What nurses really want for Nurses Week

Nurses Week

Having been a nurse for over 18 years, I have endured a few Nurses Week. At first I was lured into the charm of my first “Nurses Week” bag. I had finally arrived – my first official nurses bag. I had arrived and for a full week, the folks at the hospital seemed to actually appreciate what we did for our patients. After a few mugs, key chains, beach towels and more bags, the charm quickly grew off.

After awhile, you start to realize it is just a game of smoke and mirrors. You begin to realize that you had been tricked by the lures of trinkets, when in fact what you really want is respect, more staff and to be able to leave your water at your desk. What you really want is to be able to take care of the patients the way they should be. The way we are taught in school. Gone are those days of really knowing your patient – there are too many to care for each shift and too much documentation that needs to be attended to.

Ask most nurses who work at the bedside what they really want and most will answer more staff and better respect for their profession.

Unfortunately nurses are not part of the reimbursement for the hospital. Their care is bundled up in the “room rate”, much like the housekeeper in a hotel. By not having any tangible ties to reimbursement, nurses are the first to be cut and squeezed to work smarter and harder. Yet, the daily requirements continue to be stacked on.

Did the doctor order their bundle sets? Did you justify why the patient still needs a foley? Are your core measures and education all done? Did you document in the computer and in the patient’s folder? Have you documented in all three places that you turned and repositioned your patient and that their needs were attended to? Are their vaccinations screenings done? Fall assessments? Skin assessments? Delirium scales?  The list goes on and on before we even touch the patient.

If you ask most hospital administrators, they will tell you they staff their units “based on acuity”. The humor in this – no one monitors acuity any more. It is all about the grids and matrix. Essentially, they can do as they please and hope no one gets harmed in the process. But, ask the nurse who barely drank, ate or went to the bathroom, they may disagree about who was harmed that shift.

To add insult to the mix, now hospitals are held hostage with patient satisfaction surveys. No longer do we want to know if patients received good care, we just want to know if they perceived they received good care. Instead of rewarding the hospitals for being good manipulators of statistical data, how about we reward hospitals for having safe staffing ratios and good outcomes?

But, what are good staffing ratios? Well, that goes back to the grids and matrices that any hospital can create. Repeatedly research finds that the more patients a nurse cares for on their shift, the incidence of death to the patient will increase. Yet, despite the evidence, nurses are required to care for more and more patients each shift. Often caring for 6-8 patients on a medical surgical floor and up to 3 patients per nurse in the intensive care units. As for the emergency room, it is free game – whatever the hospital deems as “safe”.

And the irony of it all, we have to practice according to evidence, but apparently not them?

Things looked like they were changing in 2004, when the state of California mandated revolutionary safe staffing ratios for hospitals in an effort to improve patient care.  But, why, after all these years are they still the only state? Why 12 years later and after multiple attempts are national safe staffing ratios still being debated? Again, what happened to evidenced based practice?

Well, we all know it comes down to the money, because money is power. Nursing is one of the largest expenses for any hospital. This equates to being the biggest target for cutbacks. Unfortunately nursing does not “bring in the money”, so they do not wield the power and will continue to be treated like the liability they are perceived. This will continue to get worse as hospitals are more frequently run by bean counters who know nothing of patient other than what they read in books.

But, what if hospitals were rewarded for safe staffing? Or what if nursing care was actually reimbursed just as the other professional colleagues? Instead of asking the patient if they perceived good care, what if hospitals actually were reimbursed for not having high turn over of staff? Maybe even for having high STAFF satisfaction survey results?

So what do nurses want for Nurses Week?

They want a patient load that doesn’t bring them to tears by the end of the shift. They want to go home knowing they did all that they could for their patients because they had the time and support to accomplish it. They want to know they are valued and worth more than a mug or tote bag.

This is our year. This is the year we stand up and fight for our profession, our patients and the future of health care. This Nurses’ Week, instead of complaining again about the lame trinket your hospital gave you; join the conversation for safe staffing. Go to the rallies being held all over the country at state capitals. Join me in DC to rally and bring attention to the need for safe staffing. Write your congressman and ask for support for S. 864 (National Nursing Shortage Reform and Patient Advocacy Act) and H.R. 1602 (Nurse Staffing Standards for Patient Safety and Quality Care Act). Do something to be a part of the solution.

Make this the year that is more about good care and safe staffing and not about grids and matrix.

Make this the year the nurses stood together and spoke up.

Make this the Nurses’ Week we all want.

Thanks for letting me get my thoughts out. But, I want to hear your thoughts? Leave a comment below on what you would want for Nurses Week? Dream big, believe big and be the change.

Take care, be safe and wash your hands!

90 thoughts on “What nurses really want for Nurses Week

    • Thanks for the love – as always!! Your support is appreciated, as united is how we will care for our patients better!

    • Excellent and true post. Maybe, instead of dumping more patients onto a staff nurse’s load, they should give that staff nurse enough time to talk – really talk to that patient about their problems, their fears, their family. That might garner more patient and staff satisfaction than any dose of pain medication ever could.

  1. Recently retired. Was a nurse for 46 years. Worked in various settings and celebrated numerous”Nurse Weeks”!!! What you said is what I and the other nurses said as we received a thank you from administration. Over the years those “goodie bags” decreased down to a small note and a piece of candy. What kept me in nursing for all that time was not administration’s support but of my desire to help another human being in their time of need! If administration would like to recognize us then why not one year defer your bonus to hire other nurses to help with nurse/patient ratio. After all we are on the same team and that team will eventually be caring for you during your time of need!!

    • I like your way of thinking!! Could you imagine the impact if administration actually took that bold step?? Let’s keep dreaming the big dream friend. Thanks for stopping by and especially thanks for all your fabulous years of service!

  2. Couldn’t agree anymore with this!! I work when you guys go to DC bit will be writing my Congressman today!!!

    • We know you will be with us in spirit!! But your work will be just as powerful! Nurses united!! Thanks for stopping by & keeping the conversation going!

  3. My jaw is still dropped. You put into words how most of us that have done bedside care feel. And I think CNAs, RTs, phlebotomist etc. as well as RNs pretty much can relate to a lot of what you’ve written.
    Nicely expressed.
    Thank you.

  4. I totally agree! Better ratios would be fantastic instead of the penlight we received with a note from our DON that was written by the receptionist, last year for nurses week. I work in a nursing home and have equally a difficult time as all the nurses in the hospitals except our okayed ratio is 1:20 if “fully staffed”. If someone calls in its 1:40 and that’s okay to administration. Just wish I could spend more time with my patients and feel as if I am actually doing my best to care for them instead of going home each day feeling like I let them all down. 🙁

    • I totally feel your pain!! I did a brief stent in a nursing home & it was brutal! 25 patients was absolutely the norm and since I worked per diem, I hardly knew the patients….lets just say med pass was not always prompt – how could you with that many folks?! And forget it if there was an “issue”…. Thank you for taking care of our most vulnerable adults – I agree, they certainly deserve so much more. Thanks for stopping by and being a part of the conversation!

  5. Well we lost our pm differential from 230-730 pm on a 12 hour shift , while pm shift and nights retained theirs, oh and no holiday pay for Christmas Eve either, yup Happy a Nurses Week !

    • This has been a trend for years now. Haven’t seen those differencials around here for years – you are almost luck you had them this long…. Just small indications of things to come! Happy Nurses’ Week to you too!!

  6. You hit everything on the head with a hammer been a nurse for over 20 years. We are held hostage with this stupid patient satisfaction scores. Last comment of your wash hands that’s one of survey questions did you see your nurse was their hands. Administrations only wants new grads cheaper forget about nurse retention. Your salary is twice as new grad so f$$k you. Thanks for the same sentiment dissolutioned in Illinois

  7. I support anything that unites us as a profession. We lack one key trait that many professionals share and that is the ability to bill for our services. When licensed nurses began we were not employees and we worked directly with and billed our patients. Because of the economy many nurses participated in the barter system. It worked for years until the hospitals decided to take over by training nurses and essentially treating them as slaves and not much has changed. We need to charge for our services. I not sure of self employment is the answer but we need to do something so we are not treated as part of the room. I am not a monitor, toilet or a bed. I am a professional.

    • It is becoming clearer and clearer that we are going to have to change how nurses affect reimbursement. Thanks for being a part of the conversation!

  8. A hospital I had worked for made the nurses supply the baskets and goodies that were given out for nurses week, on top of that most of the basket didn’t even go to the nurses they went to the techs. And occasionally they had BBQs to show staff appreciation but charged us to eat….?. I just don’t get it. At least in your day you got trinkets….??? 😁😏😕😞

  9. This is all so true. I’ve been a nurse over 30 years so I can relate to this. I’ve been at the same hospital for 24 years and have seen some unfortunate changes as we have become part of a corporation recently and the icing on the cake was being told that we aren’t celebrating nurses week this year ; it’s going to be hospital week!!

    • I was just remarking about how isn’t that convenient that “Hospital Week” now is merged into “Nurses Week” – oh, administrators, we hear you message & we don’t like it! Thanks for being a part of the conversation! And Happy NURSES week to YOU!!

    • The hospital where I used to work stopped nurses week and replaced it with hospital week years ago. What a slap in our faces!

  10. Hi Joan,
    You nailed it!
    I would also like to add that this message should be included in nursing education programs. Nursing students need to learn about these issues as early as possible.
    As a nurse educator…..for nurses week…I would like a few things!
    I would like to have smaller classroom and clinical groups..be rewarded in some way for good teaching…not based on student evaluations of “perceived good/poor teaching”, and have the ability to fail a student when needed without pressure from administration to pass the student.

    • Oh Donna, we speak the same language!! So true!! And this is where it all starts… where I teach clinicals, we are capped out on the amount of students we can oversee by the state board of nursing. Isn’t that interesting, our nursing board mandates how many students we can oversee, but essentially doesn’t care how many patients a nurse can care for?? Little irony in there…. Thankfully, we love what we do and hopefully are making change, one student at a time.

      • The problem is we cannot continue “hoping” for change to come down the road. The new nurses aren’t going to help change come down the road. They are overwhelmed c trying to find their way and feel comfort in their chosen profession. That comfort level is a year MINIMUM in my mind (43 years as RN), more on specialty units. We need to push for changes, demand changes. Sad to say, but after all my years nursing, unless we form a very strong and united front, nothing will change. What rewards do employers offer? The hospital I worked at suddenly decided you couldn’t apply for an ICU or specialty unit unless you had experience already. ????!!!!! Are nurses born knowing this stuff? So now you don’t even have an incentive to learn more, to grow and change. WTH?

  11. Thank you! I would like to do patient care instead of spending time with my computer. I would like to pee & to eat. I would like to have less patients so my care is better & my meds are not late. I would like for satisfaction surveys to go away. I would like to have more staff so I am not working short or 5 shifts a week. I am a nurse. Let me do my job!

  12. It is literally exhausting to get to work look at the assignment sheet and see that you have six patients again today with only care partner. There are 3 feeders and two patients jumping out of bed every five minutes! It’s an awful unsafe feeling that deep in your core. Something really needs to be done about these matrices and staffing grids. It’s so unfair to the nurses first off and then the patients no longer get that bedside “love” that they need because you’re already behind in your 0800 meds and assessments! I would love to stand with you in DC but my daughter graduates from basic training! (Proud mama) I will write my congressman and express my deepest concern about this issue. Thank you so much for writing this post, it really hit home for me and this time I will take a stand!!! Nurses United!!

    • We all know the feeling, when you walk up to the assignment sheet with that pit in your stomach – worst feeling ever! Thank you for your support and especially thank your daughter for her service!! Keep those letters to our congressman – we must be Nurses United!!

  13. Nurses want to do their jobs…in a safe environment

    Nurses want to be able to talk to the patient and their family just because….not to raise the HCAPs score, but because talking to the patient and their family is a way to get to know their patients and find out what is important to them.

    Nurses want to help people understand their diagnosis, their plan of care and help ease some of the obstacles that get in the way of allowing them to progress and achieve wellness.

    Nurses want to help people transition from this life to the next with dignity.

    I am involved with a grassroots campaign to ensure that there is a nurse on the level with the Surgeon General who will raise the visibility of nurses across the country. The movement is the National Nurse for Public Health. Here is the link to learn more.

    To get this passed we need everyone to write to you Representatives and Senators in DC. Here is a handy want o do this https://actionnetwork.org/letters/national-nurse-act?source=direct_link . Takes less than 5 minutes and makes a HUGE difference.

    Best of luck at the rally next week! I will be with you in spirit!

    • Ann,
      Thank you for bringing up the legislation side of this. So many nurses blame their administrators or corporation, when the reality is that all of the demands for patient satisfaction, core measures, etc (a.k.a. VBP) starts with our government!
      If nurses want change, they have to get to those who control the change, and trust me, it’s not hospital administrators!

      One other thing….new grads have to start realizing they can’t come out of school feeling “entitled” to day shift, no holidays, and more money than those of us who have been in the industry for so many years! It’s hard to hire more staff and decrease patient loads when nurses who will actually work are so hard to come by!!

      • You are so correct – we have to be more active with our legislature. What will be interesting to see is if we will stand together with our other professional colleagues to fight this crazy fight – it affects us all. Thanks for being a part of the conversation!

    • Oh, I know you will be there in spirit and it is much appreciated!! You a definitely of champion for change and we really need to rally around this also!! Lets keep this momentum going! Thanks for all you do!

  14. I couldn’t possibly agree more! I work with a surgeon. When we get back some of those patient satisfaction scores, they primarily point to the wonderful surgeon! Nothing about the nursing care in the OR, PACU or on the floor.

  15. Well said! If we only get all our voices heard. Everyday i go to work, i tell my manager, you know i can take care of all the 6 patients you are giving me but unfortunately the care might not be as qualitative! Something needs to be done. That is always received with a smile and a comment “just get to work” until when will we just be getting to work instead of providing quality safe care needed by our patients?

  16. Very well written! We have sooo much untapped power. We just don’t know it. Then and only then will things change. Healthcare can not work with out us. We have them out numbered. I think as a profession and with the “Patient Experience” movement we have lost our voice. I am looking forward to the day when nurses say enough!!!!!! If your staff are tired and stretched, the patients suffer. Such a simple solution to a complicated healthcare system.

  17. This is so incredibly true, and deplorable. My mother and sister are both pediatric RN’S – I’ve seen how incredibly hard they work, their impeccable bedside manner, and how much they genuinely care for/about each patient. Nurses work harder, and do way more than than most, (if not all), doctors – a statement I feel comfortable making since my father is a doctor. I’m not negating the work that doctors do, but the reality is that nurses are the are the glue holding everything together. They are some of the hardest workers, but sadly, beyond the most under appreciated. They perform tasks that anyone else would find, “gross,” work hours that would be considered outrageous and impossible for others, AND THEY DO IT WITH A SMILE & WITHOUT COMPLAINING. They ACTUALLY CARE about each patient and do everything in their power to go above and beyond to make a difficult & scary time easier, and more bearable for the patients and their families. I am in awe of and have the utmost respect for all nurses.
    Furthermore, I was in the ICU for a month with pneumococcal pneumonia bilterally. I was intubated for 10 days prior to having a tracheostomy. I had fevers if 106°, and they had a very difficult time trying to keep me stable. My family was told multiple times that they needed to prepare themselves for the worst, as most patients that go into the ICU with pneumococcal pneumonia don’t make it out. After I was trached and slowly weaned off of the heavy amounts of sedatives, (propofol, fentanyl, versed, to name a few), and was somewhat conscious, (I was so confused and unsure of what was happening, where I was, or why I was there), I saw how incredibly hard working, attentive, and caring they were from a patient’s perspective, not just the perspective of the daughter or sister of a nurse. In addition to typical nurse duties, (drawing blood, taking vitals, administering meds, etc.), they are also responsible for doing things the average person would never be able to handle. Although this will be embarrassing for me to admit, it’s more important people are aware of, and will hopefully have more appreciation for, everything nurses do. That being said, I was obviously hooked up to many machines, tubes, IV’s, etc. and unable to sit up, let alone get out of the bed to use the bathroom. At first, when I was still hazy, I mouthed to my sister that I had a really bad wedgie, she laughed, and said, “nope, you have a tube up your ass.” My memory and perception of time is still distorted, so I don’t know exactly when, but later on, perhaps one of the following days, I felt I had to pass gas, not a big deal, but I quickly realized it was more than just gas… thinking I still had a tube up there I “let it all out” so to speak, only to find out the tube had been removed. I was humiliated, and felt terrible for the nurse who had just started her shift, making me her first patient. I was crying from the guilt, embarrassment, and helplessness I felt, (which, for me, was made worse because the nurses aid was a male). Can you imagine going into work and the first thing you need to do is clean up an adults “mess,” changing the sheets, and hospital gown, with the patient still in the bed? Doubtful. Now can you imagine doing it with a smile, assuring the patient it’s normal and ok? Definitely not.
    I know this is a very long winded post, but I couldn’t help myself. The bottom line is that it takes a very special type of person who willingly chooses to become a nurse. It’s one of the most challenging, demanding, and under appreciated professions out there, and I believe the time to change that is long overdue. Peoples perceptions of what nurses do compared to the reality is drastic and unacceptable. I don’t think it’s their fault, I believe that they just don’t know any better. They have been led to believe that nurses are more like babysitters and just there to help the doctors, when, in actuality, they have much more interaction with the patients, doing things some doctors couldn’t handle, and putting up with/catering to the constant needs and demands of each patient – handling it all with grace, compassion, and kindess. Plus they do it all without complaining, always smiling and putting patients at ease. Those people that are unaware of these facts need to be educated and informed of the reality so they too can give the much deserved respect and appreciation for the hard work and commitment to all nurses who have ever been mistreated. I CANNOT CONVEY THE AMOUNT OF GRATITUDE AND RESPECT I HAVE FOR ALL NURSES. And for the nurses that have not been told how amazing they are, I want to say – THANK YOU FOR EVERYTHING YOU DO AND FOR CHOOSING SUCH A DIFFICULT, DEMANDING AND UNDER APPRECIATED CAREER, BECAUSE WITHOUT YOU, EVERYTHING WOULD FALL APART! Think about, and adopt a more literal interpretation of the phrase “NURSING someone back to health.” The doctors diagnose, prescribe, and do rounds, but the the nurses are the ones who are always there with unwavering support, and sincerity with everything they do. They literally do whatever they can to make their patients feel better and get well. THANK YOU THANK YOU THANK YOU (times infinity)

    • Wow… I am speechless…thank you for your passionate and unique perspective. I appreciate you sharing your story, as it is easy to forget.

  18. It is a shame that nursing, which use to be such a dignified profession and the bachelors of nursing one of the hardest obtained degrees, has now been turned into “a high paid expendable waitress”. I too have seen many a nurses weeks come and go with a small token of gratitude given by, 99% of the time, unavailable administrators as we leave from a grueling shift. I am an oncology nurse and I love each and every one of my patients dearly and work with some truly amazing nurses who have an extraordinary passion for what they do. Nurses have been asked to put that passion on the back burner as we no longer have the time to sit at the bedside and comfort that patient who is near the end of life or comfort the parent who has just lost their child to such a devestating disease. For nurses week, I wish that administrators could walk a week in our shoes. To see the amount of time and talent it takes to truly care for a patient and family and ensure they are receiving the best quality care. By experiencing what we go through daily first hand, I would hope to shed light on the small things that make the most difference are falling through the cracks and patients truly suffer by higher nurse:patient ratios and decreased staffing.

  19. After 44 years in nursing, it has made me so sad to see what nursing care has come to. We bow down to the almighty computer which robs obscene amounts of time from patient care with ever increasing amounts of documentation, and are spread paper thin (and make sure you ” wipe down all hard surfaces with sanitizing wipes at least once per shift” in your spare time). What used to be safe nurse-patient ratios went out the window years ago. Back then, I couldn’t wait to get in my car and get to my job.The sad reality is that administration could not give a rat’s rear end about what nurses think. Patients are now set up to think they’ve checked into a 4 star hotel so those satisfaction scores come back high and reimbursement is maximized. That the nurse gets chewed up and spit out in the process does not matter a hill of beans. That it eventually takes a huge physical and emotional toll on the nurse is of no concern. I LOVED taking care of patients and their families, but the stress has become ungodly. I am off now due to health reasons (I am not saying they were caused by my job), and intend to return to a position of helping in my community, but I will never subject myself to that environment again.

  20. Very well said. Thank you for fully articulating what many nurses never get the time or the opportunity to say. Taking the time to take care of a patient well is what nursing is all about and that has been clouded by Core Measures and Meaningful Use guidelines that really just require more and more documentation that often do not help the patient much, if at all. If you had told me in nursing school, I would think you were insane, but I miss having individualized nursing care plans for a patient. I miss using my critical thinking skill to identify what the priority of care for the patient should be. And it would be so wonderful to actually have breaks and meal times to use the restroom, eat something that doesn’t come out of a greasy bag, and ensure that our own needs are met so we are not left caring for everyone but ourselves. We want to set the example, take the time to use methods that aren’t always pharmaceutical to care to patients, to educate patients on how to care for themselves. I have been told multiple times in my career that if I want to do those things I had better “learn to cut corners” somewhere else. I learned early on that I had better not clock in more than 7 minutes early or out more than 7 minutes late and still somehow manage to complete all of my documentation on time. Oh, and also ensure that your patient is “5/5” satisfied even though you will rarely be able to spend time with them unless it is staring at a computer and typing. I am sure that improving my time management skills will always be recommended on my annual evaluation. The satisfaction of having a patient tell you that your involvement was crucial to their well being and that you made a difference is beyond compare. It would be great to be that influence for every patient, the way nursing was intended to be. This will never happen until staffing issues are addressed everywhere. How do you encourage people to go into nursing when they see the personal sacrifice and stress of the profession and never get to experience the satisfaction from knowing that you are able to do your job well without having “time management problems?” I fully support your effort in this and hope this will encourage many others to become involved.

    • How often did I get the “time management” lecture during my career as safe ratios went out the door! I have always been a perfectionist with the safety of my patients at the top of my list. I refused to ever cut corners, and frankly was appalled at what is being considered by many nurses today as totally acceptable as they capitulate to administration.

  21. As I read through all these comments, I’m sad. Sad because although we all hold this to be true, we as a whole do nothing to make a difference. We are too scared to speak up. So we continue to let hospitals bully and set unsafe staffing standard without a word. instead, we just push through taking toles on our mind body and spirits. The art of nursing is dying.

  22. Hi! I’m a nurse from Philippines, and i don’t know if you guys knew, we probably have the worst environment for nurses. In OB Ward we have at most 3 nurses for atleast 60 nurses. In the medical ward, it’s lucky if 1 nurse gets just 15 patients. In addition, we only have 1 nurse attendant for 40+ patients, and that’s considered a good day. I would like to add that contractual nurses such as myself get 297 pesos per day, that will be 5 dollars a day. We tried appealing to our government to improve our condition but to no avail, a bill for nurses was authored by several senators but wasn’t signed by the president. We have one of the most pitiful working conditions for nurses, and that’s why a lot of us leave.

  23. Thank you so much for this article. Well said and written! !!! I have been a nurse now for 17 years. Always in hematology /oncology inpatient and outpatient. Specialty in stem cell transplant. I would trade in the stupid trinkets for better staffing and a simple heartfelt thank you. Unfortunately I don’t know if upper management will ever truly get it. Regardless I do what I do because it feels right and I am blessed to see it all. Good, bad or ugly. I have a deep appreciation for this beautiful thing called LIFE♡♡♡

  24. I totally agree and wish I could lobby for nurses on the government level. This needs to be law and soon. Keep me posted if there is anything I can do to help. I plan to write my congressman also.

  25. Very well written. You didn’t however address nurses that work outside of hospitals. As a hospice RN CM and home health RN CM. We get to care navy patient loads also and drive all over the place. We are mostly salaried these days, so we get paid for 80 hours for 2 weeks, usually work greater than 90 due to we now have to chart everything of computers. which ends up having to be done after your full day of work. If you do chart while with a patient you are just busy looking at the computer instead of caring for your patient. Last year received a t-shirt giving the company we worked for free advertising. And oh goody could wear it to work on Fridays. So what most of the nurses that I know that work out in the field, what we would like is to go home an be off work.

  26. And what about the proverbial “cake”. Everyone one gets a 1inch by 1 inch piece out of that sheet cake. We use to joke “let them eat cake”, guess what happened to Marie.
    Really all we wanted was to take care of our patients the way they deserve and with the help needed to do that. Happy Nurses week.

  27. This is so spot on. Use to love going to work and working as a team. Coming home and knowing I did great patient care. Over the past 38 years I have seen the huge change in patient care. The grids are rediculous and cause so much tension. I would love the bean counters who make these rediculous rules to do our job for 1 day and be able to observe them. Sad that it all is based on money and profit.

  28. I have been a nurse for 36 years this year in various capacities, from ICU to acute dialysis, recently in Home Care and a few more in between. Staffing ratios also apply for Home Care – it plays out a bit differently as ‘staffing ratios’ equates to forced overtime as we cannot pull from a float pool and have to cover all of our own patients. Sadly administrators feel that patients cannot be turned away even if we don’t have the staff to care for them. So working 60 hr weeks has become the norm here and that is just too much. I used to love Nursing. I can’t say that anymore. Well, let me clarify: when I’m across from a patient and do my teaching, wound care etc and am one on one with that pt and their family I love what I do. I very much dislike how healthcare is changing… which is everything you pointed out in your article.

  29. Excellent and important post, Joan!!! RESPECT sums it up. For the profession of nursing, ourselves, each other, the work we do, and the patients we care for. Safe staffing is a sign of respect and unsafe staffing undermines everything. With almost 30 years as an RN in many roles, I have felt this so rarely. The DC rally is very important. I won’t be there in person, but will be in spirit and am grateful to all who go!

  30. What a perfectly written article, thank you for saying what we’re all thinking. Ever since nursing school, I decided I did not want to work on a floor. Thankfully after only a few months at a nursing home, I got in to surgery. People ask me all the time “Do you like surgery? Isn’t it kind of gross?”. First of all, I find it incredibly interesting and not gross at all and I love the fact that the majority of the time, we bring in someone who is “broken” and we “fix” them. But most of all?? I love that we have only one patient at a time. I can focus all my energy and attention on one patient, just like they deserve. You couldn’t pay me enough money to work on a floor and put up with everything that happens up there. Those are some strong, amazing people working up there and they deserve to be treated better in all aspects!! Thank you again for your insight, it’s too bad hospital management doesn’t seem to understand. Maybe we should only let nurses who need a break from floor nursing be our hospital higher-ups!! 😉

  31. I think every new graduate dhould take the time to read the book ” Reality Shock” during the transformation from student nurse to staff nurse . A lot of questions are answered and the transition becomes more bearable and not a shocking.
    I did a book report my senior nursing year on this book and I highly recommend every mre nurse to read it. You can find it on Amazon and slabs tis book sites

  32. You have said what all nurses think through our long daily shifts when one wants to sit in a corner and cry so badly because we are so overwhelmed by the expectations of hospital administration in a 12 or 8 hour shift. We are flustered by the needs of our patients, the provision of excellent care and making sure our documentations are up to par. We struggle to stay true to our profession of caring for others. This constant tug of war leaves most of us burned out.
    This read is a call to action- however it’s sad that after so many years of fighting, rallies, protests, walk offs, strikes and countless hours of negotiations, safe staffing and placing priority on what nurses really want has not caught fire. Regardless of how it looks now, let’s not be complacent in our roles or tire of fighting for what we really want..let’s encourage and empower new nurses to join the fight. The future of nursing depends on our fight today. Happy nurses week!!

  33. What an fantastic article. Well written and to the point. Your one smart nurse who knows what she really wants for nurses week.

  34. I want support staff. Our hospital fired clerks, so now nurses do all the paper shuffling and answer the phone. But remember to do it with a smile so we get good scores for customer satisfaction. Sit down and educate your pt? Great idea, but how to do it with constant interruptions by the phone you are required to carry.

  35. I am a long hospital CEO. Many of my best friends and many of the most touching personal moments of my career have involved the nurses whom I have come to know and even treated me from time to time. I’m sorry that very few of those who have commented understand or don’t care to understand the full complexity of the healthcare crisis, a huge part of which is the nursing crisis. Not enough nurses and the need for instructors making training more impossible. Outstanding hospital nurses aging out and being stolen away by the convenience of working in a freestanding outpatient center or in an insurance company case management office. Patient ratio laws that are basically a joke because patients MUST be cared for, nursing shortage or not — I worked in California and know this is often the case. Needless government regulations that lay huge costs on hospitals who can no longer pass it on to patients (thanks insurance companies) yet whose expenses like that new technology and those drug cost (t. So what hanks big Pharma). And the list goes on and on. I, too, lay my head on the pillow every night worried about the safety of patients in EVERY hospital in this country and ALWAYS recommend a family member stay with the patient if possible. We, too, try to show some love to nurses during nurses week though abandoned trinkets years ago. We try to serve them in small ways like breakfasts and snacks because that it the inexpensive thing that we can try to do to show we care. Believe me, those few dollars of expensive and the time administrators and nurse leaders give would not make a dent in this long and growing list of woes. So tomorrow, we will do that and hope that at least some of our staff nurses realize it’s our way of saying thanks and to please, please, please stay with us, giving the best care we can all give to our patients every day in our hospital.

    • Thank you for an excellent response and perspective. I can only hope that we (Americans) can get back to basics. I just can’t understand how doctors and nurses haven’t had more of a voice in care and cost and worked to get the government OUT of our health care. Like you said, all the additional regulation adds to cost. And as some of the nurses in other comments have pointed out, it seems to mostly about crossing t’s and dotting i’s instead of doing what’s real.
      On another angle to this problem is the dominance of 12hr shifts now…most studies talk about how unhealthy it is (especially night shift) and that “mistakes” increase with fatigue. It seems the system has forgotten we are people, not robots. When I brought up the the fatigue issue to a CEO during a session on “distracted driving” and my concern of folks falling asleep at the wheel on the way home he replied with (paraphrasing):most of those accidents are found to be drunk driving….Do YOU believe that?

  36. As a cna we would just like some help from our fellow co workers always realize you has 3 or 4 and the cna has all Pts and their adls. And a thank you goes along way…

  37. Well written and so true! I’ve been a nurse for 30+ years and am so sad it’s come to this! Keep fighting for all that is true. Isn’t it sad that hospitals think they need to tell us how to wash our hands??? My Mother taught me more than 50 years ago!

    • I worked for a large hospital system that gave us a placard to put on our badges that said “ask me if I washed my hands”. I no longer work for a company that openly invites people to quesiton my sense of responsibility as a professional.

  38. You have made so many great points in this blog. The best I think is who is harmed in a shift nurse or patient and if our practice reflects evidence based research why doesn’t the administrators. Look what nursing did when Joy of The View demeaned our profession. Why ant we stand up for ourselves now?

  39. Excellent post, Joan. I am so glad that you are involved in this and celebrating all of the work you and the group is doing for nursing!! Wonderful news, sharing this post with others. And… as you know, another thing that nurses may enjoy for Nurse’s Week is a meaningful gift from their employer- one that uplifts them, re-energizes their career, and celebrates the art of healing practice. The Art of Nursing online program! http://elizabethscala.com/the-art-of-nursing-2016

  40. “Instead of rewarding the hospitals for being good manipulators of statistical data, how about we reward hospitals for having safe staffing ratios and good outcomes.” Drops microphone…couldn’t be said any better! Thanks for being such an advocate for both the nursing profession and the provision of giving patients safe, quality, and compassionate healthcare.

  41. Retired now. Couldn’t have said it any better.
    At one of the hospitals I worked with about 15 years ago, each floor received one disposable foam plate of about 12-15 chocolate cookies on one particular Nurses’ Week. The foam plate was the usual size we use at office/floor parties. The cookies were the ordinary type occasionally sent out with patients’ meal trays . The plate was hastily wrapped with Saran wrap type of clear plastic covering. It came with a scotch- taped written note saying ” the name of the floor and Happy Nurses’ Day”. The note was written on an irregularly cut out white bond paper half the size of a small flashcard. The plate of cookies came out of the Dietary Department and delivered by a dietary aide. None of the leadership came around to even fake the justification for this dismal show of austerity, we called a slap in the face. Needless to say, the plates of cookies were sent back “as they came” to the office of the Director of Nursing via the same dietary aide who brought them to the floors. Well, most floors took this route and the few floors that didn’t, admitted their dismay over the treatment and regretfully said ” why didn’t we think of it ?’.
    The nurses were called ” CHILDISH”.

    Happy Nurses’ Week !!!! Continue doing good. It is our calling.

  42. I’m retired. But I couldn’t say
    .anything more.. Thank you for saying it. It sounds like my work place.

  43. Thank you! Thank you! Thank you! Very well written with what is happening with nursing at this time. I would like to add one more thing….Nurses come in all shapes, sizes, colors, etc. We all have areas of expertise, yet are expected to wear any hat at any time in areas we are not trained to work, without complaint, because that is where the need is at the moment. It is not safe nursing to expect a neonatal RN to work an adult ICU unit, even as a “sitter”!! We do NOT fit in an all inclusive “RN” box to be placed where the numbers say we should go.
    I have been an RN for 30 years, am at the TOP of my pay grade with no chance of a raise. Really?
    What happened to nurse retention? What happened to advocacy? What happened to having a voice in making workplace decisions? Money.
    Thank you for allowing me to rave!

  44. It is amazing to me that we aren’t reimbursable. WE ARE PATIENT CARE! If we didn’t show up for work, who the hell would look after these patients, who are getting increasingly sicker, demanding and violent?!? Not the doctors, not the housekeepers, and definitely not the administrators, especially because most of the administration has MBA’s not MSN’S, and wouldn’t know the first thing about doing more than taking a temperature and throwing a bandaid on it.

    Press-Ganey surveys should be illegal. They things they ask patients are simply ridiculous. Of course the food is awful on a low fat, low carb, low salt diet. Are we trying to promote a heart healthy lifestyle on a recently bypassed patient. You bet your salary we are. This is a hospital, not the Hyatt.

    Nurses are the the spine of the Healthcare industry. Without us the system can’t stand and becomes paralyzed. We need to take better care of ourselves and one another. Enough is enough.

  45. Sadly, I believe everything you stated plus one additional fact. We no longer have nurses week at our hospital . We have “Hospital Workers Week “. We no longer are acknowledged for our achievements as nurses, but as one of the gang. It is de facto that nurses are not thought of as anything special or important. Try running a hospital without good nurses. The bottom line has become the bottom line.

  46. A question for Nurses who work on a Unionized hospital, Why is the experince step pay LESS when you reach 20’years of experience?? Evwry other profession you generally get paid MORE for your knowledge, experience and Expertise ! Why not Nursing? So bizarre to me

  47. You certainly touch on the nerve of all nurses. I have just retired from nursing after 43 years in the trenches- from ER to OB , Home Health and Hospice. When I began my career I worked in a hospital where we gave patient CARE- hands on- no computers- as I left nursing hospitals became businesses with bottom lines and it is about the money. I understand how this happened, but it makes our job insurmountable- way to much paper/ computer work and not enough time to minister to our patients who are scared, anxious, angry, delirious and all other adjectives. These people mostly pay high prices to go without compassion and we are left with our own frustration, anger and hopelessness for anything improving especially staffing. Young nurses become frustrated and disappointed with lack of mentoring, orientation and piles of paperwork/ computer charting. I wish we could somehow affect a change because someday we may be on the receiving end of short staffing and that really frightens me.

  48. I have retired after 46 years as a nurse, a career I so loved: at the bedside in ICU, Med.-Surg., Home Care, Research, Hospice, the military and as a civilian nurse in England. I keep wondering where we went wrong. The service ethos is dead.
    How has health care in the USA become a “runaway” train driven by souless administrators/managers whose passion is poured into keeping their positions (salaries, 9-5 jobs, weekends off and 4 weeks vacation) not in providing service. The name of the game is power, money, litigation and turf wars. It grieves me . We all work so hard and give so much of ourselves. What is the answer?
    Not looking forward to being a patient and someday we all become patients.
    Please keep up the dialog.

  49. I can’t be in DC but I totally support your agenda. I am in California & would live suggestions as to whom to contact & the best way to do so.

  50. I’m a new-ish ER RN (two years in July). I remember feeling so welcomed…the relief all the staff nurses greeted us with when they were told we were permanent hires. I didn’t understand at the time. Fast forward, and none of the nurses I got hired with is still on their original status…only a few remain, per-diem. I find myself anxious as these huge gaps are filled with travelers…knowing they will leave…and the remaining staff nurses patients will suffer. I love my job. I hate the politics.

  51. Thank you Nurses for all you do. I need your support in bringing a new product to market (if you consider it worthy) that can enable a 90 lb nurse to lift or turn a 300 lb patient effortlessly, with the push of a button . The product is brand new and with the support of the nursing community many, many people can be helped. The work of many years have always been with the nurses in mind who risk their health and well being in taking care of my loved ones as well as the literally millions of other patients around the world. The idea came about after family members and a caregiver had injured themselves in taking care of my 6 ft 7 in tall but bedridden father in law. The http://www.thenurseaide.com is a tribute to all the nurses who work day and night around the world to care for all mankind. Thank you all very very much .

  52. I work with some real maroons, as the Stooges would say. One of my coworkers today actually asked for a T-shirt for Nurses’ Week in a meeting.

    To top it off, said maroon also wanted a “better Christmas party that shows you (supervisor) care with that budget you get” (manager gets 0)

    If only video recording was legal at work….

  53. When will Hospitals realize that the only reason the patients are there in the first place is for Nursing care! It’s not for access to their Doctor…they MAY see them for all of 5 mins! It’s not for tests….those could be done outpatient. They come for Nursing care that they can’t get at home! The sooner that everyone recognizes this, maybe Nurses work conditions would improve. We need our legislators to know this! Without Nurses hospital’s do not need to exist!

    • So true!! Why do you think our voice is not being heard? Hope you join the #NursesTakeDC movement – we need to band together for our voices to be heard!

  54. I am retiring after 5 years in Med-Surg & then 30 years on Obstetrics–I totallt agree with the thoughts & feelings expressed in your article, but my fight is about over–too exhausted to fight. You younger nurses are the answer! Make administrations realize that the are treating usike an expenbable resourse, not as smart skilled profressionals!!

    • Thanks for your years of hard work and dedication to our profession! I hope we make you proud!! And enjoy your retirement!!

  55. I sould like to say, i completely agree. I am a nirse manager and see this daily yet senior leadership try to spin things to make us feel like they are right. ” look at the big picture” they say. I say what about the patient in the bed that is the true picture. I will say our current CNO has moved our ratios from 6-9 med surg patients to 5, intermediate from 5-6 to 4, progressive to 3 and ICU 1-2. She currsnlty is trying to distinguish us out from the rest of the country and make this even less. Her goal is med surg 4, intermediate 3, progressive 2, and ICU 1. We have staffing grids to never shear from this, back ups to back ups. She has nkt steered us wrong so far so I have faith she will steer us right in the future.

    • You will certainly make headlines with those staffing ratios!! Glad to see someone in management finally get it!! Thanks for sharing!

  56. You are so right! And they also tax us on the small token that advertises our hospital. No raises because we need to build that new better building! Turn over is very high because the administration does not want our older nurses calling them out on their behavior. We do need to let the public understand what a nurse does and what we deal with. It is all about the money — a BSN RN of 38 years!

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