I do not know if anyone remembers my posts about being more assertive and such. I never want to say anything to the charge nurse because I do not want her to think that I can not handle things. Well, last night I was VERY busy will a fresh knee, fresh hip, and three other patients. The CN wanted to give me another admission. I was keeping my head above water but just barely. I said I can not take an admission right now. Maybe in a few hours once these two are settled but not now. She gave me a disgusted look but I felt so good. Maybe I am actually getting a spine. You know what is weird....she asked the three nurses that were maxed out to take the admission. Not the two who had an aid with them and room for one. We all said no. Sometimes I just do not know what she is thinking. The patient did not end up staying (it was an outpatient who was on the borderline of needing to spend the night). Yah me!!! Small victorys. (it would have been a different story if they was not room for this patient anywhere and he absolutely had to stay, but in this case, I could say no).

As a chronic but recovering people-pleaser myself...yay!

Right on, Stella!

WTG Stella!

OK... I keep reading this stuff... and I keep wondering... I must be really out of the loop, or used to the "olden days" ( yeah.. I'm OLD! Ask Tweety ! He'll tell ya ! )

Or perhaps it's because I've always just been an "employee" as opposed to a "professional" until recently. So please forgive what might appear to be a truly STUPID question here... can we.. MAY we as nurses "refuse" to take a patient if your CN or whoever says you have to take one? Somehow, it just goes so much against what I have been so used to all my 50+ years !

Not that I DISAGREE with your choice in this situation.. au contraire ! It's just that I probably would never have thought I had the "right" to refuse... not out of "people pleasing", but out of "habit", "upbringing".. or "whatever"... you understand?

Do nurses then HAVE a "boss" ( yes, I hate that word, too) or not? And who IS it? Do we get to make our own decisions as you did without repercussions, or are we expected to do as the "boss" (whoever that might be) directs?

I know I sound really dumb with this, but I really need this clarified. I read about you all not accepting assignments, or units, or a particular patient load, or admissions... and perhaps the "Germanness" in me says "WHAAAAAAT!!!??? Can dey DO dis??? "

You know... that submission to authority or "perceived authority" thing... of course being in the military myself plus being raised by a military officer and strict Austrian mother on top of all that only further contributed to this work ethic... so I'm kinda in the fog here as to what we can/may or can/may NOT do ! Still in my first year as an RN here, so please forgive my ignorance regarding these matters ! :imbar

Good for you Stella! renerian

Like I said there were other people that could have taken it. In situations where we are all maxed out but the admissions keep coming, I never say no. This just was not the case. This CN is famous for lopsided assignments. The CN leaves at 9pm, after that we do very well deciding as a unit who should take any admissions. We also team up and do them together to get them done. Sometimes I think we do better when the CN is not there.

Originally posted by nurse2be in ny

As a chronic but recovering people-pleaser myself...yay!

:chuckle Me too! Me too! Hooray for you, Stella! I remember your original post about the lop-sided assignments.

Originally posted by jnette

OK... I keep reading this stuff... and I keep wondering... I must be really out of the loop, or used to the "olden days" ( yeah.. I'm OLD! Ask Tweety ! He'll tell ya ! )

Or perhaps it's because I've always just been an "employee" as opposed to a "professional" until recently. So please forgive what might appear to be a truly STUPID question here... can we.. MAY we as nurses "refuse" to take a patient if your CN or whoever says you have to take one? Somehow, it just goes so much against what I have been so used to all my 50+ years !

Not that I DISAGREE with your choice in this situation.. au contraire ! It's just that I probably would never have thought I had the "right" to refuse... not out of "people pleasing", but out of "habit", "upbringing".. or "whatever"... you understand?

Do nurses then HAVE a "boss" ( yes, I hate that word, too) or not? And who IS it? Do we get to make our own decisions as you did without repercussions, or are we expected to do as the "boss" (whoever that might be) directs?

I know I sound really dumb with this, but I really need this clarified. I read about you all not accepting assignments, or units, or a particular patient load, or admissions... and perhaps the "Germanness" in me says "WHAAAAAAT!!!??? Can dey DO dis??? "

You know... that submission to authority or "perceived authority" thing... of course being in the military myself plus being raised by a military officer and strict Austrian mother on top of all that only further contributed to this work ethic... so I'm kinda in the fog here as to what we can/may or can/may NOT do ! Still in my first year as an RN here, so please forgive my ignorance regarding these matters ! :imbar

First of all, you do NOT sound dumb asking this. I'm getting near 50 myself, jnette, and have 1/2 German blood in me, as well, so I understand your questions. I also have had trouble being assertive and remaining passive with those in authority. But being a nurse for 10 years has made me stronger (and ANGRIER at times), and I have, at least once, refused to take another patient. I know it made the supervisor mad (we don't have charge nurses, unfortunately), but I KNEW it wasn't safe-- OR fair. But the hospital was low on beds that night and I ended up taking the patient, but another nurse admitted and took care of them. I also have frequently called the supervisor after an assignment was made to state my case for either delaying the patient coming to the floor or asking them to be reassigned elsewhere.

As it stands now, our nursing supervisor assigns beds through our unit clerk without asking a nurse. I am working on getting that changed.

"I am convinced that life is 10% what happens to me and 90% how I react to it." (Charles Swindoll)

That is so weird that you have this in your post. I was having a really hard time at work a while ago. My anxiety level was at an all time high. My mom told me about this 90-10 thing. She saw it on TV. It works for me. Whenever I am starting to get really stressed at work, I think 90-10, 90-10. She had a nice story and example to go along with it too.

Your response was not only for your benefit, but for the benefit of the patient's for whom you are caring. I used to feel guilty about saying no, but now, if I feel justified, I do not.

Originally posted by stella123 rn

"I am convinced that life is 10% what happens to me and 90% how I react to it." (Charles Swindoll)

That is so weird that you have this in your post. I was having a really hard time at work a while ago. My anxiety level was at an all time high. My mom told me about this 90-10 thing. She saw it on TV. It works for me. Whenever I am starting to get really stressed at work, I think 90-10, 90-10. She had a nice story and example to go along with it too.

I love the quote too, and can say I aspire to follow the 90-10 thing, but struggle with anxiety and being a bad "reacter" to that 10% more frequently than I'd prefer.

Stella, you took a step towards independent thinking and patient safety. Keep it up. You are the only advocate you have in situations like these, and the only advocate for patient care and safety at times. Do Not feel guilty .

Jnette;

I read with interest your question. I too am older and was brought up to be a people pleaser. Now, that said, if you read the above post, you will understand why at times we, as nurses and patient advocates, must say no. It does not show weakness or an inability to do the job we are asked to do each day. It shows we are thinking of what is best for the patient and our own ability to do the best job possible. I often have to ask the CN why she assigns certain patients the way she does, if the answer is just "you are the one able to take care of the patient", I point out that I am maxed out and she needs to rethink her options, like covering a less experienced nurse with this admit, or giving one of my patients to another nurse, since this patient requires so much care. No I do not always get my way, but I do feel that I have spoken up and attempted to point out concerns that she way have overlooked or alternate ways to do the assignment. Hope this helps.