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madwife2002, BSN, RN Guide 100,162 Views

Joined Jan 17, '05 - from 'Ohio'. madwife2002 is a Clinical Service Specialist. She has '26' year(s) of experience and specializes in 'RN, BSN, CHDN'. Posts: 10,274 (21% Liked) Likes: 6,069

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  • Oct 21

    I am ready to leave the nursing profession after 6 years. I have a bachelor's degree in biology and got my associate's in nursing. In high school, I decided that I wanted a career in nursing. By the time I entered college, I decided I wanted to become an OB/GYN. Halfway through college, I realized I didn't want to be a doctor. I wasn't sure what I wanted to do but I wasn't going to change my major and start over. Fast forward about 8 years, I considered nursing and applied to nursing school and here I am.....back at square one. I wish I had sacrificed and endured one or two more years of college by changing my major and pursued something else.

    I often-times cringe when I think of going to work. My attitude changes, my heart races, and anxiety sets in. My coworkers are nothing less than awesome. Most of my patients rock. Both have been unexpected blessings to me and I thank God for our paths crossing. But management, the physicians, and the facility at which I work have made nursing a profession that I wished I had not entered. I never have to wonder how devalued I am when I'm at work. Our voices are not heard, and as a matter of fact, our concerns are considered complaints.

    Not only am I a caregiver, but I am the business office, auditor, waitress, maid, logistics, IT, quality assurance, babysitter, personal assistant, and the list goes on. When doctors fall short, it is our job to clean the mess up.....and, no, I'm not speaking of mistakes that affect patient care. I speaking of simple documentation that they are supposed to take care of. I understand the importance of having all "I"s dotted and every "T" crossed, but when will the physicians be held accountable? I can't be chasing down physicians when they forget to check the correct box especially when it has little or nothing to do with a patient's outcome. That's not my job. We nurses are stressed, afraid, furious, and just plain depressed as a result of these added responsibilities. We already worry about our patients even after quitting time. After leaving work, many of us call back up to the floor or unit checking on our patients. We are genuinely concerned about them, but it is very obvious that management's agenda is not the patients. Whatever management's agenda is becomes our agenda, right? WRONG!!! I'm here to take care of patients, not physicians.

    There are so many nurses, YOUNG, fairly new nurses, that I know that started their nursing careers with a clean bill of health. They are now on antidepressants, benzos, blood pressure meds, and others due to the stress and unhappiness. Nursing has gotten away from patient care. It's about making money for the organization which is about making the physicians happy. If that means being stripped of our dignity, we are to do what it takes. I feel as though it is second nature to provide excellent care to our patients. WE have saved many lives anywhere from observing changes in our patients to discoverering mistakes made by others (physicians) and correcting them or directing attention to the oversight. I wish they would let us do OUR jobs and provide care and management can can run up behind THEIR "customers". If we can keep those two jobs separate, that would be great.

    We are a vital part in patient care, but yet, we are so underapprecited and taken for granted. We make a positive impact in many lives, but we are the first ones cursed out because someone is having a bad day. Not only are we unappreciated, but we are very disrespected, and in many occasions we are unfairly belittled and we are just supposed to accept those words because "it's part of the job." I'm done accepting it. I'm reminded everyday there are replacements waiting in line. I'm reminded that any fool can do my job. I don't want a pat on my back everytime I do a great job, just acknowledge that I am a vital part of the team. I understand human resources has a stack of nursing applicants on their desks. I just don't have to be reminded of that everytime all my paperwork isn't on the chart (because I'm still working on it), or if I come back from lunch two minutes late.

    I am not cut out to take jabs and low-blows without throwing them back. I have so many responsibilities that I take on from the time I punch the clock to the time I punch out and I refuse to be disrespected by someone with a title because I happen to not move fast enough or I am having to clarify an unclear and, most of the time, an unfinished or incorrect order. I'm helping YOU out!! We genuinely worry and care about our patients that it often consumes us. When a patient codes or expires, we are crushed. I once had a patient who got stuck at least 15 times by various staff members, including physicians, to get IV access. The patient took those sticks like a champ, but I still went home and boo-hooed because I hated to see him go through that. We hurt when our patients hurt. On top of carrying out our responsibility as nurses, we are holding in so much emotion associated with our patients.....yet we get very little to no respect. Don't get me wrong, there are some physicians that I'm in contact with whom are polite and value my opinion and I do appreciate them. Of course I'm not always right or may not make the most intelligent statements, but they acknowledged my voice. Again, I don't want a cookie. I just want to be acknowledged as a professional.

    I understand customer service includes dealing with angry, rude, and the dissatisfied. But when I have poured my heart, soul and emotion into my job and my customers and I am still allowed to be mistreated and insulted, then that becomes a problem. I feel I have no rights as a nurse. Who is protecting me? Who is my voice? Who is standing in my defense?

    So at this point, it's time for me to bow out from the nursing profession gracefully and while in good standing with the organization, my family, and myself before I am forced out or OD on my meds(or somebody else's). My family, happiness, health, dignity, and peace of mind is worth leaving. They tell me Costco employees never leave.

  • Oct 19

    This is in no way justification of staff truely poorly treated but I wonder how many of us have some sort of healthcare related stock in our retirement portfolios. As in we want our stocks to perform well but not impact us in our individual work.

    Or in other companies for that matter that may be providing or doing something we object to.

  • Oct 17

    The other name I see used for "they" is "TPTB" or "The Powers That Be", meaning those who actually hold and wield the power to make those decision and take those actions that impact our policies and resources to care for our patients.
    I am heartened to hear from so many nurses who have not forgotten what it's like on the clinical side and genuinely struggle to balance budgetary prioroties with excellent patient-and staff-care. There need to be more of you.Please keep on fighting for our patients AND those of us still in the trenches with them, Quixotic though it may seem at the present.

  • Oct 14

    I am one who believes the detached approach administration ("they") uses is a double edged sword. It takes many skills, interpersonal and decision making alike, to weild this sword.

    "They" to a degree must remain autonomous. They must make decisions that have a ripple effect throughout the facility they oversee. No matter how well they choose and implement new measures, someone dislikes it.

    Nursing has an advantage over "they" in that our purpose is focused and we'll defined. We use pt outcomes as our guiding beacon when a difficult decision must be made. And we should. They do not have this luxury.

    I've been in middle management and am acutely aware of how no matter what you do, legions of people are going to disagree. Some are so discontent, they will even go beyond disagreement. That is when sabotage rears it's ugly head.

    With that said, I feel I need to say something after reading your article: "Never take your personal experiences as everyone else's reality."

    The "they" you have become and work beside sound like they ride home on Puff the Magic Dragon and clean their houses by singing a song to bring the broom and dustpan to life.

    This is not the reality in the majority of healthcare facilities.

    Corporate America has made its objectives the priority in modern healthcare. To refuse to humor them is to accept closing your doors.

    Yet agreeing to humor them means having to run with minimal staffing, arbitrary and misguided policy making and having to be content with a grade school definition of customer service.

    That is the riddle they face. Forced to partner with other "they" who have an agenda that does not support ours. They are damned if they do, damned if they dont.

    Sounds like the same riddle we as nurses say we are facing. Trickle down perhaps?

    Most "they" solve this riddle by submitting to the Corporate America agenda. Then they try to achieve the original agenda of superior patient care by squeezing the life out of the nurses.

    Less representation, lower wages, smoke and mirrors benefits, scarce supplies and support staff, being demeaned instead of recognized, higher standards with less support.

    This is the solution most "they" find themselves implementing, regardless of what their original intentions were.

    They burn out, just like nurses do. Of course they do. And when they do, the results are devastating to everyone who must endure their tenure.

    Most (not a select few, not some........most) "they" are either struggling to solve the riddle I spoke of and on their way to being burnt out or are already there. See, that's something else we have in common with them.

    This is the reality of "they".

  • Oct 14

    I don't buy it, and I don't mean it with disrespect to you personally, but the sole reason me leaving bedside was because of "them". It's easy to say things behind a desk, walking on high heels eating corporate served bagels and coffee while my ER colleagues struggled to even have proper staffing let alone be served a cup of kool-aid. Then I see "them" walking with a smile and making comments about "we care about patients and our staff", I laugh at this. No one becomes an administrator to "affect the community in bigger impactful way", you get out because life is less stressful and less demeaning at the desk in a suit compared to working with short staffed department all day long and get chastised because you didn't meet sepsis bolus time or patients complain because they didn't get their pain med or a retarded second pillow. It's easier to set goals and policies when you don't really have to abide by them physically. They are the reason I will never work at a bedside or hospital ever again unless I am "them." all I gotta do is act like a give a crap but just rake in my bonus and cut corners for all the other cronies to make more bonuses, if you can't beat them you gotta join them.

  • Oct 14

    I get it. I understand what you are saying. "They" do have good
    intentions, are not evil tyrants living solely to kick back in a leather
    chair and line their own pockets every day. "They" have a job to do
    just like the rest of us.

    The Director of Nursing at my hospital has a job to do, and if her job
    is not done effectively, she's fired. She's not all powerful, she has
    people over her making sure her job is done effectively.

    Many times when staff doesn't get what they, understandably want
    such as better benefits, better hours, better nurse to patient ratios,
    they blame "them". Sometimes "they" really are to blame, because
    they are doing their jobs poorly. Other times, "they" are doing the
    best they can to make things better for the floor nurses, though the
    floor nurses may not realize that.

    I've been a member of administration. I've been a case manager.
    At this point I would rather be passing out medications, wiping butts
    and charting, as opposed to having the responsibility of a manager,
    case manager, or administrator.

  • Oct 14

    I am "they" in a way. I am a member of the nurse practice counsel and "they" are grateful to have a "real live" perspective.

  • Oct 14

    I'm a they in some aspects and like OP I'm still close enough to patient care that I both know the realities and how to execute the patient care position as well as get the regulatory and reimbursement issues and have the responsibility to juggle the budget.

    What I am not is someone up in some ivory tower with stock options and any kind of a parachute.

    What I am is someone who has a voice, uses it and does influence policy. I see both the struggles and the unrealistic denial/naivety of clinical staff who do their best while also staying a little stuck by unwillingness to embrace change and kick its ass. I learned that lesson from my experience in being cross trained in clinical, clerical, quality and administration and have been able to thrive understanding the whole picture, so far. I advocate for patient, employee and company and do my best to expose my staff to all of the aspects of our healthcare business as I believe understanding lifts some of the resentment. I can't satisfy everyone but I'm always trying.

  • Oct 14

    "They" often become "us" as we advance in our careers. As an APRN, in management, I'm sometimes considered "them". I'm not naive enough to think everyone loves traumaRUs and sometimes I have to make decisions that make some unhappy.

    Its not something I apologize for but I do endeavor to bring people into the decisions I have to make if time allows. Its important that the lines between "us" and "them" be blurred for the benefit of the patient.

  • Jan 9

    This article was written by a member of allnurses. Due to the delicate and emotionally charged nature of the article as well as details, the member wanted the topic posted anonymously. If other readers have articles they would like published anonymously, please contact me by private message.

    Let’s start out with my first encounter with a parent. I was a paramedic (a newbie..a innocent.,,) called to a home of a 4 month old that rolled off of a couch. The baby is seizing and the father is talking about how he was making the baby a bottle. He was alone with the kid and the mom was at work. He claimed to put the baby on the couch and the baby rolled off the couch. A short couch...onto carpet. The story didn’t add up. The baby seized the entire 30 minutes it took us to get to the nearest hospital, and then later died from massive head trauma. Shaken baby syndrome. That was some fall.

    This was my induction into real life. I was out of my protective cocoon and my rose colored glasses cracked in the truth of real life. I have scraped children off of the highway who were unrestrained; I have whisked children out of homes that were besieged with fighting under the protection of cops; and I have taken children to the ED scared to be touched by anyone.

    The pressure of being a paramedic became too much, so I chose a new profession...pediatric nursing! (insert snarkiness here).

    I was working in the ED when a mom brought in her 13 year old. Both were afraid and the mom said the dad would be there soon. Mom did not have custody, and the dad was not happy the kid was in the ED. Dad, I am sure after meeting him, is in a gang. The cops were brought in, the mom asked to leave, the dad was cursing up a storm and I confronted him. “We will absolutely not tolerate that type of behavior in the hospital, in a CHILDREN’S HOSPITAL. If you don’t sit down and be quiet, you will be escorted out.” Nicer than a punch, and I kept my job.

    I myself was escorted by security to my car after work….fearing what may await me.

    A 15 year old on life support who OD’d to see if her mom loved her. She did not want to die, she wrote me in a note when she was intubated, she just wanted to see if her mom cared. The child took a turn for the worst with multi-system organ failure. As we strived to make her comfortable and keep her body in a hypothermic state, the mom was mad at ME because the room was too cold. She tried to fire me from being her daughters nurse. This after she so nonchalantly said, “pull the plug”. I stayed at the bedside and held her hand as she passed away, mom went to go eat.

    A 13 year old dying from HIV/AIDS. The dad wanting to be at her side, the step-mom wanting to go do stuff. The dad confided in me once, when he was irritated with his wife, that his daughter was never treated fairly by his wife. He wanted to bring his daughter home to hospice and wanted to redo her room - a makeover - just how she would have loved it. The wife would not hear of it, since the girl was ‘gonna die anyway’. And she did, in the hospital room with nursing staff at her side.

    The mother of an 18 month old who was beaten by the mom’s boyfriend. The grandmother had unofficial custody since the day the child was born. She had unofficial custody of 3 of the children because the mom was always partying and never had time for the kids. When the family decided to remove the child from life support after the baby was declared to have brain death, the mother banned the grandmother from the room. That was the only time I did not let a parent help me bathe a patient after the patient died….and I gave them a time limit for grieving as well. The fact that the mother was holding her dead child and talking about going to Chili’s and a movie later in the day sort of made up my mind, along with her acting like this was a party and yelling at her brother to “go get me a coke, hey, my baby just died and you need to be nice to me”, and “hey, you know that ************ was going to go get a new car today?” Absolutely no feeling at all about the loss of a child, but enough bitterness in her to block the one true person who cared for the baby from being at his side.

    The four year old who was NPO for surgery. As usual, the patient did not go to OR before lunch and she became fussy and..hungry...I walked past her room to hear her father yell at her to “Shut up!” as she was crying. I went in right away and she was reaching for his lunch. His McDonald’s fries and burger he was munching down on. I absolutely kicked him out of the room (sans roundhouse kick to the face).

    I know that people deal with grief in unusual ways. I have seen grief, I have seen the absolute absence of grief, and I have seen those who pretend to have grief. For me, the people who have not one ounce of compassion for the child who most needs their love are the ones who I cannot and will not ever understand. I know that people don’t think beyond their own needs, even when a child is crying and does not understand what is happening.

    But it doesn’t mean I agree with it, or have to like it.

    As a nurse, the hardest part of my job is to not say and do what I really think and feel. Or I would have been in jail a LONG time ago.

    What have you seen that makes you want to commit an assault?

  • Dec 11 '15

    Have you been looking for the perfect Christmas gift for your co-workers? Or maybe you need some ideas to give your family who are shopping for you. You know.....let them get you a gift that you might actually use.

    Nurse Beth has compiled a list of great Christmas gifts for nurses.

    To take a peek at her list, go to:

    25 Top Gifts to Buy a Nurse for Christmas.

    Thanks, Beth for helping us out with this shopping dilemma!

    What's on your list this year???

  • Nov 18 '15

    Quote from madwife2002
    First of all thank you for caring so much that you are asking for advice on the renal diet, two things you need to know are your patients on dialysis or are they on a renal diet to slow down their kidney deterioration? By this i mean are they stage 3 or 4 pre dialysis patients?

    The reason I ask this is because the Renal Diet is different for pre dialysis patients-my suggestion is call or send a note to the dietitian at the renal centre where they get their dialysis. Each patient has their own specific diet prescribed for them and the dietitian at the dialysis facility would be more than happy to send you information on each of your patients.

    Dietitian love it when nursing home staff contact them about this as they have a deep frustration when it appears NH patients eat just what ever they want, plus drink what ever they want and their lab results suffer as a consequence.
    Call the facility before you leave-staff in renal units start very early and leave a message on the dietitians voice mail or speak with an RN who can get you all the information you would ever need.

    If the pt is in end stage renal failure but not yet requiring dialysis then you need to speak with a dietitian at the doctors office or you can fax the dietitian and ask for them to provide you with a diet for that specific patient

    I hope this helps
    Tonight's project was scouring her chart to see if I could actually find any specific info. I could find a dietary consult nowhere in her chart. I could find no specifications on potassium, sodium, or phosphorous amounts. What I did find was that it said high protein renal diet so that was helpful to me. She didn't actually ask for any snacks or food. I will look and see where the dialysis center she goes phone number is and if food requests become an issue I know who to call. My other two dialysis patients were actually in the hospital right now so I didn't look at their charts last night. (Plus it was kind of a crazy shift to be looking up extra stuff ) Thanks for all your (and the other posters) help!

  • Nov 17 '15

    I would never,ever give a pre poured med.

    Can a mod move this to the PDN forum?

    Just want to see what other Pdn nurses do in these situations.

  • Nov 17 '15

    To me, this is no different that giving someone an injection that someone else drew up and handed you. Once you're the one sticking the needle in the person (or, in this case, pouring the formula into the bag), you're 100% responsible for the medication or formula and its administration. I would not be any more comfortable administering a tube feeding I hadn't prepared myself (or, at least, observed the preparation) than I would be taking an unidentified syringe or tablet from someone else, taking her/his word for what it is, and administering it. I don't care how much I trust the person who is handing me the formula or the medication, it's just bad practice. I'm surprised the nurses there have been agreeable to this practice. My position would be that, if Mom wants to mix the formula, then Mom can administer the formula, and I would be documenting the situation thoroughly.

    I'm sorry to say that I agree with the write-ups and report to BON. I hope this will turn out okay for all of you.

  • Oct 24 '15

    I am surprised that a national corporation such as Interim Healthcare would resort to placing an ad with such a flagrant cultural bias.

    I am assuming the family told the staff at Interim that they wanted no Haitian nurses, which is why the ad has such overtly discriminatory wording.