That is: “What would Florence Nightingale do?”
I’m a fourth semester nursing student now. It’s hard to believe it…. the time is flying by now, and I can see the end of the tunnel. I can practically taste graduation! There are times now where I feel like a nurse. Where all the pieces fit together and the material makes sense. There are still PLENTY of times where I sit down to chart in the hospital and think to myself: “Seriously, how will this ever feel like I know what the hell I am doing?!” The good news, I guess, is those moments are starting to feel like they happen less. 🙂
Lately in the hospital, I have started to become discouraged. And it’s not because the material is hard, or because I’m not particularly fond of my floor this semester (I’m working on an endocrine/MedSurg floor). It’s because more often than not, I find myself watching the floor nurses and thinking that this isn’t what I want to do. Now, don’t go crazy when you read that and think that I don’t want to be a nurse anymore. Believe me, I want it more than anything. But the hospital environment has become something of a stressor for me. In my head, I have all of these iconic and probably unrealistic visions of what I want to be like in my own practice. The way I want to take care of my patients. The kind of NURSE that I want to be. And the longer I work in the hospital. the more evident it becomes to me that that just isn’t going to happen.
This semester the goal is to take on more responsibilities and more patients. Right now we are running with two patients every week. It’s not a problem. I enjoy it. I get to spend some time with each of my patients. Take detailed assessments, document effectively, and then I have lots of time to plan some care for these patients. My patients ambulate, they turn, cough, and deep breathe, they get educated about their disease. They get harassed about their incentive spirometer. They get on time meds and dressing changes. I’m able to do teaching. I’m able to do lots of little interventions…. like bring a packet of crackers and a sprite into a patient’s son that has been bedside all day and hasn’t left to eat ANYTHING. It’s little things like that that make me feel like I make a difference.
The nurses that are actually working (for money) in the hospital, it’s a different story. They have six, maybe more, patients at times. And we (meaning anyone working in medicine these days) know that the patients that are in the hospitals now are no longer “easy” patients who are there to rest and recover. Even on the “general” MedSurg floors, you have a vast majority of acutely ILL patients. Acutely ill patients that need CARE, and lots of it. So here we have a nurse taking care of six + complicated patients, and by they time they pull meds, do their morning assessments, hand out those 548765876387687633333 meds, hang IV meds, and then finally sit down to document it all, they are back to square one for the next round of meds. When they aren’t doing those things, they are answering call bells (which they should be), and from what I can see you have some basic nursing interventions that aren’t getting done because the nurses just CAN’T. They don’t have the time.
They teach us in school how to get rapport going with patients, how to earn trust, how to connect with these people that we are taking care of. It just can’t be done in the real hospital world of today. It’s hard to get that rapport going when you see a patient 20 minutes a day, and of those 20 minutes, 15 of them are spent shoving meds down their throats.
I didn’t get into nursing to be a glorified pill popper and professional “charter”. I want to take care of patients. I just don’t see real “patient care” going down in the hospitals these days!
Please don’t get me wrong. This isn’t the nurses’ fault. They are all wonderful nurses, and in my time spent in the hospitals under these remarkable women and men, I have learned a LOT. There are so many great nurses there that are GREAT teachers. But the hospitals have made it so that these wonderful nurses… well, their talent and compassion is snuffed because of the corporate business healthcare machine and their staffing ratios.
I really think that everyone in medicine should start DEMANDING safer staffing ratios. You can’t tall me that if a nurse had three or four patients, that the quality of their care wouldn’t improve. It absolutely would.
What would Florence do?