McDonald's Medicine (and other ills)

  1. How about just a vent area for those of us subject to the whole "McDonald's Medicine" phenomenon (which is all of us in the USA, at least)?

    I'll start...

    I once had to defend myself against a complaint from a patient who was a frequent flyer, usually came in with pseudoseizures when she was drunk. Uncooperative, difficult, you know the types. I got a reaming out because she complained - you know, give them whatever will make them happy frame of mind. I had spent a great deal of time with her. Her main demands were to be able to go outside and get a cigarette and "somebody bring me a beer!"

    One time I got written up and reprimanded because I explained to a worried mom whose 12 year old daughter was having fainting spells (with no medical cause, had been investigated by every specialist) that a 12 year old girl can go through a lot of stress and that stress can often cause such symptoms. I was told that that was not a "polite" thing to mention. So much for patient education. I wonder what they would say about my STD prevention counseling?

    We really shouldn't be made to defend ourselves like this. Another perfect example was an informal meeting our administrator had with the nurses the other day in which he said that since we really need the docs to admit patients to our small facility, we should kiss the doctors' asses. Of course the nurses looked at him like he was crazy. One piped up, "and should we wipe it before we kiss it?" To which he responded, "Well, you ARE used to wiping asses, aren't you?"

    Just goes to show what administrators think of nurses and the profession as a whole. To me that just takes us back 50 years.

    Our hands are being progressively tied and our mouths are being shut by administration. We can't give the patient what they need anymore because it might not be what they want to hear and thanks to EMTALA we have to be brilliant triage assessors and then play dumb when the patient asks questions about whether they could take care of minor things at home. Something's gotta give!!

    Oh, by the way, how does one become a professional nurse activist? Other than a lottery win, that's the only way I can see myself keeping my sanity for much longer!!

    Babs
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  2. 8 Comments

  3. by   Jenny P
    Wildtime, I'm with you on this one. I would have gotten up, told the administrator that I'd rather quit than have him insult us like that, and walked out. That was not only an insult, it was both a slap in the face of all nurses and it shows what administration thinks of nurses. It is hard enough to put up with attitude and violence from drunken patients in ED and from arrogance aand intimidation from MDs (why else was this guy telling you to kiss their ass), but insults from your employer also? Sorry, I'm now considering myself a valuable rare commodity, and should be treated like such or I will work somewhere else where they DO respect what I do.
  4. by   misti_z
    I'm following Wildtime as well. If you/we do not stand up for ourselves they will not where to stop or that they should have stopped a long time ago.
  5. by   babs_rn
    In a perfect world all nurses - all PEOPLE - would have the luxury of getting up and walking out when matters became dehumanizing. But most of us are still stuck in the "paycheck-to-paycheck" trap and can't. PLUS we are all acutely aware of the fact that it's the same story everywhere you go - just some say it in different ways - so if we leave then it's just like jumping from the frying pan into the fire. I have yet to work in a place where the nurses were actually backed. Never had that luxury.

    What WAS said back to the administrator was more of a laugh and a "yeah, right" type of response. Nobody pretended they were actually going to follow through on that. Another real fun idea he's got going is - (small hospital, now, 3 nurses in-house to cover the floor and the ER - which hops, no assistants or techs) - they can't decide where they would put a snack machine or coke machine. They don't want it in the ER waiting lobby because "it would make it cluttered" - so they keep cokes and crackers in the kitchen. When people come up to us asking where the machines are we're supposed to drop everything we're doing to take their money and get their snacks for them. And we're supposed to say, "We don't have machines, we have one-on-one service here!" (yeah, right - in his dreams)

    Last night I took care of a particularly chatty patient who does like to talk with the administrator. Last night she told me that he had said to her that she was the only patient who ever talked with him on a regular basis (she's a frequent patient). Her response? "Well I don't know why, you're human just like us, not no better." She said his response to that was, "Nobody's ever said THAT to me before." Gotta love HER! Lol

    The kicker is that our administrator is married to a nurse. That makes his total lack of vision a little bit confounding. He's in the wrong profession, for sure: a consummate salesman. But such people forget that nurses are a strong-willed, cynical bunch who can read through a sales pitch a mile away.

    Our hospital is owned by a man who used to work as a consultant. No major corporations in here, though there's a new management team coming in in the morning to meet with us - they had to take investors to keep the place open. I'll listen to their ideas and the changes they plan to make but I'm also prepared to hit the door if it's a totally unrealistic proposition. Which WILL leave them hurting. There are already two other nurses leaving this month and another is in negotiations with another hospital as I type this. It took them 4 months to replace the nurse who worked opposite me in the ER at night. I don't want to leave because right now I'm working 10 minutes away from home, there is often a good bit of downtime in the middle of the night, and right now I have a sweet schedule worked out. They also actually pay better than other places around here. If the administration (including the nursing administration) would just LISTEN to the nurses instead of continually fighting us, since all we're fighting for is safe staffing and to have certain areas run according to certain mandates ( you don't want to know how the so-called "unit" is run and we don't have needleless systems. We run out of certain meds frequently and supplies have been scarce as well). They say it's money. We are all acutely aware of the financial problems of the hospital and we are also acutely aware of some unnecessary salaries being paid and other fluff. If you're having money problems, why on earth would you pay over $700 a month for the privilege of using certain forms (that we make copies of when we run low)?? That's enough to pay a part-time ER tech! Bottom line to me is, if you can't afford to run a business properly then you can't afford to be in business in the first place.

    I'm just waiting on my ACLS renewal card to get to me and update on my PPD and my options are all open. I can always go back to the agency (though the drive will be exhausting and I'm not in any real hurry to go back to the big hospitals only to come home feeling like i've been run over by a truck) and the local max security prison is hiring too. I've worked there before. At least you don't have to worry about bending over backwards to make your patients happy and no families to deal with either. And at least you're not expected to eat whatever is served up to you and grin and pretend to like it, if you know what I mean.

    You know, if I won the lottery I'd buy the place out and run it like it should be run - starting with a brand new building - the old one is falling apart at the seams. It's just a small place - the kind of place where everybody knows what the expenses are. It would be a nurses' hospital and patients would receive good, safe care and the nurses would be given all the respect from administration that they deserve. Their input would be taken seriously and I think morale would skyrocket. Call me crazy, but I firmly believe that strong morale makes for better "customer service" anyway. Marketing money? Forget it. Word of mouth in a small town is the best marketing strategy you have. I would be happy just to break even - in this poor rural area, that's all you can realistically hope for.

    Best of luck to all
    Babs
  6. by   canoehead
    Well, if you see all those problems maybe you should volunteer to be on a committee to address them. Take some of the down time at night and make out your own forms. Research the needleless systems and make a presentation at a staff meeting, or at an administrative level to show the money savings. Maybe write up a report about the asskissing comment, get some coworkers to sign it as an illustration of why the hospital is having trouble keeping staff.

    Personally I don't think the housekeeping staff at my hospital would put up with a comment like that, and I know for a fact that an MD would be reprimanded by the CEO and the medical director. You are working in a twisted little world, but with some nice frills, like the rich wife of an abusive man.

    I agree with previous posters, you teach people how to treat you. If you want things to change you'll have to change how you respond to those barbs.
  7. by   Mijourney
    Ahhhh.... the art of drive by politics. So this administrator felt the need to let his hair down to make a point with employees he feels superior to? Your post indicates that the "p" was left out of professional and the "r" out of respect. I agree with a previous poster who indicated that you and your coworkers need to do what you can to plan and see through needed changes in your work environment. The arrogance of this administrator will probably cause him to fall in the hole he has been digging for others.
  8. by   babs_rn
    Originally posted by canoehead
    Well, if you see all those problems maybe you should volunteer to be on a committee to address them. Take some of the down time at night and make out your own forms. Research the needleless systems and make a presentation at a staff meeting, or at an administrative level to show the money savings. Maybe write up a report about the asskissing comment, get some coworkers to sign it as an illustration of why the hospital is having trouble keeping staff.

    Personally I don't think the housekeeping staff at my hospital would put up with a comment like that, and I know for a fact that an MD would be reprimanded by the CEO and the medical director. You are working in a twisted little world, but with some nice frills, like the rich wife of an abusive man.

    I agree with previous posters, you teach people how to treat you. If you want things to change you'll have to change how you respond to those barbs.
    Staff meeting? what staff meeting? We don't have those. Any changes take place, we read about them in the newspaper along with everyone else. We have complained about that and they pay lip service to it, but that's all. Keep in mind this is a teeny tiny operation. Fully staffed is 3 nurses in house. Period. Housekeeping staff? they have a part time girl who works 20 hours per week. This is a facility that closed its doors last year due to financial troubles and re-opened under new management. That management is about to fold, itself, and has turned matters over to a new company for a 90 day trial-before-you-buy deal. We actually had the second official staff meeting EVER this morning and I will say that I am encouraged. I went to the meeting expecting a typical sales pitch and instead what we got is, "here's what we have and here's what we're going to need to do to fix it and it ain't gonna be all fun and games but we can do this thing" type of thing. Nice change of pace from all the silence we've been dealt over the past several months.

    And an apology was made for the kiss-ass comment.

    I am not in a financial position to bargain much with my career. As much as I want out of nursing I am trapped in it until either my kids are grown or they come live with me so I no longer pay child support. Any other job, I'd have to sacrifice my weekend visitation - been there and done that, been known to go up to 3 months without seeing them because of work schedules. At least here I do have the advantage of being the reliable, sensible, competent, in-charge nurse on my shift that they need and appreciate. I have been on the job search and found that nowhere within a 100 mile radius offers near the salary I make now. And I only have 10 minutes to drive to work. If I worked anywhere else (and factoring in the drive time and gas costs) I'd have to have a second job to make it at all. So you say they're just nice little perks. I tell you they are the difference between keeping my sanity and losing it - or possibly falling asleep behind the wheel on the way home. This is also the only facility that serves my hometown community and we all want to see it succeed this time. No, it's not ideal. And all the nurses at this facility (myself included) are a very vocal bunch. We make our opinions well known as professionally as possible. Administrators in general typically fail to get the message, but it's only because they've got their heads in the sand... I've never seen a hospital that didn't treat its nurses horribly. This one is actually much better than any other I've worked for.

    We'll play it by ear for now....

    Babs
  9. by   canoehead
    I thought you disliked the place- if so you can either move on, or work to change what you don't like- or accept that by doing nothing you are allowing all the negative aspects of the job to continue.

    Sounds like you don't want to change jobs or relocate, why not pick one aspect of the facility that you would like changed and present your case to change it. Sounds like a monthly staff meeting might be beneficial for everyone, or a daily housekeeper, if only for a few hours, or a clerk to do paperwork and restock, or you pick something.

    If others have the same frustrations they will support you, most of the time people just don't want to spend the energy or take on the responsibility of spearheading a change. If you decide to take that on you can really make a difference. Or you can put up with what is already there, but it seems to me that is how nursing got into this mess in the first place.

    I'll wish you luck.
  10. by   babs_rn
    Frankly, we've all been very vocal about needed changes, as I said. It's like talking to a brick wall. Administration doesn't want to spend the money and at this point in time they literally don't have it to spend - they're doing good to cover the payroll.

    But I still hold firm in the belief that it's the same everywhere you go. I've seen it for myself. So what does it matter if I leave this one to go somewhere else? It's the S.O.S. in a different package.

    I am considering leaving - to go to work in the local prison. At least there I don't have to pretend to be all smiles all the time on top of everything else. That would be a relief in and of itself. I'd have to do some agency work on the side but such is life.

    babs

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