-nursing gets no love.
-patients have gradually increasing in acuity to a point it's dangerous.
-not my job is a big problem. PT will search for nursing staff rather than help a patient to the bathroom
-EMR is unstable and rigid. no place to put own notes to describe something
-no training for equipment.
-culture has gotten more "watch your back". more favoritism. management is more remote and less involved on the floor.
-adverse events are viewed as isolated rather than patterns. example: falls. not the result of short staffing/high acuity but not answering lights.