Reply With QuoteAaron IF you think the broken window theory really applies to nursing you probably won't get many replies here..
JMHO.. But we'll see...
WR,,, three commas for Becca
Hopefully, you already read my post with "The Broken Window Theory" in it, if not, please go here:
Broken Window Theory and then come back.
After reading this, I really got to thinking about how this applied to message forums, and how namecalling gets started, then escalates, and gets worse, and of course, the civil people give up trying to fix things and eventually leave.
Heck, when I started this site, it's all I thought about. How do we keep this place civil enough to keep good people here and bad people out!
Anyway, that led me to thinking about nursing, and patient care. Remember when you were just learning during clinicals, and all of the things that you weren't suppossed to do, but saw them being done by everyone but your clinical instructor? How many of those things do you now do?
Sorry, I'm getting away from my original point again.
After doing clinicals in nursing homes, and working in a few, (this goes for hospitals too, and any care setting for that matter, but I feel like it is really true in LTC centers) I have noticed that if something is NOT acceptable by any means, then it just doesn't happen. It also seems that if something can be gotten away with, it is done, or in most cases NOT done...
Many times I have seen CNA's or Nurses NOT doing their job because others accept the behavior. Residents laying in wet beds, not being turned, treatments not being done, etc.
I've only been out of school Since September of '03, so I don't speak from a lot of experience, however, I do remember being a student in some places and thinking, "how could you do this to someone!".
After being in and around a few places, I started work at a new job to make ends meet in addition to working on this site, and having a regular job. I work in a nursing home part time. After being at this job, I realized that it is much better in terms of care, than any other place I've seen.
I've decided that the reason for this is that complacency is not tolerated. CNA's will report other CNA's who do not do their job. The level of care there is good. I like that, and am enjoying working there.
However, one certain nurse had not been doing all of her treatments. This is something that isn't hard to do, and there is plenty of time to get them done if you just do your work. She was reorientated, and reprimanded, but allowed to keep her job. In my view, she continues to be apathetic in the care she gives. When a treatment is initialed and dated on a wound, then I know it wasn't done when it was suppossed to be done.
If that isn't done, and she knows it will be noticed, what about all of the little things that should have been done that couldn't be caught?
What about the people she works with and around, or anyone, God forbid, that she might train?
To me, this is the broken window theory at work and the reason so many LTC facilities don't provide proper care to their residents. The more it happens and is accepted, the more it will continue to happen, and even get worse...
Please share your thoughts on this theory and what you think. Do you agree that it has some bearing on our profession?
I know this wasn't presented in the best way, but I just decided to post about it and just started writing so please forgive me for that...
Aaron
Aaron IF you think the broken window theory really applies to nursing you probably won't get many replies here..
JMHO.. But we'll see...
WR,,, three commas for Becca
why is that?
Do you disagree?
how many times have you heard a nurse say they left their job because they thought their license was in danger at that place? ALL THE TIME!
Tell me those aren't the people who leave!
I do disagree because I think you can lead by example. And I believe that some people are never gonna change. No matter how much you try to change them.
I think the theory is one of self fulfilling prophecy and I don't want that in my life. Look for trouble and it will find you..
I would suggest another theory and that's the theory of attraction.. Wanting what you want and getting it.
I would suggest you read Excuse Me YOUR Life is Waiting by lynn grabhorn.
And I do think nurses are apathetic or they would defend each other but they don't...
JMHO..
WR,,, three commas for Becca
I don't think you will get much response because so many just don't care.. But we'll see.. We'll see if your theory holds true.. Maybe WE can prove it wrong..
Ya know many theorists just love it when they prove their theory correct.. After all isn't that the whole idea????
The theory seems to imply that upstanding people wouldn't trash a car without someone starting it.What the theory didn't explain was who was doing the trashing.. Could it have been the low life living in the area.. Maybe it wasn't the people who hadn't trashed it in the first place? Did they ever figure that out..
See, it's like some laws that are passed .. Every one thinks they are gonna solve problems. Now take the seat belt laws.. They do save money because people aren't in wheel chairs and unable to work and "taxing" the country with expensive care.. And besides the government seems to think it needs to protect it's people. And death has always been an unacceptable fate. But is it?? Is death worse for the dead than living? Or is it worse for the people left behind.. You loses?? Now one can say that seat belts saves the government and ultimately all of us money.. But let's look at it a different way.. Animals have a natural culling going on in their lives. Predators, diseases etc.. Now let's say that the car was invented to help with that culling process so we wouldn't overpopulate the earth. We have conquered many diseases, polio, smallpox etc that culled us previously.. But wait if all those people who should have died from diseases and car accidents etc don't die doesn't that put a huge burden on Medicare and our LTC and probably more of a monetary burden on us in the long run.. Think about it.. What appears as "good" may ultimately not be so "good"
WR,,, three commas for Becca
You're missing the point. It's about knowing right from wrong, but doing the wrong thing because it is "acceptable"
For instance:
A CNA leaves a resident in a wet bed for hours because she doesn't want to change them and knows she won't lose her job.
or...
The CNA knows it is unacceptable so she does the right thing.
The LPN doesn't do the wound care EVERY SHIFT because no one else ALWAYS does it and really, it isn't that big of a deal.
or...
The LPN does the wound care even though no one will find out if she did or not because that is the level of care that is called for and anything less is unacceptable...
I'm NOT going to work somewhere if the people on the other shifts aren't doing their jobs and the management won't fire them because they are short staffed.
I can't care for people 24/7...I can only care for them on my shift. It is up to management to make sure people are doing their jobs and when they don't have enough staff to begin with, they have to "settle"...
Therefore, you have to make the staff you DO have, realize that proper care is the ONLY OPTION...
wandering, your argument doesn't hold water. If you're going to say that then why don't we stop trying to find a cure for cancer, aids, diabetes, etc. because, after all, if we let everyone live, then there will just be too many people in this world!
Natural Selection and the food chain keep nature in check. The healthy survive because they can outrun their predator and the weak are killed off, strengthening the species...
I hardly think you can talk about humans in the same context.
So you are apathetic. You're gonna leave a patient without a wound dressing changed??? Because if you fold you let them know that it's ok too..
I do get the point .. The people who didn't trash the car lead by example.. Are you telling me that you know a CNA is not changing a wet bed and you are not doing any thing about it?? Are you telling me that you know anothe LPN isn't changing a dressing and you aren't doing anything about it.. YOU can't change a wet bed. YOU can't do a dressing change.. I've found in 24 years of nursing that when I do a better job those around me for the most part step up to the plate..
This is what I am saying you are looking for problems not solving them ... If you leave do you suppose that CNA is gonna change the bed now or that LPN is gonna start doing that dressing??? You are prepetuating the theory.
WR,,, three commas for Becca..
That lead by example is right. Some people are just plain lazy and will get away with doing as little as possible (that's in life not just in nursing) That's why there are supervisors around who should be telling them what to do. Some areas require less supervision then others.
If you are in that nursing home and in charge of those patients maybe you should be saying to that CNA several times a shift lets regroup what else needs to be done. Same with the LPN that is doing that dressing change. Have you asked those people why things aren't getting done? Maybe they have more on their plate then they can handle and need help but won't ask or maybe they are just putting it off.
The laziness is in every job not just nursing, but I've found that if I say come on let's (us) go change this bed, time for vitals, etc etc then the lazy do get moving more.
Posting Permissions
