The four patients you describe remind me of the rehab unit in the nursing home where I am employed. Nursing homes have become acute care centers. The hospitals stabilize the patient and then they are sent to a nursing home for further treatment. The nurse often has around fifteen patients to care for and it is challenging and damaging to the soul. Family members often take up the nurse's time with concerns. The documentation is extensive due to medicare notes. So the nurse is quite busy. I do not see future changes because it is all about the money.
Elaine, I'm so sorry to hear about the difficult time you are having and the overwhelming number of challenges you face on the job. If only I had an easy answer. I know you don't expect that, but please know that I hear you and understand your struggle. I'm sure you are giving good care, but it hurts to know that some patients inevitably get left out. Hugs!
Defining the terms and differentiating among them is important, because each requires a different response and management plan. I think it is also important to help healthcare professionals acquire the “armor” needed to function at the bedside. I don’t mean to suggest that individuals become numb to the suffering and focus on the task at hand. Rather, I think that an acknowledgment that the work environment is stressful is required, followed by the statement “and knowing that, here are some practical strategies which you may need to employ to do your job well without having it destroy you”. I am a doctor, not a nurse, so I wouldn’t presume to suggest what those strategies could be. However, having shared various clinical spaces with other healthcare staff, including nurses, I think there are things I’ve observed which appear to be common concerns: opportunities for self-care (the usual ADLs); simple courtesy and kindness to colleagues; no “acting out” drama (to my great regret, I have been guilty of letting my own anxieties about a particular patient impact my actions on a floor or in a critical care unit); and the acknowledgement that remaining vulnerable and open are not personal flaws but rather valued traits for empathic practitioners.
At one hospital I worked at, I was always getting called to the ED for admissions, and when I would arrive, I’d see staff busy with patients tucked in rooms, hallways, wherever there was space, with a constant stream of ambulances bringing in more folks needing care. After a few call nights, I started bringing in chocolate, first for the nurse taking care of my patient, then for the whole group. It eventually ratcheted up to arranging for multiple pizzas to be delivered directly on those crazy nights where the thought of a meal break was unrealistic. My wife, herself a nurse, would remind me that food is not always the answer to stress, or even the best response, and I would acknowledge that, but then tell her it at least provided some relief immediately. As you and others continue to address these issues, Theresa, I imagine you will consider other options which will address these three concerns in a more comprehensive fashion. As a current patient, I want nurses whom I encounter to feel respected, rested, and resilient as they tackle one of the most challenging healthcare jobs in the industry.
This is really lovely. I agree with your wife that food isn't the always the answer to stress, but it is the answer to hunger and if people don't have time to eat, finding pizza in the break room can feel like a miracle. Your idea of acknowledging the stresses of the job is smart, too. I'm a big proponent of civility and politeness at work. Too many people in health care get used to being rude to co-workers and picking on the person one step below them in the medical hierarchy--that helps no one, not even the person blowing off steam. It's hard to admit we're all human, but also essential. And I give a big "yes" to no acting out. The work is hard, hard, hard, but creating a culture of collegiality will help that, even though it also requires that we make ourselves vulnerable to each other and people outside our field. We have to trust each other, even though none of our training encourages that, and sometimes the opposite. Thank you for this long and thoughtful post.
Thank you my friend . It’s hard as it was my identity. I recommended your book to a fellow retired nurse. She put it in her list right away . (Your first book) I’m gearing up to read your 2nd book. And always look forward to these emails . Xoxox
Loving your article and supporting the profession in any way I can . However , I resigned last week. Not only is it the stress of the job.... too many patients ... too much documentation....the list is long......but it is how nurses treat each other . I grew tired of upper management’s rude emails and lack of support .
I handed in my equipment yesterday and am beginning to peel away my identity as a nurse and throw myself into my art .
Wow, Mimi! Amazing. Congratulations on taking a step forward for yourself and your mental and physical health. Having made that same step myself I know how hard it is, but also how necessary. Also, I'm sorry that it came down to you quitting. As you say, it isn't just the overwork and the ridiculous amount of documentation, but the overall unpleasant environment at work. So often in nursing, you're damned if you do and damned if you don't. Despite the joy of the work, that attitude will grind anyone down. Let me know how things go for you. XO.
Amazing!!!! Go Oregon. Yet another reason for me to consider moving to your state. Thanks for your gratitude. Naming problems is so important and as you know, health care will only get worse if institutions keep ignoring the struggles of their employees, because pretty soon they won't have any employees. Xo.
I got anxious and upset just reading about those four patients, and about the impossible choice of whom to help first. It is a disgrace that healthcare is a for-profit industry. There are more important things than enriching shareholders!
Incidentally, while I dislike Pringles, I agree that the best hiking foods have plenty of salt, carbs, and fat. I like beer and cheese on my hikes!
Beer and cheese sound pretty good, too! For dinner after we hiked up Grand Canyon we had pizza and beer. Heavenly!
On a more serious note, thank you for calling out the for-profit nature of U.S. health care. I know you enjoy all the great low-cost health care in Switzerland. Imagine that--universal health care, an economy that works, and all that good chocolate! Dreams can become reality; it only takes political will.
The four patients you describe remind me of the rehab unit in the nursing home where I am employed. Nursing homes have become acute care centers. The hospitals stabilize the patient and then they are sent to a nursing home for further treatment. The nurse often has around fifteen patients to care for and it is challenging and damaging to the soul. Family members often take up the nurse's time with concerns. The documentation is extensive due to medicare notes. So the nurse is quite busy. I do not see future changes because it is all about the money.
Elaine, I'm so sorry to hear about the difficult time you are having and the overwhelming number of challenges you face on the job. If only I had an easy answer. I know you don't expect that, but please know that I hear you and understand your struggle. I'm sure you are giving good care, but it hurts to know that some patients inevitably get left out. Hugs!
Thank you so much for your heart felt comment. In my nursing home we try to do our best and work as a team.
Defining the terms and differentiating among them is important, because each requires a different response and management plan. I think it is also important to help healthcare professionals acquire the “armor” needed to function at the bedside. I don’t mean to suggest that individuals become numb to the suffering and focus on the task at hand. Rather, I think that an acknowledgment that the work environment is stressful is required, followed by the statement “and knowing that, here are some practical strategies which you may need to employ to do your job well without having it destroy you”. I am a doctor, not a nurse, so I wouldn’t presume to suggest what those strategies could be. However, having shared various clinical spaces with other healthcare staff, including nurses, I think there are things I’ve observed which appear to be common concerns: opportunities for self-care (the usual ADLs); simple courtesy and kindness to colleagues; no “acting out” drama (to my great regret, I have been guilty of letting my own anxieties about a particular patient impact my actions on a floor or in a critical care unit); and the acknowledgement that remaining vulnerable and open are not personal flaws but rather valued traits for empathic practitioners.
At one hospital I worked at, I was always getting called to the ED for admissions, and when I would arrive, I’d see staff busy with patients tucked in rooms, hallways, wherever there was space, with a constant stream of ambulances bringing in more folks needing care. After a few call nights, I started bringing in chocolate, first for the nurse taking care of my patient, then for the whole group. It eventually ratcheted up to arranging for multiple pizzas to be delivered directly on those crazy nights where the thought of a meal break was unrealistic. My wife, herself a nurse, would remind me that food is not always the answer to stress, or even the best response, and I would acknowledge that, but then tell her it at least provided some relief immediately. As you and others continue to address these issues, Theresa, I imagine you will consider other options which will address these three concerns in a more comprehensive fashion. As a current patient, I want nurses whom I encounter to feel respected, rested, and resilient as they tackle one of the most challenging healthcare jobs in the industry.
This is really lovely. I agree with your wife that food isn't the always the answer to stress, but it is the answer to hunger and if people don't have time to eat, finding pizza in the break room can feel like a miracle. Your idea of acknowledging the stresses of the job is smart, too. I'm a big proponent of civility and politeness at work. Too many people in health care get used to being rude to co-workers and picking on the person one step below them in the medical hierarchy--that helps no one, not even the person blowing off steam. It's hard to admit we're all human, but also essential. And I give a big "yes" to no acting out. The work is hard, hard, hard, but creating a culture of collegiality will help that, even though it also requires that we make ourselves vulnerable to each other and people outside our field. We have to trust each other, even though none of our training encourages that, and sometimes the opposite. Thank you for this long and thoughtful post.
Thank you my friend . It’s hard as it was my identity. I recommended your book to a fellow retired nurse. She put it in her list right away . (Your first book) I’m gearing up to read your 2nd book. And always look forward to these emails . Xoxox
Do stay in touch. I'll be thinking of you. Xo right back atcha.
Here I am again
Loving your article and supporting the profession in any way I can . However , I resigned last week. Not only is it the stress of the job.... too many patients ... too much documentation....the list is long......but it is how nurses treat each other . I grew tired of upper management’s rude emails and lack of support .
I handed in my equipment yesterday and am beginning to peel away my identity as a nurse and throw myself into my art .
Prayers and positive thoughts welcome 😍😊😊💛💛💛💛
Wow, Mimi! Amazing. Congratulations on taking a step forward for yourself and your mental and physical health. Having made that same step myself I know how hard it is, but also how necessary. Also, I'm sorry that it came down to you quitting. As you say, it isn't just the overwork and the ridiculous amount of documentation, but the overall unpleasant environment at work. So often in nursing, you're damned if you do and damned if you don't. Despite the joy of the work, that attitude will grind anyone down. Let me know how things go for you. XO.
So grateful you are writing about this topic, Theresa. It reminded me of this news:
https://kval.com/news/local/oregon-law-mandating-minimum-nurse-to-patient-ratios-in-all-hospitals-to-take-effect#
Amazing!!!! Go Oregon. Yet another reason for me to consider moving to your state. Thanks for your gratitude. Naming problems is so important and as you know, health care will only get worse if institutions keep ignoring the struggles of their employees, because pretty soon they won't have any employees. Xo.
I got anxious and upset just reading about those four patients, and about the impossible choice of whom to help first. It is a disgrace that healthcare is a for-profit industry. There are more important things than enriching shareholders!
Incidentally, while I dislike Pringles, I agree that the best hiking foods have plenty of salt, carbs, and fat. I like beer and cheese on my hikes!
Beer and cheese sound pretty good, too! For dinner after we hiked up Grand Canyon we had pizza and beer. Heavenly!
On a more serious note, thank you for calling out the for-profit nature of U.S. health care. I know you enjoy all the great low-cost health care in Switzerland. Imagine that--universal health care, an economy that works, and all that good chocolate! Dreams can become reality; it only takes political will.