Nurses Deserve Better!

I’m a writer, and I’m passionate about what I do, even if I tend to avoid hot topics when blogging. It’s not for a lack of opinion about them. I just prefer to leave controversy to the controversial. This week, however, I became genuinely riled.

I’m also a third generation nurse and have been for 22 years. I’ve worked in geriatrics, oncology, med/surg, telemetry, critical care, transplant and management, and I hold nurses in the highest esteem. The hours are long with few breaks (if any), the work is physically demanding, and the insidious emotional toll often irreversible. And – in reality – we rarely feel supported.

Grandma nurse My Paternal Grandmother

I was literally outraged this week to find out that Vanderbilt Medical Center, in my old stomping grounds of Nashville, TN, has made the decision to cut back on housekeeping and have their nursing staff clean patient rooms.

Click HERE to watch/read details of the Vanderbilt announcement

“Cleaning the room after a case, including pulling the trash and mopping the floor, are all infection prevention strategies, and it’s all nursing – it’s all surgical tech. You may not believe that, but even Florence Nightingale knew it was true.”

I could be wrong, but I’m guessing that Flo wished she’d had someone to take care of the floors and toilets so that she could concentrate on safe, effective patient care.

Vanderbilt’s administrator goes on to add, “The priority will be what patients see.”

What about what they don’t see? Who’s going to take care of that, and how often??

“We must continue to care for our patients, and we must do so in an efficient manner”

Efficiency in nursing is a challenge now given the amount of responsibility that RNs hold. What do we do when one of our patients has a crisis, and we’re wrapped in our “personal protective equipment” mopping floors?

Nurse MomMy mom

When I graduated from nursing I went through a three year diploma program in Canada that focused primarily on patient care. At some point the powers-that-be decided that we should all have a more theory based degree under our belts to raise the status of our profession. God knows that will come in handy when we’re scrubbing toilets.

This is an overall bad decision. It’s bad for nursing, and it’s bad for patients. I predict poor patient outcomes, cross contamination, increased infection rates, more critical incidences, patient dissatisfaction, burnout, sick calls, and an irreversible dive in an already low morale.

Somebody please tell me that this is a lone decision. This cannot be allowed to become the expectation across the board in our profession.

We deserve better. Our patients deserve better.

Please talk about this to your friends and family, inform the public, and be very concerned. We need nurses, and we need them to be able to practice in a safe and supportive environment. This affects everyone.

Nurse me

Leana’s blog can also be found on her website at http://www.leanadelle.com

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43 thoughts on “Nurses Deserve Better!

  1. I will never forget your loving care of my daughter during a difficult birth. You are brilliant! Your brilliance should be reserved for the care of patients. Love Judy

  2. I have been nurse for 30 years, the last 20 as a nurse practitioner. I am just as outraged about nurses having to clean patient rooms as you are. Until nurses learn to say no we will continually have non-nursing tasks added to our jobs. To a large degree nurses are martyrs. We do not know how to say no. We will continue to do what we are told to do because we will not let patient care suffer. I think the administrators that decided that nurses should clean rooms should take up a mop and do it themselves. Until we figure out how to charge for the care that we provide, we will never be supported or respected.

    • I totally agree, Brenda. The whole concept is absurd. Sure, we’ve all stepped up to empty trash and mop up blood when we’ve had to, but to make it an expectation?? They’ll eliminate all auxiliary staff if we let them. We draw our own labs, run them to the department, pick up blood products, do our own EKGs, transcribe our own orders, make trips to the pharmacy etc., etc., etc. Not to mention the charting, which is often crammed in at the end of the shift. Nurses are overtaxed. It’s just getting out of hand. Thanks for the reply, and the support!

  3. my granddaughter is an rn and a flight nurse she works her butt off with out having to be a house keeper.she loves her job and she didn’t go to collage to be a house keeper betty starrick grand mother of a hard working young rn .

  4. Let me just say a big “Thank you” for bringing more attention to this unbelievable act of disrespect for our fellow nurses! I have not heard from any one who is less than horrified by this. Obviously a decision made by some one with a degree in business with absolutely NO idea what it means to serve their fellow man. May he/she need a nurses care while the nurse is taking out the trash!

  5. I think all the RN’s at that hospital should resign .all at once . Then let the managers , administrators etc. run their butts of doing patient care and housekeeping . I don’t think I’ve ever heard anything so rediculous in my life .

  6. Unfortunately, this is not the first hospital I’ve heard making this decision. When I first heard it, I thought surely that hospital was crazy and hopefully no other hospital would be that stupid. I am so disappointed and so angry to hear Vanderbilt has made this decision. I’m finding it hard to voice how angry and how CONCERNED I am for what this means for the future of healthcare and for bedside nursing. I genuinely believe we have to stand up and say enough is enough- not for us, but for our patients.

  7. I ask all family members of hospital patients to go to the cafeteria during lunch and see which employees are taking their 30 minute breaks there. Most likely, your family member’s nurse will respond to a call while still wiping her lunch from her mouth. Most likely she or he will never have an uninterrupted lunch. So many regulations about charting now, it’s either work or chart, or work and chart later. And of course, if it’s not charted it’s not “done”. Never mind that you did turn the little lady (or not so little gentlemen) every 1 1/2 to 2 hrs. Med-surg nurse for 25 years. All the new nurses are going into specialties. Whose going to be at the bedside? Who would want to?

  8. I think cleaning the rooms should be done only after your other patients have received their patient care (bath, turning, charting, medication administration, patient education, dressing changes, etc.). Let cleaning the room be the very last thing on the list and then wait for the ER and surgery to back up because there are no clean rooms to go to. How would that work out for you administrators?

  9. I think as a nurse I make more an hour than environmental services, so how is it efficient for me to do the work that could be done more cheaply by someone else? That does not make economic sense to me. How can this be a wise business decision?

  10. I am one of three nurses in my family and my first response was to be horrified by this. Then I stopped to think and I realized that I frequently empty the trash in rooms because it’s quicker than calling housekeeping…However, I do make sure that if I do this task that I properly decontaminate myself prior to going on to patient care, but still… Eeek!~ I’ve already been indoctrinated into this line of thinking!! I do believe that cleaning rooms and mopping floors is beyond the pale in asking nurses to perform these tasks in addition to what we already do (yes, I run to pharmacy and do EKG’s and have to run dirty equipment to CPD for sterilization and then back to pick them up and do daily QC checks in addition to patient care and charting and updating physicians and stocking rooms with equipment!) I think if those tasks were added onto an already-full plate, they’d be like the lima beans I constantly pushed around and *never quite finished* as a child… Maybe that’s passive-aggressive, but then again, it’s not outright hostile like the actions of Vanderbilt seem to be. “Take it or else” seems to be the tone coming across to me, although I hardly know how paying nurses over housekeeping will help them remain fiscally solvent… But then again, that’d be those critical thinking skills kicking in again!

    • LOVE the lima bean analogy! And you’re right. We have all gone above and beyond to do tasks outside of our . . . wait . . . what’s our scope of practice again?? Nurses emptying trash and cleaning up spills is hardly a new thing, but making it an expectation? Irks me to no end. Critical thinking at its best, Mary Anne. Keep it up! 🙂

  11. Enjoy your writing. Curious as to where you graduated nursing school. Your pin looks like mine. I graduated from Conestoga College in Kitchener Ontario in 1982.

  12. The hospitals have thought about what would happen if a nurse quits because they refused to mop. The hospital would fire the senior nurse and hire an inexperienced nurse at a lower wage rate. The new nurse would fill a slot with a license. Old nurses are more expensive for the medical plan as well. A win for the institution. That is the sad fact. My advice to those RNs who don’t want to mop is to get an online MSN. Get a job in a cubicle somewhere where you can counsel nurses who complain about mopping.

    Get used to it. Obamacare, and the fact that the country is bankrupt, is going to make healthcare an unpleasant work place. You heard it here first.

  13. I’m not a nurse, but my sister is a great one. She prides herself in good patient care, but she, sometimes, has more to do now than she can do in a 12 he shift. I thought a nurse was someone that worked hard at their jobs to make a difference in the lives of their patients, not janitorial care, but one on one patient care. She comes home now so tired she has to rest for the first 1 or 2 days off before she can do anything. I feel that something like this would push some MUCH needed good nurses into early retirement and then where does good nursing experience come from? I’m not saying our newly graduated nurses are not good, most are, but good old experience is hard to find now.
    Medical care will drop drastically if any of our nurses have to do janitorial work, they don’t teach it collage and it just shouldn’t be part of a nurses job description. The term I clean toilets well should not go on a nurses resume. Thank you so much for bringing this to the attention of others that has the utmost respect for experienced nurses. Please keep us posted.

  14. Had a friend who works at Vandy clarify what is going on as I often find there is more to a story than what we first hear. This cleaning of room assignment is for nurses in OR and PACU only. They would clean the room between cases so they would NOT be doing pt care at the time they were cleaning.

      • It is not less scary if you are a OR nurse or a PACU nurse. And don’t think for a second that it is going to stay in the OR it will not come to your floor. Take a look at what nurses in the UK do now that they have nationalized medicine.

        What is more scary to me is the fact that the leaders making these decisions are PRN; political registered nurses. They are nurses who have very little leadership ability. They are tired of patient care. They have a bogus master’s degree that does nothing to prepare them for leadership but got them out of patient care. As a result, they make decisions that are symbolic rather than substantial Their first instinct is not to rock the boat but to do things that self-promote.

        To meet the coming challenges, there is wide belief that to be successful, we need transformational leadership. But instead we get floor mopping. A classic example of small minded people making small minded decisions.

        We hear talk of the need for RN’s practicing at the top of their license. Is mopping floors part of that plan? No.

        We hear talk of the need of healthcare facilities to operate under sound business practice. (Especially liberal academic medical centers who as a separate business entity have never been profitable for one day, ever.) Does this bright idea align any goals or incentives for any of the workers in that area? No.

        This is a predictable move. When a PRN looks at a spreadsheet and sees “Labor and Benefits” as the largest category of costs, that is where they focus. It is easy. It is fast. But what of the unintended but predictable cost increases?

        We hear a lot about evidence-based medicine. What about the links that begin with unhappy staff. Increased sentinel events. Or increased staff turnover. Or increased sick calls. Or increased infection rates. There is evidence of this you know. So do the PRNs quantify these very predictable results of “floor mopping”? No. This sort of thinking so far beyond them it is waste of time to even introduce the concept.

        Have a cheerful day.

      • GO KEN!! 🙂

        My “less scary” comment referred to it not being hospital wide, but you’re right again in that it’s only a matter of time.

        I’ve worked in management, and I back you 100% regarding leadership. I’ve seen plenty who have the job but not the ability. They’re plopped behind a desk and expected to nod. They sit in meetings and are afraid to speak. And I’ve worked in hospitals (maybe all do this – I don’t know) where unit managers get an annual bonus for cost cutting. Where’s the “patient-centric” logic in that?? At one facility in particular, they cut care aides on the floor, and the manager got a check. Infuriated me.

        So, point taken, which is what spurred me to write this blog in the first place. If one hospital begins this nonsense, we must all beware. A sign of some very disturbing times ahead.

        Thanks!

      • Don’t overlook the fact you would never know about this unless someone went to the press. What is the meaning? This means that this institution’s reporting system is dead. The staff has no one to talk to about their concerns. No way to voice objections or bring up ideas. Sad that the first and last resort is the local media.

        There are increasing similarities to industrial revolution labor practice. Forced to work through lunch breaks. A personally dangerous work environment. You know of course that healthcare workers are among the most likely to be injured on the job.

        So there you have it. Ineffectual ideas. Leadership through intimidation. Patient safety compromise. Dangerous conditions. There is more to come. Much more.

  15. My brother is currently a patient at Vandy, has been there off and on since April. We hear a lot of things, but what I believe is closest to the truth is that they are laying off a lot of employees, several hundred. Mostly in the maintenance and grounds keeping areas. There have been layoffs in nursing also. The grounds, I understand, as the season approaches for less need in outdoor work. I believe Vanderbilt is a wonderful, well run hospital and school, with the very cream of the crop in caregivers. As a teaching facility, I have observed great concern for patient care and proper safety practices. I can only hope the need for cost cutting doesn’t cause a decline in patient care.

    • First off, I’m sorry that your brother has been ill, and I sincerely hope that his health is now improving. We all share your hopes that patient care remain unaffected, Martha. This does create genuine concern from a nursing perspective, and it should for families as well. Please feel free to update us at any time. Hugs!

  16. I am astounded this is happening. What else could possibly be put on the nurses shoulders now? Are we going to go down to the cafeteria to make meals now? Are we going to start stocking the med machines? Nurses already have so much to do, no we have to cram cleaning rooms into the mix? I really hope other hospitals don’t catch on. I get that Flo Night understood how important cleaning was, but that’s before we had a complex comprehensive medical system with complex patients to boot. Patients will ultimately suffer, but that also means that REIMBURSEMENT will suffer for the hospital… hopefully it doesn’t last too long and no one else follows suit. Love your blog!

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