Angry Nurse

Tiara · Nov 19, 2000

The stonewalling and secrecy in healthcare has been going on for a long time and I believe it's coming to an end. Everything has been hushed up "to protect the patient" and if things were done right, this wouldn't be necessary. The stories go on and on about short staffing, etc. and it seems as if nothing ever changes. I think it is changing; the public is more aware; the hospitals are having problems with labor disputes and publicity and nurses are finally speaking up.

pickledpepperRN · Nov 19, 2000

Nuring administrators, managers, and supervisors have a responsibility to ensure the best qualit of nursing care. At one hospital we were told, "The corporate office goes over our staffing records. The unit secretary is counted in nursing hours per patient day now. That change is why we had to cut licensed nursing staff." As important as clerical work is, they do not provide nursing care. Why not count the CEO too!.

If nursing management continues to go along with this dishonesty it must be the bedside nurses. We MUST be honest. I can say I'm sorry without assuming blame. Once I did not answer a call light while caring for a patient in an emergency. The patient with the call light unanswered wet the bed for want of a bedpan. I WAS sorry. It was NOT my fault.

The public is told of "near miss" airplane crashes, they need to be told of "near misses in hospitals. Sounds like a new thread.

I know people who took management jobs and left. These nurses should have told why in an exit interview. Say, "I quit because the greedy administration did not allow me to do the job they hired me for, ASSURING QUALITY NURSING CARE!"

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OC_An Khe · Nov 19, 2000

spacenurse...

not only are nurse managers going along this deception of short staffing many are actually part of it. They're afraid for their positions and have forgotten that they are nurses also.

Mijourney · Nov 20, 2000

Originally posted by ShannonB25:
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

Hi Shannon. What was your patient's activity level? She had a BSC so I'm to assume that she had been instructed to call before she got up?

Your post indicates that either this woman is a bully or depressed or both. If you had flown in her room with blue tights with a capital "S" and a red, flowing cape, she would have expressed something negative to you particularly since you are a nursing student.

One thing you want to look at is how you are prioritizing your nursing activities. If your admission did not include performing stat activities, you could have set that aside to attend to your unhappy camper.

Another action you could have taken is that when your patient gave you the riot act, you could've called your patient's bluff and had your nursing instructor come in and talk with her assuming that your instructor is pro-student. In any event, Shannon, your experience is not unusual. Nurses get eaten by their own and others including patients. We have to learn how to buffer ourselves strategically from taking these insults to heart and losing alot of sleep over them. I feel the apology was appropriate. You don't want to give details on the whys. I think that you should continue to express concern and empathy toward this patient in spite of herself. She needs it. Shannon, you will find that you will receive a range of responses from your patients during your career. You have to develop a strong spine and still be able to demonstrate care and compassion. Best wishes.

teamrn · Nov 20, 2000

No, I don't think we need to give complete DETAILS re: why[there are problems], but I think its wrong to completely disavow knowledge of them. We need to find a way to indicate to patients that we are aware of their concerns, and are working to find solutions, w/out making patients feel unsafe and afraid that their care may suffer. Its been my experience that patients are already aware that something is 'amiss', so an indication to the contrary would be deceptive. Finding the necessary balance (telling some vs. telling all) is a juggling act in itself, so that needs to be OUR challenge. The American public is very savvy and intelligent, and does NOT enjoy hearing of a deceit perpetrated on itself. If given the facts and the opportunity, I believe they would be a valuable asset in helping to find a solution to a problem that affects THEM as well as us. Isn't that what we want? The majority don't want to see us coming to work with the negative attitudes that can result from unsafe conditions, poor compensation, mandatory OT, etc. They don't prevent it because they're not AWARE that it exists. I see no need or reason to alienate such a powerful group, and I see that exclusionist attitudes can and will do just that. Aren't we all really on the same 'side'?

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

goldilocksrn · Nov 20, 2000

I believe we should be as honest as possible with our patients, regardless of what management says. It is our responsibility. Management can lose their perspective under all of the paperwork and meetings they are caught up in. Whether or not they care, I tell them that I am sorry I could not be there for whatever reason I wasn't there. For example, today I had an anxious COPDer that needed to get up to the bathroom (we were 2 cna's short). I was in another room literally holding the hand of a dying pt. because her family had not arrived yet( she died before they could arrive, and the family was distraught) Anyway, the patient was furious. I simply told her, I had a patient pass away, and I felt she should not die alone. She didn't say another word.

goldilocksrn · Nov 20, 2000

I believe we should be as honest as possible with our patients, regardless of what management says. It is our responsibility. Management can lose their perspective under all of the paperwork and meetings they are caught up in. Whether or not the patients care, I tell them that I am sorry I could not be there for whatever reason I wasn't there. For example, today I had an anxious COPDer that needed to get up to the bathroom (we were 2 cna's short). I was in another room literally holding the hand of a dying pt. because her family had not arrived yet( she died before they could arrive, and the family was distraught) Anyway, the patient was furious. I simply told her, I had a patient pass away, and I felt she should not die alone. She didn't say another word.

We as nurses are constantly prioritizing the importance of our daily tasks. If one patient's needs are postponed or omitted due to the needs of another, it must be explained to them why they were forgotten in a confidential way. If the patients or family don't understand, they can call on management. Management is supposed to handle the problems that surface like these and deal with them. I think we should start delegating this task away to them and let them handle it. Maybe if they have to deal with angry family and patients, they can give good reason for not having the help we need.

ccelia · Nov 20, 2000

I think it is simply not worthed to be angry over an unreasonable person. Our energy should be treasured for people who appreciate.

Nor do I agree with the nurses in this forum who feel a waitress is a lower-ranked person who can be humiliated.

natalie · Nov 20, 2000

From Denver Post..

Denver hospital's ER chief pleads for with doctors to pitch in during crisis

Denver Post

Major staffing changes and troubled union negotiations at Denver's Exempla St. Joseph Hospital's emergency room have prompted the ER's top physician to issue a plea for cooperation and increased focus on patient care. He's called upon doctors to help overwhelmed nurses make beds, change IVs, give medications and speed up the flow of patients from the waiting room into the ER.

goldilocksrn · Nov 21, 2000

Originally posted by ccelia:
I think it is simply not worthed to be angry over an unreasonable person. Our energy should be treasured for people who appreciate.
Nor do I agree with the nurses in this forum who feel a waitress is a lower-ranked person who can be humiliated.

Let me first say that I respect any hard working woman. However, I went to college for 5 years to practice nursing, not waitressing. I know that the nurses on this post don't think they are above a waitress, but we get frustrated because we do so much more than fetch water. It seems sometimes that patients and family members think that is our sole purpose, to serve their every need. Let us all be reminded that our job in nursing it to get the patients back to their baseline ADLS prior to admit. (and point out the obvious to MD's).I think what makes us angry is that at this point in the history of nursing, our best isn't enough to satisfy patient and family needs.

pickledpepperRN · Nov 21, 2000

Maybe you've heard this before but if we deny that we are not provided with the people and equipment we need in order to provide the nursing care that is the ONLY reason for a hospital to exist we are accepting abuse. Does it not remind you of the family that covers up "Daddys drinking" or the victim lying to protect the abuser?

If we don't speak up about the abuse of nurses (blaming us because we are not able to do the impossible) we should do it for our patients just as a mother may tell the truth to protect her kids.

PS: Lets line up bedside nurses to tell the truth at MNM events.

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[This message has been edited by spacenurse (edited November 20, 2000).]

kurtz · Nov 21, 2000

I am really sorry but I disagree with most of the posters here. I think that it is imperative that we tell patients the reason that we are so run off our feet! It is only through these people that any sort of change is going to occur. If we just smile and say that an emergency has occured or something equally as trite these people will never know the sort of conditions we work under! Enough!! Let the people know how understaffed we are! We can't go on strike because we don't want to leave our patients so the only other way is to get these people to complain a lot more. Maybe they would complain less about us and more about understaffing if they knew the truth.