *NP*

  45. missyb says:

    It is so sad to see the state of bedside nursing today. I was a CVICU and CV step-down nurse for 10 years. I left for the cardiology office when my kids were little. I have tried to go back to hospital bedside nursing twice. I feel like they need nurses like me-passionate, caring, hard working and I love bedside nursing. But what they are doing now is NOT nursing. You can’t feed your stroke patients because if the meds aren’t passed on time, the computer locks you out. If that happens more than a couple of times, you get written up. I call the MD when I see my patient needs to be intubated. He says I have to have the medical response team(MRT)evaluate her before he can come to the room- all to ensure medicare reimbursement. I have been a nurse 20 years and do not need MRT to tell me my patient needs a tube! Not to mention the schedule. If I work 12 hours, I should be able to leave by 7:30;not so. It is 8:30, sometimes 9:00 before you can hand off your patients. And I am not milking a clock-I want to leave!
    Anyway, I have tried to talk to administration about trying new things, like staggered shifts or having a nurse come during peak hours to answer call lights, admit, discharge. They look at me like I’m a crazy person. Meanwhile, the nurses keep leaving in droves, and the poor patients do not receive the care they deserve.

  46. Anonymous says:

    Okay. So what is the solution?

    1. Jen Kyer says:

      Last paragraph. Retention projects.

  47. Stella says:

    No resolve in sight.!

  48. Denise K. Girrbach says:

    I could have written this article myself ten years ago when I left my job at The Detroit Medical Center. I was feeling that “Henry Ford” would be proud of us because what we had was a n assembly line of patient care…done quickly down the line. The room for error was A LARGE ROOM. This was an Interventional cardiac unit with telemetry. I was starting to feel that this was unsafe because post procedure the patients needed CLOSE monitoring . That’s hard to do when you have 8+ patients. I felt my license was on the line. Nursing had lost that human to human labor of love that once was there. I miss the patients and the trying to make the difference with my teaching which seems to have gone extinct. I believe we should have lower nurse/patient ratios to really do to REAL nusing. Sometimes all it takes is to hold a hand and comfort someone to REALLY MAKE A DIFFERENCE!

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