Today, my unit manager called me into her office and offered to cancel the remaining three days of my contract. (GASP!!) Yes, she gave me the option of completing three more shifts, or cancelling. I declined to cancel, of course. I listened to her concerns, and I apologized and explained myself.
I am a brutally honest person. While I am very aware (and proud) of my skills as a nurse, I am also very aware of my short-comings... I sometimes (only in extreme moments, I swear!)have difficulty keeping my mouth shut when I feel my patients aren't getting the best care they deserve. I am not very diplomatic. That is why I am not a good charge nurse, nor do I aspire to be one. I am a floor nurse.
Recently, I had a patient who wasn't doing well. I called the hospitalist and he showed up within minutes. I was busy.... so very busy. He wrote orders and placed the chart in the "orders rack", where the unit clerk and Charge Nurse would then enter the orders in the computer and transcribe the orders so that they could be administered. The problem was I didn't get the order.... until four hours later!! When I went looking for the chart, I found it STILL in the "orders rack", not yet entered or transcribed. I was very upset and I said with complete exasperation, "This order was written FOUR HOURS AGO!! And it's a "NOW" order! This system doesn't work!!" Well, the unit clerk (not our usual experienced clerk, but a "float" from another unit, took my words personally and left the nurse's station in tears. I had no idea I had upset her, let alone that she was crying, until about half an hour later when the charge nurse came up to me and said, "You made my unit clerk cry." Bad timing to inform me of this... so I said, in an annoyed tone and again, I am being brutally honest here) "What?! I made her cry? Gosh, I didn't realize I was so powerful I could make someone cry! It wasn't her fault! The doctor didn't flag the chart with the little red tab indicating "NOW"! This system doesn't work and I am just frustrated and I should make out an Unusual Occurance Report for "Delay In Treatment" but I DON'T HAVE TIME!" And I walked away. The fact is... this was NOT an unusual occurance. Their system of transcribing orders frequently results in unnecessary delays. I realize this is a serious observation, but it is the truth.)
So... When the unit clerk returned, I apologized to her and told her that I was not upset with HER... but with the system and the doctor's failure to flag the chart. I apologized to her twice. I was very sincere. I felt terrible for upsetting her! I felt much worse for my patient, who thank God, experienced no ill effects from the delay.
My co-workers have expressed their appreciation of my team efforts. When asked by a co-worker, I will gladly attempt a difficult IV start, even if I am terribly busy myself, even though it's not my patient. I will take the time to search out that beeping IV machine and fix the problem, even though it's not my patient. I'll take another nurse's pager so she can break for lunch, even though she's not my designated "break budy" but her break buddy is overwhelmed.
But I will not look the other way when someone else isn't doing their job correctly. Even if it's a doctor. Little flags on the chart!! Just push the tab over!! Make your intentions known! Help us all do our job by pushing a little tab!! Sound petty? Well, it's not!! How simple can it get? (yes, I said all these things... quietly.... but emphatically.... but in earshot of the charge nurse, I readily admit. I felt exasperated.... I felt like crying myself!)
So back to the unit manager's office.... When called into her office and asked about the situation on Tuesday, I explained the above scenario to her and she said, "I heard you say that you only have "four shifts left". I am willing to call your company now and cancel your contract." I told her I didn't want that at all and that my frustration comes from not being able to deliver safe and quality nursing care because I find their system frustrating. I assured her that I would complete my contract and be less vocal with my frustrations. I sincerely apologized three times in about 10 minutes. I also told her that I don't feel I am bringing negativity to the workplace, but that I am actually being infected by the negativity of my fellow nurses. (Oh, she didn't like that... and I regret those words... kind of... because while true, a bit too honest?)
Ohhh..... I have never NEVER experienced this kind of .... oh what's the word I'm looking for.... MAYHEM on a nursing unit. I can't fix it, I can't change it.... though I must tell you, that my suggestion for changing their method of documenting their blood sugars and insulin administration has resulted in a facility-wide change!!! How's that for wonderful contribution?! Woo Hooo! change is gooood!!
Thank you for letting me vent.... again!! I guess the million dollar quesiton is.... what does one do when a doctor writes a "Now'" order but doesn't flag the chart correctly? I get too frustrated! Must be my OCD! OCD can be a good thing sometimes.... SOMETIMES! Agreed?
