Angry Nurse - page 4

I am wondering if this has happened to any of you.... I got "talked to" by my Assistant Nurse Manager (charge nurse) because of an incident with a patient. My patient asked for some water, and I went to get it, but on the way to... Read More

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    Originally posted by erezebet:
    where i work, family members come at shift change, and many times it can be unpleasant. Most familys I interact with are wonderful but some are more of a liability than an asset. I had a patients son stop me in the hall to let me know its sad to see that I could not even feed his mother today let alone keep her water pitcher full. And yes, it is sad that the most basic needs cannot be met for my patients. And to all those family members out there, I am truly sorry. I am sorry for struggling through nursing school thinking I could help people when its not always possible. I am sorry that my job demands more than a pound of paperwork a night. I often go home after a shift and think about what I never got to do. I would rather spend time with my patients than standing outside the door at the chartbox. I hate running into rooms to pass meds as I hurry the patients along and practically shove the pills down their throat because I have to hurry to look up labs, finish a surgical checklist, do longhand discharge notes, replace pulled IV lines, hang new solutions before the others go dry, wipe the floor where my patient piddled all the way to the bathroom, assess my new admit and call the doc for 2 pages of orders as his cell phone goes in and out and I miss half of what he said, give that pain shot, call pharmacy about my missing meds, search through charts on 7 patients to discover if any labs got missed because it will be my fault, check blood sugar slips, do chart audits, check the crash cart, count narcs, sign off orders, sign mars, do discharge planning, update cardex,........I could go on but you see the picture.
    AMEN and AMEN to that!

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  2. 0
    bbqchick forgot that you must do all this without racking up overtime, because Lord knows that you should be able to do all of this during your shift. (I was told that if I couldn't, I would have to learn to "budget my time more effectively")
  3. 0
    Originally posted by goldilocksrn:
    bbqchick forgot that you must do all this without racking up overtime, because Lord knows that you should be able to do all of this during your shift. (I was told that if I couldn't, I would have to learn to "budget my time more effectively")
    I've heard that before, two points to remember. First if the manager budgeted the nurse to patient ratio correctly I wouldn't have to budget my time in an impossible situation. Secondly (if you are paid by the hour) federal law requires the employer to pay you for all time worked whether it is authorized or not. For RN's if you need to work past your shift for legitimate reasons be sure that you get paid for it. You are entitled.
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    I have been told to not tell patients or families that we are understaffed.

    I don't think it is nessesary to tell anyone this. I think that they can tell by the way were are running from one room to another. Personally I don't think they really care if we are understaffed or not. They care that they or their loved one gets what they want when they want it and it doens't matter to anyone that the patient in the next room is circling the drain.

    The other night the husband of one of my patients asked me to get him a cup of coffee, I showed him where the cafeteria was and told him that he was more than welcome to get some amytime he likes. This man comes in at meal time to eat the patients food!! Even though we have expained to him that this is not appropriate because we need an accurate idea of how she is eating, he still does it.

    Some people still look at nurses as handmaidens.
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    At my hospital, administration has a sign on the kitchen door that says, "employees only". Management is afraid of the liability of someone getting hurt, and family members don't want to go in because of the sign. That is why nurses and aides are wasting time that we don't have sometimes. I think family members can handle getting coffee or water without killing themselves. Can you believe it?
  6. 0
    Hi erezebet and JillR. In home health on each admission, we are required to review and present a patient's rights and responsibilities form. This form is signed and a copy is left with the client/family to refer to. I make sure that I thoroughly review this form on my admits, and the client/family understands that they still have 24/7 responsibility for their loved one even though home health is present. When I am present and there is an able s/o present, I don't get water or anything else for that matter. I make it clear on admission and throughout that my role is to assist the client/family in coping with an illness or disease and learning how to manage it on their own. If ordered, the aides help assist the client/family in managing their ADLs. Believe or not, aides have a vitally important instructive role to play in demonstrating appropriate care for client/family learning.
    Facility-based bedside nurses must find a way to not only tell the truth of why things are the way they are but how things need to change. Too many clients/families are discharged from the hospital with no clue as to what, why, when, who, how. The whole basis for utilizing nurses in any setting should be for patient/family education, instruction, and training. These activities can be done even while doing basic tasks. Nurses are in a unique position to provide educational/training opportunities that would improve the short/long term outcome for the patient/family and reduce unnecessary usage of health and medical resources. That is how patients/families distinguish between nurses and aides or tech and that is how patients and families are turned into clients. Two things must happen: availability of aides, attendants, and techs for basic tasks; and, significantly decreased nurse-patient ratio.
  7. 0
    Telling a patient or family that delays are due to short staffing (or other shortcomings of the facility) could be a problem (not an "issue", but a problem that needs to be resolved) because it could open the facility up to a liability lawsuit, or make the facility more culpable in an existing court case. This is why smart businesses tell their employees to never use the word "defective" when describing a product that is, shall we say, less than stellar. This is also why one computer company, many years ago, referred to software bugs as "undocumented program features".

    We live in what has become a very litigious and rude society. Families and patients demand that a cup of water is the most important task a nurse must handle at the moment, despite the code running in the next room. An ER patient seeking an abortion or a pregnancy test demands to be seen right away or she will leave.

    The best answer when a demand is made and an emergency arises is a truthful one, without going into confidential details. Make no promises, such as, "I bring that water right away," because you cannot always plan on that.

    As for telling somebody that something is "inappropriate", I learned back in Nursing school that such 'nursey' words are vague. What is appropriate for one person (walking in the hallway wearing only an open 'moon the multitudes' gown) may not be for another. Many people ignore such words which are mostly used only by nurses. I once heard a nurse admonishing a psych patient, telling the patient that her behavior (trying to bite the security officer's crotch) is 'inappropriate' . Incidentally, the patient in the hallway (mooner) needs to be directed by the nurse (moonee) back to the patient's room, or provided with more clothing or a blanket.

    We do have to be careful of what we say to patients and visitors, because it could get us into court. If the hospital loses such a lawsuit, some of our jobs could be eliminated. That is the hard reality of business and economics; there is nothing "fair" about it.

    The Asst Nurse Mgr should have approached the problem from this angle, rather than bust on the nurse. Doing so may have cleared up a problem in the long run.
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    it would cost me my job..but i would have told him to kiss my A.. he could get mama the water..some people think that a hospital is a HOLIDAY INN....jason
  9. 0
    I think that I am being taken literally here. I never actually said the word inappropriate. Just explained the reason why he should not eat the food, but it continued, even thought I explained it at every mealtime.

    I still stand by the fact that we don't need to actually tell a pt or their family that we are short staffed 1. because they can tell and 2. because they don't care.

    The fact that short staffing may open the facility up to law suits.......well if thats what it takes to get decent staffing, I say this might actually be a good thing. Although I can honestly see admisinstration coming up with some stupid idea to solve staffing problem, so they would not have to pay RN's to work there. For example, the University of Chicago's response to a law siut was to lay off 140 CNA's and replace them with no one and expect the nurses to make up for this with "increased efficiency".
    Yeh right.

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    'The smart ones figure out we're busy/short-staffed, etc'...."Smart" patients/families are few and far between (at least in the ER). Patients and families generally are looking for a fight when they come in because in our society the "squeeky wheel" gets satisfaction first. They don't care we are short staffed (I tell them anyway and tell them to write a letter to the CEO, as well as noting the short/dangerous staffing in House Sup. report)...everyone wants to be the FIRST patient..NOW...even when you tell them "someone's having a heart attack"
    "stopped breathing" etc. I have had many a patient and family walk into a trauma resusitation and say "hey, I was here first!" As long as (Nursing) Management continues to coddle these types they will continue to behave as such (remember Pavlov's dogs?), and the good nurses will continue to leave the field in droves... Just my humble opinion (and a little venting)

    The grass isn't greener on the other side -- it's just different grass

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