On a slightly related note... (to my other post)
Okay. Here's the sitch. I love NICU, love the babies, hate the unit, hate the administration, am sick to death of the lack of concern from fellow staff members, frustrated with the apathy running rampant in my hospital/units, and desperately need some advice!!! Whew.
My unit sucks, okay? There is an interesting set of circumstances, IMO, that is leading to what I feel is, overall, a badly run unit that has virtually no promotion of important patient/parent education. Our hospital has great retirement benefits and has been run badly for so long that people get away with a lot and do very little. The way the system is set up is not pro-nurse or pro-employee (or pro-parent, but I'll get to that in a minute) and it encourages (indirectly) lying from staff to get what you want/need as well as encourages a lack of interest all around the board as far as change goes.
The unit manager has been working on this unit for a long time, and either is so set in her position that she's become indifferent or else is so busy with paperwork, etc. that she doesn't have time to deal with these issues the way they really should be dealt with. She is a very nice person, but the unit is lacking in so many resources that I'm just wondering how effective she is as a manager (I know there's very little I can do about that, but I'm just wondering what can be done IN SPITE of her being in charge, you know?). She comes in a few days a week (most of the time I don't see her; I work nights) and breezes through the unit too busy to stop and talk, seems to have little interest in discussing unit events unless they're negative and an opportunity to ***** someone out for doing something wrong or criticize people for various things, etc.
Our patient demographic is in need of more education, period. We have virtually no breastfeeding/kangaroo care/basic newborn care/preparation for various diagnoses when baby is discharged/prenatal care/you name it education system set up. We have virtually no handouts to give to parents, and the ones we do are dusty and/or outdated, or people don't know where to find them to hand them out, or people don't care, etc. so the end result is that we have unprepared moms giving birth and then unprepared moms/families taking home babies who don't know what the hell to do with them.
I have always been a huge proponent of health education and felt like I had a knack for it, but it's proving to be difficult here, and I'm wondering what my options are.
An example: I designed a folding pamphlet for new parents introducing them to the NICU and attempted to present it to my superior. I was told that no thanks, we already have one. I said, wow, well, where is it? I've never seen it and had no idea. She took me to a locked "closet" that no one ever enters and inside there were CASES of these old, semi-outdated introduction to the NICU brochures. I said, okay, why are these IN HERE? And was told that no one handed them out, but if I wanted to, now I knew where they were. Hmm. Gee.
Another: I wanted to organize some classes for families regarding various things- basically start out small and move on from there depending on need and success. I was told, when I mentioned this to my superior, that someone used to do that but the parents never came. Period. End of discussion. Hmmm. Okayyyy.
And I have a ton of examples. I am left, along with another co-worker, to make my own one-sheets and photocopy them on the sly with our fax machine on a case-by-case basis (before you ask, no, I can't afford to contribute to this cause with my own money at the moment- I need support and budget money or whatever from the higher-up's). This is not working out to my liking.
I have about ten thousand positive changes listed in a huge notebook for our units, and have no idea what to do with them. I have had limited results approaching my superior, who as far as I knew, was the person in charge. What's worse, the person above THEM is even less interested because they are over the entire Maternal/Child department and are very busy. Not to mention that there is a definite hierarchy that CANNOT be broken here (or else you face some serious bleeping-out because you "broke the chain").
I am beginning to feel useless. I came into nursing idealistic and enthusiastic and after 18 months it has almost completely drained out of me and been replaced with frustration and anger and negativity.
I am considering other options but have no idea what they are. What I want to do, honestly, is work in some sort of position where I can create new programs (ie, parent or sibling classes, breastfeeding, etc.) and implement them to improve patient education. I want to organize whatever education is necessary to make our interactions with families more consistent, and by gosh, if I can't do it at THIS hospital, I want to do it SOMEWHERE.
Where do I start? I am feeling very stepped-on and small here. What do you do with enthusiasm when it is met with grunting disinterest?
I know this is long, and I'm so sorry. Honestly, this is the tip of the iceburg, and I could go on forever. I haven't really vented much of this to anyone, so forgive me! You guys are the first.
I'm thinking...gee, there must be SOMEONE in charge of this stuff! Right? I mean, there is such a lack of this where I am (not just the hospital, but the community) that there MUST be someone who does this for a living? I would gladly give up bedside nursing if I could only find a position like this, and I'm thinking, well, Lactation Consultants are in a postition to directly work with moms (multiple moms, not just those who are assigned to them), but I want to do something even more...hmm...varied than that. Not just breastfeeding.
I want to pull my hair out. Is there a place for me ANYWHERE?
Thanks for hearing me out! I love you guys.
Jun 16, '03
Wow! I hope you are not going to have a tough time.normally because of staying too long in the profession you tend to be complacent at times so any changes that can pull you out of your comfort zone will obviously make you uncomfortable(am talking about me,sorry).Most of the people I know who started something, have presented their case with the back-up from evidenced-based practice/research(including how economical it would be)otherwise they will take it as another person`s ideology,initially funding is a question,no one will spend a cent. for your proposal if you have not proven its effectivity.Try to buddy a senior staff (who do you think can elevate your proposal to the top).
(I am in the process of collecting evidence about the benefits of Kangaroo Care,once I have completed,I am going to make a nice leaflet and will present it to my manager,I know she cannot refuse because if she will, I am going to tell her that I am going to transfer to another hospital who can value my worth as a team member,lol)
Jun 16, '03
Wow! Sounds like your unit is in need of some major changes! Isn't there an education department in the hospital that can help you with some of the educational issues? Does your unit have a clinical nurse specialist?
The unit I work in requires that the family take a CPR class before they can take their precious bundle home and basic infant care is included as well. Attendance is not an issue.
It sounds like you have a lot of motivation and fresh ideas Kristi. If this unit doesn't allow you to reach your full potential and spread your wings I would find another unit that will.
By reading your posts Kristi you seem like an exceptional nurse and I wouldn't want any of your potential to go unnoticed.
Good luck to you!
Jun 17, '03
Kristi, I remember you saying before that you might be interested in travel nursing. I encourage you to look into it further. That would give you a chance to see how things are done in other NICUs around the country. It just might be the change you need professionally and personally. I left my home unit earlier this year just because I was restless. My unit was wonderful, and I was happy there, but I have major wanderlust. I am doing my first travel assignment now, and while the hospital where I am working is really awful, I am learning a great deal about myself! I can teach the little bit I know to the staff here, show them ways to improve their nursing practice from what I have learned. Hopefully things will improve for the babies in this unit by my having come here and planted the idea that there is more they could be doing to improve outcomes in their unit. Then I get to leave at the end of my assignment and move on to see some new and different place where I can learn new stuff!
Traveling is a great way to get to see the country, enhance your nursing practice, and still get paid! It takes a tremendous leap of faith, but it may be just what you need. I am glad I took the risk, and look forward to finding my next assignment for the fall.
Keep the faith!
Jun 17, '03
at least you have good retirement benefits..... I work in the same situation with terrible retirement options......I love the work...I hate the unit...the supervisor sucks...the doctors are like 2 year olds.....the upper management could care less about anything.....I really would like to quit and do gardening and sell my vegetables and flowers....
Jun 17, '03
We have a nurse whose only job is to be a parent resource person. She sets up meetings for parents once a week on a variety of topics (taking your baby home from the NICU, certain health issues, etc). They are around dinner time and include food. There is also a weekly meeting with her and the LC about breastfeeding. Plus she teaches CPR to every family for a small fee (and she waves that if need be). On top of that we have a parent buddy program she runs, where interested parents are linked with a volunteer who had a baby under similar circumstances. She also made a parent binder that EVERY parent in the NICU gets. You might want to try having them handed out in L&D, or ours are placed at every bedside when they are cleaned for the next baby as part of housekeeping's job.
Maybe there are parents who would be interested in forming a group on their own, but without someone willing to take the lead, I can't see things getting better. It sounds like you need a real sh** disturber. Normally our supervisor is very much into evidence based practicve, and if we can proove something is beneficial she'll go for it. Unfortunately yours sounds evil. I found myself on a unit I hated and I finally just left. I am so much happier now, despite the stress of changing jobs and moving.
Have you considered moving to Canada?
Last edit by fergus51 on Jun 17, '03
Jun 17, '03
When did you say you were moving? That's the only solution I see unless you can get more people interested in doing a better job for your clients.
San Diego is ready for you---come on out.
Jun 19, '03
Who's coming to San Diego?!
Jul 22, '03
I understand your frustration. I used to work in a unit like yours. The unit I work in now is a bit better, but we could always improve. We have a Lacation Consultant, 2 discharge coordinators, and several nurses who teach classes. We require parent to take CPR and a baby care class before they can take their babies home. We also offer developmental classes and sibling visitation classes. We have a social worker, physical therapists and speech therapists who also work with the parents. There are only a select few who get involved in these areas, but we can use more. We have a lot of new nurses who don't know what they are doing yet, but I hope they start to take an interest. My suggestion is to talk to administration and see what information they require to prove a need in the unit, try and get a few other nurses involved, and maybe a few parents. Other that that, I don't know what to do. Hope this helps.
Jul 23, '03
Thank you Shelley, and all of you, for your suggestions. I really appreciate it.