Angry Nurse - page 8
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... Read More
Dec 13, '00Sorry for not answering this sooner, Fergus 51, but life and work has been very busy and I missed this question til now. I work CV-ICU, nights, and am occasionally charge nurse for the unit (sorry, but the $1.00/hr more for charge just isn't enough!). I have refused to take charge unless we had more nurses, and it's amazing how the supervisor can come up with creative solutions in a pinch. In my state, we are not abandoning our patients UNLESS WE ACCEPT the assignment and then walk off. And if we accept the assignment, our license is on the line. Make a mistake, no matter if you are short staffed, overwhelmed, whatever, you can lose your license, plain and simple. I don't want to lose the one thing that gives me the priviledge to do the thing I love to do (which incidentally, pays the bills!).
I've had a night where my staff was not experienced enough to cover the severity of illnesses on the unit (1 other nurse besides me with more than 1 year as an RN, and a pt. on CRRT, 1 being pavulenized, and several with IABPs and multi-drip, vent-dependant problems). The supervisor allowed some more experienced evening nurses to stay and work a double for the next night off-- something admin. isn't allowing to do much anymore. I told her that if we didn't get the staff for these patients, they would die on my shift because of lack of experienced staff.
I've also had a night where some tele RN's came down and worked extra, I didn't give them a "real" patient assignment, but put them each in a 4 bed suite to help out and assist with rhythm and other problems for the very green night crew that night.
I've also had to point out that the patients used to die before they got this sick even 2 years ago (used this one this past weekend), and there is no way we can care for them with less nurses. I've even done a walking type of rounds with the supervisor and told her what was wrong with each patient and what experience that particular nurse has-- that really opened up THAT supervisors' eyes and I've had no problem with her since.
At the bedside, when things have gotten out of hand (say, 1 patient already doing poorly and the other one suddenly crumps), I definitely let my co-workers and charge nurse know that I'm overwhelmed and can't do it. I ask for help; and usually we work out some type of solution which gets us through the rest of the shift. The charge may take over doing labs and meds, someone else may pick up the more stable pt. for an hour while someone else watches that nurses' sleeping pt., whatever works. And you can be darn sure that we document "unsafe staffing" and "concern for practice" forms for our local bargaining unit.
The thing is that we all need to remember that we nurses are a team, and we are working to get the patient well. If my co-worker is running his/her butt off, I pitch in where and when I can and lend a hand. I expect the same in return from them, and am trying to teach the "newbies" on the unit the same idea. I feel if we all work together on the problems we have at work, it does improve the staff moral and the patients' outcomes. And there is less anger, frustration, and backbiting when we function as a team.
Dec 8, '01I DON'T UNDERSTAND THE HYPOCRISY! IF PATIENTS KNEW THEY WERE GOING TO A HOSPITAL WITH POTENTIALLY DANGEROUS STAFFING SHORTAGES AND THEY DECIDED TO TAKE THEIR BUSINESS ELSEWHERE DON'T YOU THINK THAT COULD HAVE AN IMPACT ON ADMINISTRATION GETTING OFF THEIR ASS AND MAKING PATIENT CARE SAFER W/LESS LAW SUITS. WHY FAKE THE FUNK! IF THE PATIENT DOESN'T SEE ANY DEFICITS BECAUSE WE ARE SUGAR COATING REALITY THEN THE POWERS THAT BE WILL ONLY KEEP THE SITUATION HOW IT IS! I SAY TELL IT LIKE IT IS. OBVIOUSLY YOUR MANAGER CAN'T DO A DAMN THING BUT COMPLAIN TO THE ADMINISTRATORS. THAT IS WHY PATIENTS SHOULD FEEL OUT THOSE SURVEYS WE HAVE TO GIVE THEM AND TELL THEM IF YOU SEE PROBLEMS SUCH AS SHORT STAFF LET IT BE KNOWN. I AM SICK OF US BEING IN THE MIDDLE OF THE BULL**** BUT WE ARE EXPECTED TO BE THE SCAPE GOAT. NOT! HANDLE THE BUSINESS AT HAND.
Dec 8, '01NURSE'S RESPONSE
What Do We See?
What do we see, you ask, what do we see?
Yes, we are thinking when looking at thee!
We may seem to be hard when we hurry and fuss,
but there's many of you, and too few of us.
We would like far more time to sit by you and talk,
to bath you and feed you and help you to walk.
To hear of your lives and the things you have done;
your childhood, your husband, your daughter, your son.
But time is against us, there's too much to do -
patients too many, and nurses too few.
We grieve when we see you so sad and alone,
with nobody near you, no friends of your own.
We feel all your pain, and know of your fear,
that nobody cares now your end is so near.
But nurses are people with feelings as well,
and when we're together you'll often hear tell;
of the dearest old Gran in the very end bed,
and the lovely old Dad, and the things that he said.
We speak with compassion and love, and feel sad,
when we think of your lives and the joy that you've had.
When the time has arrived for you to depart,
you leave us behind with an ache in our heart.
When you sleep the long sleep, no more worry or care,
there are others that need us, and we must be there.
So please understand if we hurry and fuss -
There are many of you, and too few of us.
Dec 8, '01What ever happened to being pt. advocates. This will probably sound silly, but lets forget about our( the nurses) view and think of it from the patients view. The hospitals want to think of the patients as customers. they are purchasing a service from the hospital. If you are running short staffed, then the hospital is not providing the service for which the patient is paying them. As pt advocates, are we not responsible for informing the patient that the hospital is charging them for services they are not providing? If the hospitals policy is to never let the patients know about this charging for services which they know they cannot provide, isn't this theft? Everyone is short staffed today, but why the coverup? What other customer service field would this behavior be acceptable in? To all of you that say, this isn't the patients problem, its the hospitals, what are you thinking of. Thats a thought process driven by business and the almighty buck, not by caring about the patient. When was the last time any of us saw a hospital cut a patients bill for services not rendered due to short staffing?
Dec 8, '01goldilocksrn,
In my eyes, you deserve a gold star.
You handled the situation exactly the way it should have been handled.
You were truthful and up front with your explanation. You also gave a reason in case another incident occurred that prevented you from being Johnny/Jane on the spot.
You did not try to make up a bogus reason or accept the blame for something that was beyond your ability to control. in fact you did exactly what many in nursing are wanting to see more of happen. You provided education to the public as to what is going on. What better opportunity could have been afforded than this.
Some have said it is not the patient's problem that we work short staffed. If it does not boil down to being their problem, then exactly whose problem is it? It is not their fault, but then again it is not the nurse's fault either.
Too many nurses have been brain washed to follow the company line in trying not to tarnish its image in one way or the other.
As for this guy who called and complained, i know him all too well. I have seen and dealt with him too many times. He likes to stand outside of doors with an upset look on his face when he does not get his requests met immediately. He truly does not care about anyone other than himself under any circumstances. He feels very self-important and tries to show everyone else that he is. He does not like to wait in line or wait his turn. he will cut in line anytime he gets a chance and will not feel bad it. In fact this guy has many disguises. He comes in all shapes, and colors, and can be male or female of any age. No mater what you do or how far out of the way you go, he will never say, "thank you". You can not satisfy him.
Many nurses will give this person excuses and rationalize his behavior and by doing so, actually reinforce it. His mother might have been in the hospital and he might have been concerned or had issues in dealing with it, but many times *******s are just *******s. Under the customer service banner you can not deal with people like this. Any attempt to set limits is just met with more complaints that you have to face.
Let me add that if hospital and other places do not want to have to face the reality of short staffing, including the complaints that it generates. Then they have it in their power to change things by providing workings conditions, pay, and the subsequent hiring of additional personnel including support and ancillary personnel to make them go away. Too many times, the buck is passed from the top directly on the nursing staff and eventually to the individual nurse who is powerless to do anything. I can see that from some of the responses you have received that some nurses like to perpetuate this as well.
You have every reason and right to be angry about what happened. You received zero back up or support for doing the very best job you could and also in the long run had the blame put squarely on your shoulders where it did not belong in the first place.Last edit by wildtime88 on Dec 8, '01
Dec 8, '01I never will understand why we cannot let family members know when we are short staffed. I have been told to use the phrase
"Staffing challenged" I really hate being PC when common sense would work better. I guess Admin thinks all patients and their familys are stupid. And, as a potential customer, I take great offfense to it!!
Dec 8, '01WHAT!!!!!!!!!!?!??!??! Doesn't your institution teach you first day what to say!!!!!!! Both institution's (hospital's) I've worked the first day taught us what to say regarding staffing shortage. And DON'T mention short staffing!!!!!!!!!!
I like that idea....keeping the staffing shortage hush hush....it only makes me look like a running idiot everyday!!!!
I never mention the nursing shortage. But I will explain about ALL of my patients in a fast synopsis. Most patients get the drift. I'm not going to hide the truth under a rock. That's what the hospitals want, that's not what they're going to get from me!!!
Dec 8, '01You know I feel my job has many levels. And at times the level is "waitress" I want my patient to feel comfortable. I'll ask all my patients at night if they need a snack.
I was a patient 2 times in the past 2 1/2 years. And the people I remembered most were the nurses that helped me bath after my surgery and the one that got me a snack. Those were simple offers but made me feel so much more comfortable. I really appreciate those gestures....I know the staffing on that unit and those two nurses I'll never forget.
Dec 11, '01Originally posted by ocankhe
We have all worked in understaffed conditions and have taken the dissatisfied comments from both managers and patients. (I don't think any RN would refer to a patient as a customer, but I have heard administrators and board members refer to them that way). The real question is how to get adequate staffing? Intellectually I agree that the public is slowly realizing that there is a Nursing shortage but until they are directly affected by it the usual American response is to ignore it. If the the RN doesn't tell the patients who will? By telling them at the point of service (a nice managed care term) it then becomes real for them. It willl not become real to the administaors of health care facilities untill they can no longer replace the RN's that are leaving their facility. And then they will try to replace the RN's with unlicsensed assistive personel.
I believe this nurse would had been thrilled to have an unlicensed staff member attend to this family's request for water pitcher to be filled. We need all the help we can get and I'm thrilled when we have nursing assistants on since it has been rare lately. Unlicensed staff can be utilized to help with a short staff situation in my opinion.
Dec 11, '01[QUOTE]Originally posted by teamrn
[B]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.
I think the big part of this problem is the son who felt there was absolutely no excuse for their request not to be met immediately. Has the "me" generation become too unreasonable.
Any person who calls community relations when water isn't delivered immediately is well versed in putting in complaints.
One reason not to tell this son that they were short staffed is this guy doesn't care.
I'm sorry to say, but my feelings are this society hasn't cared about the nursing situation crisis. Recently, during an impending nursing strike that was to take place with issues about short staffing and wages, editorials were written in with complaints from patients stating elective surgery were being cancelled.
Several articles were written that health insurance will go up with increase wages nurses obtain during contract negotiations.
Dec 11, '01[QUOTE]Originally posted by babs_rn
I don't think the general concensus means to imply that a waitress is lower and can be humiliated. I think what everyone is pointing out is the attitude of patients and others that a nurse is nothing more than a handmaid or a "glorified waitress". We have education and are charged with making life/death decisions on the spur of the moment. That should afford us some modicum of respect on a professional level, which is, admittedly, above the level of the responsibilites a waitress has. We are there to care for our patients, not cater to every whim, as a waitress is expected to do. Our jobs are more complicated and require extensive understanding and critical thinking skills. As I'm sure others in this forum have done, I waitressed my way through college. Don't misunderstand us when we use that analogy.
First, I do think this son was unreasonable with not understanding the delay in this incident. Second, respect to others should be given on any level when a person receives a service. I'm not sure what you mean by cater to every whim. Taking aside the complaint from an unreasonable family member, keeping a patient hydrated and the "whys" has been part of our education. I do not think staff providing water to their patients has been thought of us as being a glorifed waitress.
While it is not a life/death decision, it is a task we are required to do. However, I'm always appreciative when a family member sees that I'm busy will go to the ice/water machine to fill their family member's water pitcher.
With the complexity of patients in the hospital today, I feel just the opposite and nurses have gained more respect for what they do today. I have not felt that patients reflected feelings that we are glorfied waitresses. The biggest frustration today has been time. Being well organized has become essential in nursing.
Dec 11, '01I'm new to this form & I probably have a very different perspective than most. I entered nursing because of having to watch a relative suffer in nursing care. One thing that was consistant was the lack of available water. Now, when I am on duty, I make sure whoever is passing meds includes getting each person a fresh pitcher full of ice & water that will at least last an hour or two. Yes, they complain. Yes, it is a hassle. But our residents deserve to have water available at all times. If I were that womans son I would have complained only if the lack of water is a consistent problem.