Why does only nursing have to put the patients first?

Nurses General Nursing

Published

Caution, rant ahead:

So the other day I'm in a tiff with radiology because they want me to transport a patient that (per policy and per good nursing judgement) I'm not required to accompany and I can't accomodate them because well, I have other patients that I need to attend to. So they call my charge nurse who tells me that we all have to work together and put the patient first. Well if they really wanted to put the patient first, as in my other less stable patients, then they wouldn't insist on me leaving my other less stable patients to accompany a perfectly stable patient. Heck, there's no reason this couldn't have been done bedside, so if THEY truly wanted to put the patient first, they'd bring themselves on up to my floor and do it at the bedside.

I'm just soooo tired of everytime I stick up for myself, I'm accused of not putting the patient first. But other departments don't fully staff on weekends, because the patient can wait until Monday. We do labs at 4am for the MD's convenience, even though it wakes up the patients. I don't have a medication, pharmacy expects me to run halfway across the hospital for it, because most of them are at lunch. After I've searched all the boxes THEY might have accidently put it in. Heck, housekeeping won't even clean the IV poles. But the other departments, and even our fellow nurses, expect us to drop everything in a split second for the convenience of another department in the name of the patient being first. And if we dare say, "Hey, that other department could do x,y,z instead of me dropping everything, ignoring my other patients, and leaving an hour late, then getting called to the principal's office for my incremental overtime" then we as nurses aren't being team players. But do you see the other departments being team players on the weekend? Nope, they aren't there. Are they being team players at 7pm when we want to go home? Nope, they left on time at 5pm.

If nobody else wants to do it, it's the nurse's job. Not "if nobody else CAN do it." Not "if nobody else is QUALIFIED to do it." Plain, flat out, if nobody else WANTS to do it. And we as nurses are expected to suck it up in the name of the patient first. Because if we don't do it, the patient suffers. How about, "If housekeeping/radiology/respiratory/MD/pharmacy/customerservice/cafeteria/whoever doesn't do it, the patient suffers"???????? Why not lay the guilt trip on someone other than nursing for a change???

Specializes in ER/Trauma.
If it's not an 18 in the AC then no dice. Not all patients have those veins to stick.
What if the pt. doesn't have a right arm? Or has dialysis shunt on Right arm? Can't do a CTA then?

I understand a lot of it has to do with how fast the dye needs to be injected (hence large bore) and how quickly it hits the lungs (hence specific site placement) before the scan is performed.

Surely these are variables that can be manipulated? Say give an extra 3 seconds before scan if the IV is more distal than the AC or something?

cheers,

We all ultimitely have to do our jobs.

are you being serious, or is this a joke?

i can't tell, being online.:p

i had an acutely ill hospice pt, whose symptoms were not yet managed (or, it was just his time).

he started vomiting lots of blood/mucous while having profuse diarrhea.

no one was around, no one would come when i called, and this guy has his arms outreached to me, with the most desperate look that i've ever seen.

i had to carry him off commode and into bed, gave some quick iv meds and got help stat (all while trying to reassure him in my 'calm' voice.)

in spite of all attempted interventions, this is the way the pt died.

later, i called housekeeping explaining the mess.

head of housekeeping comes into assess room and tells me, that once all blood and feces is removed, he'll send someone in to clean the rest.

had total meltdown and gave him a rather loud earful.

he reports to my don, and she comes into room asking me what happened.

i explained, and she looked at me like i was crazy.

she responded with, "OF COURSE you'd clean his surroundings...he was YOUR pt."

i told her exactly how i felt.

exactly, no barriers.:flmngmd:

it cost me a 2 day suspension, 1 very meaningful warning, and a big, fat demerit in my folder.

my penalty was originally 1 day, but since i refused to apologize to head of housekeeping, it was changed to 2.

when i returned, don just couldn't understand "what happened to you???", and "i've never seen you like this before."

i told her, _____ gave me s**t and i gave it back, x 2.

she wasn't amused (that i was being so obstinate) but let it go.

we both understood ea other at that point.

next time i needed housekeeping, i left the room with a few 'smears' and dared them (suggestively) to bust my chops.

sometimes you have to fight/get our messages across, through unconventional means.

it doesn't help nurses overall, but it does feel better to retaliate...even if it's temporary.

but it did help, with my don saying "it's YOUR pt"...because then, i just felt a bit more maternal...just like an exasperated mother...and this is what you do for your kids.

truthfully, i've always felt a bit possessive about my hospice pts, so it's not a huge transition to make.

it's just how we're treated like door mats, is what bothers me tremendously.

sometimes you just need to learn how to either play the game, or leave.

more than one way to skin a cat...no matter how juvenile.:sofahider

leslie

Specializes in New PACU RN.

:yeah:Don't leave us hanging - what did you say exactly? :argue:

Specializes in CTICU.

If it's any consolation, every other department feels the same. I currently work with a group of engineers and they get crapped upon by everyone and end up doing everything that everyone else doesn't want to do - including half of the nurses jobs. I know it's because the nurses are stretched thin too, but just sayin', it's not just nursing that goes out of their way to do things for patients (including staying late or doing extra tasks that aren't their job). I wish people would just see that the goal is the patient's outcome rather than doing whatever tasks are on their "my job responsibilities" checklist and nothing else.

Specializes in CTICU.
because other influencing factors don't encourage this :

- very little restriction on nursing school entry .... employers know they have a ready supply of new nurses

- many nurses are sole income earners and insurance holders for their families

- there are many qualified nurses from developing countries who can replace them

- many nurses may be accustomed to worse conditions in prior working lives

- there are dysfunctional dynamics in nursing which wear down nurses self esteem and resolve (see the whistleblower thread)

i wish it were better *sigh*

i have to take exception to this comment - there are no immigrant visas for foreign nurses and haven't been for quite some time, so this is not true.

Specializes in CVICU, Obs/Gyn, Derm, NICU.

later, i called housekeeping explaining the mess.

head of housekeeping comes into assess room and tells me, that once all blood and feces is removed, he'll send someone in to clean the rest.

had total meltdown and gave him a rather loud earful.

he reports to my don, and she comes into room asking me what happened.

i explained, and she looked at me like i was crazy.

she responded with, "OF COURSE you'd clean his surroundings...he was YOUR pt."

Can anyone tell me why housekeeping doesn't have to clean up (visible) body fluids???

Same over here too.

Why oh why can't hospital housekeeping staff be trained to deal with this?

This gets me too - condolences :redbeathe

Specializes in CVICU, Obs/Gyn, Derm, NICU.
I have to take exception to this comment - there are NO immigrant visas for foreign nurses and haven't been for quite some time, so this is NOT true.

I'm in Sydney Australia and we have lots of foreign nurses still coming. However we are not so badly affected by the recession.

Anyway re the US - the possibility is still there. All they need is a law change and lots will flood in. The operative word is can

The threat is very real - i wish it wont happen as still far too many US nurses unemployed

Specializes in ER.
Can anyone tell me why housekeeping doesn't have to clean up (visible) body fluids???

Same over here too.

Why oh why can't hospital housekeeping staff be trained to deal with this?

This gets me too - condolences :redbeathe

Training...

GLOVE UP, DIG IN.

There.

I was once told housekeeping couldn't clean iv poles because they didn't know how. I offered to give them an inservice.

Specializes in Oncology/Haemetology/HIV.

My two.

I currently work in a prestigious facility. People come from around the world to see us a get specialized treatment. Our medical and nursing staff are quite diverse, of all nationalities, religions and cultures. Many of our pts are on specialized diets also for medical reasons.

HOW D$&@ HARD IS IT TO PROVIDE ADEQUATE DIET CHOICES AND ACTUALLY DELIVER THE CORRECT ONE TO THE PT?

I have had pts call me to the room to show me their prospective menu to pick from, and they are required to be lactose - there may be two or three items available for a meal, none of which are an entree. We have a substantial Muslim and Jewish population but can't seem to get anything but prepackaged meals that pop open in the microwave (rendering them nonkosher). I have pts that have to be on an extended period of full liquid-lactose free, and can't have more than a day or two go before they get the wrong thing. The family can have lodged formal complaints, and one or two meals will be right, and then dietary screws it up again. And of course, nursing takes the heat

I know that dietary aides do not have our training and don't get paid as much but get real. It's not rocket science and it is a medical necessity to get the correct diet in many cases.

The other is when management puts nursing "in charge" of things that they have no way to control. When the JCAHO mandate came out on med recs came out. We put them for signature daily where the MD can't miss them. We remind them. We fill out everything but the stinkin' signature. We ask them if they were completed - they say yes. Just to find that they are not signed or checked. Then we are chasing them by phone.

They know that they are required and they are professional adults. Why is nursing held responsible if it doesn't get checked off and filled out.

My two.

I currently work in a prestigious facility. People come from around the world to see us a get specialized treatment. Our medical and nursing staff are quite diverse, of all nationalities, religions and cultures. Many of our pts are on specialized diets also for medical reasons.

HOW D$&@ HARD IS IT TO PROVIDE ADEQUATE DIET CHOICES AND ACTUALLY DELIVER THE CORRECT ONE TO THE PT?

I have had pts call me to the room to show me their prospective menu to pick from, and they are required to be lactose - there may be two or three items available for a meal, none of which are an entree. We have a substantial Muslim and Jewish population but can't seem to get anything but prepackaged meals that pop open in the microwave (rendering them nonkosher). I have pts that have to be on an extended period of full liquid-lactose free, and can't have more than a day or two go before they get the wrong thing. The family can have lodged formal complaints, and one or two meals will be right, and then dietary screws it up again. And of course, nursing takes the heat

I know that dietary aides do not have our training and don't get paid as much but get real. It's not rocket science and it is a medical necessity to get the correct diet in many cases.

The other is when management puts nursing "in charge" of things that they have no way to control. When the JCAHO mandate came out on med recs came out. We put them for signature daily where the MD can't miss them. We remind them. We fill out everything but the stinkin' signature. We ask them if they were completed - they say yes. Just to find that they are not signed or checked. Then we are chasing them by phone.

They know that they are required and they are professional adults. Why is nursing held responsible if it doesn't get checked off and filled out.

because nurses are the only PATIENT ADVOCATES :sarcasm:

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