Mallory Buxton, BSN, RN
Founder & CEO, Solos- Concierge Nurse Patient Advocates
The Power of Touch, Myths about Higher Education, and Harnessing the Talent of Nursing Students
3 Major problems in America's healthcare system today:
1.) Nosocomial infections
2.) Chronic nursing staff shortage
3.) New grad RN's feeling ill-prepared to take care of their patients upon graduation
I have a solution for all the above.
Ask any new nurse if they feel prepared to take care of 5-7 patients straight out of nursing school and I can guarantee you the answer will be a resounding, "NO!" Ask any seasoned nurse (someone with 7+ years of nursing experience) if they feel their unit is adequately and safely staffed, and I will also wager there will be a strong, "No," reply as well. Now, let's ask nurse managers, directors and hospital executives what one of the biggest problems they face on their to-do list, and you will find nosocomial infections at the very top. (Nosocomial infections are infections that patients did NOT have before being admitted and are acquired in the hospital. Medicare & Medicaid do not reimburse hospitals for the care of patients who acquire these infections, so many unit directors & managers feel the heat to prevent these.)
My solution to nosocomial infections: It's easy. The power of touch. What I mean is we need to get back to bed baths, clean linens and emotional support. We do this and our nosocomial infection rates will plummet. Patients will have less anxiety, less pain and be clean therefore leading to less infections and complications ultimately leading to earlier discharges and less time in the hospital. Unfortunately though, nurses are being given more and more patients to care for on a 12 hour shift with less and less ancillary support. Support staff from nurse's aides to housekeepers to dietary aides are being cut and the simple duties such as taking out the trash or clearing the lunch tray fall on the nurse. I am incredibly happy to take out the trash, in fact there are few things that make me happier than a clean and organized room, but doing all these tasks for 5 patients severely limits the nurse's ability to: be a nurse. Basic hygiene, emotional support, and the pure joy of "getting to know your patient" go to the wayside. It's all nurses can do to pass their meds on time without getting "dinged" (you get in trouble if you do not scan medications and administer them within their schedule time frame) and hastily listen to breath sounds before copying & pasting an assessment. This is less than ideal, and I know many, MANY nurses are not fulfilled with this type of practice. Sadly, this is the case in every city and hospital I have worked in and with every nurse I have talked to across the country.
Now for the chronic nursing staffing shortage and the correlation to higher education: Units all across the U.S. are utilizing registry and travel nurses to meet their bare minimum staffing requirements. This is in part due to nursing burn out, budget cuts, rising insurance costs, stricter payout schedules from Medicare & Medicaid and also the idea that has been planted, watered and fertilized in in the nursing culture: Go back to school. Get your masters, PhD, NP (Nurse Practitioner), CRNA (Certified Registered Nurse Anesthetist) degree. Just go on and keep getting more degrees and you will be happy. This will make you more money, give you more letters behind your name and help you feel more satisfied at the end or your 14 hour shift. I know that this is controversial, but I'm going to go out on a limb here and tell you all that whoever "they" are (society, your friends, family, fellow nurses, doctors) they lied to you.
From my experience, friends, acquaintances and family who received advanced degrees beyond their BSN, none of them are any happier. And this is not that they are bad people or have poor attitudes. It can be attributed to the way our healthcare system is set up in America and the direction it is heading. Budget cuts will continue to happen and the providers and bedside nurses are the ones who feel the burn and sting of these cuts the most. The very place where we should be amping up our care to prevent nosocomial infections and spread love & compassion is the place that suffers the greatest: The bedside. Unfortunately the cutting of bedside care is the current solution in many hospitals and is very short sighted. It only exacerbates our healthcare problems. So here's my radical advice: If you're a nurse, don't go on to receive more degrees. You won't be happy. I'm just saying. You heard it hear first. Instead, search for your true passion and go after that.
And here is my solution for new grad RN's feeling unprepared after graduating nursing school AND the lack of ancillary support at the bedside: Let us have the nursing students perform more hands on care during clinicals! From bed baths to helping patients get up to the bathroom and ambulate after surgery to vital signs and critical thinking: Let's harness the immense work force of the nursing & medical students. Medical students would also greatly benefit from more hands on patient care. I know what a lot of you are thinking: Nursing students already do this. But not really. They are in constant fear of "doing too much" and being told to "Wait for your instructor or preceptor to get here." In the meantime patients are suffering. There is no substitute for human to human contact and touch. You can study all the textbooks in the world but caring for a living, breathing patient is a true art and something that is developed and refined over the years. This is an absolute win/win for everyone involved.
Here's why: Nursing & medical students get more hands on care experience, patients feel loved, nurtured and cared for thereby experiencing less pain, decreased healing times, lower blood pressure, increased serotonin & dopamine production, the list goes on... AND the hospital gets all this hands on help for FREE!!!!! Can I get an Amen? Nursing school did not prepare us in the least for real world nursing mainly because we did not get enough hands on experience. Let's have nursing students take patients assignments and relieve some of the strain off of the nurses working. Nursing students will feel so much better prepared for the "real world" of nursing and patients will benefit from the increased human interaction.
I'm anxious to hear what y'all think of these propositions. I hope they spur your thought process and help you to think & look differently at healthcare today. I'm also very interested on how artificial intelligence (AI) will disrupt our healthcare system and the nursing industry. AI is coming. It's not if, it's when it will be here and you're either being disrupted or disrupting when it comes to business. I intend for Solos - Concierge Nurse Patient Advocates to be on disrupting end of the spectrum. I'm not sure how we will do it, but with our main focus on the patient and a mission to end loneliness and ensure that no one ever feels afraid or alone I know that we are on the right path. Our target of helping 1B people will be incredibly more doable with the help of AI. Let us not be afraid of it, but embrace it and move humanity forward with the help of it.
Mallory Buxton, BSN, RN
An entrepreneur & believer