Indy 9,512 Views
Joined: Apr 27, '04;
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The CNAs' attitudes might be the result of them not wanting to at work there in the first place. A huge number of the CNAs in my city (and many other cities across the US) are part of a "forced workforce" due to welfare-to-workfare regulations.
Many of these mostly single mothers would much rather stay at home and raise their children, but they are being forced into accepting certain jobs in order to keep certain public assistance benefits such as food stamps, section 8 housing and welfare payments. The welfare-to-work programs tend to track women into jobs that entail quick training and little formal education such as nursing assistants (CNAs), dietary aides, childcare workers, etc.
When we've got a literally forced workforce of caregivers in America's nursing homes, bad attitudes happen because many of these single moms simply do not want to do backbreaking CNA work.
I do well with longer shifts. It's the shorter 8-hour shifts that burn me out because I am forced to report to work five days per week.
With 12-hour shifts I have four days off per week. The 16-hour double shifts enable me to have five days off per week. I'd rather not come to work five days a week when compressed schedules allow me to have more time off.
I've been coded. Down unknown amount of time under water before CPR was started. Shocked several times. I obviously survived but don't remember a thing. The only thing that happened from it was that I was always scared in a pool of being dunked. I would panic thinking I would never come up.
Honestly though I never knew it happened. My family kept it from me for 19 years. My mom never talks about it because she thought she lost me. I ask my dad and he says I am resilient just like him and his dad. Both whom should have died several times and never did.
It also spawned the tattoo on my side stating "do not go gentle" by Dylan Thomas. It's a wonderful poem about fighting death.
I was reaidng an old thread and found this lengthy comment quite relevant...
OK, so in another life, I was a physics major, so I have to quibble, but not only for the sake of quibbling. In the seventeenth century, before there was a theory of gravity, Galileo demonstrated that objects do not fall to the ground with a speed proportional to their mass. A bowling ball and a baseball fall at the same rate. So does a feather, in the absence of air resistance. That's picky, I know, but it does tend to reinforce the argument that people often dismiss theories without full understanding them. (I don't fully understand Watson, either, but I am impressed at how much her theory of caring, stripped of jargon, is good, common sense.)
So, I've had an interest in science as long as I can remember, and I did, briefly, major in physics, until it proved incompatible with my minors in girls and beer. At around that time, I was forced to take some psych courses, and in those days behaviorism was all the rage. I HATED behaviorism, which I felt was adequate for training mice to run mazes, but had prescious little to do with people. I've never disputed that operant conditioning can work, but the mere title of Skinner's Beyond Freedom and Dignity damns the whole movement. To me--and I'm right about this--there is nothing beyond freedom and dignity. Without them, my cats' lives wouldn't be worth living, and they understand that, even if Skinner couldn't.
Still, behaviorism was the rage, and I know why. Psychologists had an inferiority complex. Physical sciences dealt in objective, quantifiable data and repeatable experiments. Psych dealt in feelings and wanting to have sex with your mother and other unscientific stuff. So, behaviorism to the rescue: a theory of psychology that is repeatable and quantifiable, and if perhaps not entirely objective, at least dispassionate. Hurray!!!
Except, of course, that psych was still 50 years behind the times, because the physics of the 20th century has taught us that that which is quantifiable, repeatable, and objective is merely an approximation of reality, workable for such everyday tasks as putting a man on the moon, but inadequate to fully explain how he got there. Not long after mathematicians proved that a logical statement can be both true and false, physicists found particles that behaved in just that manner. To over-simplify quantum electrodynamics, all of reality is invisible electromagnetic fields. And while theories have supplanted QED, they haven't made reality more concrete. The distinctions between actual concrete and a vaccuum just get more and more vague.
So, here we are in nursing, some arguing evidence-based practice and you have to treat what you can measure, when the most fundamental of sciences tells us what can be seen and measured is just the tip of the iceberg, and others saying, no, no, no, you have to treat the soul as well as the body (and often trying to show measurable, objective data to support their position.)
I tend to get fidgety when people start talking about the profession of nursing. I was a carpenter for most of my working life, and I never saw anything wrong with a good, honest trade. But carpentry was not just a trade, it was (and still can be) a craft, because wood isn't entirely dead. It isn't steel, it isn't plastic, it moves, it breathes, it retains an element of the chaos that the tree had when it was a living being. And I really like the idea that nursing is both an art and a science--a craft, if you will--because we do need evidence-based practice, but we aren't diesel mechanics. Our medium moves and breathes and poops and cries and has fears and dreams and freedom and dignity, and when we are able to synthesize all of these conflicting values, it's not merely a profession: it's magic. It's nursecraft.
Is God willing to prevent evil, but not able?
Then he is not omnipotent.
Is he able, but not willing?
Then he is malevolent.
Is he both able and willing?
Then whence cometh evil?
Is he neither able nor willing?
Then why call him God? -Epicurus
I totally agree that nursing schools play a large part in this negative perception of LTC. The emphasis is skewed so heavily toward hospitals it isn't funny. Nursing students are hit over the head with the notion that "real" nurses work in the hospital. They need more clinicals in skilled nursing facilities and sub acute care. Espeically since all indicators point toward these areas, not the hospital, will be were the major growth is.
I enjoy my LTC job. And if I ever transfer to acute care, any smart manager would realize my LTC background is a plus, not a liability. LTC teaches you to be fast, efficient and resourceful. Being able to spot and treat a brewing case of pneumonia or CHF exacerbation during a 40-resident med pass is no small feat. It's something only a "real" nurse could do.
I just listened to the whole 911 call. Does anyone even know what the real cause was of her collapsing? Did she choke? Heart attack? Stroke? If she was choking, why tell them to lay her flat and start chest compressions?
Does anyone else feel like maybe the 911 operator wasn't even listening, or really assessing? She seemed to be talking over both of the other people in the phone call. They would try to answer the few questions she did ask, and she would immediately cut in. That part bothered me a lot.
What is the survival rate for 87 year old arresting outside of hospital? If a defibrillator is on hand...even if you try it you do no harm. But CPR can be devasting when applied to the wrong patient and an out-of-hospital arrest in an 87 year old is a lucky death for her. I can't believe so many people are willing to participate in CPR in someone who has zero chance of intact survival. We are supposed to people of science and do the best for the patient by using FACTS, not moral one-upmanship. And besides, we have no knowledge of the facts in this case and probably never will.
As someone with the high ethics, I will not allow my patient to suffer. The death process is inevitable and who is to say what hastens it.
I take umbrage to the fact that a family member can actually say, "oh he would still be alive were it not for."
Alive for whom? and for what purpose?
Seriously, our society wants to control everything...including the death process which was never ours to begin with.
I will NOT allow a patient to suffer.
Nursing is a profession that demands a lot.
It demands your mind.
Your favorite pen.
Your closest drug book.
Your families good nature.
Your spouses kindest ear.
Your faith in humanity.
Your blind eye.
Your other cheek.
Your longest sigh.
Your deepest breath.
Your best shoes.
and really in the end, a little bit of your soul, as it will change you in ways you never thought possible.
For some it is a job, for others a passion, but for all something meaningful, whether viewed as good or bad, positive or negative, hurtful or helpful.
I personally love being a nurse, and I hate it sometimes too. I work nights, I miss my husband, but at the end of it all I feel I have truly made an impact on someone's world each time I cross back over my threshold and lay my head on my pillow.
PS. Take a little time to search the site and you find many stories of what nursing means to all of us.
Best of luck!
I went to a community college with a program that had been around a LONG time. My program was disorganized, the instructors prided themselves as being "weed outs" and schedules were changed at the last minute. Sometimes entire clinical sites where unknown until the night before. They would tell you that you have to be flexible if you want to be a nurse. Just like another poster said I would hear "welcome to nursing". It's BS but all I can tell you is stick through it and warn anyone else looking to go through your program about what their getting into!
I hate when that happens. Or, I get the comments that "Well, you are going for your RN, aren't you?" Or, when do I plan to be a nurse and I tell them I already am.
I admit to everyone that I am proud to be an LPN and have no intention of becoming an RN. To do so would be only from peer pressure, not my true desire. Lately, I have made it my business to say that I am a Licensed Practical Nurse (with great emphasis) because when I get through with teaching, caring and performing my skills, I want them to know that LPNs are competent, knowledgable nurses as well. I am a task oriented person who does wish to focus more on the nursing skills than paperwork. I am observant, I continue to read and update myself on as much as I can so that I can improve my practice. I made a careful decision when I chose which nurse I wanted to be and have no regrets.
If a person asks me in a respectable way, I mention some of why, but those who are rude and condescending...well, they get what they get. Be proud of your accomplishments because you WILL be a NURSE soon!
Tell them what I'm telling them -- I'll be a "new" RN with 2 years job experience, and no loans to pay back. If they insist on being a horse's backside, I then tell them it took me 5 years to pay off my BA, and I promised myself that this time, it's pay as you go, or you don't go....
This is definitely an admonishment that every well-intended nurse, especially new ones, need to learn. Part of what keeps us going as nurses is the praise we receive for doing nice things for patients, and we're taught to work with the patients to do what works for them. This also represents a very big problem with nursing that manifests itself in many situations. For every nurse who tries to put her foot down and establish limits, another nurse will rush to coddle/enable defeating the original purpose, with the enabling nurse often lecturing others on how they should be more compassionate, giving, warm, etc. When nurses want to demand better conditions and refuse to take impossible situations, there's always a nurse who chides them for "neglecting the patients and forgetting the calling." This is why nursing is not respected (if it's so respected, how come it's not automatically a felony to attack us and you'll find more security in a bank than most hospitals?). There's always some goody-two shoes who will step in and play the martyr/savior, allowing the manipulative patients and greedy administrators to pit people against each other. Some of these people are simply well intended and want to do a good job, not perceiving the consequences. Others base their identity and self-worth on being the good one, the one who does the jobs nobody else wants to do, the one who patients wish all nurses could be like. These people are opportunists who use the perceived poorer actions of others to bolster themselves.
I'm going to say something that will sound horrible and selfish, but it's true. When in a workplace, it's not good to be the one who always goes the extra mile. Not only will it become expected of you (the burger and fries for a fingerstick is a perfect example), but others will resent you for going soft on the limits. This is not about lazy people resenting a hard worker or mean nurses bullying a nurse who honestly cares. This is not about keeping expectations low so you can have an easy job. I speak from experience. Back when I was a new nurse, I was able to go extra miles because my patient loads were much lighter. I loved the praise of being such a caring nurse, and I thought that the other nurses' advice to keep to the objectives were a result of being jaded. I sometimes fell into the manipulation trap. However, when my training wheels were removed, I realized that I couldn't do it all. Some of my patients (it was LTAC) had grown accustomed to my treatment. I had to learn that I'm not Jesus Christ, and that people are going to have to wait unless they are in bad enough shape to be my first priority. As I grew seasoned, I saw bright eyed new grads doing the same as I had. It was destructive to hear the occasional line-toeing patient to have the complaints of, "Well so-and-so did this for me!" We nurses need to look out for each other rather than let manipulative patients and work-loading administrations pit us against each other with the "Why can't you be more like _________" game.
Your actions were well intended, but the fact that you caved to her manipulations and take pride in being more liked than the book nurse show that you are being played like a harp. Good luck learning to set limits and realize that you can't do everything perfectly.
Doesn't sound like she "went out of her way to be rude" but rather didn't go out of her way to be nice. Think about it, she's stuck at work the Sunday morning after July 4th. If she got the holiday off to spend with her family, didn't get to bed until late after fireworks. We're all supposed to put the patient first, but come on, we're all human too. And I don't see the hospital administrator thinking that the patients are important enough to bring themselves in on a weekend, much less a holiday weekend.
I recently had a family member in the hospital. I had thought it would make me more sensitive to pt/family complaints. Instead, it's made me realize that what's important really should be getting the patient better. I didn't care who smiled or was all business or even who was kind of mean. I cared that she went from could have died to better than before her admission. The emphasis on "customer service" make me even more angry than it used to. It's a huge mixing up of priorities.
So you didn't get service with a smile. Your kid is better right? Isn't THAT what's most important?
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