May I vent about rural hospitals? LONG rant! - page 2

I agreed to work ICU at a local rural facility. When I arrived for the first time, as usual 'nobody had time' to orient me properly (the norm) so I poked around and got my bearings. It was a 5... Read More

  1. by   Spidey's mom
    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
  2. by   4EverStudent
    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.
  3. by   Hellllllo Nurse
    Quote from mattsmom81
    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!
  4. by   mattsmom81
    Quote from Hellllllo Nurse
    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

    But things were better way back then too...not like now. :uhoh21:
  5. by   mattsmom81
    [QUOTE=4EverStudent]. 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)
  6. by   mattsmom81
    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.
  7. by   AmethystVeralyn
    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?
  8. by   Destinystar
    usually changing shifts and getting more education will get one out of the type of scene that you were describing.
    Quote from amethystveralyn
    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?
  9. by   nightingale
    Quote from AmethystVeralyn
    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.
  10. by   mattsmom81
    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.
  11. by   AmethystVeralyn
    Quote from mattsmom81
    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.
    Last edit by AmethystVeralyn on Jul 23, '04
  12. by   barefootlady
    Amethyst, I know and fully understand some of these situations can cause added stress and added work to an already overloaded day. I know being made to feel like the "left out" member on any nursing team can hurt and cause deep feelings of anger/resentment. Most especially when evals are usually good. Please try to find some stress counselling in your area. Once a person goes through a situation like the one you were in and it goes on for a long time, there are always residual issues that need to be resolved. You sound like a kind, caring, knowledgeable nurse. I hope your job situation has improved . Let us know how it is going with you.
  13. by   jeepgirl
    that is so scary! i can't believe that they just dropped a GN in the ICU to let her run wild!

    in our units, our gn's get at least 12 weeks floor in addition to hospital orientation. also, they usually get an extra couple weeks.
    it is written in our policy that a new grad will not be in charge of a unit.

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