What is the dumbest most degrading, most unprofessional thing... - page 7
that you have heard of a hospital requiring nurses to do? I was in a meeting with a group of nurses yesterday - most of us with more than 25 years as RNs - and was hearing about the lovely new... Read More
Aug 10, '08Quote from Cindy-sanSome profound truths about health care today, expressed in words anyone---even those CEOs who sit up nights thinking up new ways to justify their phoney-baloney jobs and fat paychecks---can understand. BRAVO!!!!!!Honestly, I think the problem centers on, the almighty dollar. Everyone is out to make a buck today. I can understand on some level, most hospitals are deeply in the red, insurance and medicare doesn't pay for x-y-and-z.
I remember the old PA my MD had telling me how they had to fight to get paid half the time and they were rarely victorious. It ****** me off because at the time, I was still in school and under my mom's insurance and I had to fight those losers over at Cigna to pay for anything and everything. Everytime I had an appointment or a test, my school documents were suddenly lost and I was no longer covered by them. And my mom was paying through the nose for that horrific insurance.
So, w/ hospitals closing and CEO's wanting to justify their overblown paychecks, they're all out to show they can make a buck. And, in deference to Generation Me, they'll do whatever they can to schmooze these people, while pulling the curtain over their eyes as to how this impacts the level of care.
There was a post somewhere here recently about an "undercover pt" (I believe it was), this woman was judging and picking her dentist based on various amenties available in his office. Me? I don't care if a doc gives away first class plane tickets on every visit, I'm not going to any GI doc nicknamed "the perfer" (yes, I know a doc like that).
I don't really think that docs who run hospitals get together and say "those stupid nurses! How can we degrade them even more today?" My old hospital was run by a business man. His concern was the pts. Mainly, their money and satisfaction scores. He wanted to make them happy w/ stupid things, so they would come back and bring their friends. Nothing about actual nursing care for pts. Believe me, I was on the nurse advisory comittee for my old job. Once a month, we met w/ the Nursing VP, various other people, occassionally that moron CEO. It was all about P-G. No one gave a damn about any of my unit's concerns.
And the docs were on our side with many issues, particularly staffing. I caught a bunch of snide remarks about how "I'm not sending my pt to the floor, they'll die there." It doesn't take a genius to realize that a 1:12 ratio is unsafe.
But rather than spend their money improving staff ratios, so pts could get the level of care they deserve and staff wouldn't get so burned out with crazy loads and leave in droves and more money wouldn't be spent on hiring new people to replace them, money was spent on other things. Making the hospital name bigger over the front door. I don't want to think about how many millions were spent on a food service program that came with a garantee to "improve your PG scores by x-number of points!"
And then, there was the staff. "Patients are scared, how can we make them feel more at ease so they'll like us? I know! White uniforms, that's their image of a nurse! Familiar sayings! Pillow fluffing! Computer scanning to make people see how high-tech we are! Hourly rounding so they feel like there are more than 2 nurses on the floor for 24 patients! It's not like those nurses do anything anyway. We'll give the nurses stupid badges and the pts silly booklets to make them feel more involved, and cha-ching!"
I don't think they want to degrade our professional status, it's more like they don't give a damn about it. [/incoherant rant]
Aug 10, '08Quote from rph3664rph - Don't you just love the stink eye?!! My sons get it from me a lot of the time, I think I was the first one to ever give it to them. I gave it to my dh by accident one time, meant to give it to him, just didn't mean to get caughtHere's another demeaning thing that happened to me, although not in health care.
When I was a teenager, I worked at Target and it was a pretty good job until we got this assistant manager who was a.....never mind, I can't use those words here. Anyway, this was before scanners and we had to key a 6-digit code into the cash register for inventory purposes, and were not supposed to look at our hands. To ensure we didn't, every register was covered with a piece of felt.
Customers would ask me about it, and I always ignored them. If they asked me a second time, they got the stink eye from me. After a few days of this, the first thing I would do when I came to work was remove the felt and throw it in the garbage. I got in trouble for doing that. So what.
Aug 12, '08Quote from medsurgrncoThe "pumps and pearls" set is at it again. POTTYING? During our hospital's annual "skills lab" this year, they actually had a "skill validation" station with candy kisses and little souvenir laminated cards with bullet points for "commode chair etiquette." -"insure privacy", "place call light within patient's reach", "stay with unsteady patients," "use proper body mechanics when transferring patient from bed to commode."When the hospital where I worked started hourly rounding, I was so tempted to say to each patient, "I'm here to do rounds. Do you have any needs regarding pain, positioning, and POTTYING?"
What an insult! Yeah, it's going right in my pocket next to my ACLS algorithms. NOT!
Where do they get these consultants from? I'd venture a guess and say they're not licensed RNs, so why are we letting them get away with insulting our practice as professionals. Our so-called nurse leaders and change agents and champions ought to be ashamed of themselves for not being able to stop administration from cramming this STEPFORD PR garbage down our throats.
Aug 12, '08Oh, I almost forgot...here the administrators go again, trying to chip away at the nurse's credibility as patient advocates. Anyone else feel insulted by this poster/button campaign?
"It's O.K. to ask if I've WASHED MY HANDS."
Aug 12, '08Quote from RN4MERCYConsidering study after study has shown that physicians are worse about this than nurses, there's no way I'd agree to wear them unless the MDs had to wear them too.Oh, I almost forgot...here the administrators go again, trying to chip away at the nurse's credibility as patient advocates. Anyone else feel insulted by this poster/button campaign?
"It's O.K. to ask if I've WASHED MY HANDS."
Aug 12, '08well im still a student nurse and a newbie here in this forum. anyweiz, yeah, i agree thats stupid. i never thought that theres such thing as SCRIPTS that nurses use in the hospital. its plastic. and truly degrading.
but actually in some country, (i wont mention the name) instead of being caring to the patients, they actually never care. student nurses often see that to staff nurses. they dont make rounds, dont even give the medicaions on time and violates the principles of sterile/clean technique. poor patients.
Aug 12, '08Quote from RN4MERCYNot only is it 'ok', but our posters say "PLEASE ask me if I've washed my hands"! I think I'd keel over backwards, dead and stiff, if I ever saw a doctor wash his hands before entering a room, after entering a room, upon leaving a room....or, frankly, EVER.Oh, I almost forgot...here the administrators go again, trying to chip away at the nurse's credibility as patient advocates. Anyone else feel insulted by this poster/button campaign?
"It's O.K. to ask if I've WASHED MY HANDS."
I don't do buttons. Ever.
Aug 12, '08Quote from Michigan RNOr, being the PITA that I am, I would have drawn little pictures on them and passed them out to patients!It's not so fun when its mandated. I would have told them to shove their paper hats.
How about writing "I'M WITH STUPID" across it, and an arrow pointing to the left....and then cutely standing next to the nearest suit?
Aug 12, '08Quote from gnu2thezuAh, but if the patient dies, they're pretty sure the family will be MOST interested in finding out if the COUNTERTOPS were dusted that shift....right? Priorities, after all.I think administration feels the important stuff is tidy rooms and public relations. I, on the other hand, am thinking the important stuff is meds, procedures, titrating drips to keep the patient alive--could be wrong though!
Aug 12, '08Here's my issue with scripting (aside from the obvious that I am a highly trained and skilled medical professional and the English language was a pretty much a prerequisite to my program) When our NM introduced the idea, she actually had the gall to use her recent to trip to a drive thru resteraunt as an analogy. "Would you care for any condiments? How many napkins would you like? Will you need any silverware?"
This ol girl almost fell out of her chair!! I stood up and said, "Are you actually comparing an overworked, understaffed, underpaid ER to Denny's???
My theory is I know I don't "have time", NM knows I don't have time, the patient I just told "I have the time", doesn't know any better in most cases. So when I promise the moon and then don't return for an extended period of time because I've been pulled into a code, an acute MI or a crashing kid, the patient is simply left to believe that I
A: Don't Care
B: Am incompetent
C: Am lazy
Because after all, I told them "I had time" to attend to their every (trivial) need.
I out and out refuse to set myself up for that. If hospitals want us so desperately to deny that we are busy and insist on us lying to patients, then they need to make it so we aren't busy by hiring and paying for more of us.
Aug 12, '08Ok, I totally agree with everyone....but here's my question.
What are we going to do about it?
We talk about quitting all the time because of stuff like this. It's usually my first response also, but seriously, that isn't going to help. When are we going to stand up for ourselves!!!
Just REALLY needed to get that out.
Aug 12, '08I had a hard time paring down my list but to summarize:
I was asked to do the following as an Nurse Practitioner under managed care planning:
1) Don't sit down in the exam room during a patient visit. It gives the patient the expectation that you have unlimited time to spend with them to get to the reason of theand don't ask open ended questions.
2) Went to a "efficiency/improved team work" seminar that wanted me to
wear a headset during the patient exam to listen to staff in charge of clinic flow to keep the clinic flow going. I said I couldn't listen to the patient and they got mad at me. I eventually got tossed out of the seminar due to my attitude that seemed to want to pick and chose their program. One of my best ideas was to throw out eligibility altogether and just have one, single-payer instead of multiple insurance plans to pay for the visit. That is where a lot of clinic time is wasted in my current job in public health.
3) Same seminar session would have a "scribe" take my charting notes while I am examing the patient, write my note and do my plan for me with my dictation to speed up the thru-put time.
4) Answer to a "Dr. Black calling" signal that was proposed if a clinician was in a room with a patient too long (longer than 20 minutes). It was a way of getting the clinician out of the room to answer a fictitious call and end the visit.
5) Buy my own clinic equipment. If you can't get your management team to buy you clinic equipment (like a simple weight scale) to save time buy it yourself at WALMART.
6) If a patient can't pay for their visit to save time and the clinic money and save your job, send the patient to the neareast VERSATELER and have them withdraw the money needed to pay for your fee before you treat them.
7) Don't write a letter to an MD regarding a patient clinically mis-mangaged by the said Doctor that you are refering the patient to a specialist (to diagnose the damage done) and then send it and chart you are sending it to the said doctor. NP's are not suppose to write letters to doctors.
8) Asking me to use the new "ATM" card reader installed in my homeless clinic to charge some homeless patients a fee. They don't have credit cards in addition to not having a home. That's why they are called "homeless"
Just a short list of some of the dumbest and most un-ethical ideas from management who bought into "damaged care" theory of increasing revenue at the expense of quality care and nursing ethics.
Nancy Lewis, RN FNP