Oct 30, 2001 05:59 AM
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There always seems to be a shortage of nurses. Have you every wondered how this could be when the nursing schools are always full? Many ideas come into view. I can tell you why I think shortages continue to be a problem. The problem begins with the schools.
Nursing students are not prepared for reality, no matter what the curriculum. The courses are based on ideal situations. The experiences taught in hospitals or other facilities are taught during the day. You are mainly exposed to the supervisors and team members of the day shift arena. When you graduate and begin your career, often you are placed in another setting. The shift worked initially will be evenings or night. This is only a small bit of reality for new nurses to face.
Patients look forward to having a student nurse. They know the student will give the best care possible. Of course, she is getting graded, after all. Also, the student will only have 2-4 patients. The patient compliments the instructor; the instructor relays the comments to the student. The students'idea of nursing is one of great pride and respect. In contrast, as a graduate nurse, you may be given 20 plus patients in any given shift. The new graduate may be the only one on the floor giving IV medications. This new nurse may be the only one to round with the doctor and take down any orders given. I remember having thirty pediatric patients, all on IV medications. This was considered a normal situation. All nurses would be in that situation at any given time. One just prayed for wisdom and guidance. You would concentrate on your patients and their care. No room for excuses, excuses were considered taboo. Everything would be done efficiently and effectively. Anything less would be frowned upon. Other nurses would be the main ones to discuss below standard technique displayed by nurses. It makes no difference if you are new. You are a professional. You are expected to act like one.
On one shift I would have so many duties, it would be hard to determine what to do first. Below is a list of duties I would have. Let me remind you that the list is incomplete.
Make patient-nurse assignments for the day
Assess each patient every two hours
Give all IV medications
Start all IVs on patients admitted
Restart all IVs on existing patients
Assess any laboratory test or other diagnostic test and report results if deemed necessary
Be available when physicians visit the floor
Document all orders while making rounds with the physician
Document on all patients via computer and patient charts
Evaluate documentation made of others ; make corrections if needed or sign off if acceptable
Make sure others take lunch breaks
Cover while others on break
Report to next shift promptly at shift change
Inventory check for the floor
Assess the crash cart and reorder anything missing or expired.
The list could go on and on. I hope you get the idea.
Students are taught proper lifting procedures to decrease the opportunity of injury. What about the patient with an immediate need? Waiting is not an option; therefore, the nurse does the job alone.
Students are taught precautions to minimize exposure to life threatening disease. What if a patient stops breathing in an area with no personal protective equipment? Do you immediately begin rescue breathing or do you wait. Many begin rescue breathing without thought of personal protection.
Students are given time off during holidays and time off when the weather is dangerous. Nurses work every holiday, on the weekend, and when the snow is knee deep. Sickness does not arrive promptly after Christmas.
Students are taught to be emotionally detached in order to be more objective. What about the premature infant that you have watched grow for five months in the nursery? The one that rarely gets visitors. The one you have declared, despite all your teachings, my baby. The one that looks for you in a crowded room, follows your voice, squeals when you pick her up. The one you helped get ready for discharge, then cried when she went home.
Students are taught that nurses are the most important patient advocates. In reality, nurses may have days when giving all the medications on time was a miracle. You will go home frustrated many days and pray you did not forget a patients heart medication.
I believe that schools of nursing should tell everyone that applies for admission the following:
YOU MAY SUBMIT YOUR REQUEST FOR ADMISSION TO THIS SCHOOL ONLY IF:
You have the ability to put others before you, daily.
You are able to make sacrifices in your life and not question the reason why.
You are able to work nights, weekends, holidays, and during bad weather without complaint.
You are able to come in on your day off if needed.
You believe that you can do the work of several nurses, because it will seem this way at times.
You believe that you can make a difference, as an advocate for patients and other nurses.
You believe that you can make a difference in a life and perhaps save a life one day.
If you think you still belong in nursing, then you will be expected to reach out to those in need, those suffering, and those dying. This is expected of you at all times. Nursing is not only a job; it is a calling. Not everyone will qualify. To qualify you need to search your heart. Only then will you find the answer. After all, we are angels of mercy.
A little unrealistic, I know. One has to appreciate the fact that nurses have no unions to assure proper treatment of the profession. Our retirement plan is in the hands of our employer or we can independently plan. Heath care has become a business, like all the others. Money has to be made. Profits must be realized. A shift will go without the nurses it should have. At the same time, standards of patient care cannot be lowered. Nurses must find happiness in what they do; and students must be made aware of all these challenges.
