The math doesn't add up

[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."

[FancypantsRN]

Yes... "Thank you for choosing my ER for the 3rd time this week for a runny nose, sore throat and now a mosquito bite. I am sure the ambulance that brought you in yet again just forgot to write theirs. So, thank you from all off us.

I suppose I would be terminated as well :)

To the OP -unfortunately the math will never add up

[lemur00, BSN, RN]

I really think a "patient thank you note" meme would be pretty hilarious.

[bsnanat2]

I am coming to the conclusion that leaders in all level of nursing have lost their minds. I have been a rule follower all my life, but I am now rebelling. There will be NO thank you notes and I WILL eat my lunch in peace. I WILL NOT brush your hair but I WILL give your visiting adult child a brush so they can do it. I no longer feel obligated to explain to management what I am or am not doing or why I am or am not doing it. I simply, quietly go about my business. I do not ask permission to eat; I simply go to the back and eat.

When the current system collapses under the weight of its own stupidity, I'll be there to quietly take care of the survivors.

[N.U.R.S.E.]

Really, yeah another chore on top of the other 3 kazillion things I have to do. Truly, you are being much too kind. Oh well so much for my bathroom break. Reminds me of this funny cartoon program where the cartoon character is dividing food or money and he counts, one for me and one for you; two for me and one, two for you; three for me and one, two, three, for you; four for me and one, two, three, four for you you get the picture. Oh I see you went to the Enron School of Accounting that says it all.

;

[That Guy, BSN, RN, EMT-B]

We are supposed to do those too. Oops. Must have forgot. My bad. Now get out of my ER. :)

[madwife2002, BSN, RN]

Years ago we would give out similar cards to our patients when they were leaving. The patients loved them and our pt satisfaction rate went up!

They were pre printed and you just added their name

We all hated doing it

[PalmHarborMom]

My husband was hospitalized in August and we received a hand-written card in the mail from the first hospital he was in. First, it was weird. We received the card BEFORE he was released from the hospital that he had to be transferred to because the first hospital (the one that sent the card) was responsible for all the new medical issues. Secondly, it is just plain ridiculous to send a card to someone that due to the errors made in that hospital, the patient now needs dialysis, blood transfusions and their error caused a heart attack.

Here is what the card should have read.....

"Dear patient,

Thank you so much for making your stay into a major in-service teaching opportunity. Yes, you needed a pillow because you were uncomfortable... but so that I could have an easier shift, I gave you Dilaudid. The RN chose to let the CNA take your vitals all night, even though she gave you a powerful narcotic that you have never had before. Hey, who needs an accurate BP taken anyway, just take it over and over again until you get a high enough false reading. As your wife arrived in the morning, you were barely clinging on to life and we were oblivious, but we belittled her for noticing until she blew a gasket. Yes, she was concerned that your BP was only 72/34 but we thought that we knew better. Like we told you, those machines are very inaccurate. She is just a nursing student so what did she know. Evidently, more than we did. Having prolonged hypotension caused Acute Renal Failure and you got to visit with the Dialysis nurse for several hours and get a blood transfusion while we awaited your ride to the hospital that would fix all of our screw-ups. So thank you for giving us a grand opportunity to spend some much needed time teaching each other how to not kill our patients."

Sending cards could be a nice thing to receive in the mail as a "Hope you are doing better" card. BUT hospitals need to be mindful that when they are the ones that caused more problems than a patient came in for..... it might not be the best idea.

In the end, the hubby's kidneys had completely shut down, needed dialysis twice and they pulled off 5L of fluid, his lungs had started to fill up with fluid, had a fluid shift that resulted in 30lbs+ of weight gain, he needed 2 blood transfusions, and the prolonged hypotension caused a non-STEMI. We probably were not the best family to send a "Thank-you/ hope you are feeling better" card. By sending it before he was even out of the hospital that they had to transfer him to.... made them seem even more inept.

[blondy2061h, MSN, RN]

My husband was hospitalized in August and we received a hand-written card in the mail from the first hospital he was in. First, it was weird. We received the card BEFORE he was released from the hospital that he had to be transferred to because the first hospital (the one that sent the card) was responsible for all the new medical issues. Secondly, it is just plain ridiculous to send a card to someone that due to the errors made in that hospital, the patient now needs dialysis, blood transfusions and their error caused a heart attack.

Here is what the card should have read.....

"Dear patient,

Thank you so much for making your stay into a major in-service teaching opportunity. Yes, you needed a pillow because you were uncomfortable... but so that I could have an easier shift, I gave you Dilaudid. The RN chose to let the CNA take your vitals all night, even though she gave you a powerful narcotic that you have never had before. Hey, who needs an accurate BP taken anyway, just take it over and over again until you get a high enough false reading. As your wife arrived in the morning, you were barely clinging on to life and we were oblivious, but we belittled her for noticing until she blew a gasket. Yes, she was concerned that your BP was only 72/34 but we thought that we knew better. Like we told you, those machines are very inaccurate. She is just a nursing student so what did she know. Evidently, more than we did. Having prolonged hypotension caused Acute Renal Failure and you got to visit with the Dialysis nurse for several hours and get a blood transfusion while we awaited your ride to the hospital that would fix all of our screw-ups. So thank you for giving us a grand opportunity to spend some much needed time teaching each other how to not kill our patients."

Sending cards could be a nice thing to receive in the mail as a "Hope you are doing better" card. BUT hospitals need to be mindful that when they are the ones that caused more problems than a patient came in for..... it might not be the best idea.

In the end, the hubby's kidneys had completely shut down, needed dialysis twice and they pulled off 5L of fluid, his lungs had started to fill up with fluid, had a fluid shift that resulted in 30lbs+ of weight gain, he needed 2 blood transfusions, and the prolonged hypotension caused a non-STEMI. We probably were not the best family to send a "Thank-you/ hope you are feeling better" card. By sending it before he was even out of the hospital that they had to transfer him to.... made them seem even more inept.

I'm sorry for what happened to your husband, but I promise you if/when you become a nurse you will be having the aid do vital signs and giving patients dilaudid. I would have to guess more than the dilaudid caused such severe hypotension.

[PalmHarborMom]

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.

[Esme12, ASN, BSN, RN]

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....!

[anotherone, BSN, RN]

this will be one of the corners I cut!

[netglow, ASN, RN]

Oh God. Cannot believe you have to give a thank you card.