Angry Nurse

Overland1, RN · Nov 16, 2000

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.

ghostriderjason · Nov 16, 2000

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

JillR · Nov 16, 2000

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.

NurseyK · Nov 16, 2000

'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)

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

Mijourney · Nov 17, 2000

Hi. Jerry Falletta made clearer what I pointed out in my first post regarding the legal repercussions from discussing certain types of information. I wonder. Don't hospitals have some type of bill of rights for patients?

babs_rn · Nov 17, 2000

Originally posted by nrsjo:
We have a rule that you are to never tell "customers" that you are short staffed. However, when they see you working double after double, they figure it out for themselves.

As for complaints, well, people these days will complain if you put the ice cubes in their glass wrong. They have no clue or concept of what nurses do all day. As long as we continue to treat patient's as "customers" and give them the sense they are staying at a resort, we will always be regarded as nothing more than the hired help as opposed to the professionals we are.

HEAR,HEAR!!! My VERY STRONG sentiments exactly!!!! Since when did a hospital become the Holiday Inn? (Or the Marriott?)

goldilocksrn · Nov 17, 2000

We are viewed this way because it is the only way we have been portrayed on tv. You never see a nurse on those real-life ER shows. You see "nurse-ratchets" in movies like "one flew over the cookoos nest" and many sitcoms. They need to see what we REALLY do. I don't know if it would make a difference, but it would give them a different perspective. The truth is though, hospitals would never allow cameras to follow nurses, because the public would be APPAULED at what they saw. I know I am..

dwajr · Nov 19, 2000

As an Assistant Unit Manager myself I would encourage you not to project an incompetent image onto the unit. It is enough to say a priority situation came up. I would not apologize if I were you! Apologizing implies you did something you are sorry for. I would not be sorry I responded to a situation appropriately; I would be proud! Furthermore you are a Nurse NOT a Waitress!

Speaking directly to the short staffing issue: as an Assistant Unit Manager I would ask you to come talk to me directly as opposed to just WRITING ME UP for not providing adequate staff. You see when that happens... I GET THE TALKING TO ;-)

OC_An Khe · Nov 19, 2000

Originally posted by dwajr:
As an Assistant Unit Manager myself I would encourage you not to project an incompetent image onto the unit. It is enough to say a priority situation came up. I would not apologize if I were you! Apologizing implies you did something you are sorry for. I would not be sorry I responded to a situation appropriately; I would be proud! Furthermore you are a Nurse NOT a Waitress!

Speaking directly to the short staffing issue: as an Assistant Unit Manager I would ask you to come talk to me directly as opposed to just WRITING ME UP for not providing adequate staff. You see when that happens... I GET THE TALKING TO ;-)

AS WELL YOU SHOULD. In most states as the representative of the hospital you assume part of the legal liability for inadequate staffing. You can be held responsible if litigation results in a claim against the hospital. All nurses need to assure that there is adequate staffing for patient care and nurse safety. You need to defend nurses to senior management, I've rarely found RN's crying wolf about not having enough staff to care for their patients. You were an RN before you were a manager, don't change your professional affiliation and don't defend inadequate staffing to "staff" as your effectiveness as a leader will fall.

ShannonB25 · Nov 19, 2000

I think this is a very valid discussion, one that needs to be addressed. I'm a senior yr nursing student. In clinicals I experienced something similar. I was doing my first admission on a post-surg unit. In the next bed a pt was being transferred to ICU, required the rest of the RN's on the floor to just move the woman. Apparently one of my pts needed to go to the bathroom during this time (it took me about a half hour to do a full admission). There was, however, 2 CNA's at the desk who were answering call lights. When I made it in to check on my pt she was very upset because she needed to help getting up to get to the BSC, demanded an apology so she could "forgive me". This woman was 53 yrs old, fully continent, but had to use the call light 3 times to get assistance to the BSC. I apologized, tried to explain briefly that I was doing an admission and that the other RN's were doing a pt transfer of a very critically ill pt, to which she cut me off and said that she didn't care- she needed to go to the bathroom. She also informed me that if this happened in the future that she would urinate in the bed and then inform my teacher of why she had done so. I left that day feeling pretty down because I felt like I had let my pt down, even though in retrospect I don't know what else I could have done at the moment. My instructor told me to get ready- there will be a lot of pts that will not be happy with me. They don't care if the pt in the next room is coding, they want to (fill in the blank) when they want it. It was an eye-opener for me. How would you all have handled this situation? Shannon

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"The highest reward for man's toil is not what he gets for it, but what he becomes by it."-Johan Ruskin

ShannonB25 · Nov 19, 2000

I think this is a very valid discussion, one that needs to be addressed. I'm a senior yr nursing student. In clinicals I experienced something similar. I was doing my first admission on a post-surg unit. In the next bed a pt was being transferred to ICU, required the rest of the RN's on the floor to just move the woman. Apparently one of my pts needed to go to the bathroom during this time (it took me about a half hour to do a full admission). There was, however, 2 CNA's at the desk who were answering call lights. When I made it in to check on my pt she was very upset because she needed to help getting up to get to the BSC, demanded an apology so she could "forgive me". This woman was 53 yrs old, fully continent, but had to use the call light 3 times to get assistance to the BSC. I apologized, tried to explain briefly that I was doing an admission and that the other RN's were doing a pt transfer of a very critically ill pt, to which she cut me off and said that she didn't care- she needed to go to the bathroom. She also informed me that if this happened in the future that she would urinate in the bed and then inform my teacher of why she had done so. I left that day feeling pretty down because I felt like I had let my pt down, even though in retrospect I don't know what else I could have done at the moment. My instructor told me to get ready- there will be a lot of pts that will not be happy with me. They don't care if the pt in the next room is coding, they want to (fill in the blank) when they want it. It was an eye-opener for me. How would you all have handled this situation? Shannon

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"The highest reward for man's toil is not what he gets for it, but what he becomes by it."-Johan Ruskin

teamrn · Nov 19, 2000

In all due respect, dwajr, for years nurses have 'taken it on the chin' and done it your way and let management 'handle the complaints'. Patient care has NOT improved because of a 'talking to' that you may get from your manager. I feel that patients have EVERY right to be aware that staffing isses ARE real, and if that means that the nurse whom they may have a relationship with tells them-quite frankly I don't care WHO tells them-they do have a RIGHT to know.

Why do we in healthcare feel the need to 'hide' behind a shroud of secrecy to pretend that everything in healthcare is allright-when we know in our heart of hearts that its not? Consumers may take time to 'catch on' to what we see every day, but once they know, I believe they will be a formidable force for change, and healthcare professionals from top to bottom will have egg on their faces from a deception that 'everything is all right'. I cease to see patient advocacy here. The damage done from this deception will take YEARS to remedy, and I see that as an unnecessary erosion of trust.

[This message has been edited by teamrn (edited November 19, 2000).]