I have been a nurse for the last 10 years. In that time I've worked in the areas of Med/Surg, Oncology, Pediatrics, Long term care, and Medicare. Each year I've watched as the laws have changed making it harder and harder to do the job. I've watched as State and Federal laws are contradicted by corporate policies, rendering that law ineffective, and I've watched as good nurses have lost their license because some rule had changed and they didn't know about it.

Recently a local news station had an expose' about abuse and neglect in nursing homes. In that time frame they talked about alcohol and drug addiction being rampit among nurses, and nurses who steal from patients. What should have made me feel sad for the victims, only made me feel like raging at the news station. In 10 yrs of nursing I have only seen 1 case of intended abuse/neglect. I've seen 1 case of theft of narcotics, and 2 cases of staff showing up under the influence.

I currently work in long term care, and most of our residents have some form of dementia. What we, the staff, face every day is caring for ppl who are one step away from some form of phsycosis. The system as it's set up now, makes it impossible to take care of residents who are acting troublesome. I'll give you an example.

Recently we had a resident who was acting violently towards other residents. throwing things at them in the dinning room when he didn't like what they had to say or what they were doing. The law says we can not isolate residents as a means of disepline, it's considered abuse. We can not medicate as a means of restraint, we can not use restraints of any kind. So, as a way to deal with this situation we talked with the family and the resident in question and had them sign an agreement that the behavior would stop. That lasted a day because even though the family did try to get through to the man, he suffers from demetia and doesn't remember anything from one day to the next. After this happened several times and the doctor played around with his meds attempting to find a combination that would solve the problem. The management finally told the family that they would need to look for another place for him to live. Well that bombed out, because with his violent background no other facility wanted to take him on. The last time I saw him he threw a table knife at another resident at his table, and when the staff went to remove him from the dinning room they found another knife in his pocket. At that point our DON ordered that he be sent to the ER for an emergancy Phsyc evaluation, then told us that no matter what we were not to take him back. A short time later we received a call from the ER saying, "Hey you can't just dump him here like this!" Our DON showed some backbone and refused to take him back, telling the ER nurse that we had done everything we could for him and therefore could no longer meet his needs.

Of course the family was furious and have been making all kinds of threats. There's been talk of a law suit, and I have no doubt that in the end this decision will cost our facility thousands. But what do you do in this situation?

I can give you hundreds of senarios just like this where one individual consumes the time a nurse has on the floor and others get neglected in the process. However, it's not the family or that resident that will pay the cost, it's the nurse, because while the nurse is spending her time trying to calm this kind of person down, others needs are not gettin met, the families of those ppl get upset too, and blame the nurse.

I have 35 residents on my shift. If I'm in the middle of inserting a catheter and someone falls I'm in trouble. If I finish what I'm doing the person on the floor has to wait, and if they have an injury the family screams neglect. If I don't finish what I'm doing and instead go to the fallen person then the family of the person I left screams neglect because their loved one is now suffering. It's an endless cycle of you're damned if you do and damned if you don't. I've been bitten, scratched, and punched. I've been urinated on, and had feces thrown at me. I've been called every name in the book and had my breasts, crotch, and butt grabbed more times then I care to mention. This happens when you try to clean confused residents up and they don't understand what you're doing. You don't have to do anything to insite their rage, if they don't get it, you're in trouble.

I'd just like to know when someone is going to stand up for us! The nurses who are out here doing the best we can under impossible odds!

it's unfortunate that our laws have been amended to the point that they no longer work to protect anyone. Nursing isn't the only profession that is under this kind of chaos. The police have the same frustrations to deal with. The rules are so contradictory that it's almost impossible to catch the bad guy.

I understand that ppl get hurt when there is not enough rules, but doesn't it seem like the State and Federal departments, that are making the rules, should maybe consult the corporations that are running the show and get on the same page? Their not the one's doing the job but they are the ones paying the bill when the facility gets sued so you would think the corps would take an interest in the law making.

I feel your pain, sister. I've been doing bedside care for almost 28 years and things have really changed since I started. I've done mostly ICU (CCU, NICU, etc.) but have tried psych, prison nursing, private duty, long term care. Even got into legal nurse consulting (which I still do on occasions). You show me anyone's charting and I can show you where they're lying. It's simply not physically possible to do all the things that got charted as done.

I once got my butt chewed because I charted that I did not turn a patient every 2 hours as is the policy (and standard of care). I tried explaining why it was impossible to comply and the supervisor assured me that everyone else had been able to do it (according to their charting) for the past 3 months. The patient was 950 pounds, had undergone a gastric bypass, developed complications and came to ICU when she was down to 850 pounds. According to policy we are not allowed to lift/turn more than 50 pounds per person without assistance. There were only 4 nurses working in ICU. If all of us go to turn a patient the most we can collectively lift/turn is 200 pounds (per policy). If we do not comply with policy and wind up hurting ourselves, we are not covered by workers comp. According to their rules it would take 18 people (all the nurses available on 3 units) to be able to turn this woman every 2 hours. I guarantee you that 18 nurses did not stop what they were doing to go to another floor and turn this woman every 2 hours.
She also had an order for daily weights and the only way we could comply was if we got several people to roll her bed down to the loading docks and weigh her there. Also never happened. The daily weights were faithfully recorded on the chart every day.
Nurses are resorting to "pencil-whipping" their documentation to show that they are "good nurses" when, in fact, the rules are set up to make it impossible to be a good nurse. I think most nurses are good nurses and go above and beyond at a furious pace all day long, sacrificing their family time and own health to be able to care for hostile and demanding strangers. We are totally unappreciated or recognized for our work.
When the Murrah bldg. was bombed our pastor wanted to honor the "heroes" and asked for all the cops and firefighters to stand up and be recognized for their efforts that day. I stood up and the pastor said, "I didn't know you were a firefighter, or are you on the police force?" I said, "No, I'm a nurse. The only rescue worker that died that day was a nurse who left her family to drive to our state and help. I think she's a hero." He sputtered for a bit then said, "oh and nurses, you stand up too."
When a cop shows up at a gun fight and saves the day, he's a hero. When a firefighter runs into a burning building and drags out an old lady, he's a hero. But when a nurse runs into a room with a G.I. bleeder who's just blown like Mt. Saint Helens, spewing infective body fluids all over the place and develops Hepatitis B for her efforts, well that's just all in a days work. We don't get hazardous duty pay or combat pay even though we frequently earn it. (Not dissing cops or firefighters--would just like equal recognition).
I better quit here or I'll have to post it in the rant section.

First of all I want to thank all the nurses and CNAs. I appreciate all of you. You are indeed unsung heros. I've watched my good friend and my daughter's boyfriend work long hours and go literally weeks without a day off. It's not fair or right and puts them in harms way oh so many times. What will happen to the RN at that hospital when she makes a mistake on meds; not due to her incompetence but due to exhaustion? How will she be able to live with it? I say a prayer for them daily. My job is bad enough I don't want theirs. So once again Thank you.

Don't worry . . . it is not just the health industry.

I work at a public school. The kids are horrible, and nothing can be done to them. Everyone's child is an innocent angel. I have a few parents that are normal, though, and realize that their kids are not perfect angels. They basically tell teh school to do what we have to do. I like them

Thank you all for your input. I'm glad to see that I'm not the only one who feels this way, and I'm not the only one who's not handling it well. lol To me this is like the giant pink elephant in the room that no one is talking about. There is no way that patients are getting the kind of care they need with our current system, and nurses are dropping like flies with there own health issues, from the stress of the job. In the last six months we've lost 3 nurses to heart attacks. One of them was a 30 year old pregnant woman, and it's only going to get worse as we baby boomers come of age. I'm 45 years old. I used to be a very outgoing extroverted kind of person, but in the last few years I've become depressed, reclusive, and prone to antisocial behaviors. A year ago I picked up smoking and when ppl ask me why I don't quit I laugh and tell them, "It's the only thing that keeps me sane!" I don't mean to sound flippant but I'm a take action kind of person only I don't know what action can be taken to solve this problem. I thought about writing an article and submitting it to the New York times, or USA today, just to see what America thinks of this issue. What stops me is that even if ppl wake up, nothing will be done about it. They'll sympathize for awhile, but nothing will really change. The healthcare industry is the one of the largest providers of employment in the world today, but to be a part of it is like selling yourself into slavery! What can be done to change that though? That's the burning question in my mind.

How to fix the issue?

1) Reform the liability laws for medical malpractice. Thus cutting down on the sheer amount of redundant documentation nurses have to do. For a 1 hour transport I have to spend 2-3 hours filling out the paperwork.

2) Curtail and severly limit the power of JACHO. They alone are responsable for so much of the needless crap that gets in the way of direct patient care.

3) Institute reasonable and MANDATORY staffing ratios for all facets of nursing.

many fo these things can be acieved by organizing. The Union that represent my hospital is set up and run by the nurses. From the president on down they all have to be nurses working at the facility. Collective bargaining has so much more to offer.

I live in a right to work state. Arizona to be more specific. it's a republican right to work state. What that means is that there is no union. A company can fire you without explanation, or for any reason they want as long as it's not about discrimination, which is a joke, cause all they have to do is say, "Your fired" No explanation necessary, and you have to prove that it's about discrimination if you think you can. There's no job security here, and even though you can walk across the street and get another job, that place will be just as bad, or worse. I was offered $28 an hour to work in one place, $26 to work in another, but I took the job that offered $22 because it's an older facility, has a good reputation for being supportive of their staff. I can't complain cause my patient ratio is the best I've ever had, and although the benefits and pay suck, the corp. who runs it seems to really care and they are as supportive as they can be.

The fact is though, being in this profession is a lot like being in an abusive relationship. The ever changing game keeps you off balance and living in fear. You want to get out, but then you think of how much time, energy, and money you've put into this career and what a waste it will be to just walk away. When we moved here last year, I took some time to explore my options. I found nothing else that would pay me a similar wage that didn't require going back to school. I spent $15,000 on my education, much of which I'm still paying on, to work for even less and still have to pay that payment.......well it keeps me locked into nursing.

I would love to work for a company that has a Union but a few years back when I worked for the hospital the Union tried to come in. The hospital sent a letter to all employees saying, "If you are caught talking to anyone afiliated with the Union you'll be fired without notice. I was told at that time that in Arizona we're not allowed to strike. We're considered a service profession and ppl can't live without us, so we can't strike!

I live in a right to work state. Arizona to be more specific. it's a republican right to work state. What that means is that there is no union. A company can fire you without explanation, or for any reason they want as long as it's not about discrimination, which is a joke, cause all they have to do is say, "Your fired" No explanation necessary, and you have to prove that it's about discrimination if you think you can. There's no job security here, and even though you can walk across the street and get another job, that place will be just as bad, or worse. I was offered $28 an hour to work in one place, $26 to work in another, but I took the job that offered $22 because it's an older facility, has a good reputation for being supportive of their staff. I can't complain cause my patient ratio is the best I've ever had, and although the benefits and pay suck, the corp. who runs it seems to really care and they are as supportive as they can be.

The fact is though, being in this profession is a lot like being in an abusive relationship. The ever changing game keeps you off balance and living in fear. You want to get out, but then you think of how much time, energy, and money you've put into this career and what a waste it will be to just walk away. When we moved here last year, I took some time to explore my options. I found nothing else that would pay me a similar wage that didn't require going back to school. I spent $15,000 on my education, much of which I'm still paying on, to work for even less and still have to pay that payment.......well it keeps me locked into nursing.

I would love to work for a company that has a Union but a few years back when I worked for the hospital the Union tried to come in. The hospital sent a letter to all employees saying, "If you are caught talking to anyone afiliated with the Union you'll be fired without notice. I was told at that time that in Arizona we're not allowed to strike. We're considered a service profession and ppl can't live without us, so we can't strike!

I live in a right to work state. Arizona to be more specific. it's a republican right to work state. What that means is that there is no union. A company can fire you without explanation, or for any reason they want as long as it's not about discrimination, which is a joke, cause all they have to do is say, "Your fired" No explanation necessary, and you have to prove that it's about discrimination if you think you can. There's no job security here, and even though you can walk across the street and get another job, that place will be just as bad, or worse. I was offered $28 an hour to work in one place, $26 to work in another, but I took the job that offered $22 because it's an older facility, has a good reputation for being supportive of their staff. I can't complain cause my patient ratio is the best I've ever had, and although the benefits and pay suck, the corp. who runs it seems to really care and they are as supportive as they can be.

The fact is though, being in this profession is a lot like being in an abusive relationship. The ever changing game keeps you off balance and living in fear. You want to get out, but then you think of how much time, energy, and money you've put into this career and what a waste it will be to just walk away. When we moved here last year, I took some time to explore my options. I found nothing else that would pay me a similar wage that didn't require going back to school. I spent $15,000 on my education, much of which I'm still paying on, to work for even less and still have to pay that payment.......well it keeps me locked into nursing.

I would love to work for a company that has a Union but a few years back when I worked for the hospital the Union tried to come in. The hospital sent a letter to all employees saying, "If you are caught talking to anyone afiliated with the Union you'll be fired without notice. I was told at that time that in Arizona we're not allowed to strike. We're considered a service profession and ppl can't live without us, so we can't strike!

i do not mean to sound like a broken record, but all this insanity going on, with understaffed healthcare institutions and abused nurses, i think it's designed from ground up to force eugenics into the mainstream.

make people fed up and desensitized to the point they will agree with killing everyone who does not fulfill the required criteria (think form with checkboxes)....

all that money going nowhere, while the ones keeping everything afloat get spit in the face, i wonder what else the guys in charge are trying to accomplish?!

Originally posted by Long Lance
i do not mean to sound like a broken record, but all this insanity going on, with understaffed healthcare institutions and abused nurses, i think it's designed from ground up to force eugenics into the mainstream.

make people fed up and desensitized to the point they will agree with killing everyone who does not fulfill the required criteria (think form with checkboxes)....

all that money going nowhere, while the ones keeping everything afloat get spit in the face, i wonder what else the guys in charge are trying to accomplish?!

Interesting theory, I don't know anything about "Eugenics" Do you have more information? I think it's time that we all start talking about this, instead of just accepting it as the way things are. I do agree that you become desensitized to it all. When I first started I cried a lot over patients I lost, but now days I don't cry anymore, instead I try to get the body out of the facility as fast as possible. Not because of any noble reason either, just the work involved slows down everything else I have to do. God! I hate that all the humanity is gone out of nursing today!