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gentle 7,379 Views

Joined: Dec 13, '05; Posts: 459 (21% Liked) ; Likes: 246

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  • Mar 12 '13

    I work on an inpatient psychiatric unit. We all know where that falls in the hierarchy of specialties.

    We have a patient who was diagnosed with cancer while on our unit. My favorite comment of the day came from the well respected oncologist seeing him: "People always ask me how I can do what I do, but I have no idea how you all can do what you do!" His new found respect made my day and from the smile on his face, the psychiatrist's too.

    There are so many different types of illnesses, patients, settings and situations. It's a good thing every specialty has people who were made just for each individual's suffering. Hope all of those searching for where they belong will soon find their place.

  • Jun 30 '10
  • Jun 30 '10

    The best thing about our unit is how the cohesiveness of the staff. We really are a team. We have become a team because we are united against a common enemy. That would be you.

    We come to work each day because we have families to support. We do not have families to give us something to do when we are not at work. Regardless of your opinion of yourself, your bottom line is NOT our first priority. Our families come first, patients second, coworkers third...I think you fall into place around #65.

    You have made decisions that compromise my family. I have young children. When you decided that EVERYONE needed to work 10-hour shifts, did you take into account that that would mean that some of us spend 2-3 hours with our children in a 24-hour period now? Does it concern you that multiple staff members have broken down and cried at work because they love their job, but feel compelled to leave because they feel like they are neglecting their families? Does it concern you that half of the department nurses DID quit or transfer out when you decided to change our schedules without consulting us? Does it concern you that you have 22 orientees being trained by traveling nurses who can't find telfa, let alone teach the new nurses (many of them new grads) about surgeon preferences or hospital policy?

    You have made decisions that compromise patient safety. We have consultants following us around with clip boards to make sure that we turn the room over quickly. Some nurses cut corners to get turnover times down. We don't spend enough time with the patient prior to their procedure, our rooms AREN'T ready, and patients are the ones who suffer.

    When we come to you with our concerns, "There's the door," is not an appropriate response.

  • Jun 30 '10

    Quote from sunnycalifRN
    Wait until you take care of a patient from the jail . . . handcuffed to the bedrails (like that's going to hold him!!) with an officer at the bedside and a second one at the door. Murder, rape, assault with a deadly weapon, etc . . . these are not "nice" people! But, you just put aside your feelings and opinions, and deliver nursing care.
    Not saying they are all nice, but oddly, the nicest patients I usually have are the prisoners. They are often so glad to get out of their daily environment. Although I admit I am silly enough to lock my car doors even when driving 75 mph past a sign that says "Hitchhikers may be escaping inmates."

    The patients I like the least are actually the VIPs, lol. "Do you know who I am? I donated a bazillion dollars to this hospital, I pay your salary, blah, blah blah." It's all I can do not to either laugh or consider pillow therapy

    It reminds me of that great line from the Princess Bride: "Yes, you're very smart. Now shut up." I always want to say: "Yes, you're very rich and important. Do you feel validated now?"

  • Jun 30 '10

    Impressive! Such thoughtful comments !!!

    In your haste,oh untouchable nursesIt wouldn't hurt to validate the feelings of the OP, before handing out your sage advice.

  • Jun 29 '10

    Don't confront her. If you're with her alone she'll probably say you touched her or something.

    As soon as you find a new job, quit this one. Don't give them two weeks, just quit. Normally I'd never recommend that, but they're obviously looking to fire you, and they don't care what bills you have or how many kids you're supporting.

  • Jun 29 '10

    Quote from fanfan8787RN
    I am sorry to hear about you situation. If at all possible seek part-time employment elsewhere. It is my firm belief that nurses should not have just one job. Everyone makes mistakes and it is very easy to get let go for any reason.

    Confronting the offending individual won't do any good. I'm quite sure that the "Powers that be" know about the coworker's behavior and turns a blind eye. Good luck.
    I totally agree with this post. Just start looking for a second job which might turn into your only job. Defend yourself the best you can, but don't expect any miracles when it comes to a dishonest troublemaker being straightened out by management. She serves a purpose for them.

  • Jun 29 '10

    I am sorry to hear about you situation. If at all possible seek part-time employment elsewhere. It is my firm belief that nurses should not have just one job. Everyone makes mistakes and it is very easy to get let go for any reason.

    Confronting the offending individual won't do any good. I'm quite sure that the "Powers that be" know about the coworker's behavior and turns a blind eye. Good luck.

  • Jun 21 '10

    It's finally happened.

    The Grim Reaper has struck my workplace, and I'm one of his unlucky victims. Three fulltime nurses and a medication aide who once held secure jobs, now stand figuratively on the trapdoor of the gallows, shaking our heads in astonishment at finding ourselves here and wondering how the hell we're going to get out of this predicament.

    It's not like we got fired. We're just not on the schedule anymore. Our facility's census, which can be as high as 135, has been hovering at around half that for the past year or so; now, thanks in part to Medicare cuts, our management has slashed staffing basically in half. In the blink of an eye, I went from 32 hours per week down to eight, with only a minimal chance for more during the course of any given week. The decisions were based on seniority; another nurse even lower down the totem pole than I has been placed on PRN status, and still another has been let go entirely, while the CMA's hours have been cut to one 7.5-hour shift per week.

    Wait, it gets even better. This is a small town surrounded by other small towns. There are few nursing jobs open, if any, and most of what is available is either part-time or health insurance or other benefits, of course. That is bad news for anyone, but especially for a nurse with a bad knee (that's about to be operated on) and a couple of chronic health problems requiring daily medications.

    Don't get me wrong; I'm not giving up THIS easily. But I can already see the possibility of winding up in a job where, instead of asking folks to rate their pain, I'll be asking them how they like their eggs.

    If I were a better person, I would foreswear bringing up politics here; but since it's my blog, I'm going to say what I think. And what I think is, if this is the kind of "help" our government officials meant when they claimed that healthcare reform would benefit everyone, they can put it in a place that's accessible only by endoscope.

    I was never unemployed when I was "helping" myself. Does anyone really think they have plans to "help" all of us who are losing our jobs, especially those of us in later life who find ourselves starting out at square one again? At fifty-one, I'm not even sure how many more times I should HAVE to start over; I certainly don't appreciate being forced to now.

    But I have no choice: I can't live on one shift per week. I also can't afford to retire, not that I really want to (although I'd give my collection of hundred-dollar work shoes for a 3-day-a-week job that would let me eat AND pay all the bills in the same month). So I've got to polish up a resume that hasn't seen the light of day since 2006, dust off my one pair of dress shoes, and try to arrange my face AND my thoughts in more attractive lines before hitting the pavement.

    This is, of course, not what I'd expected to be doing at this stage of life. And I'm alarmed at how rapidly my self-confidence has dissolved in light of these developments. Suddenly, I'm horribly depressed and anxious.....and here I'd finally gotten comfortable with who I am and where I fit in this world; I'm also experiencing that sickeningly familiar rollercoaster ride after having found the right balance between life and work. And while I'm reasonably sure I can find another job, the pickings are so slim here that I'm afraid I'll wind up taking anything just to put food on the table.

    Just in case you're wondering: No, going back to school is not in the plan book. I'm still paying on my old student loans, and I have absolutely NO desire to tackle O-chem and statistics. Moving out of the area is also not the answer; our roots are here, and so are our grandchildren. I would be willing to travel a little to get back and forth to work---I've done it before---but with gas prices near $3 a gallon, I'd rather not if I can avoid it.

    Now for the absolutes: I can't handle more than the very occasional 12-hour shift. I can't work Med/Surg for any length of time......both are far too hard on me physically. Nocs are not really an option either; I had trouble with mental fuzziness and confusion when I worked 11P-7A in my early 40s, so I can't even imagine how I'd perform now. And the types of nursing I will never, ever do in this lifetime are NICU, corrections and mental health/psych---I think I'd sling hash at Denny's before taking a job with critically ill babies or in any facility that locks the staff in with the inmates.

    Other than that, I'm open to suggestions. Don't mind me if I just "hang around" for a while and see what you all come up with!

  • Jun 20 '10

    There are many reasons for this occurance.I guess some are burned out,some dont like to teach students,some wants to focus on their sucks to be a nursing student and rely on the mood of a particular nurse you are working with for for that day..Just focus your eyes on the ultimate price.Develop a thick skin,face the challenge,maybe you can learn something important from that not so polite nurse-sometimes the ruddest nurses are the best teachers,remind yourself that once you graduate and go through orientation period you will be working on your own,and also make yourself a promise to treat nursing students with respect once you have years of experience.

  • Jun 20 '10

    This happens everywhere, at least from what I have seen in my many years in nursing. Although I am only a personal support worker, we too get student psw's and some staff here treat them awful! I like to make newcomers feel welcome and am eager to show them the ropes and help them navigate their way around. I do this because I know how nervous they are and how much better it is for them and us when they get into the 'swing' of things. Unfortunately some staff are just plain mean and ignore their requests for assistance. And like a bad cold others get 'infected' and get an attitude towards students and new staff too. It's too bad this happens. It is not necessarry to be like this. All it does is turn people off and then they don't come in to help when we are short. Can't say as I blame them.

  • Jun 20 '10

    I realize that I went to nursing school in the dark ages...but the bedside nurses were not responsible for patients assigned to nursing students while the students were on the floor...the instructor was. We practiced on the floor under the direct supervision of the instructor...not the unit nurses.

    This was part of the arrangement between the hospital and the nursing school. Similar arrangements are made for all disciplines training in that setting. This is common place in teaching hospitals and the staff should be accustomed to it. If bad attitudes and behavior is noted as commonplace it is because the management allows it and possibly behaves that way as well.

    I do have to say, however, that I have been in the acute hospital setting a great deal in the past 5 years...seeing patients in different specialty units. And I have noticed that some nursing instructors seem to be "invisible" during the course of the day. It seems that the students are tired of looking for her and rely on the staff to answer their questions, etc. This surely creates friction as well as liability issues.

  • Jun 20 '10

    Quote from gentle
    @ OP:

    I see this quite differently. I too work DOU. You aren't there to feed the patient, help the patient get to the bathroom or help the CNA!!! That statement isn't okay for me.

    You are there to learn. I'm going to explain to you why we are giving Mrs. X clonidine for her blood pressure instead of metoprolol at this point in time. Mrs. X will be fine if she doesn't eat her breakfast, lunch or dinner immediately. She won't be fine if her blood pressure is too high and heart rate is in the high 50s. I have a decision to make and you need to know exactly why I'm making that decision.

    I take your presence very very seriously. I want you to learn and grow. I want you to work side by side with me with understanding.

    I understand that my patients need emotional support. However, it sucks to provide emotional support to someone who is slightly dusky or has a small change in fluid electrolyte balances. Small changes can lead to big problems later if I don't pay attention. I want you to learn how to pay attention too.

    Meanwhile, there are other experiences I am more interested in you seeing. For example, I want you to witness a potential hostile situation being managed calmly and carefully with wisdom. You won't see this if you are taking someone to the bathroom. I want to explain to you why it was important for Nurse Y to use humor, with an irritated family member. Or perhaps it was better to provide an over abundance or empathy at that moment.

    Ever considered service recovery? When something goes wrong. How do we correct the situation.

    All these things cannot be learned and understood if you are taking someone to the bathroom or providing emotional support to a noncompliant diabetic who has gotten themselves readmitted for the 5th time in the last 6 months.

    And even if my posts come off rather brusque, guess what I am still trying to teach you. I'm trying to get you to understand what my goals are for you. Believe it or not, by the time you will have finished with me you will have gained more knowledge and wisdom, than with a nice nurse who isn't going to dig in and really teach you.

    Contrary to how media has portrayed nurses in the past, we are not always going to be nice. Nice is useless if my patient is crashing.

    Nice was also a useless trait Friday night when my patient had a bradycardia of 50-40 at 2300. Now it's your turn. Why did I consider nice being a useless trait for this 75year old man at 2300? There was no atropine ordered for use and the patient was tolerating the heart rate fine. His initial SBP was 142. I paged the cardiologist 2times by 0031 and he hadn't called back. SBP 139. Patient is a sweetheart of a guy. Has had diarrhea for a couple of days and is still having this problem. I gave the immodium. IVF are running. I work the night shift as you have guessed and my patient has had a long day. He's ready for some sleep. I spoke with the attending physician, who said to monitor the patient because the patient was maintaining his BP and was asymptompatic. My patient was on bedrest, so I bathed him because of the loose stool. He also wasn't diaphoretic or dizzy again my patient was on bedrest.

    Again, it's your turn now. What have your instructors taught you? Take the time on and off today and think through, why I might have been showing patience (character trait) but not necessarily nice. Why was I more concerned?

    To figure out the answer, you will have to ask me questions. I will be in and out today - It's Father's Day!!!! and We are off to make sure the Daddy has a wonderful day :redpinkhe
    I totally agree with you. When I was a student I had nurses who treated me like a CNA and "extra help". I specifically had one of my instructors tell me to do just RN tasks and not aide tasks for the day. This meant to do assessments and give meds, chart. My one patient needed her teds put on. The nurse who was assigned to her said that I could put them on her. I told the nurse that my instructor wanted me to do RN tasks that day. She nastily replied that it was a nursing task. I was a CNA at that point and felt this was something that could be delegated to the CNA's. When I explained this to the primary nurse she got more argumentative about the issue so I just went and did it. When I have students I try to not treat them as aides but as future nurses. How are they going to learn if they are treated as aides all of the time?

  • Jun 20 '10

    Quote from kayty2339
    you are right in that there is a lot that i can't do yet, but i guess for the pts that don't need a whole lot of attention, the nurses just aren't in there checking up on them. i had a pt yesterday who complained that she hadn't seen or met the nurse yet and it was already 1pm. we leave the hospital at 2 so i guess she was just leaving everything up to me until we left? some of my classmates have said the same thing. also, our instructor tries do do whatever we can't do and just has us watch, so that takes up some of the tasks that need to be done as well.
    to the others stating that it may also have something to do with the instructor. you may be right. it is our instructors first time ever teaching clinicals, she is actually still in school for her masters to be a nursing instructor. maybe she just hasn't gotten the hang of how to coordinate us with the nurses that well yet.
    i'm in the icu, so even when there's a student, i sit right on top of that patient all day so i know what's going on. some patients will still say they haven't seen the nurse all day. don't take the patient saying they haven't seen the nurse as gospel -- patients lie. or are mistaken. or are engaged in a little staff splitting.

  • Jun 19 '10

    Quote from tokmom
    Aww, I'm sorry about your back . I have back issues and I'm in disbelief they made you still work! I can't even imagine!!
    I hope you can transfer to anesthesia, and if not, can you try a different venue of nursing all together? What is your second love?

    Good luck and I hope it works out.
    Thanks for the reply. Given that I have a dodgy back my options are limited. I may try for informatics or occupational health and safety.

    I have applied to study law, I find out this Friday if I get in. If I do then I'll cut my hours down and work 4 day a week and study part time. I'm looking for a way out.