"Send my girl down here now"...(Please.....) - page 4

by Jason-ACNP

2,829 Views | 41 Comments

I was writing a progress note today on a cardiac step-down unit when my concentration was shattered by a booming voice coming through the patient-call system. An 60 y/o gentleman (for lack of a better word)exclamied, "Send my... Read More


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    I see your point, and of course the government is not going to support a strike. I don't remember the air traffic controllers being fired (although I'm sure they were) but I do remember Regan pulling rank in the eighties when he fired a large number of airline stewardesses (and maybe pilots) during the eighties when they went on strike.

    However, there is a difference here. There aren't 2.5 million stewardesses (or even 5% of that) working in the airline industry, and thus their political power through votes is miniscule. Secondly, the nation is not going to go into a crisis if they don't receive peanuts or drinks on their flights.

    However, can the government really afford to fire nurses who are threatening to strike or walk-out? Are they going to turn the duties over to the environnmental care techs? It wouldn't be feasible for them to do so (to say the least). Even if 250,000 nurses (10% of nursing population)were striking, there is no way that they could fill those positions with scabs. There simply aren't enough to fill the positions. It would send many hospitals in this country into a severe crisis. I've heard the argument that MDs, PAs, pharmacists, and paramedics could take over nursing duties, but lets be realistic. How long could that last? Many would cringe at the thought of carrying out "nursing duties", and thus I doubt that they would do it very long. Besides, they have their own roles to fulfill.

    The bottom line is that while I agree the government will never be close friends with the nursing profession, they would have no choice but to respect the power that nurses wield if this profession became more organized. I don't doubt that the ANA could desperately use a change of leadership(i.e. someone with a backbone). I think that they may be out of touch with reality. Yet, even if we had effective leadership, it wouldn't do much good if we don't come together as one. It's really simple. You go to X, Y, and Z politicians and tell them "Here is our agenda. If you geuinely support this agenda, then you will have the endorsement of this organization. With that comes "X" amount of PAC money, and a large number of votes. If you accept our agenda and then renig on this deal, then you may very well be committing political suicide. WE WON'T WAIT for the next election. Instead, we will organize a walkout across this state (or the country)which will generate more than enough media attention to let physicians, hospital administrators, and the general public know that "Enough is enough". Again, the AMA and the general public would go into an uproar if the government attempted to fire nurses. With all due respect to nurses aides and other ancillary staff, do you really think that physicians would allow them to manage vents, adminsiter chemo meds, push intravenous meds, hang blood products, etc? It would never happen. That's why some hositals are having to pay some (in-house)agency nurses $95/hr.

    The questions (im my mind)are this. How much more are you willing to take? How much longer are you williing to take it? What is your breaking point?


    Originally posted by cmggriff:
    I have to agree with Wildtime on the government issue. This is the same government that fired the all Air Traffic Controllers when they treatened a strike.

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    One of the recent admissions to my ward was a known IV drug abuser. Although he had a heavily exuding wound and was known to be both HIV+ and hepatitis B+ he refused to stay in his side room and inisted on walking around the open ward, often after pulling his dressings off.
    On one occasion when we had run out of methadone and his dose was twenty minutes late he used his mobile phone to complain to pharmacy about this. He constantly verbally abused staff referring to us as "*******" and worse and physically assualted one of our doctors, inflicting a bite wound.
    On discharge (after we had successfully healed his abscess) he complained to the NHS trust about the "discrimination" he had suffered on the ward due to being an IV drug abuser. Needless to say the Trust wrote a grovelling apology letter and totally failed to support its staff.
    This is disgraceful. I acknowledge that IV drug abusers may have complex needs in the healthcare environment but this patient's behaviour was totally unacceptable especially since his dependency needs were fully addressed. NHS staff deserve better
  3. 0
    I'm amazed that he stayed long enough for his wounds to heal. How could management allow him to endanger other patients by taking off his dressings out of his room? I'm going to steal the ROM line to add to my repertoire. A class in recognizing abuse and responding appropriately should be taught in nursing school. I worked in a prison and didn't see the degree of abuse some have described here.
  4. 0
    Yet another perfect example that healthcare is a buisness, not a mission. It's all about customer service, and the concept "The customer is always right" is clearly evident in your situation. God forbid that patient choose another hospital next time! (although I'm 99.5% sure that YOUR and EVERYONE else's tax dollars paid for the bastard to be there).

    One more thing. When patients act in that manner, "acknoledgement" of their disease process no longer exists. I'm sorry (no I'm not) but I really don't give a damn that he's an IV drug abuser. He's not coming on my unit, imposing his tyrannical demands on to a staff that is already overworked as it is. No one on that floor shoved a needle of dope into his veins. He did that all on his own.


    Originally posted by Sue D:
    One of the recent admissions to my ward was a known IV drug abuser. Although he had a heavily exuding wound and was known to be both HIV+ and hepatitis B+ he refused to stay in his side room and inisted on walking around the open ward, often after pulling his dressings off.
    On one occasion when we had run out of methadone and his dose was twenty minutes late he used his mobile phone to complain to pharmacy about this. He constantly verbally abused staff referring to us as "*******" and worse and physically assualted one of our doctors, inflicting a bite wound.
    On discharge (after we had successfully healed his abscess) he complained to the NHS trust about the "discrimination" he had suffered on the ward due to being an IV drug abuser. Needless to say the Trust wrote a grovelling apology letter and totally failed to support its staff.
    This is disgraceful. I acknowledge that IV drug abusers may have complex needs in the healthcare environment but this patient's behaviour was totally unacceptable especially since his dependency needs were fully addressed. NHS staff deserve better
  5. 0

    You are right. CNAs are included.

    As far as the NP salary goes, that is appalling, but it's all about supply and demand.

    Originally posted by wildtime88:
    Do not leave out the CNAs in this, they also get the same treatment we do if not worse in many cases. We need them and they need us as well.

    This is off the topic subject a bit, but did you see the posting from the NP on another topic who reports NP wages around 35 an hour. That is simply appalling. I can make that much easily as a agency RN.
  6. 0
    Under the UK healthcare system we had no choice but to treat this patient. We also had no choice about tolerating the abuse. All patients deserve the best care we can provide IV drug abuser or not. My point was that my employers, the NHS Trust should have backed their staff up in an intolerable situation. I was not suggesting that we should not have provoded the best care possible given the difficulties.
  7. 0
    Hi. Good topic, and many good responses. Like previous posters wrote and Jason acknowledged, it's difficult to tell what state of mind this person was in when he demanded his "girl." I would be curious to know, even if it does not matter, the social history of this man.

    Jason, I think taking a firm attitude is important when you witness disrespect. It's great to see that you made a decision to stand up for your coworker. You also make a great point about the expectation of patients when they are receiving care from a nurse.

    It's high time that we nurses stood up for ourselves and not continue to overly pander to our patients and make them dependent or establish codependent relationships with them. We know that hospital administrators in their quest for more profits will not give the green light to nurses to demand respect from the public or other staff. Therefore, we have to take the initiative ourselves.

    One way I approach incidents like this is to simply tell the patient(or family for that matter) that references to the staff by other than their given name won't be tolerated. That this patient's doctor ordered his activity level which gives him the freedom to get his magazine himself, and he is encouraged to take advantage of that.

    I feel for you and the other staff once the cath has been done. Years ago, a patient would be on bedrest postcath for a day or so and then it was decreased to eight hours. Since I'm no longer in the hospital, I don't know what it is now.
  8. 0
    I sometimes wish I was able to react like that to abusive patients but would most likely loose my job if it were found out. I have many times wanted to ask the patient or family if they think their behavior actually makes us want to come to the room faster. I have told patients I do not need to listen to what they are saying and that none of my nurses need to come into their room unless they can be in control of their outbursts. I am at least able to get support to do that. In this age of customer service though it seems that we are told (by those who never enter patient rooms) that the customer is always right, even if they are yelling at us. That is pushed so hard that it is extremely disheartening and I know that it has led to at least 2 of my nurses leaving - the profession. It does seem that it has gotten worse over the last couple years also. No answer as to why. I unofficially applaud you Jason (I'm even nervous on the bb!).
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    I work in a long term care facility with a subacute unit as an LPN.I was helping the CNA's pass out dinner trays and I set a tray down in the room and opened everything up for the residentwhen the daughter,who was there to feed her mom shouted,"Come back over here girl and tell me what is on this tray!" It was puree and I really had no idea what it was but I made it up because I didn't want to have to go back in there and deal with her!
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    Sign me up for the list of people supporting Jason. Yes, this man may have been fearful or feeling out of control, but as far as I'm concerned, you're never too old or crotchety to learn that you can catch more flies with honey than vinegar. Yes, it's generally a bad idea to treat the people most directly responsible for your comfort and well-being--i.e., the nurses--with contempt and disrespect. Go figure.

    I had to do this once with an ICU pt. He was an ex-career military guy and from what I could tell after 12 hours of caring for him, pretty much a misogynistic control freak with a REALLY bum ticker, not to mention bad kidneys and some other problems. I walked into his room at start of shift to find his Foley stretched dangerously tight, one of his IV's about to fall out, and a continuous run of really scary dysrhythmias on the monitor. He started demanding a phone and some other things which weren't my first concern, and when I told him so, he pointed his finger at me and started "lecturing" me about how he was paying X amount of $$ for this room and he demanded "service", etc. etc.

    I sat down and explained to him that he was there because he was critically ill, and I was there because he was critically ill. I explained that I was not the maid, or his waitress, and he was going to have to trust my professional judgement, education and experience that his IV, foley and rhythm were more urgent than his telephone call, although I would be happy to get him a phone after I sorted out the more pressing problems. He sulked and pouted and gave me the silent treatment the rest of the evening, but he seemed to get the point and quit complaining about the "service". People like this get away with crap because everyone's always let them.

    I had another pt like this--a "problem pt." that several floors refused to take care of because he would throw meal trays, scream at staff (ANY staff, including docs) and just generally throw a tantrum when things didn't go his way. His wife would simper, "Oh, well, he's always been like this," which made me want to snarl, "Gee, thanks for enabling his dysfunctional behavior for the past 35 years, Cookie!" Maybe if someone had let him know, just once, that *grown-ups* don't behave this way, he would've knocked it off. Anyhoo. The day nurse reported that when they brought him back from CT, he decided while rolling down the hall that his pillow needed to be fluffed. Like, now. The nurse told him she'd do it when they got to his room (about 60 feet away). Apparently that wasn't soon enough, because he started pounding the siderails with his fists, screaming, "Fluff my pillow, you *******, FLUFF MY PILLOW!!" at the top of his lungs. She said she was laughing so hard by that point she was doubled over and could hardly push the bed.

    I think the lesson is, sometimes jerks get sick too, and all the therapeutic communication in the world will not make a lick o' difference with some of them.


    [This message has been edited by Stargazer (edited April 23, 2001).]


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