I recently saw an article about Vanderbilt University Medical Center’s nursing staff.

The administration there came up with the brilliant idea of cutting back on the housekeeping staff and making nurses do some of the cleaning, though it’s not specified how much. Nurses would be expected to take out the trash and linens, and mop up spot cleans on the floors, among other things.

They mentioned Florence Nightingale. But good ol’ Flo didn’t work these days when nurses do much more than light lamps, give baths and put warm compresses on people. She wasn’t responsible for titrating IV medications, giving chemotherapy, or bringing someone back from cardiac arrest. And she didn’t have to document everything she did in an EHR either.

The response of the administrators to backlash from the nurses was to tell them not to vent about it to the patients, to go to the administrators and vent. That heavy-handed approach always backfires. People are already talking about it in online nursing forums and other social media. No one trusts the higher-ups, few people want to risk their job by speaking up. The truth comes out in other ways and makes its way to the mass media.

Does the administration really believe patients live in a vacuum and are incapable of independent thought? That they don’t  observe what their caregivers are doing as they watch them work and see how stressed they are? Does it make them feel good about their health care when they know their nurse is trying to juggle 5 or more patients at once and is being pulled in 3 different directions all at the same time she or he is giving them their medications?

I can vouch for the fact that my coworkers and I regularly remove trash, linens, and meal trays, clean chairs between patients, wipe down surfaces, keyboards, computer equipment, pumps, and so on throughout the day. I don’t have a problem with that. We do it when we have time, but if we don’t have time, we page housekeeping.

Spot mopping in a hospital isn’t just mopping up spilled Jell-O. It’s more likely drippy Clostridium difficile-infected diarrhea, that is super contagious. Or Hepatitis-infected blood that can carry transmissible virus from hours to days on a surface. Or any number of viruses, bacteria, or fungi that would like nothing better than to find their way to an immunocompromised host and have a feast, i.e. you or your family member in a hospital bed.

Housekeepers are trained in what cleaning solutions to use for different spills, how to properly dispose of things, and how long things need to be scrubbed, cleaned, and dried so they are infection-free. Nurses do not get that kind of training.

Nurses are trained in physical assessment, applying both critical thinking and highly technical skills to our knowledge of physiology, disease processes, pharmacology, safety, and optimizing patient outcomes for quality of life, along with saving lives.

Vanderbilt is a Magnet institution. These days, Magnet sounds like a bunch of academic and administrative types shilling for their own industries. It’s a marketing ploy that doesn’t even work as a recruiting tool anymore. Nurses see right through people spouting “Get a BSN” out one corner of their mouth and talking out the other side, “Clean rooms too.”

I’m sure they have a special course in the bachelor of science in nursing programs for learning how to do basic housekeeping.

Magnet proponents prop up higher education, cranking out excuses for offering jobs that don’t show promise of any upward mobility. Promotions are few and far between in nursing. There’s almost unlimited lateral opportunity, if you’re interested in getting a few cents a year pay increase for experience and no more influence over the way things are done in your workplace. If you want nurses to get more education, great. Treat and compensate them like professionals, instead of slave labor. Don’t burn them out in a few years.

Do Magnet institutions back their claims of nurses needing BSNs with financial incentives? Sometimes they’ll offer a pittance for tuition reimbursement, with negligible or no increase in pay for the degree. Education is not cheap. It could take a working nurse with an associate’s, or even a bachelor’s in another field, five years to complete a BSN program going one course at a time in order to be fully reimbursed.

Nurses are too afraid to speak up in their organizations and be vocal. Is it really worth staying in a job that beats us up, burns us out, and ruins our health? If all we do is cower in the corner all the time, we might as well dig ourselves a shallow grave and tip over in it right now, next to Florence. Nurses, remember that apathy and fear are as good as death, and in the case of health care, might just be the equivalent thereof.

Alene Nitzky is a registered nurse who blogs at Journey to Badwater.

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