The math doesn't add up - page 3

by noyesno

17,344 Views | 132 Comments

I'm a math person, so it really bothers me when my manager asks us to do an additional task or duty without subtracting a current task or duty. The math doesn't add up. Our current duties take up a full shift. If you add... Read More


  1. 0
    blondy2061h- They have determined that it was the Dilaudid, by the cardiologist, nephrologist and pulmonologist. Hypotension can be an adverse effect of Dilaudid and there are people that are hypersensitive to narcotics. Even the doc's said that it is not a common reaction but one that they had all seen in the past.

    The strongest pain med my husband had ever taken was Percoset and that made him have bad nausea and vomiting. He asked for a pillow and received the pillow and Dilaudid. Had the RN or anyone, properly taken his vitals throughout the night all of it could have been avoided. He was in the hospital for observation after a routine procedure from the urologist. He does have diabetes, HTN and kidney disease (creatnine normally 1.3) but all of his co-morbities are controlled. So he is not one of those non-compliant patients. We have been advised to make sure that he has Dilaudid added to his medical alert bracelet.
  2. 7
    Quote from MunoRN
    Once upon a time, "time studies" were common in Hospitals. They're still consider obligatory in other occupations where you would need to know if the cumulative time required to perform the expected tasks matches up with the time available, since you can't expect things to be done, to the standard you want them done, if you aren't providing the time to do them. This seemingly obvious rationale has been largely abandoned by Nursing administration.

    But yes, there was a time when in order to add 2 minutes worth of work to a saturated workload, you had to make 2 minutes available somehow. Then as time studies started to show the time available was far exceeding the time required for what was expected, time studies stopped happening, which then just opened the door to adding tasks with reckless abandon.
    They stopped doing time trials when they realized that we couldn't possibly accomplish what we accomplished in the time allotted. That each nurse did 11.2 hours worth of work in eight hours.

    It made them look bad......

    Now to the Thank You notes.....Thanking them for what??? I remember getting thank you notes/gifts from patients....I still have a hand painted porcelain round jewel box from a patients wife.

    What the heck is wrong with everyone....!
  3. 5
    this will be one of the corners I cut!
    SleeepyRN, lemur00, Daisy_08, and 2 others like this.
  4. 1
    Oh God. Cannot believe you have to give a thank you card.
    noyesno likes this.
  5. 4
    Quote from noyesno
    I'm a math person, so it really bothers me when my manager asks us to do an additional task or duty without subtracting a current task or duty. The math doesn't add up.

    Our current duties take up a full shift. If you add something more, something else needs to be eliminated.

    For example:

    When my manager says, "I'd like you to provide the patient with handwritten thank you cards. These cards will take about 2 minutes to write and distribute per patient." She should also say, "therefore, you no longer have to complete care plans for your patients, as those take about the same amount of time. From now on, I will write the care plans for you."
    While other posters address the thank you cards in your example (said cards should be renamed the letmekissyourbuttocksonemoretimebeforeyoufilloutyo urcustomersatisfactionsurvey, btw), let's look at the math, you math person you! Math has nothing to do with nursing in a 12 or 8 hr shift. Jane Doe needs 14 minutes to waste your time on Mon, on Tues, she needs 22. A new duty of stocking towels needs 3 minutes per pt IF you have the time at all/remember and give a crap enough to actually do that. Point is, there's too many variables for the math to EVER add up.

    You're real point, I think, is that we're too busy putting out fires to satisfy the demands put on us by ppl in management who don't currently/haven't ever done our job (and if so, I agree!). In the nameofStudorweprayamen.
    IowaKaren, Szasz_is_Right, noyesno, and 1 other like this.
  6. 3
    Quote from anotherone
    this will be one of the corners I cut!
    Me too! I have yet to write out one of these thank you cards. I like to say out loud, "nurse refused," whenever I'm asked to do things like this. Makes me feel like a BA. No gracias, I'm not thanking patients via thank you cards. Not genuine, don't have the time, etc.

    Lov'in these replies. Bunch of geniuses on AN.
  7. 0
    Quote from MoopleRN
    While other posters address the thank you cards in your example (said cards should be renamed the letmekissyourbuttocksonemoretimebeforeyoufilloutyo urcustomersatisfactionsurvey, btw), let's look at the math, you math person you! Math has nothing to do with nursing in a 12 or 8 hr shift. Jane Doe needs 14 minutes to waste your time on Mon, on Tues, she needs 22. A new duty of stocking towels needs 3 minutes per pt IF you have the time at all/remember and give a crap enough to actually do that. Point is, there's too many variables for the math to EVER add up.

    You're real point, I think, is that we're too busy putting out fires to satisfy the demands put on us by ppl in management who don't currently/haven't ever done our job (and if so, I agree!). In the nameofStudorweprayamen.
    Excellent points MoopleRN. Me gusta.
  8. 8
    Quote from mercurysmom
    Hmmm, a personal "thank you" note from the nurse at discharge? The way I used to write "Thanks!" and drew a smiley face on the bill, topped with a few mints, the way I did eons ago when working as a waitress? What exactly are we looking for in terms of a reaction from the patient, a tip?
    Yes, I'm sorry, but this is strange. Now if the hospital wants to send home a brochure that says, "Thank you for using THUS AND SUCH HEALTH SYSTEM, that's great. What does that have to do with nurses sending out thank you notes to their patients? Are physicians and social workers doing this?

    I think this has reached the point of ridiculousness.
  9. 2
    Quote from CheesePotato
    Aaaaaaand that little "must do" would effectively spell the end of CheesePotato's nursing career. Really. Because my mind immediately went to the following chestnut:

    "Dear Gentleman of 513B--

    That we stand here on the cusp of your release from the hospital to long term intensive care, I would like to take this time to reflect on our time together and offer heartfelt thanks.

    Thank you so much for not only drinking and driving but going that extra mile for excellence and bringing it all home with a well placed, "LOL U no it buddyz" text that effectively helped you flip your car across a four lane expressway. I mean, I really didn't need sleep anyway, so getting called out at two AM to flood you with blood products, realign your pelvis, both femurs, your tibia, ulna, place a couple chest tubes and rex open a bit of your skull was exactly what I needed. Let us not forget the vomit and blood on my shoes and scrubs to the point it saturated my undergarments. I had been meaning to swap them out anyway.

    Oh, and those other two that suffered from your awesomeness? Yeah, that just made my night way fantastic.

    Ah yes, memories.

    Thank you. Truly. Thank you.

    Love and snuggles,

    ~~CP~~"

    Can you say terminated?

    For the life of me, I will never understand management. Last year they wanted us to start verbally thanking patients for "allowing us to participate in their care". Really? You flipped your ATV while high as a kite. This is not really a highlight in my world right now, thank you.

    But, may I suggest writing out a few quick fill form letters and having them placed on rubber stamps? Think of the time you will save while meeting your quota of thank you letters!

    Cheers,

    ~~CP~~

    P.S.

    A certain Lemur mentioned something about a Thank You note meme and after I got done coughing my gum back up out of my lung, I decided that was a splendid idea. Give me a day to get it all ironed out, but it will be a sister blog to my current one *see my profile for details. All credit goes to Lemur for something that is pure hilarity and genius. ::salutes::


    noyesno and opossum like this.
  10. 3
    Quote from MsBruiser
    Welcome to healthcare. The only way to escape that nonsense is to leave patient care. Innovation in nursing is usually the creation of more needless work or another useless form.

    Thank you notes to patients from nurses is innovative? Wow. As I said, let the hospital send it with their brochure.

    As a patient, I'd prefer excellent care and the personal interaction that comes with a genuine "Best to you and fare-thee-well" or a genuinely caring follow-up call.

    You can take certain things a bit far. Is this reallly something for which we should kill more trees?

    IDK. Sounds like a SNL skit. Pt in wheelchair at hospital door and nurse across from pt. The exchange goes like this. Pt: "Thank you." Nurse: "No. Thank you." Pt: "No. Thank You..." ad infinitum...
    martinalpn, noyesno, and opossum like this.


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