May I vent about rural hospitals? LONG rant!

mattsmom81 · May 17, 2004

Good point Scherzo...and I may have to resort to Safe Harbor in my current job...I have gone on staff at a relatively rural LTAC hospital with a small ICU and they are wanting us to take some fairly sick patients without appropriate resources. I have pulled Safe Harbor forms up from my BON and placed them in my locker.

allnurses Guide · May 17, 2004

Of course I'm gonna have to come to the defense of my little rural hospital. :) We have great and fairly young docs . . .29, 44, 46, 52, 54, 55 and 60. Have a well-trained 3 bed ER staff (EMT's, Paramedics, MICN's). Surgery crew that is awesome. Ortho and general surgeon. Labor and Delivery. 17 Acute beds. The nurses never have over 6 patients. We usually work with two RN's and two CNA's. Our DON is awesome and very supportive.

Of course we have no true ICU patients but we do have Heparin drips, Dopamine drips, Insulin drips, Cardiac patients on monitors, etc.

It can be boring at times . . .and then all heck can break loose.

steph

4EverStudent · May 19, 2004

I am sorry but I have to defend some rural hospitals as well. They are a valuable assest. I have worked in both and am now in a large hospital and still work prn at a small critical access hospital. The rural hospital usually has a better patient to nurse ratio and the nurses work together as a team. Thier staff is just as knowledgeable as the ones I work with in the larger hospital. In this state LVN's are allowed to push IV drugs so it surprised me when I heard that complaint. In the smaller hospital we do have surgery day; mostly outpatient minor stuff. We get alot of trauma in the ER in the rural hospital and we stabalize many before transferring them out. The patients and thier families love being able to stay close to home and are grateful for the good care they recieve. Especially the elderly spouses who can't drive to the nearest hospital. In the large hospital I work for new RN's are constantly requesting the ICU and ER and night positions usually so that they can just get thier masters requirement so that they can go on to become a NP. I have also worked as a traveling LVN and worked with RN's that didn't know that blood hemolyzed and need to be transfused within 4 hours or even how to check to see if the patient was having a blood transfusion reaction because they felt that it was ok to start the transfusion with a temp of over 103. When I the lowly LVN pointed out this I was told that just to stop the blood medicate and restart it later when thier temp went down. I also had to point out the irregularities in the patients heart rate. When I questioned the RN who was giving me report they didn't know what her rhythm was prior to the blood transfusion was the patient ended up transferred to ICU. When I asked for the forms for possible blood trasnsfusion reaction I was informed that "they" don't do that and the RN in charge just told me to throw the blood away. This was a smaller hospital but not what you are referring to. My point is I was offended by that you would have to work with LPN's and do thier work as well as yours when I have worked with and have had to clean up after many RN messes whether it be a rural hospital or a large one. I would rather work with the staff that works together for the patients well being no matter where that it.

Hellllllo Nurse, BSN, RN · May 19, 2004

This new grad was all puffed up they were letting her in the ICU...I gave her the CYA talk with plenty of warnings...reminded her she would likely be alone at night in this ICU very soon...her eyes got real big and hope she's thinking about what I told her.

Sounds like this new grad does not have the sense to know better. Hospitals love these types!

When I was a new grad, a hospital tried to put me in ICU, with no orientation or training whatsoever. I refused. They replied "We think you are selling yourself short. You can do it!"

Big sales pitch, haha. "'Won't you come into my parlor', said the spider to the fly...."

I said "No thanks. I know better."

I agree with another poster- You're wise to stear clear of that place!

mattsmom81 · Jun 1, 2004

Big sales pitch, haha. "'Won't you come into my parlor', said the spider to the fly...."
I said "No thanks. I know better."

Yup. LOTS of hospitals operate this way don't they? Give a young nurse a title and a little praise and they can swindle...er,talk...her into anything...

Actually I was talked into my first charge position in this same way :rotfl:

But things were better way back then too...not like now. :uhoh21:

mattsmom81 · Jun 1, 2004

. My point is I was offended by that you would have to work with LPN's and do thier work as well as yours when I have worked with and have had to clean up after many RN messes whether it be a rural hospital or a large one. /QUOTE]
Hmmm.I don't see anywhere in this thread where anyone mentioned not liking to work with LPN's...and I sure didn't say that (I used to be one myself)

mattsmom81 · Jun 7, 2004

I did not mean to insult those of you who enjoy your small rural hospitals...and I've certainly been dumped on at inner city mega hospitals too. Just not in the same way...

As a nurse returning to agency work. I need to remind myself the important questions to ask before I take an assignment at a rural facility, so I am not caught off guard as the only RN in the building, etc. This can happen especially at night (which is my shift of choice). I am kicking myself for not asking the right questions, then being overwhelmed by the responsibility I carried..

I've had some wonderful shifts at smaller rural hospitals...the people there are generally very nice and friendly, the environment more relaxed than the metroplex hospitals. :)

AmethystVeralyn · Jul 22, 2004

A very long gripe held back for several years.

Could someone please give me some advice.

I worked in a place for five and a half years where a certain hand full of staff members were always playing head games.

They would insult me by demanding that I work alone

while the rest of them all worked together and would refuse to

offer me any help with transfers and would also go out on breaks

together without stopping to ask if I needed help.

I always made it a point not to do this to anyone and always offered to help the others before I left the floor.

For a few months when I worked on the day shift

they stuck me on what everyone knew

was the hardest patient goup in the building, eg. "We have to do something about

group six...maybe we'll put K. on it." I jokingly answered

"What did she ever do?" The next thing I knew

it was not her but me that was on

group six with no explanation and they refused to offer

their assistance, and then acted like I was being unfair to them

because I couldn't finish my assignment in the required amount

of time. They were insinuating to me that I was refusing

to help them put away clean laundry

because I wanted to take advantage of them

when they really knew I couldn't

finish my assignment early enough to help them.

They also probably knew that I was

working with no breaks and about five minutes for lunch.

Sometimes they would REFUSE to help me with transfers

on patients who were officially two person transfers and demand

that I transfer them alone

and then would get enraged

when I would refuse to threaten the patients safety this way.

Then someone had the nerve and audacity to write

that I was, "very bossy to fellow staff members..."

when it's the other way around and I was

very blocked when I needed to stand up to them.

Sometimes I would try to reason with them and

they would go deaf and report me to the supervisors.

During these episodes no one took time to hear

the actual facts when they insisted on putting words

in my mouth and making me out to be taking advantage of them.

There was one episode where a girl REFUSED to help me transfer HER patient after I answered her signal light.

She said, "I'm taking care of Mary," when it appeared

that she was really just standing there and did not

have Mary in process.

At this time I was already busy

with my own patient group which was still the

hardest one in the building

and I had to get a visitor to help me (the patients

daughter in law) However, this girl, instead of saying

she was sorry she reported me to two supervisors for

telling the daughter in law that she,

"disappeared" (a nice way of saying she was rude)

One of these supervisors immediately scapegoated

me, "Why didn't you finish care on Bessie?"

Then she claimed that the girl who

refused to help me in the first place, "would reciprocate,"

when this hadn't been the case with some of my co workers

for an extended period of time.

As if this wasn't enough they lied to the

supervisors and the DoN on a number of occasions, always

claiming that I wasn't working as, "part of a team." The reality

was that they would sit in the nurses station

and watch me

answer their lights and do things for their patients

and would refuse

to admit that I ever did anything for them or they

would, "go out for a smoke."

I am always forgiving on people

who forget to say thankyou but when they lie

and make it appear that I'm

taking advantage of them it always

sets me into a rage.

So I had to sit in the DoNs office after they turned me in for allegedly not participating in teamwork and I had to listen to her put words in my mouth and

assign attitudes and opinions to me that were not my opinions.

She then refused to listen to my side of it.

Also around this time period, when I was done

with my work on my wing I would go help the

others on the other wing (the harder wing)

until one charge nurse insisted that, "you don't have to help them."

I realize now I was wrong to go along with her

on this. I should have gone to help them anyway and

explained my reasoning.

But nowhere did I ever hear anyone say,

"You were good about helping on the other wing why don't you do it now??"

Instead they went blind and acted like I never helped them.

No matter where you work the game of, "You're

not gonna help me," and the game of, "She can't do it by herself,"

are not part of being a team!!

In these cases they are bullying

people who are more than glad to help them and making up

their minds for them.

One night I was doing hs care on an abusive patient who belonged to another girl because she was nervous about

taking care of her.

I had done this for

a number of weeks because of my concern for this patient and

because I wanted to help the girl assigned to her. While I was taking care of her one of the girls I was

working with reported me to the charge nurse (the same one who

scapegoated me when I couldn't get help with the transfer)

and she came in the room and started screaming

at the top of her lungs

that "We are a team!! ...You're the only one

not working as part of a team!!"

Then they were smug

because she was screaming at me like I was some sort of

an idiot.

As it turned out

there was a new rule that on my assignment

that I was supposed to

put gowns on all the patients

but they didn't bother to tell me

this until it was too late to follow through

so they had it looking like I, "wouldn't gown the residents," just to be a jerk.

I think on some level they knew

if I had known this

I would have made sure I did what they asked.

Later on one of the charge nurses friends who worked

on the other wing told her, " I heard you over their screaming

at her....." and I had commented to her that, "I couldn't read

their minds!!!"

I also was sometimes confronted with things I

actually did, at which time I appreciated the feedback

of various people which included visitors.

During these times some other people would

complain about the way the were treated by other

staff members.

Some of them were excellent nurses

and they quit.

I discussed these problems at great length

with the assistant DoN and again with the DoN

and with one floor supervisor

and was shocked to find that none of these discussions ever

made it into my file including one where every single thing I

said was written down word for word.

Instead there is a written comment that I am

"not a team player," that stares me in the face when

I open my file. There was no mention of the fact that they deliberately set me up.

They constantly demanded that I do, "the onsies," while they refused to help me and refused to communicate and

then went out for a smoke while I worked without breaks.

They tried to make certain patients into, "onsies," that really were not one person assists and then they would

bully people into moving

them alone just because some other people could move them.

I always made sure

I never forced anyone to transfer a patient alone when

they asked me for help but no one would ever acknowledge this.

Over the years my evals hardly ever reflected the problems

I was having on the floor and instead told me I was an

excellent worker. This made it confusing when I thought

about quitting.

My husband suggested, "they're trying to make it so miserable

for you that you have to quit."

I finally did quit when I realized that their game of lying and going deaf had no solutions.

What should you do when people in your work place

are in a habit of twisting the truth and are accusing you

of things you're not doing and you can't afford to quit?

Destinystar · Jul 22, 2004

usually changing shifts and getting more education will get one out of the type of scene that you were describing.

a very long gripe held back for several years.
could someone please give me some advice.
i worked in a place for five and a half years where a certain hand full of staff members were always playing head games.
they would insult me by demanding that i work alone
while the rest of them all worked together and would refuse to
offer me any help with transfers and would also go out on breaks
together without stopping to ask if i needed help.
i always made it a point not to do this to anyone and always offered to help the others before i left the floor.
for a few months when i worked on the day shift
they stuck me on what everyone knew
was the hardest patient goup in the building, eg. "we have to do something about
group six...maybe we'll put k. on it." i jokingly answered
"what did she ever do?" the next thing i knew
it was not her but me that was on
group six with no explanation and they refused to offer
their assistance, and then acted like i was being unfair to them
because i couldn't finish my assignment in the required amount
of time. they were insinuating to me that i was refusing
to help them put away clean laundry
because i wanted to take advantage of them
when they really knew i couldn't
finish my assignment early enough to help them.
they also probably knew that i was
working with no breaks and about five minutes for lunch.
sometimes they would refuse to help me with transfers
on patients who were officially two person transfers and demand
that i transfer them alone
and then would get enraged
when i would refuse to threaten the patients safety this way.
then someone had the nerve and audacity to write
that i was, "very bossy to fellow staff members..."
when it's the other way around and i was
very blocked when i needed to stand up to them.
sometimes i would try to reason with them and
they would go deaf and report me to the supervisors.
during these episodes no one took time to hear
the actual facts when they insisted on putting words
in my mouth and making me out to be taking advantage of them.
there was one episode where a girl refused to help me transfer her patient after i answered her signal light.
she said, "i'm taking care of mary," when it appeared
that she was really just standing there and did not
have mary in process.
at this time i was already busy
with my own patient group which was still the
hardest one in the building
and i had to get a visitor to help me (the patients
daughter in law) however, this girl, instead of saying
she was sorry she reported me to two supervisors for
telling the daughter in law that she,
"disappeared" (a nice way of saying she was rude)
one of these supervisors immediately scapegoated
me, "why didn't you finish care on bessie?"
then she claimed that the girl who
refused to help me in the first place, "would reciprocate,"
when this hadn't been the case with some of my co workers
for an extended period of time.
as if this wasn't enough they lied to the
supervisors and the don on a number of occasions, always
claiming that i wasn't working as, "part of a team." the reality
was that they would sit in the nurses station
and watch me
answer their lights and do things for their patients
and would refuse
to admit that i ever did anything for them or they
would, "go out for a smoke."
i am always forgiving on people
who forget to say thankyou but when they lie
and make it appear that i'm
taking advantage of them it always
sets me into a rage.
so i had to sit in the dons office after they turned me in for allegedly not participating in teamwork and i had to listen to her put words in my mouth and
assign attitudes and opinions to me that were not my opinions.
she then refused to listen to my side of it.
also around this time period, when i was done
with my work on my wing i would go help the
others on the other wing (the harder wing)
until one charge nurse insisted that, "you don't have to help them."
i realize now i was wrong to go along with her
on this. i should have gone to help them anyway and
explained my reasoning.
but nowhere did i ever hear anyone say,
"you were good about helping on the other wing why don't you do it now??"
instead they went blind and acted like i never helped them.
no matter where you work the game of, "you're
not gonna help me," and the game of, "she can't do it by herself,"
are not part of being a team!!
in these cases they are bullying
people who are more than glad to help them and making up
their minds for them.
one night i was doing hs care on an abusive patient who belonged to another girl because she was nervous about
taking care of her.
i had done this for
a number of weeks because of my concern for this patient and
because i wanted to help the girl assigned to her. while i was taking care of her one of the girls i was
working with reported me to the charge nurse (the same one who
scapegoated me when i couldn't get help with the transfer)
and she came in the room and started screaming
at the top of her lungs
that "we are a team!! ...you're the only one
not working as part of a team!!"
then they were smug
because she was screaming at me like i was some sort of
an idiot.
as it turned out
there was a new rule that on my assignment
that i was supposed to
put gowns on all the patients
but they didn't bother to tell me
this until it was too late to follow through
so they had it looking like i, "wouldn't gown the residents," just to be a jerk.
i think on some level they knew
if i had known this
i would have made sure i did what they asked.
later on one of the charge nurses friends who worked
on the other wing told her, " i heard you over their screaming
at her....." and i had commented to her that, "i couldn't read
their minds!!!"
i also was sometimes confronted with things i
actually did, at which time i appreciated the feedback
of various people which included visitors.
during these times some other people would
complain about the way the were treated by other
staff members.
some of them were excellent nurses
and they quit.
i discussed these problems at great length
with the assistant don and again with the don
and with one floor supervisor
and was shocked to find that none of these discussions ever
made it into my file including one where every single thing i
said was written down word for word.
instead there is a written comment that i am
"not a team player," that stares me in the face when
i open my file. there was no mention of the fact that they deliberately set me up.
they constantly demanded that i do, "the onsies," while they refused to help me and refused to communicate and
then went out for a smoke while i worked without breaks.
they tried to make certain patients into, "onsies," that really were not one person assists and then they would
bully people into moving
them alone just because some other people could move them.
i always made sure
i never forced anyone to transfer a patient alone when
they asked me for help but no one would ever acknowledge this.
over the years my evals hardly ever reflected the problems
i was having on the floor and instead told me i was an
excellent worker. this made it confusing when i thought
about quitting.
my husband suggested, "they're trying to make it so miserable
for you that you have to quit."
i finally did quit when i realized that their game of lying and going deaf had no solutions.
what should you do when people in your work place
are in a habit of twisting the truth and are accusing you
of things you're not doing and you can't afford to quit?

nightingale, RN · Jul 22, 2004

A very long gripe held back for several years.
What should you do when people in your work place
are in a habit of twisting the truth and are accusing you
of things you're not doing and you can't afford to quit?

I am sorry about your former situation.

Hopefully, the answer is you can have another job waiting for you.

mattsmom81 · Jul 22, 2004

Sounds like a hostile place to work and hopefully you can find something different. If you must stay, you need to seek help from someone above you in the organization who can help you. Do you have an employee assistance program? Union? supervisor you trust who can advise you how to proceed? Remember if your eval says something negative it must be discussed with you and you must have the opportunity to respond...I would write all over that eval myself and ask for more details of whys, wheres, and whos..

We've discussed bullying and mobbing behaviors quite a lot and if you do a search you will find many discussions. Sometimes these places are too far gone/dysfunctional and the only thing we can do is get the heck outta Dodge. Best wishes and hope things go better for you soon.

AmethystVeralyn · Jul 23, 2004

Sounds like a hostile place to work and hopefully you can find something different. If you must stay, you need to seek help from someone above you in the organization who can help you. Do you have an employee assistance program? Union? supervisor you trust who can advise you how to proceed? Remember if your eval says something negative it must be discussed with you and you must have the opportunity to respond...I would write all over that eval myself and ask for more details of whys, wheres, and whos..
We've discussed bullying and mobbing behaviors quite a lot and if you do a search you will find many discussions. Sometimes these places are too far gone/dysfunctional and the only thing we can do is get the heck outta Dodge. Best wishes and hope things go better for you soon.

---------------------------------------------------------

A very long gripe continued.

In this place there was no help for employees having

problems unless you wanted to talk to the DoN

or nursing supervisors who were sometimes

very biased or so overwhelmed with work that they

were asking

their co workers to leave them alone.

The supervisors that were willing to support me

either resigned because they were being given a

hard time by the other nurses

or they did not always work the same

shift or the same wing.

It was confusing to have a near excellent eval

every year and then have people tell you

the complete opposite of what it says.

I also forgot to mention that I did change

shifts three times during the years of my

employment and in so doing

put myself through the ringer. Each shift had

their own set of problems

including that on the day

shift I was told by a girl I did rounds with,

"We don't have time to wash them in the afternoons

so we just change them,"

It was after I reported this

to the DoN and she confronted them that they all started working in groups

and refusing to work in the same room with me.

Then they switched it back on me and said I was not

working as part of a team when it was really that they were refusing to let me work with them.

When I changed from the day shift to the evening

shift there used to be days

when the day shift

nurses would be filling in on the evening shift

so I could never really escape from them.

I was also infuriated to find out that the game of,

"You do the onsies," was transferred from the day

shift to the evening shift, when it used to be that

three girls would work together from one end of the hallway.

The advantage of this is that someone

you hated earlier sometimes becomes someone you like because we were not permitted to isolate them. This way,

I often found out that someone who infuriated me in the past would turn out to be someone I learned to appreciate.

This way also, there was no way for anyone to claim

that, "she's not helping us," when the fact is they

deliberately set them up and are refusing to support them.

It also protected patient safety because the

so called, "onsies," are not being transferred alone

by people who are too intimidated to ask for help with them.

I did have one co worker who changed off our shift

to get away from the same charge nurse I had

a problem with (described above) and she was

glad she did.

As for getting answers about the negative

feedback I did ask a lot of questions

and was not able to get details. As I found out later I was understood to be saying, "I don't understand

the problem," when that was not the issue

and I hadn't said that. When I was confronted I often took the opportunity to discuss my concerns about the patients

but in the end I didn't even get credit for this.

Charge nurses should ask questions

like, "Is there a reason why you didn't...."and

then listen to your response

instead of making assumptions about your

attitude like the ones I dealt with.

They could also benefit by asking, "did anyone tell

you that you were supposed to........"

or, "You mean you actually told her to do this and

she wouldn't cooperate.??" (which is what they made it look like)

The same people that refuse to help with transfers

are said to be working as a team when they are

really just working as a click.

They are also displaying a blatent lack of concern for

patient safety.