The Death of Bedside Nursing?

A number of blogs and responses to blog entries focus on the current state of "bedside nursing." As its name implies, bedside nurses provide care in hospitals, long term care facilities, rehabilitation centers and any other place in which patients are for the most part, in bed.

Although healthcare shifted from inpatient care (even for "observation" or while patients underwent diagnostic testing) to outpatient/ambulatory care during the 1980s, the pendulum is swinging back again to inpatient care as people live longer and develop treatable comorbidities. The need for bedside nurses has never been greater.

Bedside nurses appear to fall into three groups: the new hires (mostly new grads) who struggle to stay afloat, the disillusioned (who vent on blogs and report that they are actively looking into other areas of nursing), and the dedicated few who have chosen to remain in bedside nursing. The bloggers paint a clear picture of the reality of bedside nursing. One nurse wrote that she feels like the William Tell Overture is playing and she must work at breakneck speed. Another wrote that demands from patients' families are particularly draining. He described how family members expect him to move furniture around the patient's room, set up cots, and know when the MD will be making rounds. He also wrote that he's seen the number of phone calls from family members go way up over the past few years, as families call him, and not the patient, to see how the patient is doing. He ended his blog by saying that at times, he felt is job is more PR with the family than patient care at the bedside.

Often a blogger will recap the details of a recent shift and describe how ten different things needed to be done at once. Bedside nurses have to prioritize care and express frustration that they cannot provide the level or quality of care that they want to provide. "There's little time to assess a patient, almost no time to talk to a patient," wrote one nurse who added, "and you can forget doing things that should be done like turning the patients and patient teaching. Discharge planning is done 15 minutes before the patient is discharged, if you're lucky."

Most bedside nurses work 8-12 hour shifts, are rarely done on time, and unlike other healthcare areas, which are closed on weekends and holidays, provide care 24/7. One nurse blogger wrote that her husband wishes he could work three 12-hour shifts a week ("he thinks this would be easy!") but he "does not understand how mentally, physically, and emotionally draining these shifts can be." Another nurse observed that bedside nurses are not a "robotic commodity" and that hospital administrators should recognize this and provide bedside nurses with the tools, resources, work schedules, and compensation they deserve. She added that bedside nurses also need to be "kinder to one another," which is the topic for next week's blog.