"And it's all going to be your fault"

Nurses General Nursing

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You know, I've been thinking....

Dangerous pastime, apparently, because the more I think about this, the madder I get. I am not doing my blood pressure any favors here.

I have been a member for a while now, read these threads even before I became a member, and I have noticed a disturbing trend. I am wondering if anyone else has as well.

It all our fault.

I don't care what happens, who does it, who causes it, the nurse gets blamed. Management backs up the customer-cum-patient, admin backs up the managers, HR backs up the admin.

So, I dreamed this little warning label of sorts up for all those wide-eyed, fresh-faced nurses-to-be out there. I wish someone had told me what I was getting myself into.

Dear Soon-to-Be Nurse:

A Friendly Warning. It's all going to be your fault.

After school, you'll get a job. You'll be ready to take on the world. Get ready. It's coming.

You'll get asked for medical advice by every family member, friend, relation, acqaintance, and person you don't even know that gets wind that you are a nurse. One of 4 things will happen:

1) You will advise them, they will not follow the advice. They will not get well. And it's all going to be your fault.

2)You will tell them that you would rather not advise them, that they need to consult their regular doc. They won't do it amd that won't get well. And it's all going to be your fault.

3) You will advise them and the advice will not help and the y will not get well. And it's all going to be your fault.

4) You will advise them, they will get well, pass along the advice to a friend, who had a DIFFERENT problem, and he will not get well. And it's all going to be your fault.

You will go to work. You'll go in to meet your patients for the day (or night). You'll smile and be perky. They will complain because they just found out that they have a dreaded disease and they don't want to be smiled at. And it's all going to be your fault.

You'll go in to see your next patient, still upset by the reaction of your first, and are a little less upbeat. They will complain because they have had a bad day and they think that their nurse should be happy just to serve them. And it's all going to be your fault.

The doctor did not order the pain medicine that Patient Number 3 ordered because the patient is a known drug abuser who is only in for his fix. The doctor explicitly states in his orders that he is not to be called for orders for pain. That patient refuses to accept this. And it's all going to be your fault.

Patient Number 4 is NPO, and Aunt Katie can not understand why he can not have something to eat. After all, he's hungry, and you are starving him to death. All the other nurses fed him. You're just mean. And it's all going to be your fault.

The doctor comes in to see Patient 4 and finds him wolfing down pizza that Aunt Katie brought him because she knows what he needs better that you do. They snuck the pizza in as you were coding Patient 5. Patient 4 now has to reschedule his surgery since he ate. And it's all going to be your fault.

The doctor will call the supervisor to tell her how incompetently run this floor is and how no one ever does what they are supposed to do. The supervisor will pacify the doctor and the patients and family. She will tell you to be more careful in how you present yourself, because the patients perception of you, while not measurable, is important. Never mind that you have done everything by the book, to the letter, and that, Oh yes, nuber 5 is alive, thank you. No, no, we have to work on our image and smile, smile, smile, (except around patient 1) even though you may have just herniated your umbilicus doing compressions, because our patients have a perception. And if it goes to heck, it's all going to be YOUR fault.

No, the above did not happen. Maybe I am just jaded. That's why I got away from the bedside, and why I am getting my NP. I want to be a manager that has my nurse's back. That will say, "No, Mr. Loudmouth, you may NOT have 4 cheeseburgers. You may NOT call my nurses foul names. You may NOT help yourself to any and everything on this floor like it was your own personal mini-mart." If I ever acted the way I have seen some sups act, "Well just watch how you present yourself.", I would hope someone smacked me!

Flame me if you want to. I really do think newbies should be warned about things. I think they should be trained how to handle it, not sold up the river. Maybe this would also help with the shortage. Just maybe. Thanks.:D

Specializes in Operating Room.

I think the OP is right on the money and I'm a newish nurse(just under 2 years). I would also like to add that certain personality types get blamed more than others. Meaning, management doesn't like to confront the bullies, the lazy, or the loud. If they can try to pin something on Nurse Nice, they figure they're covered. And God help you if you sprout a backbone and attempt to defend yourself. You'll incur more of their wrath because Nurse Nice is supposed to back down immediately, according to their warped little rulebook.

Yep, I'm jaded already but at least I am in a better position to fight this kind of nonsense!

Specializes in Telemetry/Med Surg.

Yep...all of the above is true...and then some.

Sooo true - I was blamed for the crappy toilet paper and the fact that the patient could not take "his" rolls home with him......

BecauseI control what toilet paper supplier our teaching hospital uses....

Doctor can't come in to discharge a patient until after 3pm and the patient asks every 5 minutes when the doctor is coming and can't you control the docs schedule. Patient is angry and it's your fault.

Even better, resident goes in at 6:30 am and tells the family they'll go home today. Of course, the resident has no more right to discharge a patient home than I do. So for the next EIGHT HOURS until the attending gets there, I keep getting asked when they're going to get to go home, because "The DOCTOR told us we were going home today." And of course, the eight hour wait, is my fault.:banghead:

The resident did this with a bunch of patients on our floor that day, so we all spent half of our morning and afternoon explaining the difference between residents and attendings. I told the attending that if she didn't talk to that resident, I was going to. Because I sure wasn't losing out on next year's raise because some stupid resident screwed up our floor's Press Gainey scores. The Press Gainey scores are MINE to screw up!!:D

My definition of nursing is all the stuff that no one else wants to do. And you are directly responsible for the outcome of all of it. Not always, of course. But more and more as time goes by.

When I complained that housekeeping wasn't cleaning the IV poles, I was told it was because they didn't know how. Since I'd been doing it (because well, it would be MY FAULT for making the patient sick with a dirty IV pole), I offered to give them an inservice in IV pole cleaning. Then I got in trouble for being a smart orifice.:nono:

A couple of years ago I got chewed royally out by a GI doc because my patient had only taken a few sips of her Golytle.

When he had finished reading me the riot act, we went in together to look at the patient.

She projectile vomited right at his shoes.

THAT was not MY fault!

I got chewed out by a GI doc because my patient had some ice prior to a EGD. When I explained that the attending doc had told the patient they could have the ice, not me, I got chewed out for letting the attending let the patient have ice, when I didn't even know the attending had done that until after the patient had the ice. Because it's MY FAULT that I don't follow all the docs around to all the patients and make sure that they don't do anything that will upset the other docs. :rolleyes:

Specializes in Home Health, Geriatrics.

How true your post is.

I don't know how many times I have had to stop a med pass to pacify someone in room *** because it's 4pm and patient has to have their insulin at exactly 4pm, no ifs ands or buts.

Patient in room $$$ has x diagnosis. Family is in to visit. You have to stop everything and talk with family. They are still not satisfied. You have done everything possible, yet it's all my fault.

patient 000 has a 6pm IV Vancomyicin (sp) and you are 2 minutes late getting it to him because you are caught up with patient xxx. It's all your fault.

I could go on and on.

Specializes in ER.
The NM backed her up, said we were promoting "relationship-based care". So, in other words, schmoozing is more important than an antihypertensive, a pain med, or an antiarrhythmic.

:rolleyes::banghead:

Specializes in PeriOp, ICU, PICU, NICU.

I absolutely agree with the OP. Been a nurse for almost 8 short months and boy is it true!

This is the best thread ever!

Specializes in Emergency.

I am a new nurse at 11 months past graduation and 10 months working in the field.

I have found out that it is true that when things are not going well for a patient it is my fault, or the nurse before me (and I just walked into the problem without any warning that there was a "customer service" issue) was not helpful, or I get report on an A&Ox3pt who is fine until I go to introduce myself at which point they are confused, agitated, and the family is upset.

I have also found that I get lots of patients and family who see that I will be their nurse, and when I go to do report, say things like "thank God you're here!" or "I'm so glad you are my nurse tonight." It really makes all the bad stuff go away.

I am new at this. My patients know this because I tell them if they ask, and lots are amazed that I have been a nurse less than a year. I am never afraid to say"I don't know, but I will find out." and my parting words when I leave a room are "Call me if you need anything." It doesn't matter if my patient is a crack addict prostitute or the director of a prominent local company. I will treat you the same. This might sound to some nurses like I am naive and really new at this (yes I am), but I think about how I would want to be treated if I were sick, or if my family member were in the hospital. Yes, I have developed a really sick sense of humor since I have been a nurse, but I do not let it affect my care of any patient, and I get compliments on my bedside manner, as well as the respect of the other staff I work with.

It is all my fault. But do I want it to be my fault that things went badly or do I want it to be my fault that they left the hospital with a sense that we really cared?

Your choice.

Specializes in Utilization Management.

Three shifts go by and no one notices the stat order for Lovenox, and the last nurse, who actually found and gave the med, is written up by the manager, and somehow, it's all her fault.

*Yes, it really happened. We bedside nurses lost a good one that day.* :scrying:

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