Why I Choose To Take A Stand For Safe Staffing and The Nursing Profession #NursesTakeDC

  1. Jan says:

    Staffing MUST BE based on objective patient acuities and not just numbers….hospitals must accept that they HAVE to supply those numbers of nurses needed….and that MUST not be through mandatory OT unless there is a natural disaster….incentive pays and voluntary on call ‘fresh’ staff should be part of the arsenal of nurses they draw from. I worked 39 years as a NICU RN and its only getting worse with all the insurance and government people telling us what we need to do….people who have NEVER worked along side us. Hospitals and nursing homes are a dangerous place unless you can advocate for yourself….good luck in washington!

    • Mina says:

      Agreed Jan. Mandatory Oncall has been banned in 13 states. Let’s call our nursing associations, and push for this to be illegal everywhere in our country!

      • Cathryn says:

        I love you. You are correct. And have been a nurse for 30 years. Thank you thank you thank. Ohhhh the things I have seen. Plz plz plz keep on!!@

    • Donna Dillon says:

      You. Know our hospital. Used to staff by acuity ! Now they don’t ! You can have acutely ill patients in 6 rooms and be accountable to all six ! Nurses can’t even take the time to eat or go to the bathroom ! Glad I am retired ! Donna R Dillon

  2. Michelle says:

    This is so true but not just in the hospital, it is in every aspect of nursing. We are just a means meet a quota. I spent a lot of time and money going back to school to be a RN later in life, but it has been very disheartening what healthcare is.

    • Lorraine Richardson says:

      I would love to see the day when a nurse can work in the capacity of a NURSE and not just push papers or computer operators for that matter. I’ve been a nurse for 22 years now and over the years it seems as if a nurse’s license is always on the line. Orgaizatons are not seeking to provide quality care to the patients we serve, resulting in lots of caring nurses leaving the profession. This is very sad. Hurray to the bold nurses that are bringing this to light.

    • Rob says:

      Completely agree!! The government and the MBA needs to leave healthcare. You have a degree in business not healthcare- leave!!

    • Rose says:

      I went back to school in my mid forties: single again with 2 daughters and got my associate degree with financial help from my brothers. Although I have been practicing as an RN for 12 years (mostly ER), there are very few areas of advancement available without a BSN, whether you have experience or not. That is why nurses with BSN degrees, but very little experience are able to fill these positions. Just one of the reasons the ‘heart’ is being sucked out of nursing. I would love to teach clinicals, where experience can help prepare new grads for the practicalities of real life nursing. I feel students need to be taught from the heart, not just a book, which is impossible to do without experience. I really feel the ‘heart’ is gone and has been replaced by ‘financial gain ‘ and ‘fear of being sued ‘. Very sad, because we all suffer.

    • Melissa says:

      I agree. I’m a case manager for a PCP practice. Well, actually for 10 practices. They are part of an ACO so my job is to keep them out of the ED and hospital. A lot of what I do is mop up behind VNAs’ shabby work because they are rushed and overworked. It is everywhere. I just resigned because of the outrageous hours I work. I have NO time for my friends, family or myself God forbid. It’s everywhere. Not just acute care. But what I am appalled about in Kelsey’s article is that nurses are documenting things they didn’t do???? I can not even imagine doing that. That is very scary.

  3. Lu says:

    It has been going on for years and now it got worse and worse. As much as we should be concern about our patients we should concern about the nurses..their well-being and their health

    • Lisa says:

      You know there are so many amazing nurses who seriously might want to give home care a chance. The pay may not be as great as it is in the hospitals but I feel that there are some definite benefits working with one client at a time; no need to be pushing around med carts. Especially with children I believe that it’s very rewarding & sometimes you can just since the love that the child may have towards you not to mention parents who know when nurses are so genuine & you form a close bond with; I know that because I am a parent of a child who needs nurses in our lives!

      • M Wsrd says:

        I left a 25 yr hospital career for home care! Love love love it! Yes less pay but I am HAPPY!!!

      • Susan Smith says:

        Unfortunately you don’t get to see the business side of home care either. I am in management in home care. Government reimbursement allows us to pay very little and most companies do not offer benefits. The paperwork is every bit as excessive and cumbersome as in a hospital setting.

        As a Casemanager I am every bit as frustrated not having time to engage my patients as I would like.

        As a DON I am frustrated that I can’t attract folks who would be fabulous as HHAs or nurses because I can’t pay them well and cannot offer benefits. This leaves me with subpar employees who provide subpar care, call off and have subpar professionalism. There are so many people who need homecare but I have to decide daily which struggling family doesn’t get care because we can’t admit them due to inability to staff them. I personally work three jobs to pay my bills because I make significantly less than hospital management with equal but different stressors.

        As a field nurse, I enjoy the patient care but documentation is excessive and the pay is low. I am now responsible for sicker and sicker patients being sent home too early and am dinged for sending them back to the hospital they shouldn’t have come home from. I am willing to give up some pay for other perks but it’s not a proportionate trade.

        Until government reimbursement rates for our services increase, I will be desperate for good nurses who I may or may not even recommend home care to depending on their life situation. If pay and benefits don’t matter, it can be a perfect job for the right nurse.

      • Penny says:

        I’ve been a homecare nurse 23 years and have been there that long because of the one on one time I’ve spent taking care of my total patient. But! I’ve quit and come home. HCAPS scores and quotas are now so much more important to the powers that be. We now do pretty much every high tech skill in home except surgery and with less time and money for skills training but cuts to reimbursement for outcomes. I know, because I’ve also been admin for 17 years. But I’ve been that admin that still works in the trenches alongside my staff. Working 10-12 hours all day, out on the roads, then coming home to rush thru “home life” only to sit with a computer another 4 hours charting what should’ve been done “in the home”, and making sure you’ve gotten all the happy stuff covered for those patient satisfaction scores leaves nothing for the nurse or the folksaround them. Nothing. It used to be a beautiful thing because we were able to really be nurses and also have time. I miss that so terribly.

      • Suzanne says:

        I agree Lisa. I’ve been a nursing home LPN for 8 years and the changes I’ve seen in that short time are so disheartening. I began doing home care part time just over a year ago and LOVE it! For me the pay is actually better ( my LTC facility has an awful pay rate) but the benefits are not so great. However I get to actually be a nurse, not just a pill pusher, fall catcher, and charter. I hope someday I can fully transition to home care and leave the LTC far behind.

      • Lisa says:

        I’ve done this and enjoyed the one-on-one, but…we were required to finish the visit AND charting in 45 minutes. Even to the point of having to be lectured on a 45 minute visit for hours and hours. The owner even made everyone do a “mock visit” at a hotel with all the upper mgmt. of the hospice, so they could help you to do it all in 45 minutes. That’s when I left. My patients were dying and they, and their family, deserved my care. I shouldn’t be watching the clock when I’m teaching a family about medications and what to expect as death nears. Sad.

      • Rachael Ginder says:

        I agree. As a mom that has cared for over 200 dying and medically fragile infants since the early 1970’s , most coming from Riley Children’s Hospital, I know that the hands on care and actual doing medical things are special in home care. Not as many patients, bosses and more flexability in hours ect. In our case as my husband and I are getting older, 79 and 83 and love our 3 adopted delightful special girls but need nursing help to continue giving the best care. Please if you are passionant about your nursing and want a good place to work, let me know. We are NW of Anderson In and would love to talk to you.

    • Sue says:

      I’m 60 years old and continue to work in the hospital! From day 1 staffing has been an issue no matter where I worked! The difference today is the acuity of the pt and insurance companies dictating the care! The insurance companies decide what is necessary and the educated physician and other healthcare professionals assessments are challenged! All about the almighty DOLLAR! SOCIALIZED medicine at its best!!! The Rich and Hollywood will never be affected by any of this……good luck on DC…. ! And Obamacare didn’t help guys! Just my opinion!

    • Monica says:

      I’m not an RN, but I’m a Retired Registered Dental Hygienist who has been a frequent flier at a local hospital due to Chronic Pancreatitis and Adrenal Insuffiency. While I developed some wonderful relationships with RNS & Techs, it was still a full time job being an advocate. God HELP those that don’t have someone with medical background, pharmacological knowledge to help with the ck and balances; because 1) Dr’s have made numerous mistakes that I’ve caught with my meds or tx, & 2) I’ve been in arguments with nurses over if an IV was infiltrated or not “because you’re a hard stick and I just don’t have time” or a med was admn wrong way, dosage, or not a med I should even be given (Dr’s fault). However, the RN didn’t want to take the time to call the Dr to confirm. It’s always about time. Dr’s always have one foot in the room and one foot out to make a fast getaway. Sadly, my last stay at this Hospital, everyone I’d known but one person had been “let go”, as the hospital had been bought out the week before my admission. I didn’t know anyone and that was incredible considering how often I was admitted and the length of my stays each time. I was like family. I stayed 5 days before my ID Dr bailed me out of there. They were downright rude and man, except for two, one in a 24 hour period and the other a 12 hr shift. The most appalling experience ever, so much that I’ll never go back as a pt. Dentistry is getting to be the same way, too, my friends. GOOD LUCK … CHANGE IS NEEDED BADLY. ♡♡♡♡♡

  4. Cindy says:

    Abuse we take from families verbally and they dictate treatment!!! Hospitals only are concerned with satisfaction scores not doing a good job or being a great nurse!! It has become a personality test!!If the patient likes you and mentions you in a survey your doing a good job ( hospital gives you a gift too) which is very wrong! I usually get the dementia, ETOH patients who never remember anything so I am unable to get recognition sometimes which is unfair! I am an RN for over 35 years and I am so happy the young nurses are standing up against abuse and ridiculous business satisfaction scores! Corporate is so clueless as to the long difficult 12 hour shifts with pure anxiety we carry constantly with no breaks or lunches! I support this action and good luck! I could write a book about my 33 years- nursing respect is out the window and I will be happy to retire in a few years is my goAl!All the best! I now dislike nursing because they deplete your energy, demoralize you for an error, strip your integrity and decrease any positivity and dreams you once had in caring for people! I am beyond exhausted now with nursing!

    • Joanna says:

      I agree! I’ve been in nursing for 14 years, and if a patient think you were mean, you get in trouble. My company is now listening to phone calls and critiques you. This is ludicrous!!!

    • Donna says:

      As a critical care nurse in a cardiac ICU, I COMPLETELY agree with you. The patient-family care model was designed to educate and inform patients and families, and to allow them to participate in their care. In no other profession are educated individuals exposed to so much verbal, emotional and mental abuse, while being held to “satisfaction scores” as a way to measure they’re worth.

      • Liz says:

        Your last sentence could not have better summarized the sad position that most nurses are in today. It was one of the reasons why I left to earn a graduate degree in a non-nursing, healthcare-related field. I would love nothing more than to be at the bedside, but after 5 years of being an RN, my physical, mental, and emotional health has gone downhill drastically. What is additionally hearbreaking is to be exposed to students at my school (going into Health Management/Administration) who have no clinical healthcare experience, yet who are already trained to focus on the ‘bottom line’ (financial compensation) above everything else. Most of these students, by the way, are in their mid-twenties. Their program is one of the best in the country for Health Management, so these students may potentially be the ones telling US how to practice in the future, whether by setting hospital policies or setting insurance reimbursement standards.

        Enough about that though. All I will say in closing is that the disconnect between the idealized view of nursing that is taught to us in school (and remains highly symbolic within the minds of our patients, families, and hospital administration) could not be any different from the harsh reality of the field as the way it truly is. And what a shame. Nursing is one of the best, most amazing fields that anyone could possibly go into…yet it is not worth all of the constant abuse and loss of health to remain in.

      • Deb says:

        Well said. Upper management seems to only look at the bottom line. I have been an emergency RN for more than 20 years and now work in Behavior Health. And , yes, new grads are precepting new grads; they don’t know what they don’t know. Most RN’s in the emergency department are caring for 5 patients, all needing emergent care for whatever their problem(s) are and we have been told we must take our lunch break or be written up for NOT taking a break. To whom are we to give report to when every other nurse is already caring for 5 critical patients of their own?!! It’s all about the bottom line, budget cuts in every part of healthcare and satisfaction scores used to determine how well we are performing. It is not a joke, nurses are held responsible because a patient complains about a stale sandwich. We are expected to tolerate being called every nasty name , physical, and verbal abuse. I witnessed a nurse battling her own fight with cancer being taunted by a patient because she now wears a headscarf or cap because of her hair loss. The patient yelled at her saying it’s too bad she’s going to die anyway, then walks away laughing. This is just one example of the disrespect we are supposed to tolerate . I’m saddened that I no longer feel the immense passion for the nursing profession because it is a beautiful, rewarding profession populated with extremely smart, well educated, and genuinely caring individuals.

      • Jill says:

        Very well put!….another profession that might have it worse is law enforcement, they can be at the end of a gun!

      • Julie D. says:

        Yes, there is another profession that suffers from similar problems and that is teaching. Classes are over filled, often 25 kids or more to one teacher. Some parents think it’s the schools job to feed them , educate them, counsel them, praise them, all the while the parents don’t want to do their part in raising and disciplining their kids. But, if their child doesn’t get the grades they expect, it’s the teachers fault! I have a daughter that just got her teaching degree and another that returned to college for a second degree in nursing. They both went to school to be able to have jobs that helped others, but the future of both professions looks bleak. It’s heartbreaking knowing how hard they have worked, not to mention the friends that are nurses and teachers that are already going through this. Greed and profits drive everything, especially in memory care and nursing homes. So understaffed and inappropriately staffed with people who aren’t trained to handle the complexity of dementia patients. The money is spent on frivolous distractions that are meant to impress the family members, without enough attention to the quality and quantity of the nursing staff. Until you have to go through it with a family member, you can’t imagine how frustrating and heart breaking it is to find out the caregivers are not doing their job and your loved one cannot tell you until it’s too late.

    • Michelle S says:

      Well said! I just left floor nursing after 20+ years of it at our hospital. Brutal and exhausted. Gone are the days that we actually got to be a “bedside nurse”! I miss those days …but I am in a newly formed position as an RN still in our hospital system. I feel lucky that I am in this position but my heart is at the bedside 🙁

    • Amy says:

      I’ve been a nurse for 35 years. I don’t understand attaching compensation to patient satisfaction. You can bend over backwards and some people will never be “satisfied”. What should matter is outcomes. Do the patients get better, not readmitted? That’s the true tell. But then no one asked us cuz we’re just nurses, what do we know??? Laughable!!! If it weren’t so serious.

      • Linda says:

        It’s about CMS and their regs

        • Crissy says:

          Yes- hospitals didn’t come up with this pay for performance crap! Our very own government did! Not only is everything tied to core measure performance but patient satisfaction ratings. What did our wonderful regulatory committees do to the nursing profession? Put more pressure on the bedside nurse to do it all! The ratios don’t matter so much. 4/5/6 patients- you still have to focus on the documentation more than the patient so your company can get paid for this visit…you have to chart so much that you’ll never find a perfect ratio! The change needs to start with our government. Hospitals aren’t fully to blame here!

          • Jenci says:

            YES! I thank you for your perspective! I’m a hospital administrator with a nursing background, I can tell you ITS NOT ME! I’m just trying to keep the hospital open so people in our community have access to healthcare! The government/CMS/insurance companies are a horrible influence on healthcare!

        • Gen says:

          I totally agree with you! It’s amazing everyone wants the government to be more involved in healthcare, yet they truly are the root of the problem! They mandate all that charting and by the individual whom supposedly performed it. Don’t get me started on Medicare! They are the reason everyone is so quick to push those patients out the door so they don’t lose more money and in hopes the next patient has commercial insurance to try to recoup that loss. I wish everyone the best of luck in DC and suggest you do a little more homework on why our healthcare system is failing and not puff the chests of politicians in making the American people actually believe that we need their help when in fact they need to be told to butt out….After all they are the ones controlling those pesky “scores” and using them as the healthcare pay score. Hence, you score 80% etc that is what you will be paid for…

      • Ashley says:

        That’s the whole point though! Patient satisfaction is not about pushing us to be more compassionate, it’s about those patients who just can’t be satisfied rating us a 6 and minimizing reimbursement. It’s about not having to pay the hospital bill in full because the patient forgot we told them a million times that narcotics cause constipation so we apparently didn’t discuss medication side effects. It’s all about what can the government do to keep from paying the obscene hospital bill in full, and it’s been successful. Never mind morbidity and mortality is increasing. Never mind MDRO rates are increasing at a phenomenal rate because we gave abx for a viral infection, but, hey! The patient got what they wanted which was some sort of pill and a steak dinner (my hospital legitimately serves steak on Saturdays) so we MIGHT be rated a 7 or 8 which doesn’t provide full reimbursement. We are not in a service industry, we are in the life saving industry. The thing that blows my mind is that the people posting on this great post are not the only people who see that HCAPS are a disservice and are actually HARMING people and the general public than making patients happy and healthy. There are multiple scholarly articles based on this premise, and yet, here we are. Something has to give. Hospitals can’t pay for nursing, even doctor, training and retainment incentives if they are not receiving the funds to do so. So either we stay on the track we are with higher nurse patient ratios, lower satisfaction ratings, higher morbidity and mortality rates, and allowing people who have the ability to google guide their care; or we allow the people who have been trained for literally years in higher education and hands on training and experience guide these sick patients care whether they like it or not. If they don’t like it, then , hey, sign out AMA but you’re care is still paid by your health insurance, you’re penalized by higher premiums and when you come back to the hospital because, turns out, we were right *mind blown*; the readmit cost is still paid in full.

      • Roxanne May says:

        I agree! Basing anything on those scores is crazy!! Who sends them back? Crazy pts and families who hated everything and everyone!

    • AC says:

      Amen Cindy! I too have been a nurse for 32 yrs. I am sooo glad I’m on this side of my career instead of just starting in this profession. Pt. satisfaction is all corporate wants.. at any cost, mostly at the nurses expense! Being pulled to other areas of the hospital during low census is another drain. I work in a specialized area where other nurses can’t help us because we are”specialized” but we are expected to go help them… I’m done…!

      • Cindy says:

        I’ve been a nurse for 35 years also and you nailed this. Pain management is a good example. Patients with drug abuse history get angry because we can’t provide them with narcotics when they want, so you expect them to give you high satisfaction scores? That’s just not going to happen, so then reimbursement suffers because of it being tied to satisfaction. This is only one example. The nursing shortage is really going to become a national crisis if we don’t start addressing it more seriously.

    • Lucy says:

      Right on point!

    • Linda says:

      Yes, I have experienced these things too, and we are all treated the same as if we are simply interchangeable cogs.

    • Katy says:

      This is exactly why I am leaving direct care nursing. It is no longer safe to care for patients when you are having to care for 9 or 10 per shift. I’m no longer willing to put myself at risk for an injury or be responcible for a patient that falls due to lack of staffing to save a buck.

    • Monica says:

      I in no way meant to sound disrespectful to your profession, btw … I empathize & detest with the gov’t involvement in medicine. I am, I promise you, not a disrespectful patient; UNLESS, I’m being disrespected. I first try to calmly resolve it; but doesn’t always work. ): I know what is like to be on the other side and I totally get time schedules. The 23 yrs I worked, I rarely had a “tech” to assist me, yet was expected to clean someone’s teeth in 20-30 minutes, chart pocket depths, educate, plus we also had to wait fir the dentist to come ck our pt … HA! Impossible, esp if the out needed x-rays, țoo! (We had to develop them too!) It’s a burn out scenario.

    • Kat says:

      It’s not that they’re clueless, they just don’t give a f**k…I feel bad/sad for you great caring nurses, but corruption is everywhere, we HAVE to band together, we are ALL being abused by the powers that be, they are systematically taking all of mankind down. Read the NASA document called Silent Weapons, Quiet Wars @ stopthecrime.com, WE NEED TO WAKE UP!!…god bless ✌??

  5. Carmen A. Sanchez says:

    I am a new nurse, but I feel exactly what you described in your post. Two months and I am already frustrated for the way healthcare industry tries patients and nurses. My days go in the way you describe yours.

    • Channon Brown says:

      I’m a new nurse as well and I spend at least 3 hours after my shift charting. It’s crazy. I don’t even feel like a nurse. I don’t feel like I’m at the bedside like I should be. I never get breaks or lunches and barely get a chance to use the restroom. Not a good start for a fresh new nurse.

  6. Debbie mathews says:

    I am with you!

  7. Peggy says:

    So very well written
    I am retired now.
    I loved my career as a nurse for 40 years and was proud of what I did every day at work.
    But I could see the writing on the wall in the last few years
    I’m glad I’m not doing it any more.
    I wanted to be there for my patients.
    And there just wasn’t any time.

    • Valerie Puryear says:

      Like Peggy, I was a nurse for 40 years. I feel lucky that I was able to retire as corporate was shifting from patient care to a customer satisfaction model. I loved nursing, but I am happy to have it behind me.

  8. Sonya says:

    I agree with all you have said! I have been a nurse for 30 years. I can honestly say I have witnessed in the last 8 years a huge decline in quality and quantity of bedside nursing! What the government and companies told us would help us and give us more time with patients has absolutely done the opposite it takes soooo much time from patients,to sign on to computers and scroll through record to document over and over every shift that you are doing hrly rounding that I don’t believe it’s really being done! I also think so much emphasis is being placed on documenting over and over core measures so the hospital gets paid max amount that patients ptoblems and illnesses are getting missed! If a patient comes in with sepsis why do I have to be sooo concerned with whether they smoker and that I offered nic replacement and that I done smoking cessation teaching while there and after discharge what exactly does that have to do with sepsis and why should whether or not I offered smoking cessation during Hosp stay and after discharge have anything to do do with how much hospital gets reimbursed. BUT it does! If we fall out on a core measure the Hosp don’t get paid as much! Really like people don’t know smoking is not healthy! Whatever happened to patients taking a little responsibility for themselves! I hope this March on Washington helps something! Before long we aren’t going to have any bedside nurses! And that really hurts me!!! I truly love nursing and I hate seeing this happen to the career I love!

    • Nancy says:

      I have been a nurse for 36 years and totally agree with you Sonya. What was suppose to improve care has done the opposite and there is more coming if not stopped. Healthcare reform is necessary but not at the detriment of nursing and patient care.

  9. Andrea rivers says:

    Beautiful! I have felt this way for the past 16 years. You have spoken eloquently, and most importantl,y truthfully. We must all hope, and actively work to bring about change. Nursing at is core, is about healing & caring for the entire person – not simply managing an acute disease. The egregious examples you discuss affect every single floor nurse in America. You make a very important point when you correlate the relationship of poor patient care, and corporate agendas. Patients having to wait for an hour to simply go to the bathroom is to often not the result of incompetent or uncaring nursing staff, but instead the fault of an impossible staffing matrix. Nurses who try to keep up with holistic nursing, in the cooperate healthcare system will quickly burn out, and will neglect their on wellness. We must as nurses, represent wellness. We must, as nurses, take care of our own spiritual, physical, and mental health so that we may be strong and positive advocates for the health of others. Unfortunately , the current healthcare system does not allow this. Again, thank you , for your sincerity and truths. There, is not a floor nurse in this country that has not felt and experienced the shameful realities you have talked about in this forum.

  10. Caroline Anthony says:

    I can relate to every word you said. Thank you and I am going to do my best to be there in may.

  11. Brenda says:

    You tell a true story that I know well. In the field of nursing today it’s a struggle. As you have stated, the patient nurse ratio is ridiculous and getting worse. Our ratios are based on numbers; but it should be based on patient acuity. What does this patient require and how long will it take to carry out the care plan outlined for the patient to recover. It has become a rat race and it ain’t pretty. I am retired now, but my back and feet and 12 hour shifts that easily become 13-14 hour shifts help push me out the door. We have lost the time to be the compassionate, caring nurses that we dreamed of being. Doing away with the 8 hour shift has done more to push nurses into retirement than any thing else. Your article is accurate and I hope eye opening for those who can change things and make nursing what it was always meant to be. I’m pulling for us.

    • Karla says:

      I totally agree with everything said. I have been a nurse for 36 years. I have worked intensive care, management, home care and long term care as a consultant. There is not one area of “hands on” nursing that have not seen the decline in patient care due to the numbers game. One of the earliest changes that I have noticed to be a detriment to patient care, is the shift changes from 8 hrs to 12 plus hours. Nurses are to exhausted to perform well after 8 hours. It creates more burnout and the patient care suffers. The extra day off a week is spent just recuperating and resting. My family knew this well. They often commented ” Don’t bother Mom . She just worked the past 3 days”. I was worthless to myself or my family on the first day off. Several years ago where I worked, we were to record the acuity of each patient according to a scale provided. This was supposed to be used into our staffing module. We rarely saw staffing adjusted accordingly and eventually the scoring was stopped. Computerized charting also created heavy demands. CMS regs, Oasis and JCAHO have gone to the point of ridiculousness. Where I currently work, we even have a pop up to document hand washing, bag barrier, PPE used and hand hygiene instruction on each and every home care patient visit. Give me a break. If we chart every motion and word throughout the day, there is no time left for anything else.

  12. Vjollca says:

    It’s so true for this . Most of the hospitals. Don’t really care about patient . I was in hospital last week. For chest pain. I was seen there they send me home lest then hours “. I never felt better when I left hospital . So I end it up going to another hospital drive hour and half to go there . When I went there they took the time and diagnosed me with low potassium. Witch that’s why my chest hurts . But the first hospital didn’t take they’re time to do test . They didn’t take me seriously. Send me home I could been going in chardiac that’s next day is I didn’t go to the next hospital . The hospital I was there they care about the number of patients . Not care about patients . Our health care going out of the window. But at same time Nurse she was the best Nurse and I know her personally . But of course it’s not up to her . It’s up to big boss above her she can’t take the time to take care patients. I totally underhand and agree with this . Nurses should be worry about the care of there parties. . Not what they documenting in the chart . I could died that next day or if I didn’t talk to another of my it’s and Nurse . She told me to go somewhere els beacuse it’s something wrong . It’s not because they missed low potassium beacuse they didn’t take patients serious . Hope something change of this . I’m trying to finish the school to becoman and nurse. But hoping by next three years something going to charge .

    • Sherry says:

      I my self have been in nursing as a RN for twenty years it has changed so much it’s not about the actual health of the patients but if they enjoyed their meal or their family was served coffee etc. I have reached my ending point with bedside nursing looking for a job that I actually only deal with patients and MD no more families and all of the other obstacles in our way ! I am giving my job another 10 years god willing at a smaller hospital and retiring early can’t not do it anymore!

  13. Michelle Carroll says:

    It is absolutely Wonderful IF NOT breath taking to see a generation come along and feel how I have felt, seen what I have, do what I have done & still doing but ( in a little bit of a different circumstance) and VOICE the GRAVE CONCERNS OF the lack of healthcare!! Majority of the time…I did not get what one would call a “lunch break.” I would work back to back and be on call, and go home thinking (after pulling a 12/16/18 hour day I would sleep to find myself being called back after possibly 4 hours.
    Patient care and the advocacy of patients have went to the wayside persay. It is no longer. I’ve always stated, “If one is in it for just a paycheck, GET OUT!” Granted there is no room for human error but it can happen. I could go on but to know someone beat me to the punch…GOOD FOR YOU!! I hope to join many!! The Companies do not care because they do not provide the bedside care. It is easy to say what we need to do, but it is harder ohysically and mentally on us as well!! I’m glad I had patients want me and remember my face and name. That is the gratification, however I could go on about the injustice done to healthcare workers!!!
    Wishing you the very Best and to say….
    I DID NOT do it for the money…but for the compassion I have for others, the love I would want to receive and my family and I enjoy seeing through the outcomes!!! God Bless all of those who are in the Medical field!! We do not get recognized enough!! “Rock Stars” in the facilities when your doing your job!! Take Care!

    • Nathaniel Collins, APRN, FNP-BC says:

      Love your comment. As I was reading near the end, I kept thinking that a majority of hospitals in my area are “not-for profit.” However, the worked experience is severely the opposite. We need to see the profit gained is reinvested into nursing services at the bedside and not on a pie chart or budget sheet. That stuff is smoking mirrors. Thanks for posting your thoughts for me to enjoy. Great job Kelsey!!

  14. Karen says:

    It doesn’t matter where you work. You are buried and you can’t be the nurse you want to be. I’m never happy with my jobs because it’s all about the money not the care.

    • Lori says:

      I was fired from a great hospital after working there ten years, 25 yrs of nursing in total. It was a horrible overwhelming PM in which admissions kept coming, I had umpteen antibiotics to hang, an influenza test to administer, and just an overall circus of a night. There wasn’t any way possible I could possibly complete all the nursing tasks thrown at me that night and my manager just sat there watching me fail instead of offering help. After all, what was more important than the patients receiving their care? But she simply documented my failures, even though I was going as fast as humanly possible. I got called in the next day and canned and I have to tell you the relief was so great, I simply smiled and thanked them. I am not Superwoman, and I was a good, competent nurse. But I saw way more than once how they’d set up a nurse to fail and if you went to the manager to express your staffing concerns you were just told to suck it up and get busy.

  15. Jana says:

    That’s an award-winning, perfectly stated, generalization of nursing. I completely agree with everything you said. Funny that right now, as I’m working on my BSN, we are talking about “taking one for the team”, and what it implies- abuse! Even though I won’t make it to D.C., I’ll be there in heart as this is exactly how most nurses feel. Thank you for posting!

  16. Jane Lambert says:

    I have been in nursing 43 years. Psychiatric nursing for about 38 of those years. Great hands on bedside care disappeared along time ago….to the hospital, office etc…but not to me as a nurse. We became nothing but paper pushers( now computer charters) and money makers for Healthcare many years ago. At one point and time if was felt nurses could basically be done away with just use a tech on the floor , unless a highly skilled department. Many of my patients can’t advocate for themselves , they can’t even tell you they are in pain much less where the pain is and at what level. Assess, assess, assess is all I can do. We are always short staffed. Yes, we have to fill positions sometimes knowing this is not the right person , but the staffing pattern says I need them and no one else applied. It’s a constant battle for you to care for you patient ( we can’t call them patients anymore they are clients), supervise your staff, keep all the paperwork /computer work caught up so you don’t get dinged when the state comes in…something added to the job everyday except more pay. In Alabama we have program approved by the ABN and the ADMH where aide level staff are trained to assist with medications in day hab programs and residential homes. Yet, they are working on my license. This is also approved in many other states.
    I love nursing but everyday get closer and closer to hanging it up. Sometimes seems like nobody cares about the patient except me. They are to worried about the budget . Prayers for all the new nurses out there it is a tough yet rewarding life full of opportunity to touch many lives. Sometimes the only kindness they ever see.

    • Cyndi Hager says:

      I am a technical partner on a med/surg unit. I am 58, been a tech for 4 yrs. We have become Epic computerised and charting drones. I have at least 8 patients a shift and a lot of times more. I work 3-11:30 but refuse to leave my patients until EVERYONE has been tinkled and tucked. We have lost so many REALLY GOOD CARING AND DEDICATED people due to the understaffed/over stressed/overloaded workload we have had to absorb. On the night shift we usually only have 1 tech to 24 patients, 4-5 nurses, very sick patients and 2 of the night techs are over 60 yrs old. I ALWAYS volunteer to stay even knowing I will clock out at 7:30am only to return at 3:00 pm for my regular shift. I don’t chart unnecessary crap that’s NOT why I do this job but still my patients are being neglected by rules and profits. I have so much more to say but have to get ready for my next 120 hour week that should really only be 80.

    • Sheila says:

      I’ve been in nursing 35 years and I’m fed up at my facility we have now been informed that we will receive a corrective action if our charting is not perfect, ugg I’m so sick of this , also working less staff due to the corporation being in the red for 4 years ?

  17. debbie postlewaite says:

    As a nurse of 23 years I agree with you and have witnessed this getting worse every year. When the government makes ridiculous cuts in funding or the insurance companies make impossible demands the stress goes up to find creative ways for companies to increase profit. I read this piece and was shaking my head Yes!! Nursing homes are even worse dear. I got out of bedside nursing and the abuse of nurses increases. Just a nasty profession for the nurse. Epidemic for the patient. Greed is a terrible habit.

    • Tammy Guerrero says:

      I too worked in a nursing home, once upon a time. And I truly loved it. I can remember sitting at the bedside of a pt, holding her hand because she was scared, and terrified of going to sleep. It felt wonderful to be able to just sit there for 10 or 15 minutes and give her comfort as she drifted off to sleep. I really miss those times. I got out of the nursing home due to constant understaffed. I would go home most nights, there at the end, just crying my eyes out because I KNEW that several people had to sit in their soiled clothes for a couple of hours, but I’m only one person. It’s simply heartbreaking. Change MUST happen, or we are going to seriously run out of nurses….everywhere. I applaud all who can make it to DC!! My heart is there with you all!!! And, I am a CNA, not a nurse. More than 25 years in this business. Now working in the clinic setting.

  18. Hilary Hardy says:

    Well said! I have been a nurse for 23 years and it is so sad how little patient care we have. I have worked as a nurse in ICU, PACU, GI Lab, Telemetry, and the past 10 years a School Nurse. I matter what type of nurse it is all about the paperwork and less about the patient. I am so sad and struggled like you have to think about changing my profession. I love nursing so much and pray for change. I truly believe that is why I changed my area of nursing so much, hoping for change. I am fortunate I could seek different areas, but in the end it is still about the paperwork. Praying for change. Thanks for taking a stand. ?

  19. Kathy Marshall says:

    Great blog! I feel the same way. I have been a nurse for 40 years and have watched a lot of changes over those years, and not always for the best. I would love to go to D.C. in May! To many patients and not enough staff is a major problem causing stress and burnout in nurses and poor patient care!
    Would love to have more information on Nurses Take D.C!

  20. Nancy Brewer CCRN says:

    I left the nursing profession for the exact reasons you have addressed. Go nurses its about time.

  21. Sheronda Peyton says:

    I totally agree with this and support this whole heartedly. I’ve been a nurse for 11 years and I am totally burnt out. I’ve left work so many times in emotional distress. I’m at the point where I am steering my career in another direction as a nurse.

  22. Samuel Nazareth BSN RN says:

    I used to work in California and we have 4-5:1 patient nurse ratio because that’s the state law. Lesser risks and more safer for both ends.

    • m says:

      It’s the law because of the efforts of the California Nurses Association. Are you a member?

  23. Kimberly Broughton says:

    I stand with you. I love nursing… but I miss it. Even though I am currently working as one.

  24. Carrie says:

    I agree with everything you have said!

  25. Ann says:

    I can agree with everything you mentioned here. If I can’t make it to DC what are the other ways I can truly make a difference? Also I am curious what type of RN position you are working now. I’m looking to take a break from the bedside as well and would appreciate any advice or recommendations. Thank you in advance.

  26. Have you considered that most charting is driven by government beaurocracy and Lawyers, not corporations?

    • Kelsey Rowell says:

      That’s why it’s called “NursesTakeDC” because yes, yes we do…..we didn’t just randomly pick DC

      • Kim Haynes says:

        Your writings were all very true. However, when I read the title about it being a business, I was hoping it would focus more on HCAP scores, as they drive the healthcare field for all the WRONG reasons. These scores do not drive quality healthcare, as it is supposed to do, as it has been twisted to drive patient happiness and customer service for reimbursement. Are we scoring and focusing on the fact that we were safe, caring, following evidence based practice, and did all we can do to care for you as the whole person? NO! It has been twisted to the advantage of “give me everything I want”. Pompus, arbitrary crap. We, the healthcare community, play along and foster the scoring for Trip Advisor. Why? The government devised this scoring system as a lose-lose situation to avoid payment. The people who visit our institutions know this now and make rediculis demands, “or else”. Therefore, we waste precious time, nursing time, on everything but real patient care. Do away with this and we will see real change. I don’t know how. Hopefully you do. Patient ratios are important, however no matter how small they get, with these scores in place, we will continue to waste time on ridiculous demands. I appreciate your hard work and I hope your efforts bring change so that we can get back to the basics and regain our love for nursing. Thank you.

    • Vic says:

      This is true. It is not the hospitals but government. The hospitals are either working on a less than 2% profit margin or in the red. They are as upset as the nurses. One answer is close the hospital.

  27. Leslie Ahearn says:

    Thank you so much for sharing what you did. I am behind you 100%, but I feel in this day of Me, Myself and I, it’s all about what I can get out of a situation and how much money I can make and who cares who I hurt in the process. Sometimes I think that all this technology has been more of a hindrance than a help to mankind. Facebook should be renamed My Neighbor’s Face and this way our thoughts would be on our neighbors face and not our own as in all those selfies. It is indeed so very sad that things are being charted that we’re never done. I live in Elko, Nevada, and the hospital here cares nothing about its patients, it’s all about the money, honey. It’s only with people like you that will bring change and I pray for you all the best! May God Empower you and bless you, thank you!

  28. Lynn says:

    This is why, I have been in the operating room for the last 30 years, at least there I have one patient!!!

    • Tammy Lindsey says:

      I’m a disabled RN now, I worked in surgery most of my career, but that has numerous problems too, during the week days you would have extra staff but after hrs. I would be the only nurse, one scrub tech and nurse anesthetist and the surgeon. If anything extra was needed, I was the one who had to run get it, I was the only one that could hook up equipment, positioning the patient, lifting legs that sometime weigh as much as me, to put in strips. On call from 3pm on Friday till 7am on Monday, sometimes doing back to back surgeries, recovering the patients myself, transporting the patients myself, Drs. and anesthesia and tech. waiting on me to recover the patient, Surgeon impatient, the tech had to clean the room, so much for terminal clean that supposed to be done. Some weekends we might not be called in but some weekends we would just get home and get called right back in, holidays it was the same way and this would all be after you had worked a forty hr week and on call a night during the week, there was times where we would still be working in the morning when the rest of the staff in. Then after working there for years and you start making more money then they nitpick till they can find a reason to let you go, so they can let you go to hire a new graduate making less money and treat them the same until they leave. You can only take care of one patient at a time, but you are rushed to turn over rooms as quick as you can. Wish everybody good luck in Washington DC, should have been done a long time ago, I also worked at a long term care facility, patients that came from ICU with drips and you have four patients just like them, some on ventilators, Never enough help, wish I could go to Washington too, but my health won’t allow me to go, I have a mother that was a RN too, when we worked the floor sometimes we would have 18 patients a piece and at that time they said no overtime, so at 3:00 we would clock out and come back and chart because we were not able to chart the whole day we could only take care of the patients, and they would not pay us after three, so we were working for nothing!!

  29. Nancy Terrell says:

    Good job Kelsey, I have been a nurse fir 36 years, all of which were in the hospital. I loved bedside nursing, but it’s changed,as you have well described.I left the hospital last year for an inpatient hospice unit, where I can be a bedside nurse,best move ever! Good luck with making voices heard, I’m ready to retire!

  30. juella says:

    totally with you guys.. been a nurse for 12 years! what can we do to support?

    • Jami says:

      I’ve been a medsurg nurse for 12 years at the same level 1 trauma center in my town. It has continuously been in the red due to the increase in crime violence and increase in indigent care. So many readmits because our population of patients refuse to change their behaviors, follow up with their docs or even go to the appointments we make for them at the local clinics. We are constantly “dinged” for this and nobody puts any blame on the patients for their noncompliance. Wages are cut, raises are almost never, and less and less staff are in each department. Experienced nurses are leaving and new nurses are starting in critical care areas which was something that was earned back when I started. The hospital seems to hire new grads over experienced nurses because they are cheaper. And now new nurses are going straight into NP school with less and less work experience because they hate the bedside. But regardless of the area of nursing or experience, the emails are still there….you know ….”you forgot to update your plan of care…or room 1 didn’t have their fall braclet on…u forgot to chart the pain reassessment…etc” I feel like all of you….exhausted, overworked, less empathetic to others, and just flat out frustrated with how nurses are treated like crap. And to make it worse…..the hospitals can’t afford to compensate us with a competitive salary cuz there isn’t any money. Yet our duties, responsibilities, and workloads increase day by day. Beyond frustrated with a career I once loved. Good luck in DC! Every nurse will support you!!!

  31. Teresa Andrew says:

    I’m a respiratory therapist, over 45 years now. I feel like you wrote my life story. I work with those nurses every day and have to say it is true. I believe all of us picked our profession for the same reasons and now are victims of the demands and pressures you describe. Love my job but I have to retire before it kills me.
    I fully support your cause, and thank you for speaking out!

  32. Stephanie says:

    I was a great ICU nurse. But I quit. At 52 years old my heart and mind couldn’t take being thrown in 2 different ICU’s and the ED in a single 12 hour shift. I couldn’t take watching new grads being hired in specialty areas because they cost less. I couldn’t take the same new grad killing a patient in ICU because they gave Lortab every four hours -and the patient had liver enzymes through the roof. They were so green they didn’t know Lortab had acetaminophen and too time-panicked to look at the labs. I’m wasting my knowledge and skills working surgery recovery. I’m bored out of my mind. But I sleep at night.

  33. Monica says:

    This is very very true. We are not able to go through the nursing process because it’s no longer about patient care but all about the numbers/money…..which is sad. This causes us to get low patient satisfaction scores for which we are counseled and reprimanded. Please share and get the word out so we can change the way healthcare is done and viewed.

  34. HB says:

    Great article Kelsey.. I agree with all you said and wish you well. I have been a nurse for over 30 years and recently retired. I loved being a nurse. I am glad you are taking a stand for all nurses.

  35. Melissa Rich says:

    I have been thinking and voicing the same concerns just to be told to give it more time and I would get used to it and more efficient. I’m thorough and won’t compromise my assessments, therefore, I run behind all day. I became a nurse to provide holistic care, but that is not a priority with today’s healthcare. Thank you for being a voice for us and starting this initiative.

  36. Keiko says:

    The issue is deeper than just a ratio. It goes to inadequate ( not updated) nursing education, non-nursing personnel teaching nursing students, ill fitted work flow, practice policies developed by people who are away from bedside etc… these things pile up and causing issues in nursing at the bedside thus actually causing more health care spending without good outcomes. I agree many come to nursing with good hearts ? but we also must look at the business side of healthcare system in order to be able to “talk the talk.” We must make all people involved in pt care including finance and management listen to nurses

    • K White says:

      I was reading through all of the comments just to see- just with the that someone would bring up the points that you have Keiko!!! Thank you! I went into management from the bedside after 10 years of direct care nursing practice and was vilified by the same people that I was supporting because I “didn’t get it”. But I do get it, I understand the challenges, the selflessness that goes into nursing, the challenge of protecting yourself from potential emotional and physical abuse that you can come in contact with every shift.

      However, to fight this fight, it isn’t about ratios. It isn’t about just numbers and how many patients we have. And California, after many years as the only state with mandatory ratios, doesn’t have all of the answers (take a look at quality and occurrence of never events). I applaud this stand and intention- I would advise all of us to talk to as many nurses as we can, get as many samples of nurses throughout many years of experience and education, as well as those in all facets of the profession; Managers, directors, CNOs, home health, pyschiatric, etc to truly understand the depth and breadth of what we are up against.

      The financial challenges and budgetary constraints of what healthcare is up against goes beyond the walls of the facility. Unless we understand and have someone take a stand against insurance companies, Big Pharma, and all those that lobby the government for a piece of the pie, we won’t be able to shift finances to what really matter- educated and skilled nurses hat are able to provide quality care and education to patients; an essential component to keeping people healthier and keeping costs down.

      THANK YOU for blogging, making social media more aware of our challenges, and giving us a forum to even have this discussion. Anything I can do to support you and even go to D.C. to join you, I would be honored to support our profession.

  37. Beth says:

    This is all of healthcare. Doctors, nurses, therapists, etc.
    Squeezed to do more with exceedingly less.
    In my particular area, we are essentially government run. Medicare and Medicaid account for our revenue and in large part our regulations. They continue to try to help the situation through more mandates. Demand certain outcomes–that we can’t control. Demand excellent charting—that we can’t complete with the size staff we have. But I see the numbers. There simply is not enough money for more staff. And if we found extra money it’s so difficult to find nurses right now. The shortage is scary.
    Healthcare is in crisis.

    Arguing about the insurance has the attention of the world right now, but we continue to neglect the patient aspect of this.

  38. Mary B says:

    You are absolutely correct! I have been a nurse for 25 yrs, worked in hospitals for 17 yrs, Neuro, CSICU, ICU, 15 yrs ER, homehealth every weekend for 12 yrs, LTC 7 yrs as supervisor! My last 2 yrs I have been working at home and I will not name the company on here, but ever where I’ve worked the last 10 yrs is all about their money and making sure their pockets are lined! I miss the bed side but if I can’t nurse the way I should, I will just sit at home and talk to them on the phone and hope I make a difference that way! God Bless Nurses Everywhere! Nurses Take DC 2017!

  39. Dana Fahrney RN says:

    You have articulated the concerns and thoughts of most of the nurses I work with. I have been in this profession for 25 years and have seen these changes progressively get worse. Now we are told that if a patient is scared we are not allowed to hold their hand. No touching unless medically necessary. Nursing is body, mind, and spirit. Compassion is being rejected. Patient satisfaction and surveys are the prime concern. Be one minute late with pain medication and that equals a bad review. Don’t spend time with the patient or appear hurried, bad review. And don’t get me on poor staffing and staff that doesn’t like or do their job. Thank you for giving nursing a voice. I will try and attend the May event.

  40. Judy says:

    Thank you for saying what the majority of older nurse know as the sad truth!!! I just wish we could do real nursing again–as it is supposed to be.

  41. Lynn Ensley says:

    I worked in acute care in various positions for 42 years but mainly as a staff nurse in critical care. I can relate with everything that has been said. Our hospital has been critically understaffed not only because of the nursing shortage but as a cost saving measure. I have spent the past 2 years since retiring helping our nurses get to a vote to form a Collective Bargaining Unit. We just got the interest cards signed to have to vote. I think if all the nurses in our country would stand together they would have a chance of having their voices heard to improve staffing and working conditions. During my career we underestimated our power! Excellent idea to have Nurses Take DC! Be active in your professional groups and make your voices heard!

  42. Scarlett says:

    For me, everything changed when we were told that they are not patients, but customers. Go onto any unit in any hospital, and you will find more nurses at the computer than in with a patient. So much for faster charting with computers. Patients do not get the care they deserve, not by a long shot. Patients do not get bathed, do not get fed if they cannot feed themselves, lay in their own excrement (how long does it take for stool to become dry and caked on to skin), do not get out of bed as there is not enough staff to get them out of bed. The list goes on and on. Nursing has become a very sad state of affairs.

  43. Debra says:

    Bedside nursing is not valued by hospitals, nor is it valued by nursing programs. There is so much emphasis placed on graduate programs, practitioners programs, nurse anesthesia programs, etc, that new nurses are working at the bedside just long enough to advance and leaving the rest of us who DO value bedside nursing to flounder. It’s extremely disheartening to us nurses who love bedside nursing. We are the backbone and the glue of patient care and yet we have no value. I would just like to know who is going to do our work when we have left nursing from burn out and an extreme lack of support? Heaven help those patients then. Somebody needs to wake up soon!

    • Binky says:

      Amen—- 100% agree and it saddens me so! N angers me even more! I’ve done Er nursing as an rn for 14.+ years and as hospital corpsman in us navy since 1994. Why does no one in the authority to change what is happening seem to care!?!?! Why am I constantly being made to do less and less patient care and more charting and charting on care I don’t even have time to do!?!?! How is this ” patients first” !?!

  44. Kirsten says:

    This is so heartbreaking and I think it very true of all professions in the health care field (including mental health). I have my master’s in social work and started my first job as a therapist a little over a month ago. Already I have seen how we focus on profit instead of the human beings we are treating. We’re told by upper management that we need to have more intakes because insurance will “pay the big bucks” for them. It’s just disheartening and takes the joy out of life and the job when you are told to focus on pleasing insurance and making money. In my practicum placement, I had clients telling me how their psychologist only met with them for about 15 minutes (and it was meant to be a therapy session, where they talk through/work on issues). Health care has become an industry that has adopted a business model like McDonald’s.

  45. Kathy says:

    Nice article! Unfortunately , that is the turn that HealthCare has taken in the last 10 years! All about profit ,not about GOOD patient care. Not just nursing but the WHOLE system. It will change when something drastic happens. Hang though. Don’ t let management win!!!

  46. Cricketsmom515 says:

    Here is a note I sent to ZDogg MD:
    Hi, ?,
    I am a “zpac member”. Here is another thing that is broken with the healthcare system, also. I was a Unit Secretary for 30 years, my job was eliminated because the Doctors and Nurses now must do their own orders. I know you are probably thinking, “and your point”? But I do have one. I saw doctors and nurses spending more time with their noses in a computer than assessing patient’s. I’ve seen patient’s angered because they feel their nurse or doctor doesn’t care about them personally. I watched as the job I did for thirty years, become a discombobulated mess when doctors and nurses started trying to be secretaries. Here is one example: the ER doc orders cardiac enzymes q8h, then the patient get to the floor, the nurse can’t find the order so she puts in an order for them q6h, then the hospitalist gets to the floor and can’t find the results, so then he orders them q8h, and then the cardiologist then takes the patient to the cath lab and when the patient returns to the floor he also orders cardiac enzymes q8h and by the time the lab calls after getting orders that look like to them the patient is getting cardiac enzymes q1h or they don’t pay attention to what’s printing out hand them off to several different phlebotomists, the patient has been poked several times and now they are P.O’d. Then when they are discharged the patient gives a low score to the survey. In this one example, had the unit secretary been doing the orders, I would have found the duplicate order’s, notified the nurse and called the doctor to have the nurse correct the orders. Then I as the secretary would the notify the lab of the situation long before the patient would have even gotten their second stick. Or just think the nurse would have more time with her patient and maybe notice that the phlebotomist have been in her patients room way to much and question them. I think we were vital member’s of the care team. Yes maybe hospitals still have unit secretary/cna’s or unit secretary/monitor tech’s or in some cases, unit secretary/cna/monitor/ecg tech but when you start to put to many duties on one person they may burn out. Or like me, if I wanted to do direct patient care I would have gone to nursing school. I went to school got my associates as a unit secretary. This was my career path. I planned on retiring doing this career but it has gone the way of the dinosaur. If healthcare needs fixing, the unit secretary is part of the solution. So please don’t forget about us.

    Thanks for letting me vent…btw if you read this and think it has any relevance don’t use my name because I’m still looking for a job…?

    • connie Baggett says:

      You are so right. I have to carry a pocket phone and all calls are directed to me..if i am in middle of med passes, iv change, dressing change, patient teaching or whatevet i have to stop and interupt evetything to play secretary too. It is ridiculous not to have a secretary !!! One more thing that makes my job unsafe.

    • Virginia, RN says:

      I was actually just venting to a coworker yesterday that doctors shouldn’t be allowed to enter their own orders until they pass a Computerized Physician Order Entry competency… because they don’t have/take the time to check for duplicates or to read through the whole screen to make sure that each part of the order is correct and complete. We nurses have to correct/delete so many orders, it’s not even funny! It’s a good thing we aren’t mindless order followers or they’d be in a world of hurt.. Unit secretaries would be very helpful/useful/valuable!!

  47. CMC says:

    Where do you think the patients coming to the ERs will go if you limit staffing and say “no more”? The patients keep coming because they are sick – your push to limit the ratio benefits you, but patients then will be totally turned away for care. Would you rather them get no care or some care? It isn’t about profit, it’s reality. I’m a 21 year RN, and I’ve been around a lot longer than you. When you’re busy, guess what….so are the other hospitals in your community. No matter what state, what community, the issues are the same. If you want to help healthcare take on the issues of improving health, reducing readmissions, community health, etc., not focusing only on your ratio – it’s very self serving.

    • T Rich says:

      The push to limit the nurse: patient ratio benefits both the patient and the nurse. I have a license to protect. Being forced to give substandard care to patients while I click “buttons” to meet charting requirements means that I am not present in the room catching the subtle symptoms that indicate my patient’s health is deteriorating. It means that I am not able to do pre-discharge teaching for new meds and lifestyle changes, especially important if I am sending home a patient that will not be followed by home health. It means that I am not available to assist my tech in turning and bathing a patient, hence catching skin breakdown before it becomes a “problem.” When I fail my patient, I risk more than my job, I risk my license. If I lose my license b/c I have failed to chart something that was actually done, then you lose a nurse–permanently.

      No worries though. I have already left the profession–for the second time. Why? Because my family is damn sure more important to me than money, not to mention the grief/guilt I carried knowing that every one of my patients failed to get my best while I met “standards” and “core measures” set by people who aren’t in the medical profession. Let’s not forget that my leaving was also strongly motivated by the asinine thinking of people like you.

    • Virginia, RN says:

      I feel like this post is more about inpatient ratios than ER situations and making sure the patients have a nurse who is able to care for them for more than an hour of their day… that is not self-serving.

  48. Michelle says:

    Well said, everything you wrote pretty much sums up my experience as a nurse. I’ve actually been thinking about going into a different field, because sometimes it’s just too much.

  49. Nathaniel Collins, APRN, FNP-BC says:

    Love this post. Very well stated. I believe that nurses should stand, be heard, and not be moved. Also, legislation is needed to repeal the years gone, AMA lobbied, legilative action that prevented nurses from practicing NURSING independently. As the centralization of healthcare trended to “Hospitals” and no more house calls, NURSES were filling this void in the home, YES! However, when totally bullied into subservience through policy making, nurses had no way to safeguard the profession due to the arrogance of another. NURSING is NOT a sub-line in the space of medicine. It is a totally different approach to restoring health. Additionally, upon the great shift in policy, Nurses could not then establish policy for reimbursement of services or advocate the development of the unique service. Translation, today’s structure treats NURSES as expense line items in a buget report, while selfishly hiding the fact that reimbursement for NURSING SERVICES is billed, but stuffed into a convoluted DRG code. In closing and not to ramble, I sincerely appreciate your message and look forward to a rising of the profression to finally stand ALL with a single goal OUR patients.

  50. Leigh says:

    It is sad but true. I have been a nurse for 10 years and have considered changing professions a lot lately. Twelve hour shifts turn into 14 hour shifts because we have to stay and chart. I can handle anything they throw at me but it breaks my heart when I have to clock out and think that I didn’t take good care of my patients. If a patient leaves thinking I didn’t care about them, that hurts. But those who really need and appreciate our help don’t get it. Those who complain and cause issues get whatever they want because administration would rather make the problem go away than address it. It is all about those patient satisfaction scores and not patient care. It is expensive to run a hospital and cuts to reimbursement don’t help matters. But the emphasis is on the wrong thing. The government is to blame as they make policies for reimbursement that are nearly impossible to achieve. We can educate patients and educate them some more, but we should not be held accountable for them not being compliant when they go home and are readmitted because of it a couple of weeks later. You are right, nurses need to start standing together and demanding change. If we don’t, it will only get worse.

  51. Marcy says:

    Word. I have said much of this myself, and they continue to try to get blood out of a bunch of dried, dead turnips.

  52. Rmccurry says:

    This is a big problem and it stems from such a competitive market that has turned healthcare into a customer satisfaction oriented market. Nursing care should be great and it should be delivered in a way that customers are satisfied but it should not effect payment for care. If the care is given it should be paid for also the government keeps creating more and more rules that effect payment. Medicare tries to find any loop hole to keep from paying. I don’t think it’s the hospitals or facilities fault nursing has turned into what it has…..it’s the government driving this change and facilities can’t keep up. Everyone wants higher salaries due to the amount of work we have as nurses and the government and insurance companies don’t want to pay for care. Not to mention all the people who run to the ER for everything and don’t pay the bill. Healthcare isn’t free it costs to run these facilities and with reimbursement being lowered and the rules and regulations being increased it’s expected nurses do more with less. That is not the way it should be but none the less I don’t see it changing anytime soon!!! We need a healthcare reform!!!!

  53. Kimberley Downie says:

    YES! YES!! YES!!!

  54. Sonday says:

    I’ve just read many of the same statements that I have heard and said myself for at least the last 15 yrs of my 30 yr career in nursing. I am overwhelmed with gratitude that a stand is going to finally be taken in DC this May. As many have already said I won’t be able to be there in person but will be behind my faithful co-workers in spirit and with prayers to finally be heard! I’m so excited about it. The written words in these entries are truth about what nursing has become pure and simple. What exactly is the government and corporations thinking when the baby boomers are now becoming elderly with health issues and nurses are running for the exit door mostly for sanity! I’m with those who get to go 100% and am so proud of you all!

  55. Melissa says:

    Thank you Kelsey, for sharing from your heart; your love of nursing drives you forward to fight for nurses and patients and is also very much alive in many other frustrated nurses. I pray for a huge turnout in DC and for our legislators to see the numerous messengers and hear the message before they experience sub-par nursing care due to lack of staffing when they need it most.

    Will there be a letter writing campaign we can all participate in, sending letters to our senators and representatives? We need to present them with the numbers they think they want, and then reveal that these numbers actually mean absolutely nothing regarding the quality of care the patient has received.

    Subjectivity needs to be eliminated and it is nurses’ burden /responsibility to open these legislators eyes and minds so that they can comprehend this simple concept! A recently discharged patient having 6/10 pain, with continuing constipation, and in a really bad mood should have no ability to affect how much a hospital will or will not be reimbursed by medicare/medicaid/insurance companies. How can the answer to a question at one point in time have that much power? Who decided that made sense? Nurses need to make these legislators understand how absurd this is.

    Remember that nursing’s issues won’t be addressed until the core issues that hospitals are facing are addressed first; make sure you are familiar with the updated Joint Commission requirements, CMS dictates, and any other “thou shalt” issues.

    Good luck and many prayers!

  56. Sherri Smith says:

    I have been an RN for 32 years and can relate to everything you said. Five years ago I left the bedside to manage the quality assurance performance improvement department. Part of my job was to make sure all core measures were met and customer service scores improved. I quickly realized that nurses would be asked to do more and more with less and less just to satisfy government regulations. The ironic thing is patient care suffered because the nursing staff spent so much time jumping through regulatory hoops to satisfy medicare and patient safety requirements. While monitoring patient satisfaction, I felt very little job satisfaction. I missed the fulfillment of hands-on patient care, and I felt like every nurse dreaded seeing me because I might add to their work load or remind them of a measure they had failed. One year ago I became a hospice nurse. I have been reminded of my reasons for becoming a nurse. I can make a difference for patients and families. Many times in my career I have struggled with unrealistic expectations set by those who have never walked in a tired nurse’s shoes. I have addressed many managers regarding unsafe nurse/ patient ratios and have tried to be a patient advocate. I even managed a unit to try and make things better for the staff but lost the battle to the almighty dollar. I was forced to send staff home as the census dropped only to over burden the remaining staff with excessive admissions. The electronic medical record hurt the nursing profession almost as much as 12 hour shifts. The joy of helping others was replaced by frustration and fatigue. I admire your voice for nurses and wholeheartedly support positive changes for the benefit of nurses and patients!

  57. Anne Monte-Parker says:

    I have been a nurse for 24 years. Patient outcomes would improve if we direct our attention back on the patient. I agree that nurses and doctors need to make a stand. We need to advocate for our patients and ourselves.

  58. Kim says:

    I have been a labor and delivery nurse for over 21 years. I went to travel nursing to get away from the politics, but the short staffing is everywhere. Management tries to tell nursing that this is “the new norm” If that is so, I pray I’m never sick enough to go to the hospital. This post explains how many of us feel. Nurses are leaving in droves because they are run to death and tired of going home feeling like they never did enough.

  59. James Deweese says:

    This is great nurses are taking a stand on this issue but is the hospitals really listening? With the hospitals pressuring the nurses and the high patient per nurse ratio mistakes are bound to happen and your license is at risk. The only effective way to combat this is to organize and form a Union! When you look at our Unionized nurses to our north, they have negotiated not only protections for themselves but for their ability to care for the patients.

  60. Cathy Leibensperger says:

    I retired early sadly, (I love Nursing) because I spent 4 to 5 hours per day documenting so that my employer could get reimbursed for the care provided. You are so correct. There is a dangerous shortage of Nurses, Nurse Practitioners, and Physicians, and it is mostly due to the reimbursement requirements of INSURANCE COMPANIES who do not care if you live or die.

  61. Lisa says:

    Thank you for standing up!! It’s finally our time. You’re absolutely correct…social medIA needs to be used to our advantage! This is such an important event to us as Nurses, family members and as a Patient. Again. THANK YOU

  62. Shelly Kunzi says:

    You have spoken for all scopes of practice in nursing. Home health care is now based on points and nurses are expected to do 6-7 points a day and complete the charting in the home and not finish any at home. Not to mention all of the phone calls to the doctor offices scheduling patients etc and driving …. Unreal expectations if they want the patients to actually get more health care than just a quick assessment. It sickens me because they want us to keep patients from getting re-hospitalized and minimize the visits for the companies to gain the most profit from the payment for the episode. So how as a nurse can you feel like you are really doing your job and provide the care the patient really needs and deserves? You can’t! Something had got to change, the patients getting discharge from the hospital are sicker, have more needs and which we aren’t able to provide, but yet we have to prevent them from going back to the hospital because it affects our 5 star rating.

  63. Jeneen says:

    I have been a nurse for almost four years as well and I’m already so exhausted at working at the bedside. I couldn’t agree with each and every one of your statements. They are exactly what happens at the bedside each and every day. There is not one day that goes by where I don’t think my license is on the line because of the overwhelming ratios and tasks to do with so little help and so little time. I saw a proposed ratio once before that nurses are trying to get passed and I think if this was mandated nationwide then nursing professions would actually be more enjoyable and sustainable for our dear patients. As in the area I work in, telemetry and stepdown, 1:3…… right now I have a ratio on those units of 1:5-6.

  64. Marsha says:

    This is very well said and ON POINT! Believe me other healthcare prodessionals ( Physicians, Dentists, Hygienists, PA’s, etc.) feel the same way. It’s sad that production and profit is weighed more than patient care.

  65. Marsha says:

    correction above, “professionals”

  66. Gail Long says:

    What if Siri were in each patient room, and you spoke as you CARED? Hey Siri, nurse… Here, am changing the dressing for mr…. In room number…..?
    The caring is getting done,and voice to text for that file (patient name and number) is done, hands free in consecutive as care time.

  67. Tracey Thiels says:

    I have been a floor nurse for some 40 years now, nursing used to be fun especially in the Maternal Child area, but now with the way things have become, it’s not fun any more. I have worked maternal child nursing for 37 of those years in units where a new nurse couldn’t get a job because no one ever left. Now with combining units and such, we can’t keep nurses. We’ve seen some 150 nurses come in and train and leave again, not to mention 95% of the original nurses, on a unit that has only 22 beds with equal amount of babies. It’s sad that healthcare has become dehumanized like it has. I have to say that the 12 hour shift thing is the worst thing in the world. When a nurse works that many hours in a day, things can get dangerous for the patient, and not even mention that your time off is spent lying on the sofa at home unable to do much because you are too exhausted to move. I had hoped to work for about 5 more years but sadly as I sit in my recliner with my worn out knees, I’m afraid next year will be my last, if I make it that long. Hopefully going to Washington DC 2017 will do some good. I’l be there in my thoughts and prayers for a better future for my upcoming sisters and brothers. Good Luck

  68. Rhonda Hummel says:

    This is pretty much why I never went on to be a nurse and stayed being a CNA for 28 years, most of which has been working in nursing homes but did work in our local hospital for 7 years. I love the patient care, having the privilege of truly getting to know my residents, who are my second family and hate the charting. God Bless all you nurses out there……we CNAs have your back and support you!!!!

  69. Lois mitchell says:

    Kelsey. I’ve been a nurse since 1987. Nursing used to be a lot of fun. We took great care of our pts ,each other and we got our work done We were proud of our jobs and our places of employment. . I’ve lived through D R G’s , Lpn vs RN wars. ,every different charting system. . I’ve seen charting based on acuity disappear that’s when pt care began to really suffer. We changed to ratio standards that might call for 3.5 nurses(. We never knew how yo get that 1/2 nurse. So usually what that meant was that we would get 3 nurses instead of 4. So instead of a decent night we pounded the ground without lunch. Really you can forget breaks because your choice was leave for a break and get behind on charting and staying late . The charge nurse took a full team and generally was another nurse. Plus reporting off to incoming nurse on all pts plus hers. She was extra burdened. All paperwork should be universal everywhere Again good luck

    I know the paper charting might sounds archaic to younger nurses but it worked. If we need to use computer systems..,they need to be designed by nurses! Not lawyers or accountants. Charting needs to be streamlined. You should be able to chart on vital signs in one spot not 3.. If you charge for an I v bag hat needs to automatically go under intake from that charge. Only if fluids died or not absorbed to you subtract from the totals I have Ida’s that could shave time but they fall on deaf ears I wish you luck I

  70. Jo says:

    I’ve been an RN for 21 years, mainly Cardiac step down units. I’m also a retired military spouse, so I have worked in Acute Care Hospitals in several states. We were stationed in California when they went to state mandated nurse to patient ratios 4:1 on my step down unit and 5:1 on med-surg. units. We were transferred to North Carolina in 2004, and are now in Northern Virginia since 2006. I ended up leaving bedside nursing in 2010. I could no longer handle taking on up to 7-8 patients and being charge nurse at the same time. I am currently in a specialty area, Cardiac Stress Testing, and I loving it! Finally getting to talk to and care for patients again. I tried to go back to bedside nursing over a year ago, and after 9 months of 6:1 on a progressive care unit, I was done. I have voiced needing mandated nurse to patients ratios in Virginia. I remember being told by another nurse ( who spent little time with her patients), “then you need to go back to California”. I am very disappointed in what Nursing has become. I gladly support OUR cause!

  71. Cyndi says:

    Now please not everyone yell at me at once but truly if our nursing profession looked ahead and watched how corporations are slowly (now not so slow) eroding our nursing profession into robotic and dogmatic examples of “excellent nurses by perfect charting” more nurses would start to mobilize and unite. California Nurses Association has worked each and every day to strengthen laws and hospital standards by UNITing the NURSES to be the advocates. A lot of nurses want to nay say unions but they are responsible for safe staffing, nursing ratio’s and better laws. Our nation of nurses should all be joined to one union, one cause… the cause of nurses united for safe patient care. If you really want to see change, contact the union. Join one union across America and we all can fight for the best for our patients.

    I have been a ICU RN for 16 years, watched a lot of changes (good and bad) for my profession, but the apathy by our profession is the most appalling. We did this to ourselves by not demanding better. So we need to change this together to keep our future patients (many of whom will be us in later years) from not getting the care that every single human being deserves. Remove reimbursement based on patient satisfaction. H is not for hilton, its for hospital!


    thank you –

  72. Amber says:

    You are so VERY right! Not only do we get “dinged” for things that we don’t do we always get in trouble for the things we do do. I hate the fact that there are times that we know for sure we did something but we didn’t chart it bc we were so busy doing EVERYTHING else! I know “if you don’t chart it, it didn’t happen” but DANG our minds can only hold so much of the things we are doing before we rush off to take care of the next patient. There are not enough hours in the day to chart everything. We are HuMan and sometimes we forget too. I worked in ICU then moved to home health and now hospice bc each job promises “More time for the patient” however they all end up the same. I do not except failure for myself and when I don’t have a chance to spend the time needed with a family member or hold my dying patients hand I feel like I have failed! I come home daily and am so disappointed in our healthcare system. I too LOVE being a nurse! I LOVE “taking care of others.” I just feel like we don’t actually get to do that anymore. I feel like we spend more time “taking care of satisfaction scores.” It is very sad and until it gets better we will continue to be short staffed bc all us nurses are going to quit. It breaks my heart! Nursing is a very special job with very special men and women!

  73. Nursing which I felt and believe is to care for humanity is turned to be very inhuman . I am an international nurse for 22 years and have seen the nurses treated like dogs in the US. They are abused by the company they work for . Nursing is become like a hotel to stay rather than a hospital to get better. All that matters is money.
    The healthcare and insurance companies are taking advantage of the financial decline in the US and are trying to create a conception that we need to create safe practices for our patients. Reality is that there are so many safe practices to serve for the patients but there are no enough hands to carry out the safe practices. There is no safe nurse- patient ratio for our patients.
    We need to be patient and nurses advocates to severe humanity!

  74. Sue says:

    Be a teacher. Yes, the same blame, verbal, mental, and emotional abuse and the same expectations of scores being used as a measure of teacher abilities. Both are service professions. Both attract fewer and fewer recruits. Both have high and early burnout. Both need reform, but do not see that happening in the near future. Good luck to all nurses on your march. May you make an impact!!

  75. Jacqlyn hargett says:

    Wow I couldn’t have said it better myself!!!! I’m still at the staying late to finish my charting phase but even then I still feel like I don’t spend enough time with my patients. I would love to make it to D.C.!!!!

  76. Teena says:

    And this is why I had to leave floor nursing.

  77. Sallie Olson says:

    As many of us older nurses age out of the profession, the nursing shortage is just going to get worse. That comes on top of all the issues you have addressed. It’s not going to be easy to change. Nursing needs to be run by nurses, not be accountants or politicians.

  78. Ryan says:

    I am a surgical nurse and pacu nurse in a rural area.we often have to kick people out of the door who just woke up from anesthesia to make room for the next patient, at times it’s not safe but we do the best we can with what we got. Obama care created all of this hcap crap. Government needs to get out of health care and focus on the needs of our nation. Praying Trump will change what Obama had done

  79. Brenda says:

    It’s every department in a hospital. My radiology department where I work is extremely understaffed. Management doesn’t even care. All they care about is the dollar signs. Where we use to have 2 technologist plus a student to a room we now have 1 technologist and most days no student. Completely ridiculous. I’m waiting for something catastrophic to happen, but then again I’m sure it will still not fix a thing. You can’t care or help sitting behind a desk and thinking you know what is going on. FIGHT FOR MORE THAN NURSING!! Good luck in DC

  80. cbr says:

    I feel like this goes for all healthcare professionals not just nurses. Basing healthcare on customer satisfaction is absurd.

  81. Tracy says:

    Just left bedside nursing after 18 years for this very reason. I now work for an MCO. I miss my patients but it was so emotionally stressful at work and away from work as well. After work I always asked myself if I gave the time to my patients I felt they needed and the answer was always “no”.

  82. Donna says:

    Good luck—and I really do mean this. Having been a nurse of 15 years serving in every area including trauma and SMAT with the state, and now doing MDS Coordinating/Case Mgmt., I know nothing has changed. I left the hospitals to go into rehab because it touched my soul but it’s no different. I was so burned out I almost left nursing last year, honestly looking at barista jobs just so I could get away from my stress. When hospitals started being judged on ‘service’ and satisfaction ratings we complained. We were told it is more important to be judged on ‘speed’ than quality or accuracy. We began doing the very things you stated–running for food trays and staying late to chart because we were geared to work harder!! I’m just trying to stay on thru all of the injuries–bilateral shoulder tears, knee injuries, back injuries including a broken back, until I can retire to the pitiful health system we have now. We’ll see. I don’t expect it to improve but I sincerely hope it does. Remember the dollar rules this industry.

  83. Holly says:

    It’s. an issue evryehere not just in the hospitals. I work in a rehab/long term care facility and sometimes on the rehab floor we will run with 2 nurses and 2 lnas have 22 patients each and receive 4 admissions. Sometimes our patents have Ivs and tube feeds as well as wound vacs or they might require a 1:1 for safety or feeds. We don’t receive any help from management. We don’t even have time to chart till our shift is over and on a 3-11 we’re there till 3am. Hopefully something is done nationwide or the nursing shortage is going to continue. Nurses are getting Burnt out too fast regardless how much they love helping people.

  84. Amber says:

    Hit the nail on the head. Nurse for 3 years on med surg, charge nurse for the past year and my body literally hurts sometimes not because of the long hours or heavy lifting. It comes from the severe stress I go through that could be eliminated if they would just spend a few hundred dollars and staff appropriately.

  85. Priscilla Biedebach says:

    I was a CNA for 7 years and Lvn for 27 years in Nursing home, sub acute units and post surgery care. I left at 62, took my SS because it was as you write. Alot of legalities are involved. The people you work with also can bring you down. I tried many times to take a stand for the nurses stating to DON and Administrators that the patient load was much to heavy with all the other responsibilities. Their answer was always the same , Don: I’ve worked alot of other places and I have seen them do it, so it can be done, you just need to manage your “time”….Oh the headaches…the state gives so much money per patient in the nursing homes and the state allows for a nurse to carry 20 to 35 patients which is INSANE!…but if the Nursing homes can get away with it they will…very very sad. I’m with you 100%. My daughter and granddaughters are both nurses and I love that they have great hearts and will find rewarding times caring for the sick, and I give them lots of advice and try not to worry.

  86. Kelly says:

    We are turning into hotels and I’m just waiting for the mandate to leave mints on the pillows and then get a bad survey because the patient likes dark chocolate not milk chocolate.Meanwhile, you have helped them tirelessly for your whole shift.
    It’s ridiculous!

  87. Musashi says:

    I am a young nurse, 24 years old now. Became nurse at 22 and started working on floor which gave 6- 7 patients. Couple of months after i started working, I got into a major accident from being overworked. I was doing a 12.5 hour shift ( 30 minutes for lunch break) overnight and did not get out till 8:30 am. And while driving back home, I fell asleep in car, crossed the double line and hit a tractor trailer head on. I was in ICU for weeks and am alive with God’s grace. I do not have any major complications from the accident. But I decided that I am not doing this anymore and left bedside nursing. I went on to become a nurse in an outpatient care facility and I love it.

  88. Jessica Carrier says:

    I think hospitals would not be as concerned about reducing staffing to cut costs if they were reimbursed better by Medicare, Medicaid, and all insurance/payers. The fact that reimbursement depends on patient satisfaction scores is ridiculous. The government has too much control over healthcare policy. It is impossible for a hospital to staff well, have state of the art technology, and keep it’s facilities top rate without making money to pay for it. I appreciate the passion that all nurses have for their patients and the boldness they display when speaking out.

  89. Andrea says:

    Where are all the physicians in this overall discussion? Sadly, unless doctors and their organizations start speaking up, I don’t think anything will change. It seems like respect is only held for physicians and that anyone “below” them doesn’t have a voice that will be taken seriously. Do the doctors you work with understand/see/feel/appreciate the urgent problems at hand? I feel so passionately about this issue. I spent 10+ years as a Nuclear Med Tech and I really feel so much empathy for the nurses on the front lines. It’s out of control what is going on now with the satisfaction scores, etc.

  90. RN94 says:

    we cannot really put the entire blame on the hospitals re: the quick move of the patients either out the premises to home or another levelnof care. facilities from acute hosp down to nursing homes are bound to medicare guidelines and insurance authorization thus if patient stays longer then they have to suck up the financial burden. the government will play a big role in changing all these implemented mandates and one is the Obama Impact Act and other PPS guidelines affecting acute and sub acute facilities. And as a nurse myself, i agree that most of the burden are felt by us who are the frontliners in care.

  91. Tammy says:

    Thank you for this blog, Kelsey! I hope together we Can make a difference! I’ve been a nurse for 7 years and have experienced Every single thing you have talked about and could not agree more. It’s So sad!

  92. It all boils down to finances. Health care in the US is expensive, not because nurses are making too much money and God know that CNA’s could make more at McDonalds. So when the administrators state that they have to “Keep the salary budget in line” these salaries are not the big ticket items driving the budget. I sincerely feel that no hospital administrator should be taking home a million dollars per year when the people actually taking care of patients make less than 1/25 to 1/50th of that. Basic math says that if a hospital cut one of those top positions, they could hire between 25-50 more caretakers.
    I proposed that everyone working in an administrative position in a hospital should be required to have at minimum a CNA license and work on the floors 2x per month. I think we would see some major changes especially salary restructuring. Would it be too awful to be able to come out of the office when it got crazy busy and be able answer lights/ If the MD’s and my Nurse Manager can do it, others can, too. When I started nursing 25 years ago, we charted on paper as you walked out the door. Done. Now you must access and enter every bit of data. I have yet see too a program that lets you chart in less time than it took to jot notes on that paper chart. Yes, everyone could come up and look at it, but most importantly, MD’s and other caretakers could see real time what was happening.

  93. Barbara says:

    After 41 years in nursing, the change in healthcare to corporate sucked nursing into it. 2016 change came with new medical director in my dept. 3 incidents made me decide to retire early. 1. Worked 23 hours straight. 2 exhausted nurses asked our doc to please stop procedures at 2 am, we were exhausted and a fresh staff would be in at 7. No, we were going to keep going ( non emergent cases) I don’t remember driving home except I hit the side of my garage. 2. Finished last case, drive home in heavy snow, the highway had not even be plowed. 2 hours later, get called back, the attending decided to do the case that was booked for the morning. Drive back to the hospital, roads still not plowed and now very slippery. The team all made it in, the attending walked a few blocks from his home, ” wasn’t it great walking in the snow?” NO we were thankful not to be in an accident. Again a non emergency case. 3. Vascular case, the fellow could not find the IJ ( and he’s very competent) asked his attending 3x for help. Nada. This attending likes to text all day on 2 phones. Now I’m getting pissed, my tech is too. I say ” I wish Dr A was here” I go to lunch break, upon return Dr A is scrubbed in, teaching and helped finish the case. The tech saw him and grabbed him for help. Sad, this is how we’re working.
    Nursing Management was aware. Those long call hours continued. I loved my work, I began to hate my job. So I decided to retire earlier than I had planned. It was the correct decision. I understand how newer nurses are frustrated, I had worked when you could spend time with patients, develop those rapid assessments and feel like you did a great job.

  94. K. B. says:

    I completely agree with everything you’re saying, but it’s also important to be an advocate for CNAs. You mentioned that she got “dinged” because she couldn’t reach her tech….well let me tell you, as a former NA, I would ALWAYS have at least double the number of patients that my nurses had. NAs are the grunts of the nursing units, they’re the ones running downstairs to get patients’ new lunch trays, changing the linens, giving baths, responsible for getting vitals, responsible for assisting all of their patients with ADLs, and countless more daily tasks outside of actually caring for patients, and they’re all doing it for less than half of what an RN makes. I was fortunate enough to continue my education as a CST and I’m further returning to school to become a PA, but many NAs don’t have the financial ability to or must take many, sow years taking classes 1 at a time to continue their education. The status of healthcare is so poor in America and I worry if we’ll ever get it right. But we have to stick together, every hardworking healthcare provider and advocate for all those who support us.

  95. Diane says:

    Not only true in nursing but also in physical therapy. Having worked in inpatient rehab, SNF, and home health the last 30 years it’s all about your productivity now. I have retired because of it. I will not sit by and see something documented that was not done . I do not know how you treat a patient for the required minutes appropriately while getting your documentation done at same time. I’ve seen new graduates get it done but actual patient care suffers. I wish you well at the march.

  96. Phyllis says:

    I left nursing after 38 years in a Pediatric Hospital. Great place to work when there were few patients….but when census went up above 50% occupancy, there was no way to flex up to cover the patients. ICU/CCU/NICU nurses have lower volume of patients while the “floor” has more (anywhere from 4 to 7) patients. Unfortunately, “floor” patients are often kicked out of ICUs too soon because of ratios and bed space, but they still need ICU level care on the “floor”. How can you expect patient satisfaction to be up when PATIENTS ARE NOT SATISFIED BECAUSE THEY ARE SICK!!! Parents are never satisfied that enough was done…aunts come in and curse at you because the sheet that was changed 2 hours ago is now wet and you are responsible!!!
    There are a lot of wonderful nurses out there as evidenced by the earlier responses. But there are a lot of nurses who only became a nurse to either make lots of money or catch a doctor…you see this everywhere and in every profession…but it is different in nursing where other people’s lives are at stake…we don’t need the “Lookey-Lous” who bring our caring levels down. And these are also the nurses taking the “office jobs” which set policies for floor nurses….things they never wanted to do…
    As with a lot of other comments, I usually spent 1-2 hours of my own time completing the computer-work that is now required —after my shift was over…while my husband waited on me as we worked at the same institution…he got off on time and left as he had no required paperwork to do.
    There is need for regulations and standards in nursing but patient satisfaction is not the way to set goals as I said earlier… they are not satisfied BECAUSE THEY ARE SICK!!!

  97. Verena says:

    Is there anything going on for Canadian nurses?

  98. Jim says:

    I am fortunate to work where I work. a 4 to 1 ratio in a Emergency Department. If it ever gets like some of you say I will go to another field.

  99. Lisa says:

    I couldn’t agree more! RN for 8+ years bedside and we still take 6 patients but the acuity keeps getting higher! We need more staff!

  100. janet walker says:

    Kelsey you have spoken so eloquently I have been a nurse for 22 years dedicated and committed to the profession. I also have tried many different types of nursing only to find the same thing over and over again I would love to be able to stand with you in DC. like you I also believe we nurses together can make a change may the lord bless and guide you in your journey

  101. Betsy says:

    Love this article. There is nothing like being “nurse tired”. I’ve been a nurse for 32 years and honestly don’t know how much longer I can do it. My family hates my job and I feel guilty all the time,always late getting home and exhausted.

  102. Misty Milling says:

    Kelsey – I applaud you for speaking your mind and wanting to make a change. I can empathize with your frustration having been an RN for 27 years. I love what I do and also have a passion to serve and heal people. However, I have to ask the question how do you propose to actually “fix” the problem. Putting nurse:patient ratios in effect won’t keep patients from coming to your facility seeking your medical care and expertise. Patients won’t tell their MI’s to wait an hour because my nurse needs lunch. I agree that healthcare organizations should consider patient acuity in regards to staffing, and many already do when adjusting a department’s manhour per stat. And unfortunately charting is a necessary part of what we do…it is not a governmental or organizational nuisance, but a legal necessity due to our culture’s readily litigious mentality. Change that and you will have a true accomplishment. And if false documentation is a part of your organization’s culture, then that’s where the change needs to begin. We MUST, as professionals, hold each other accountable!!! When did it become ok to be complacent and allow our peers to put our patients at risk?
    I knew going into nursing would be hard work, physically, mentally and emotionally. But still to this day, I cannot imagine doing anything else. Yes, we have challenges. But I believe that many of the “solutions” to those challenges need to start with looking at ourselves and our own practices.

  103. Barb says:

    Retired after 40 years of Nursing, your comments are right on….I was so glad to retire because I could see the writing on the wall…charting, computers and high HCAP scores…not beside nursing,where you might save a life…and then to demoralize this nurse, I have to find my own health care coverage…does not matter that you spent 40 years in the field…Now, I wonder whether to renew my license because it took a lot of blood,sweat and tears to earn it or let it fall by the way side…I know, I will never work as an RN again…it is so sad.. So good luck, to all the RN s in Washington DC..and Gid Bless..

  104. Angela White says:

    Everything I’ve always wanted to say! I do feel we need to stand up and advocate for patient safety (and protecting our licenses against unsafe practices!)
    Shared, well done ??
    A.White, RN, BSN.

  105. Joyce Schober says:

    I have been a nurse since 1975 . It was my life’s dream . For me to stay that long you know it was a good job. I raise 4 children and worked 25 year of nights. I finally went to days. I had no idea how tired I was. I gave had both my knees replaced because oj all the walking, but in those early years I felt like I really made a difference. Now it does my heart good to see a young nurse what to stand up for the patient. T hat is the heart of nursing, and we have moved so far from that. I am not a computer person and feel it has come time that I step out of it all. I do not get that feeling of making a difference. This make me sad that after40+ years I walk away like this. But I can’t do it anymore. This has not happened because of nurses we have worked on trying to staff for acuity not numbers. But somehow we lost that. I pray that you continue to fight for what most nurses go into nursing for. Patient care. Having been a patient I have seen what that computer does and it is not warm and fuzzy. Please continue the fight.

  106. Kathleen Davis says:

    I am in agreement with all these comments and your blog Kelsey. I worked in critical care for 22 years and in day surgery 22 more years. You have described the hospital situation perfectly. The last 20 years of my career I was taken from the bedside to the computer to charting things that were meaningless to my patient. I retired from my profession because it became a numbers game and business could care less about the needs of my patients. I applaud the young nurses who are taking a stand today. Everything you have said is true.

  107. skyygirl61 says:

    Wow, oh just wow. I have been saying this forever. I am a nurse in the cath lab. In 2007, before I became a cath lab nurse, I worked in an IMCU, did relief charge and basically enjoyed my job. I left to go to cath lab in 2009. I then had a change of heart and had gotten burned out with the HORRID amount of call we take so I decided to return to my IMCU job (2014). I could not believe how much time I spent in front of the flipping computer. I went back to cath lab. Excessive call time seems much better than sitting in front of a computer. It’s not perfect but it at least gives me interaction time with my patient. I would love being bedside but the time it takes to “document” all that I do would make me crazy. The other thing is the rapid accelerated nursing programs that are just there to graduate nurses. They are totally unprepared for the job they are walking in to (this is not the case for all new nurses). I was picking up a patient the other day for a procedure and she asked if she could give her meds. . .I asked her what they were. She said “well, there is clopidogrel, don’t know what that is for, aspirin, clonidine, and Plavix.” It was an interesting conversation that followed. I just believe that the ratios are off and the nurses are not properly trained, for the most part. This profession needs help. I don’t want to feel like the Jiffy Lube nurse. . .only there to do what I am told to do. I went to school to think on my own.

  108. Vicki says:

    Thank you. At work, I just said that there will be a revolt from the medical field. I was laughed at. Why is reimbursement contingent upon HCAHP scores and % of patient portal registered? You don’t get to pay less for your food when you like another restaurant more. You don’t get a discount at the movies if the movie was not in the top percentile. Floor nurse are held accountable to staffing ratios while more and more pencil pushers are hired to keep insurance, Medicare and Medicaid guidelines in check. We must satisfy patients’ pain but must be careful not to push them into addiction. There is so much teaching to be done. Keeping up on new trends and equipment as well as increased charting. Nursing is hard but there are those moments when the patients make it worthwhile.

  109. Kim Duncan says:

    Well said and I agree 100%.
    Anyone with a nurses union at your hospital, is your ratio and being able to CARE for your patients better consistently?

  110. Tammy says:

    Working for 20+ year as a floor nurse RN, BSN in chronic hemodialysis with 12 hour shifts that turns into 14 or 15 hour shifts. I feel the pain of the excessive CMS mandates. The rushed assembly line nursing where my pulse rate is usally in the 90’s or low 100’s only while at work. The physical and emotional stress involved in wanting to give the best possible care with inexperienced staff and being short staffed. Watching turnover when the new staff leave because of feeling improperly trained and feeling abandoned once they are declaired “fully trained”. Being rejected for personal time off over and over again even with the time in the bank because of low staffing. The low staffing is just an excuse. If nurse/ patient ratio’s were established for safe patient care then more of the new nurse graduates would stay rather than leave and some who had left the profession would come back to nursing. Might be surprised by the # of RN’s with active license’s who choose not to work in hospitals, clinic’s etc. because of the work conditions and have left the profession. Nursing shortage! I don’t think so. It’s a hiring shortage! I know if something doesn’t change soon that this would be my reason to leave. Letter writing campaign. I’m in, just tell me where to sign! Our patients deserve better care.

  111. Beth says:

    I finally got to retire this year. My job was killing me….honestly. Your article hits the nail on the head.

  112. I. Mercado says:

    While reading this I could not help but get teary eyed. Everything you wrote were true. I’m having 20 patients in an Acute Care setting. Yes, 20. I love my job, I love being a Nurse it is just that the higher ups does not see the important of proper patient-nurse ratio. We have to finish my med pass to 20 patients, add the discharges and admissions we get in between. No time to assess the patient, to talk to the patient cause we only got 8hrs to do all the things people expected us to do.

  113. Anita Vaghar says:

    Thank you for portraying what nurses have had to deal with for years! I gave my all but it was never enough. I had to leave the job but have never stopped being a nurse to family, friends and coworkers! I will be with you in spirit on May 4th.

  114. Maureen P says:

    The picture you convey is so sad and true. To briefly address a comment in an earlier post, the nurse to patient ratio discussed by many is not “self serving”, it’s about patients receiving the care they need and deserve. Exhausted nurses with patient assignments that no single nurse should be responsible for result in errors or omission of treatment. Nurses are made to feel guilty if you need to call out due to illness (they would rather you be there sick) or for a family issue (ie: ill child). You drag yourself in because you know your absence will only make it harder on your colleagues because there will be no replacement.

    I am an LPN with 40 years of nursing experience. However the hospitals in my state no longer allow me to practice bedside nursing. I am not licensed to practice at the level of an RN but I feel there is a place in hospital bedside nursing for LPNs. There are some great “Patient Care Techs” but they are limited in training & treatments they are allowed to perform. The LPN can assist the RN in passing meds, monitoring IVs, treatment and each time the LPN assesses the patient each time she/he enters a patient room. But we are no longer found on the hospital floors and I’m afraid I see our numbers dwindle in other areas as well. At the same time there are several LPN programs in this state with tuition as hire as $30,000. But I have wandered off the main topic. Unions have been mentioned by several. There are a few hospitals in this state and in particular one hospital whose nursing staff went out on strike. Many people felt they were neglecting the patients that needed them or were being “self serving”. But it wasn’t more money they were after. It was the need for adequate staffing leading to quality care and patient safety that put them on the picket line. It was all about the patients they cared so much about and their sacrifice paid off for the patients. Several facilities in my area have started “Nursing Practice Counsels” operated by staff nurses developing and implementing nursing practices in their facilities.

    Successful business is the goal of the institutions here and the proof is obvious as the bigger hospitals have taken over all the other hospitals in their county & beyond, like PAC man, chomp chomp! It’s all about the business. Hospitals were founded, many by the Catholic Church or other religious institutions to care for the sick. Now I feel that caring for the sick is just a way to help PAC man pad that bottom line.

    Sorry to be so long winded but like many of you I have seen the plight of nursing become more and more troubling. I have been so fortunate in my own nursing career which has been primarily in one facility for 35 years. We have started a “Nursing Practice Counsel”, nurses making the decisions on how we practice and with the support of our Administration. As an LPN I have always been valued but still worry about my segment of nursing at my facility. There were 8 LPNs when I started here and we are now down to 3. I will be 70 in Sept and will probably retire and fear there will soon be only 2 remaining. Wishing you the best of luck in DC in May!! I pray your voice is heard by someone who can actually make a start at fixing it!

  115. Donna Rabinowitz says:

    Unfortunately the Nursing profession changed when higher levels of education were being pushed. I started my career in Nursing right at the time they were splitting the Nursing profession into factions of levels of degrees. Pushing Masters and Doctorate. I was trained in a 3 year Diploma program where clinical/hands on training was 50% of the curriculum. Nursing assistants and Patient Care Techs were ultilized as an extra pair of hands. Nurses did the “bedside” nursing care and were able to assess the patient while giving a bath, helping them use the bedpan, etc. A tremendous amount of information was able to be obtained with this approach! I was mentoring a Nursing student in a Bachelor’s program who said “it was not her job to put a patient on a bedpan”. More and more paperwork was being pushed with “Care plans” getting increasingly complex. Nursing changed when they brought in Techs to do the bedside care, and forcing Nurses to become managerial and “paper pushers”.
    The change really became apparent when I became a patient myself! Having had a C-spine total disc replacement, I ended up doing my own neuro-checks because the nurse never did any after the first one upon transfer to the floor. Fortunately, with my husband being a physician, I was able to get discharged after 2 days, because I knew I’d get better care at home! The lack of empathy has gone by the wayside from most of the nurses. They’re so overworked, burn-out is expected!
    I’m not able to work anymore, but I have seen the unfortunate changes that has occurred in the profession throughout the past 30 years. Critical changes need to be made in this profession to better care for patients, and to prevent the constant “burn-out” of nurses!

  116. Alice says:

    I am so proud you are participating in the March and I so wish I could be there be I know that won’t happen. I have been an RN for 7 years doing beside nursing on a Med/Surg unit and I am so burnt out and ready to walk out. It’s all about making a connection with your patient so the patient satisfaction scores are high. I know that the big wigs have no idea that making a connection involves time spent with a patient. But when you have 6 patients and 5 of them are fresh post-ops and you are literally running your butt off then there is no way you can spend the time needed to make the scores high. Let alone to get your charting done and leave on time. You have a medical assistant assigned to your group who is MIA most of the shift and nothing is said to them about it. So you end up doing their job and yours too. I end up getting yelled at because the patients call light is in over time because they want the temperature ajusted in their room but the person yelling at me because it’s gone in over time doesn’t care that I’m in another room with a patient just brought up from the OR and I’m trying to get them moved over on to their bed and get vitals and get pain meds for them. I thought prioritization was a major part of nursing. Oh again my medical assistant was no where to be found to help warm up the patients room. My beeper goes off for things that should never be sent to the RNS beeper. I’m so tired of being held responsible for things that a nurse shouldn’t be. And not being able to do anything about it. I was yelled at and completely belittled by one patient because our cable company didn’t carry his golfing channel and this was considered my problem. Really. Because I wasn’t taught cable TV repair in nursing school! I’m sick of drug addicts dominating my time that should be given to patients that really need me. I’m sick of all the constant repetitive charting that takes my time away from my patients or causes me to be 2 hours past my shift end to get it done. I’m burnt and ready to get out. Yes I see a huge nursing shortage coming. And it’s corporates fault. Having to keep patients with dementia for 3 days before they can be sent to a nursing home and then additional days until they have a bed for them. You end up chasing them all night because they are climbing out of the beds. I can go on and on with this. I hope you can get DC to listen to you and make the changes needed. If not God help the people that need medical care in the near future because there won’t be any!!

  117. connie Baggett says:

    Well said. 37 years as an RN. Everything you said is so true. Probably wont help me as i plan to retire within a few short years. But this insanity has to change. Not right or fair to nurses or our patients . If California can mandate ratios…every body can. Support your ideals 100%!!!

  118. Lynne says:

    I think that most of us share the frustration of not being able to care for our patients like they deserve. Do you think that if we did a twitter or e-mail blitz for the president or other elected officials on those days that they would take any notice? I unfortunately would not be able to attend. We as a group do constitute a large voting block. Can you imagine how many messages they could get at all hours of the day and night.

  119. Bette Young Byrd says:

    Sad to say it’s that way in teaching now too. No time to actually teach the children because I am doing IEPs and paper work reports and parent teacher conferences during planning time. The GAME’S the same just different professions. It wasn’t this way 30 years ago! It was enjoyable then! Now not so much…… Bette

  120. Laura Hodges says:

    I am a Registered Nurse, class of 1989. I worked in a hospital for 23 years until I was “asked” to leave in 2011. Tried to solve the problems and was told I had a negative attitude. Human Resources was very fond of me. I learned my lesson about HR and who they really represent. Since “leaving” the hospital I am now a small business owner. Best thing that ever happened to me. I am now able to love on my patients, spend as much time as I want with them and very little charting.
    My business is Needs for New Moms in Greenville, SC.
    There is life outside the hospital, and a better one at that. Oh, and I have an Associate Degree in Nursing. Amazing what I have accomplished without a Bachelor of Science in Nursing! Get out there and be yourself!! Live life!

  121. Diane says:

    Just today I had a patient come to me (as nursing supervisor of a building) and ask for pain medicine. Stated I’ve been asking the nurse but she hasn’t brought it to me..When I approached this young nurse, she stated she didn’t have time because she was late passing to the rest of her patients.. Threw me back a bit. But I could tell she was stressed so I medicated the patient myself. .But after the day was over we had a little talk and I gently reminded her that it is our responsibility as nurses to take care of our patients pain and to be strong enough to ask for assistance when needed. These times in healthcare are hard and I agree 100% that business has no place in healthcare.. Kudos to those who can make it to Washington and my God lend his hand..I am a 60 yo nurse and have seen the changes come down the pike for the past 30 something years. We need strong leaders and people who will listen..

  122. Rob says:

    This is not new and it is not cyclical. Everything you state I’ve experienced for the past 34 years. You only have four years of experience in nursing. It sounds like you are no longer doing inpatient care. What nursing school did not teach me, nor you apparently, is how to prioritize, time manage, and use the limited resources available to maximum effort. Those skills, once you master them, saves a lot of stress. I sought out CE courses that taught me those skills. And as far as computer documentation, my current employment setting has COWs (computers on wheels). I take the COW into each patient room and do my charting there while still having interaction with the patient.

    Hang in there. It is all about the mindset. Or maybe, I’ve just been blessed with having three exceptional employers and healthcare systems to work for the past 34 years.