But what if I just don't LIKE it?

CPCTColeman · Feb 14, 2016

@working bee Im starting on med surg monday. Well my orientation at least but Im a CPCT.

MT Fun_Dips · Oct 24, 2021

Being a lab Tech at a rural hospital, I found this topic eye opening to see medsurg from a nurse's perspective.

I hate medsurg as well, but mainly because of the nurses instead of the patients; and I only seem to have this problem with medsurg RNs. 80% of you seem to genuinely hate your job in that department and it's draining to have to put up with that.

For context, I work nights, and during my shift I'm the only one running the lab. We do not have a night phlebotomist so I have to do all the draws—including morning draws and ERs. While my main priority is to do all the daily maintenance, QC, and calibrations so the analyzers can continue giving accurate results, you guys treat me like I'm just a phlebotomist. One whose sole purpose is to cater to the orders you put in with a smile. The bitterness about your job seems to constantly be redirected at me as you talk down to me like I know nothing. I've had on multiple occasions medsurg nurses flat out refuse to draw from PICCs, not because they aren't pulling, just because they can't be bothered to when I can just stick them instead.

Your attitude at work affects patient care even when you're not in the room with them when you show it. If you dislike your department to the point where such attitude can't be bottled up to maintain professionalism (especially when your supervisors aren't watching) you shouldn't be an RN.

For the other 20%, I appreciate what you do and greatly respect the hardship you have to go through, especially during this pandemic.

NotMyProblem MSN, ASN, BSN, MSN, LPN, RN · Nov 12, 2021

On 10/24/2021 at 7:05 PM, MT Fun_Dips said:

Being a lab Tech at a rural hospital, I found this topic eye opening to see medsurg from a nurse's perspective.

I hate medsurg as well, but mainly because of the nurses instead of the patients; and I only seem to have this problem with medsurg RNs. 80% of you seem to genuinely hate your job in that department and it's draining to have to put up with that.

For context, I work nights, and during my shift I'm the only one running the lab. We do not have a night phlebotomist so I have to do all the draws—including morning draws and ERs. While my main priority is to do all the daily maintenance, QC, and calibrations so the analyzers can continue giving accurate results, you guys treat me like I'm just a phlebotomist. One whose sole purpose is to cater to the orders you put in with a smile. The bitterness about your job seems to constantly be redirected at me as you talk down to me like I know nothing. I've had on multiple occasions medsurg nurses flat out refuse to draw from PICCs, not because they aren't pulling, just because they can't be bothered to when I can just stick them instead.

Your attitude at work affects patient care even when you're not in the room with them when you show it. If you dislike your department to the point where such attitude can't be bottled up to maintain professionalism (especially when your supervisors aren't watching) you shouldn't be an RN.

For the other 20%, I appreciate what you do and greatly respect the hardship you have to go through, especially during this pandemic.

It would be interesting to know how you would know this as I’m pretty sure phlebotomist are not allowed to touch PICC lines. Could it be that your viewpoint is as it is because you are overworked and you resent having to come to the floors to do some of the many tasks of your job? Are you considering becoming a nurse since you’re on a nursing discussion board? Or are you here with your year of experience to educate “80% of RNs” on how to be RNs?

I actually respect the work of phlebotomists, lab techs, or whatever titles they may hold; and actually enjoyed working in the facilities where RNs had to collect their own labs because blood collection and starting IVs had me as the go-to person for those hard-stick individuals. My question to you is, how many nursing duties have you had to perform in our absence?

If there is such a rampant lack of professionalism and personal disrespect to you from the majority of nurses iwhere you work, have you considered employment elsewhere...where you’d have other phlebotomist to help rotate your assignment to the floors? Have you reported this behavior that is unacceptable if even ONE nurse, let alone 80% of RNs talk down to you? Are you aware that nurses do not order bloodwork without the direction of the physician or approved hospital policy? And if they are put in, it is your job to “cater” to those orders, although the smile is optional. If you miss a lab draw, who do you think the doctors are upset with? How many times have you had to try to explain to a physician why lab tests/results are not in the system?

One of the things nurses can do without consent of a physician is make nursing diagnoses. Did you know that? And the one most applicable to your post is a lack of knowledge related to RN responsibilities as evidenced by your entire post.?

MT Fun_Dips · Nov 12, 2021

53 minutes ago, NotMyProblem MSN said:

It would be interesting to know how you would know this as I’m pretty sure phlebotomist are not allowed to touch PICC lines. Could it be that your viewpoint is as it is because you are overworked and you resent having to come to the floors to do some of the many tasks of your job? Are you considering becoming a nurse since you’re on a nursing discussion board? Or are you here with your year of experience to educate “80% of RNs” on how to be RNs?

I actually respect the work of phlebotomists, lab techs, or whatever titles they may hold; and actually enjoyed working in the facilities where RNs had to collect their own labs because blood collection and starting IVs had me as the go-to person for those hard-stick individuals. My question to you is, how many nursing duties have you had to perform in our absence?

If there is such a rampant lack of professionalism and personal disrespect to you from the majority of nurses iwhere you work, have you considered employment elsewhere...where you’d have other phlebotomist to help rotate your assignment to the floors? Have you reported this behavior that is unacceptable if even ONE nurse, let alone 80% of RNs talk down to you? Are you aware that nurses do not order bloodwork without the direction of the physician or approved hospital policy? And if they are put in, it is your job to “cater” to those orders, although the smile is optional. If you miss a lab draw, who do you think the doctors are upset with? How many times have you had to try to explain to a physician why lab tests/results are not in the system?

One of the things nurses can do without consent of a physician is make nursing diagnoses. Did you know that? And the one most applicable to your post is a lack of knowledge related to RN responsibilities as evidenced by your entire post.?

Thank you for your belittling reply. It embodies the very reasons I made the post in the first place.

To reiterate, I'm not a phlebotomist, I'm an MT, and the reason I know the PICC pulled fine is because after making multiple draw attempts (not from the PICC), a nurse who didn't even have that patient offered to pull from the line and had no issue doing so. The nurse who was responsible for that patient refused to do so. This wasn't a one off occurrence either. And yes, I did report these occurrences.

I understand that doing draws is part of my job, but you're clearly twisting what I said. It's not my SOLE job, and medsurge draws do not take priority over ER draws in most cases.

To respond to your barrage of questions, many of which seem to attempt to belittle my post, occupation, and/or level of education. If miss a draw I'm held accountable if an order was placed for it, and I'll be the one explaining to the physician why it's not done. As to how many times this has happened where I had to explain this to the physician I'm at a loss, as it would be strange for me to memorize such a thing (I doubt you care if it's anything other than 0). The doctors will hold the charge nurse accountable if no orders are placed for a lab, because like you said that's their job, although I've had to to it for them on more than once.

I find it funny how you acknowledge that talking down to Laboratory staff is unacceptable behavior, but you seem to have no confliction doing it here.

NotMyProblem MSN, ASN, BSN, MSN, LPN, RN · Nov 12, 2021

5 hours ago, MT Fun_Dips said:

Thank you for your belittling reply. It embodies the very reasons I made the post in the first place.

To reiterate, I'm not a phlebotomist, I'm an MT, and the reason I know the PICC pulled fine is because after making multiple draw attempts (not from the PICC), a nurse who didn't even have that patient offered to pull from the line and had no issue doing so. The nurse who was responsible for that patient refused to do so. This wasn't a one off occurrence either. And yes, I did report these occurrences.

I understand that doing draws is part of my job, but you're clearly twisting what I said. It's not my SOLE job, and medsurge draws do not take priority over ER draws in most cases.

To respond to your barrage of questions, many of which seem to attempt to belittle my post, occupation, and/or level of education. If miss a draw I'm held accountable if an order was placed for it, and I'll be the one explaining to the physician why it's not done. As to how many times this has happened where I had to explain this to the physician I'm at a loss, as it would be strange for me to memorize such a thing (I doubt you care if it's anything other than 0). The doctors will hold the charge nurse accountable if no orders are placed for a lab, because like you said that's their job, although I've had to to it for them on more than once.

I find it funny how you acknowledge that talking down to Laboratory staff is unacceptable behavior, but you seem to have no confliction doing it here.

So you’re not a phlebotomist, but a MT. We are not phlebotomist, either, and blood collection was not and is not part of any nursing program. But this is a task that is expected of us should whomever from the lab fails to perform this task.

But does that make you an expert on what nurses do, so much so that you can come an insult 80% of the RNs? Is there a website where MTs are being insulted by RNs? I’ll just bet that you’ve said nothing to those who’ve actually offended you. If your facility is so small that you run the show single-handed, it should be easy to address and identify the nurse(s) causing you so much grief.

For what it’s worth, not that you care and not that I care if you care, (as my handle suggests, that’s not my problem), I did not belittle you. It was You who came here and belittled “80% of RNs” and then you take offense when I actually clarified several key points in what nurses actually do, stated that “talking down to anyone by even ONE nurse is unacceptable”, and suggest that you find another job or report this behavior???? Supposedly, we are nurses talking amongst nurses, yet here you are with you disdain for the majority of us.

As for the PICC, for all you know, it was a new nurse who had no experience with collecting blood from lines or an experienced one who was tied up with something else. Did you ask the assigned nurse why you were called for a peripheral collection or did you go to the first nurse you saw to point out the presence of the PICC? But you deduced that the nurse just didn’t want to. Some of these lines can be positional and have had unsuccessful attempts by several nurses at sampling. What evidence do you have to support your negative claims about the performance of 80% of the RNs that you’ve encountered?

You have a lot to learn, my dear, because you COMPLETELY missed the point. I said nothing about your level of education, only your limited amount of experience to even be aware of ALL that we do, including taking the heat when labs are not drawn. You never have to answer to ANYTHING that nurses forget or just have no time to do. Yet you feel compelled to come here and straighten us out. That is truly laughable.

I’ll say again here what I said to a nursing student a few days ago about cheating students. If you’re not going to report the unacceptable behavior where a change can be made, then let it go and distance yourself from them. This student, however, claimed to have physical evidence that was sent to him or her and followed up with the decision to report the undesirable behavior. What is your course of action?

londonflo · Nov 12, 2021

On 10/24/2021 at 6:05 PM, MT Fun_Dips said:

I've had on multiple occasions medsurg nurses flat out refuse to draw from PICCs, not because they aren't pulling, just because they can't be bothered to when I can just stick them instead.

I am very sorry to hear of your experiences with RNs refusing to draw from PICCs. Patients have PICCS for a very good reason and of course you know that. These patients are hard to draw from and having a 'used pin cushion, bruises and all' for an arm, is never comfortable, or humane. Please continue your work to get the RNs to use the PICC, even if it is reporting it up your line. If an RN cannot appreciate the true purpose of a PICC for fluids and blood draws it doesn't seem to me they have any empathy for the lived experience of the patient. I am so old I remember when we did not have PICCS or Central Venous Access lines. It was true torture to get blood draws.

**CalicoKitty, BSN, MSN, RN** · Nov 13, 2021

For PICCs, some are ordered simply because the medications that need to be injected have a high risk of causing damage to the veins, or a lot of fluids. Many hospitals have policies about accessing them. If a patient is receiving some medications (such as TPN, heparin, insulin, vancomycin, among others). Drawing blood from a PICC line must be done carefully. There is the typical risk of hemolysis if pulled too fast or with too much force. They can be diluted by the saline or other fluids running (which can alter the results). The potentially life threatening infection risk (CLABSIs are a huge no-no for hospitals and get reported to agencies). Results can be more accurate from a peripheral stick. There is also the risk of the PICC not working due to being clogged by the blood. Some hospitals have policies regarding how often blood can be drawn from them.

londonflo · Nov 13, 2021

1 hour ago, CalicoKitty said:

For PICCs, some are ordered simply because the medications that need to be injected have a high risk of causing damage to the veins, or a lot of fluids. Many hospitals have policies about accessing them.

Any hospital I worked for had policies and procedures for accessing them. Insertions costs could range from $3,000 to $6,000 or more so there needs to be adequate justification for insertion and use. We did send some patients home with them but more so with central lines.

If the patient showed up in the ER, despite oncology RN professionals freely offering to come to the ER to get blood tests or start fluids via the central line, we would often find the patient being admitted from the ER to the oncology floor with a peripheral in place. There may be a special place in hell for those ER nurses who chose starting a peripheral versus asking for help. LOL

allnurses Guide · Nov 13, 2021

I concur that you should give this some time. However it is not true that you need two to three years in M/S to be successful in nursing. It certainly helps but with the right mentorship you can and will succeed. I have been a nurse for 20 years, consider myself to be successful and never worked a day in M/S.

I notice you like doing IV's, dressing changes etc. Infusion nurses and wound care nurses are in high demand. Just because you are in your first year does not mean you can't show an interest in another area. While some specialized training is required you could plan your career in anny direction you want to go, But no matter where you are those first months/year will be anxiety producing as you find your way from beginner to expert.

Instead of giving up on nursing I suggest you look at where you want your career to take you. Where do you see yourself in 5 years, 10, 15. Have a goal, make a plan, put the plan in action and don't get distracted.

Hppy

londonflo · Nov 13, 2021

On 11/12/2021 at 7:39 AM, NotMyProblem MSN said:

You have a lot to learn, my dear, because you COMPLETELY missed the point. I said nothing about your level of education, only your limited amount of experience to even be aware of ALL that we do, including taking the heat when labs are not drawn

Why would the OP need to know all the specifics of an RNs job while participating in an medical assistant job. Are you saying: "NotMyProblem" from your Reponses here that what you do in your job, licensure requirements, must be the basic education for an MT and then they should learn their own job.

Getting timely labs drawn is always a bone of contention! Have you had a 'peak and trough' done at the actual time required? I heard endlessly that at one hospital (Hospital A) the length of time for a peak to be drawn and reported to the MD was a joke due to the time interval that required the phlebotomist to go to ER, etc. before drawing

"And Oh yes, I was told, (Hospital B) were always right on top of it." I was then at the other hospital (Hospital B) ) and their peaks were ALWAYS coming in (late) as the same time interval as Hospital A.

I was in one hospital where a teenager was delivering an unexpected precipitous birth. When the lab came in to draw blood, the patient moved swiftly into delivery and held on to the lab tech's hand for life, while the baby was delivered. The lab tech was a soothing voice through the teenager facing all this. An MD or resident was NOT present despite the later charting.

NotMyProblem MSN, ASN, BSN, MSN, LPN, RN · Nov 13, 2021

4 hours ago, londonflo said:

Why would the OP need to know all the specifics of an RNs job while participating in an medical assistant job. Are you saying:  "NotMyProblem" from your Reponses here that what you do in your job, licensure requirements, must be the basic education for an MT and then they should learn their own job.

Getting timely labs drawn is always a bone of contention! Have you had a 'peak and trough' done at the actual time required? I heard endlessly that at one hospital (Hospital A) the length of time for a peak to be drawn and reported to the MD was a joke due to the time interval that required the phlebotomist to go to ER, etc. before drawing

"And Oh yes, I was told, (Hospital B) were always right on top of it."  I was then at the other hospital (Hospital B) ) and their peaks were ALWAYS coming in (late) as the same time interval as Hospital A.

I was in one hospital where a teenager was delivering an unexpected precipitous birth. When the lab came in to draw blood, the patient moved swiftly into delivery and held on to the lab tech's hand for life, while the baby was delivered.  The lab tech was a soothing voice through the teenager facing all this. An MD or resident was NOT present despite the later charting.

I didn’t say the OP needed to know any of what we do. My point was that an assumption was made and 80% of the RNs were tried and found guilty by the OP based on that assumption. As busy as acute care nurses are, any number of things could have been going on.

And if you reread my post, the “Not my problem” comment was directed at the sentence in which it was stated and nothing else.

NotMyProblem MSN, ASN, BSN, MSN, LPN, RN · Nov 14, 2021

@londonflo, in my 35-yr nursing career, I’ve never had an issue with a lab tech/MT/phlebotomist. I’ve even made a point (as a 20+ year night shifter) to collect my own 0600 PTTs and troughs just so it wouldn’t fall through the cracks of shift change. I’ve witnessed far too many nurses being chewed out by physicians or bullied by oncoming nurses when the lab results are not in or even collected. In my response to the OP, nowhere do I imply a reason for labs not collected. I’m all too familiar with skeleton crews on nightshift, and not just in the lab (which I don’t believe the OP realizes). Just because he or she sees more than one nurse doesn’t mean that, given the responsibilities nurses have, we’re not extremely short-staffed and overwhelmed equally as well. Points to consider before convicting “80% of RNs”, (after such a short time in the field).