So...you've had a bad day? - page 2
You are dealing with a demanding patient, family , doctor.. short staffed and no break. Look at it from the OTHER side of the bed. The patient and the family is in a life changing ,... Read More
Sep 22, '12For those patients, I have empathy. But, there are many patients who like to make it too much about them. A cared for a woman who could independently ambulate to the bathroom. She called me into her room one night because her leg was bent. Not understanding the problem, I moved the blanket to have a look. Her knee was bent, in a very natural, easy to undo way. I told her to straighten her leg out, she told me that it was my job to do that, and since she pays my salary I better. I pulled the blanket up and walked out. We are human, and some patients could stand to treat us that way. Also, if I am working short staffed, and with no break, I am tired, probably have to pee, and am quite thirsty. I will utilize all my knowledge to help, but I may be in a less than desirable mood while doing so.
Sep 22, '12I think most nurses who vent about their bad day feel just as bad about the care they would've given to their patients but couldn't due to crap circumstances beyond either of their power to control.
Sep 22, '12I do agree with your point of view however, nurses are human, too, and we're allowed to have a bad day and complain about it. Especially now with increasing patient acuity and being short staffed.
However, you should never directly say to a patient that you are short-staffed. It can scare them because it makes them think there aren't enough people or resources to adequately care for them, making them feel unsafe.
Sep 22, '12Quote from turnforthenurseRNYes, much better for them to think their nurse is just too lazy and incompetent to care for them properly rather than they know the truth.However, you should never directly say to a patient that you are short-staffed. It can scare them because it makes them think there aren't enough people or resources to adequately care for them, making them feel unsafe.
Sep 22, '12I agree and disagree with the OP.
On the one hand, I can certain empathize with a lot of people, and sometimes overbearing or demanding patients/families have a legitimate reason for being that way, even if the way they are expressing their feelings is not the best.
For example, just recently, I cared for a man whose wife was seen as very negative, rude, and overbearing. At first, she seemed like this to me, too, but I have a lot of patience and don't often let these things get to me. Then I had to go in and do my patient's weekly PICC dressing. The wife stayed through it and we got talking. I learned that the patient was initially admitted to hospital many months ago, got better and was sent to a rehab unit, and then regressed and got sick again, landing him back in the hospital. His wife was very frustrated and just wanted her husband to get better. I could see then why she was so nit-picky about everything - she just didn't want anything more to go wrong so her husband could get better and return home with her. After that talk, she stopped being rude and negative, and we worked together rather than butting heads over every little thing.
HOWEVER. That does not excuse people from being aggressive, overly demanding, offensive, or manipulative. Someone can yell at me all they want about their broken TV but it is not within my skill set nor is it my priority to get it fixed. Yes, I will call the person who sets up the TVs to let them know the TV is broken, but no, I will not go out of my way to entertain the patient when I have other, more important, matters to deal with. Most patients are understanding of the fact that I had other patients to attend to and must split my time accordingly, but there are others who think I'm their personal servant or something rather than a nurse caring for 4 or 5 people. I mean, I literally had a patient with perfectly functioning arms who called because she wanted her purse moved from one side of the bed to the other. Just...no.
Also, I have no issue telling people that we're short-staffed or that I need to take my break. When I am out of the room, a patient doesn't see where I am or what I'm doing - for all they know, I could be working with other patients or I could be having my lunch. They don't necessarily know that. So, if I'm running myself into the ground and haven't eaten or drank anything by the afternoon, I do all the urgent things I need to do and tell my patients, "I haven't had a single break yet today. I'm going to eat quickly and when I come back, I will take care of x, y, and z." (The x, y, and z are usually little things, like an extra glass of water or something - things that can wait 15-20 minutes!) Most people are usually all right with that.
Sep 22, '12Quote from woohExactly. Why should I get blammed for the situation management and administration creAted. Why cover up for them when that means I will be viewed as incompetent . noYes, much better for them to think their nurse is just too lazy and incompetent to care for them properly rather than they know the truth.
Sep 22, '12My worst day was yesterday. My patient came back from IR in the middle of shift report with a emergency lumbar drain only to find there is not one lumbar drain on the unit. Central supply sent the wrong set up and needed to order another one while my patient has neuro changes while the transfer nurse for my other patient keeps calling me and the unit asking when I'm going to call report and send her upstairs.
I tell him I have a critical patient that needs to be cared for first and meanwhile we're on the phone with the doctors because their orders make no logical sense and through all the umms and well and changing his mind 5 times about where he wants the lumbar drain my patient is having delay in care.
I get another call from the tranfer nurse after I get my other one hooked up to drainage telling me she needs to be up by 1100. Its 1000. Im working on it. I work frantically charting her assessments and then meanwhile I have not charted a thing on my other. Take my patient up. Getting dirty looks from everyone. Come back down and told they called the charge stating no tranfers after 10am. Not what the nurse told me. New policy not written but coming.
My lumbar drain patient also has meds every 2 hours and is rolling around in bed with no care that she has a drain. I get her settled and yes! I have one patient and I can chart now.
Charge then tells me 10 minutes later I have a patient coming in 15 minutes. I go and get the room set up and get my patient and the time is now 0200 and between doing all the ICU orders and settling my patient's I was about to loose my mind because I had not charted a thing until 430, My team helped me and I go out on time but jesus I had never gotten so behind. I could not sit for 10 minutes without an alarm going off or med was due. Plus I they were both contact patients.
Did I mention this was my 3rd day off orientation in a level one STICU?
I love my job!
Sep 22, '12Quote from woohLOL I know, I feel awful when I haven't been back to someone in what feels like a long time to me...you KNOW it's been a long time to them! And you can't explain anything you've been doing with another patient, or say you're short or that you had to cover lunch, or that you're in charge and had to deal with another nurse's patient issue etc.Yes, much better for them to think their nurse is just too lazy and incompetent to care for them properly rather than they know the truth.
Sep 22, '12Quote from OnlybyHisgraceRN3 critical patients in the ICU?! That is insane!Its' not about us or the patients, its' all about MONEY. Lets get more staff, more equipment, breaks (longer than 15-30min) and it can be more about the PATIENT. Don't give me three critical patients in ICU and expect perfect hourly rounding, with no aide and two out of the three patients are isolation and 1/3 patient is morbidly obese.
Often, I leave work physically, emotionally, and spiritually wounded because I give my all. If it was all about me I would not have become a nurse. The money is not worth it.
Sep 22, '12I've always thought the reason we weren't supposed to say we were short staffed is because the hospital would rather the nurses look bad by looking lazy or slow instead of the hospital looking bad because they can't/won't hire more staff.
Sep 22, '12Quote from hiddencatRNMy bad days aren't the days packed with back to back sick patients, they're almost always the days packed with entitled, healthy patients with vomiting times 1 eating McDonald's and oh I need a cab voucher how do you expect me to get home. Days I run my butt off with super sick and busy patients are days I leave with a sense of accomplishment and feeling of purpose.
But either way, it's OK for me to have needs regarding the experience of my day, and to vent about them somewhere separate from work.
YES YES YES!!! The "entitled" patients are the ones! Also each time I got a drug seeker--I thought to myself--I did not go into nursing for this!! I want to help the sick and needy!!
Sep 22, '12Regarding the OP, I work at a level 1 trauma facility that also serves as a safety net for the community. We do have some busy days. However, I am there because I love the facility and my coworkers and I also like earning a paycheck. My patients are there because they got burned, hit by a car, smashed in a MVC, shot, stabbed, developed an infection or broke something. They are definitely having a worse day than me.
It's good to keep things in perspective. I'm on call tonight so I hope they play nice in the hood. I would like a full night's sleep and whoever is out tonight would probably benefit from not being shot or stabbed.
Sep 23, '12to the OP-it is NOT all about the patient in MOST healthcare institutions. It would seem that the private sector these days is more about the MONEY. The system appears broken from that regard...