Never understood nursing

  1. I know this is my first post on your forum, and I am a guest here. But I hopefully can get some answers to a problem that has seemed to plague me since I started practicing in medicine. I am hoping that you will be honest enough to tell me why things have gotten to where they are. And by the way, my wife is an EM nurse. That is how we met.

    I started in emergency medicine 10 years ago in NY. I spent 10 years prior in EMS, and also did a residency in EM for two years after graduating PA school. I have a fairly decent background. Right out of school, I worked in 4 EDs. One hospital in Brooklyn, on my first day, the charge nurse and two others came up to me and said "You are the new PA, let's get one thing straight, we have 4 year degrees, you have a 4 year degree, you are no better than us. You need labs drawn, x-rays put in, IV started, you do them yourself. It's bad enough we have to do them for the doctors, we are certainly not going to do them for you". They were called into the ED directors office the next day. They brought the union who threatened to have the whole hospital walk out if the director had anything to say to the nurses. Then at another hospital in NY, I had nurses tell me and the docs what procedure they would "allow us" to perform on our patients. They ripped up my prescriptions right in front of me and told me when they would not "allow me" to give out narcotics. In Virginia, large level 1 trauma center, they refused to do UAs on most patients. They didn't feel the test to be important. I had them tell me if my UA was so important, "are your legs broke, why can't you get it from the patient and walk it down to the lab?" They played passive aggressive for years, not giving my cardiac patients nitro or morphine for up to 2 hours consistently, answering "I heard you, put the chart in the rack and I will get to it when I get to it". Of course they refused to allow me access to the Pyxis to get the meds myself. I had them yell at me whe I wrote parameters for Cardazem for BP. They told me I was to assume ALL nurses know parameters and how dare I question their knowledge. They then told me they will question all of my orders for at least one year until I prove myself to them. That seemed to be a reoccurring theme in most ED.

    I have war stories that I could go on for at least 10 pages. I have just touched the tip of the iceberg. So after almost 10 years of this and 10 emergency departments, I got to the point that I started to hate nurses in general, and thought that this is what I could expect for the rest of my career. Then of all places, I came to Las Vegas. I asked about the nurses here. I was told the same as all of my other hospitals (no one ever tells you how bad things really are as you would never take on a new position there if you knew). But to my surprise, it has been the best experience I have ever had. They are so nice, so professional. There are no power struggles. We all work together. What a difference when I get up every day to come to work.

    So what gives? I have never seen a profession where so many are hateful, unprofessional, uncaring about their responsibilities (patients) and could care less about how little they are performing their jobs. This did not appear to be the minority in any of the places I had previously worked. Have I just had the bad luck to have picked 8 out of 10 of some of the worst places?
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  2. 143 Comments

  3. by   LeahJet
    Your previous places of employment do not sound normal. That is to say that the behaviour that you described is not the norm for nurses. I have worked in over 10 ERs all over this country. The only time I have ever seen nurses giving docs/residents/PAs a hard time was when they were either unsafe or needed to be brought down a notch or two.
    In fact, I find it hard to believe that so many places you worked had so many nurses behaving badly. Maybe this is a personal issue.

    oh, and for a first time post on a nurse's forum, your generalizations may not be taken so well. One may even mistake you for a troll.
    Last edit by LeahJet on Aug 14, '06
  4. by   PACPhD
    Quote from LeahJet
    Your previous places of employment do not sound normal. That is to say that the behaviour that you described is not the norm for nurses. I have worked in over 10 ERs all over this country. The only time I have ever seen nurses giving docs/residents/PAs a hard time was when they were either unsafe or needed to be brought down a notch or two.
    In fact, I find it hard to believe that so many places you worked had so many nurses behaving badly. Maybe this is a personal issue.

    oh, and for a first time post on a nurse's forum, your generalizations may not be taken so well. One may even mistake you for a troll.
    No, not a troll. May have been prior to this job I now have. You will just have to take my word for it but it was not a personal issue with me. The other clinicians in each plase also felt like they couldn't believe how everyone, not just me as a PA was treated. Sorry for jumping right in head first on my first post and not trying to attack anyone. Just been so miserable in my past places that I wondered why it went on.
  5. by   LeahJet
    Quote from PACPhD
    I have never seen a profession where so many are hateful, unprofessional, uncaring about their responsibilities (patients) and could care less about how little they are performing their jobs.
    I'm sure no one will take this as an attack.

    Just trying to be helpful here, but maybe your attitude about nurses (in general) contributed to the way you were treated. Maybe your first work experience with nurses was negative and you have taken that attitude with you.
  6. by   vamedic4
    Hi PACPhD...and welcome to allnurses.com. It sounds as if you've had some really bad luck with nurses in a previous life! Good to hear that you're in a better place now.
    Many nurses (and EMTs and medics) feel threatened by others whom they see as possibly "infringing" on their territory. YOu'd be amazed how territorial health care workers can be. As a former field provider I KNOW you've experienced it first hand. Just keep that in mind...it's not just the ED...and it happens all across the country. The Physician's Assistant phenomena is a relatively new one outside of doctor's offices...even though they've been working for years in other places like ERs, ORs, even in the ICU. It is just going to take some time for "some" healthcare workers like the ones you mention in your post, to realize that WE'RE ALL ON THE SAME *******' TEAM, WORKING TOWARD THE SAME *******' GOAL. Boggles the mind.

    I agree with LeahJet...your previous employers DON'T sound at all normal, but I hope that your most recent experience enhances your view of nurses and all that is GOOD about the nursing profession.

    Have a good night
    vamedic4
    Not a nurse, just an understanding dad, husband, medic....
  7. by   goats'r'us
    the things you speak of are far from normal and far from ok. That said, I can assure you that it happens every day, between all different members of all different staffs, in all different professions, all over the world, and it's not just you.

    I think all members of the team, not just nurses, can get a bit terretorial, and when they find their niche, they can tend to protect it. maybe, it the past, a dragon-like creature swept through the departments you worked in, bossing the nurses about and raising hell, so that when you came along, the nurses were used to having to fight back.. i don't know, it's just a thought. i'd like to think that people aren't like you describe just for the hell of it.

    i know that in places i've worked, there's always been a few people like you describe, who you have to really prove yourself to, and to whom nothing is ever good enough for, but i've generally managed to pal up with some nicer people and gain protection that way.. i guess a PA stands out more than 'just another new nurse'.

    anyway, i'm sorry this has been your experience, i can assure you that the majority of nurses are not like you describe, and i hope to hell that those few nurses haven't given us all a bad rap in your eyes. (clearly they can't have.. you did marry a nurse, after all!)



    oh, and a word of warning, along the lines of what leahjet said.. some of the nurses on this site, are like the nurses you describe, and may bite. I don't think your post is a personal attack on nurses, but some people might. be aware.

    and, for the record, i feel awful that i felt i needed to warn you about that, because i'm fairly sure that if i, as a nurse, made the same complaints that you have, i wouldn't get lynched.
    Last edit by goats'r'us on Aug 14, '06
  8. by   traumaRUs
    I too have worked in several ER's in the country and feel that this negative culture isn't the norm. Sorry you had such a bad experience with it.

    That said, I saw PhD in your name - just curious why did you pursue this degree path? I gather your master's degree is as a PA? Or something else? I have a post-MSN clinical nurse specialist and I'm always interested in people's reasonings for choosing their particular educational path.

    Good luck...BTW I worked at the hospital on South Maryland Parkway in the early 90's and loved it. It was a for-profit hospital then and catered to all the movie stars. The current CNO was my second shift nursing supervisor and she is a wonderful, very patient focused nurse.
  9. by   Tweety
    Quote from PACPhD
    I have never seen a profession where so many are hateful, unprofessional, uncaring about their responsibilities (patients) and could care less about how little they are performing their jobs. This did not appear to be the minority in any of the places I had previously worked. Have I just had the bad luck to have picked 8 out of 10 of some of the worst places?

    I don't know what to say, it sounds scarey that you've come across so many ERs like that. We don't have PA's around here, I can say for sure that our ER is not like that.

    I'm glad you've finally found your niche. Since you know there are good places, I would just let the past go.

    I will ask you one thing please. Do not judge the entire profession as being hateful, unprofessional, uncaring...................Thanks.
  10. by   Jelli_Belli
    The law of averages would tell us that you working at 10 different hospitals, with dozens of "bad" nurses who were so cruel and vindictive to you, would be quite the statistical anomaly.
    It seems to me that the common denominator in all those bad situations discribed was, well, you. Just some food for thought.
  11. by   TazziRN
    I'm sorry, but my first thought was what Jelli said. Those attitudes are NOT the norm and if that's what you kept experiencing, I can't help thinking that it may be the result of actions/perceptions from you? Interns learn very quickly (or most of them do, anyway!) that if you piss off the nurses they can make life very miserable for them. It kind of sounds like that may be what happened to you?
  12. by   SummerGarden
    I am in agreement with the other posters. I do not think the nurses were against PAs... I think they were against you. In any case, it was a toxic work environment created in part by you and it is best that you removed yourself from the situation since you do not seem to know other methods or techniques that would have resolved your problems. Good luck in your new environment.
  13. by   SmilingBluEyes
    Be careful about painting a group (any group) of people with a broad, negative set of statements. It's not conducive to productive dialogue and/or debate. That said, sorry for your troubles. But please understand, there are many good people in nursing; you just seem to have had a run of very bad luck.
  14. by   SkateBetty
    I re-read your post a couple of times, and I have to admit it bothers me. First, I have learned, over 45 years, to take people one at at time, and that means folks of all occupations including doctors, nurses, patients, cashiers, plumbers...you get the idea. I've found that it is impossible to classify members of any group as being unprofessional, miserable, or happy, because individuals are different.

    Is it possible you do not understand the behavior of nurses because you are the kind of person who is frequently misunderstood? Are you polite and respectful to people you meet? Perhaps you are the sort of person who likes to exude confidence, but to those around you it comes across as arrogant, bossy, curt, or in some other way offensive? What would your wife say about your personality? Does she post here? Maybe it's you who has changed over the 10 years, and the nurses you've met in this recent hospital are different because you are now different? Perhaps you've grown, realized you get more of what you seek from the nurses if you use positive personality attributes such as patience, respectful tone of voice, humor.

    Just curious...do PAs normally move to 10 different hospitals in 10 years? It's not an accusation, just a question.

    I have a sister who is an ENT, another sister that is a PA, and my mother and I are nurses. My ENT sister has always been such a close friend. We exchange stories about work, we laugh, she encouraged me through nursing school in middle age, and never, ever did I feel her lord her superiority over me. We exchange information equally, ask each other questions, and the air between us is of complete respect. My other sister talks down to me as if my education was insignificany and paltry, and I couldn't possibly rise to her level of knowledge and superiority. Her manner is insulting, her questions patronizing. My second sister has a history of not getting on well with people on the job. She is defensive, and insecure. She finds herself in frequent altercations with people, and she seems always to be the victim of some insult.

    Please tell me, I have to know...what sort of personality do you have?

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