"In the Eyes of an RN Nurse"

"Graduating from nursing school as an RN in 1995 was equal to embarking on a journey in my mind." There have been so many changes that it would take all year to describe them.  The biggest change and the change that has impacted the nursing field the most I think, has been the "decrease in reimbursement from Medicare." Feckers, C. "In the medical profession we would like to say that patient satisfaction and safety govern the decision we make I don’t believe that is always the case." Feckers, C. I think the major changes we have made have been to get better care for our patients, but to also get them in and out in a short time span to make money or break even. In 1991, the supplies were not limited, patients got a bath daily and the time for other care every night. "This began to change. I worked the evening shift and remember hearing the patients complain that the linen on their bed had not been changed since they came in." Feckers, C. This was just the beginning of the changes in patient care. Because of decreased money from Medicare, the number of hours allowed to be spent on each patient began to decrease, after that a bath took to much time. "Soon after our focus of care began to change our lengths of stay also began to decrease." Feckers, C. Patients would have to be let out of the hospital in shorter time, than a normal 3 days or week. We tried to keep patients healthy before they got to the hospital. We also started looking to the home health nurses and public health nurses, to help. "The home care nurses were given much more autonomy and began working collaboratively with the physician to maintain the patients health thus keeping them out of the hospital." Feckers, C. In the hospital the nurse has gained responsibility to care for the patient and work with the case management team to actually make the patient  be able to stay in the hospital. This, with the fact that patients were encouraged to help in their care and to call if they thought they have been released from the hospital too soon. Another HUGE change in the medical field in the last 14 years is technology. With technology entering the hospital older nurses and, the doctors are expected to use the computer to find things needed to care for the patient. This has been hard for many health care people. "The future will be interesting and exciting as nursing has changed so much since I began. Nurses will be required to do many things that are outside of the usual comfort zone." Feckers, C.