is this typical ??? (long)

  1. please be patient...I am not really sure how to word some of this.
    as some of you may have read I have had, and continue to have, my struggles with my new dialysis job (just finishing week 5).
    I am beginning to notice some very real differences in the behavior of these personnel as compared to others that I have worked with in other settings. I do not know whether I am indeed in with a bunch of really unprofessional people, or whether this is just normal for dialysis and I am being overly sensitive or uptight.

    Background: We are in a somewhat rural area, 12-bed clinic. I am the only RN (yeah, pretty scary considering I have no clue what I am doing) - there are 3 LPNs and 1 tech.

    The LPN training me uses lots of profanity in front of patients... nothing horrible, but Sh@t, D#mn, etc....but still things I never would dream of using in front of pts. There are other comments, many of them, hard to summarize but just unprofessional in my opinion.

    The LPN that has been there the longest, who is right now effectively the lead nurse, seldom uses such language but just yesterday spoke of one of our noncompliant pts as being a "piece of SH@t"...while the man was dozing in his chair 3 ft. away!!!

    I mentioned in my other post how they all cackled for hours the other day over an electronic whoopee cushion that they were using to play jokes on the patients and their families. I was brought up not to joke about such toilet humor in public and was offended. The patients seemed to laugh and go along with it but did they have a choice?

    Now most of our pts are simple country folk, but I think they deserve the same respect and professionalism as any patients anywhere. To the nurses' credit, they do seem to clnically know what they are doing and to genuinely care about the patients, but their behavior appalls me.

    Lastly, coming from a hospital environment where HIPAA is beat into us on a regular basis, I cringe when I hear the staff discuss details about patients with other patients. I dont mean incidental disclosure, I mean for instance telling pt x about new pt y - her age, her diagnoses, her social situations, etc. I realize that they all spend a lot of time together each week and it is normal for them to get to know one another and inquire when one is out, etc., but shouldnt it be up to the pt what to disclose?

    OK gang...am I just really uptight and being a witch? do I need to just "get a life" and try to fit in with this? Are the standards of professionalism different in such an environment?
    OR am I uncomfortable for a GOOD reason? Do I just not fit in with this environment and should I just take my cues and try to exit?

    I am really sorry that this is so long and all over the place. so much of this is so hard to put into words. I love our patients but have never felt so out of place with a group of coworkers...and have never been treated the way that they have treated me.

    please be honest... I can handle it. I need to know.
    •  
  2. 12 Comments

  3. by   babyboomerRN
    OMG!!!!! where is your manager? he/she should be dealing w/this behavior NOW... keep in mind that yes, staff and pt's do become close and yes, they do form relationships that might be a little more "casual and laid back" than your typical nurse/pt.relationship but HIPAA is still HIPAA and being a professional in the clinic setting is still VERY important. if your manager and charge nurse will not help put a stop to this behavior than maybe that particular clinic is not the right environment for you. but try and stick it out, maybe your influence will help change things for the better for the pt's. good luck to you!
    Last edit by babyboomerRN on Jan 8, '06
  4. by   sunshine9
    I don't think that you are being uptight or a witch for feeling the way that you do. I would be cautious how you dealt with your feelings and the situation though. Because it is such a close atmosphere and they deal with these patients on such a regular basis they no longer associate between the caregiver/patient relationship. There has to be some type of boundary and that's where rules and regulations come in. Obviously they have let the familiarity and comfortableness with the patients take over in this situation. I'm not exactly sure how I would handle this situation because it is definately a difficult one to deal with. But I also agree, if it becomes to overwhelming, to look elsewhere for a job.
  5. by   mtnmom
    well I resigned today by mutual agreement (gentle pressure?) OK, I got fired I guess thats how to put it.
    first time anything like this has ever happened.
    I am in a small way relieved b/c my struggles are over. The nurse that fired me (an LPN) stated she knew from the first I wasnt going to make it , that she had never had an ER nurse come in and do well. (Go figure???)
    I am now just trying to regroup and look for other employment. I am hurt, bitter that I was lured away from a good job....angry at how I was treated by the staff at this place...disappointed that as hard as I tried it did not work out. I do love the patients and will miss them.

    I keep telling myself that this has got to be part of some grand design that God has for me....otherwise I really will lose it!!!
  6. by   Fiona59
    Call your old employer and ask if your positon has been filled! Chances are it hasn't. Put a positive spin on your situation, emphasize the new skills you have learnt and how you are now a stronger, more rounded nurse!

    Good luck.
  7. by   mtnmom
    why was I too stupid to see the "writing on the wall"? no job I have ever gotten as quickly as this one has been any good.

    I was told today that usually nurses are expected to be on their own and taking a full patient load in 3 WEEKS.....and I had been considered slow because I was not.

    Because I want to take time to thouroughly learn and understand something, and because I want to be a professional, it cost me my job.
  8. by   studentrn621
    Don't feel bad. I haven't been in dialysis long, but our nurses that are new to dialysis usually take about three months to train. If they are on the floor in 3 weeks they already know dialysis and they just need to become familiar with the machine. Maybe try another clinic. Good Luck!
  9. by   AmyLiz
    Quote from mtnmom
    I was told today that usually nurses are expected to be on their own and taking a full patient load in 3 WEEKS.....and I had been considered slow because I was not.
    That's a load of you-know-what. The center that I work with has orientation/training for all new-hires (RNs, LPNs, and Techs) that lasts around 8 weeks. 4-5 weeks in class training, then preceptorships afterward. No one is expected to know what they're doing that soon. Sounds like a blessing in disguise that you got out of that clinic!

    That being said, I too get rather fed-up with staff behavior (or would that be misbehavior?) at the center where I work. I've likened it on some days to working at Romper Room. Seems to be several people who are chronically late or who call off sick constantly. Then there are a few gals there who are so LOUD that it drives me up the wall. Yelling across the clinical area, laughing and carrying on. Drives me insane. There is a huge lack of respect for fellow staff members and management. People talk behind other people's backs (and sometimes in front of them!), hold grudges, etc. Some folks flat out refuse to take care of certain patiens for one reason or another...it's ridiculous. Frankly, I don't mind the work, but the people I'm working with drive me insane most of the time.
  10. by   jnette
    Wow, mtmom................ that really bites !!!

    Sounds to me like there was some professional jealousy going on there.
    You were the professional outsider, and they didn't want their ways interfered with.

    I agree with those who say the line about "three weeks" is a crock, because that's exactly what it is! 6-8 weeks is neccessary before taking on a full patient load, and you cannot expect to feel truly comfortable until one year in the field.

    Heck, it takes about three weeks just to get the machines downpat.. to be able to set them up properly each time. And they know that, too, they were just giving you a line of bull.

    As far as the "familiarity" with the patients, yes, that DOES happen in most units, but again, there's a line. While we do feel like "family", we also keep it professional. We joke around, and carry on with them, and they do reciprocate, and enjoy it. But we do NOT cuss in front of our patients.. that would be unprofessional in ANY setting. Nor do we pry into their personal business, or reveal our own. We let the patients share with each OTHER to their own hearts' desire, but we don't offer information about one patient to another patient.

    Dialysis is certainly more lax about HIPAA due to the familiarity aspect, but even so, we do try to teach even our patients about privacy issues when they begin to inquire of other patients.

    It's sad.. you would have been a wonderful asset there. But I think this is what the banana bunch feared. The party would be over for them. Really a shame.

    Not ALL units are like this. Our unit is a wonderful, caring, lighthearted, yet professional unit.

    And we would rather die than call in sick ! :chuckle Not that we wouldn't want to at times, but we care about each other (our colleagues) too much to put anymore undue stress on them, as well as for our patients. So yes, we really have a good team. As always, there's going to be a little bickering here and there, but you have that in the BEST of "families", right?

    I'm so sorry to hear this. I do hope you can find something where you will feel accepted and comfortable.. SOON (((HUGS)))
  11. by   steelcityrn
    Sounds like the job was all wrong for you. Dialysis work is not for many. Don't feel bad, you gave it a shot. Think out your next move well and move on!
  12. by   Mastersby2011
    I have been in dialysis over 14 years, worked for two different clinics and both facilities gave at least 3-4 months to train. You are better off there but don't give up on dialysis. It is a great field to be in. I would have been fired too, because I would have had them turned in to the state for that type of behavior and breaking confidentiality. Sounds like a horrible place to work and a very unhealthy patient area. Sure patients worry about each other they are like family, but if the patient wants to tell them that is fine, it is not up to the staff to be the informants. I am glad you have the ethics to not want to be in that type of situation. Good luck on what ever you decide to do.
  13. by   mtnmom
    OK, I have taken the big step and filed a complaint with the BON against the 2 LPN's in the clinic who were the most unprofessional.

    I hope it was the right thing to do - at least maybe something will make them sit up and look at how they are conducting themselves. If it will make the environment in that clinic better for the patients in the long run - then so much the better.

    At least if the nurses conduct themselves in a professional matter then the patients will be more comfortable and more apt to follow teaching that is given, IMO

    As for me, I am on to the next thing whatever that is - still looking for a job
  14. by   trvlnRN
    Sorry it didn't work out for you. It is a shame that your dialysis experience was such a negative one. That is obviously a very unprofessional group you were working with. HIPPA violations! Were was the manager?! This company/clinic could find itself in a lawsuit if this behavior continues....that being the case....it's best you aren't there. Good luck to you.

close