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| No. 30 | 
Apr 11, 2008, 05:03 PM
 Re: Nurse sees worst, best of profession during daughter's ER visit Originally Posted by canoehead  I agree this would help, but damned if I am going to ask permission or forgiveness from 50 people every time I need to pee. It's a personal need and if anyone doesn't allow me that privacy can bite me. I'm sorry the line has to be drawn- I've given up breaks, I've given up personal comfort- thank goodness someone allows me to eat once every 12 hours, and I'm supposed to ask for understanding because I NEED to EAT? No way.
That said (and I meant it), I do try to go around each hour to ER rooms and say "We've done x, y, z, and now we are waiting for f__" We also ask registration to make a general announcement to the waiting room if there's going to be a slow down in people being called back- usually because ambulances are arriving.
Why do people assume that we are uncaring or lazy when there is a delay instead of assuming that there is someone that needs attention? It is an emergency room you know.
It seems to be just human nature to assume the worst or the ugliest. I have often wondered myself why people assume the worst. 
No one is saying to get permission to take care of basic bodily needs like eating, drinking, using the john. Nurses are foolish to not take necessary breaks. It's just a matter of where and of trying to not let patients think we are not doing their care right if we are taking care of us for a while. Whenever possible, it's just simpler to go where they can't see us or hear us if we don't fel like having to explain or ask permission or communicate right then. I agree, it gets old, no matter how much we care about people.
 | | Advertisement Sponsored Links | | | | No. 31 |
Apr 11, 2008, 06:41 PM
 Re: Nurse sees worst, best of profession during daughter's ER visit
It is hard to be in a situation that molther was in because it is hard for anyone to be sick. We teach about it, but when it's us or a family member or good friend, we feel what our pts feel - the loss of control anyone has when they are sick or injured badly. I've cared for pts where a family member is watching (even writing down the exact time anyone comes in or goes out of the room!). It can be intimidating. I guess someone who has a position of authority such as a professor teaching probably feels more helpless bec. she's used to getting what she wants and is in control of the situation. Anyone could really feel guilty about "missing " something in someone who got sicker later because if it, especially a close loved one like a child. I can certainly understand the Triage people ordering food or laughing at something, but we have to learn that if we see someone in close prosimity to us that is in suffering over a loved one, to go somewhere else and order the food, or laugh, or make a personal call unless there is just not a way to do this. We need to sensative to the needs of our pts and their families. What does anybody else think?
| | No. 32 |
Apr 11, 2008, 06:45 PM
Re: Nurse sees worst, best of profession during daughter's ER visit “…the worst was they didn't care about my daughter. They didn't care about the young woman across the room, also crying in pain, also waiting for hours. They didn't care about the young man who came in bleeding profusely.”
-WOW! What an incredibly singular line of perspective the author is using. Does she actually think that no one cared??? It sounds to me that she was in a busy ER on a (typically) busy day. What are the nurses supposed to do? By law, they cannot diagnose and they can’t treat without a physicians order. Every place has different protocols about abdominal pain in triage. Some places hire a doctor and the back up staff to be in triage to at least start the medical process of basic diagnosis and pain management. Some places don’t. But I guess in the eyes of the author, the fact that the facility that she visited does not is the fault of the triage nurse.
___ “The initial nursing triage staff did the bare minimum required of them; they did it without a smile or a touch of concern. They did it quickly and efficiently and soullessly.”
-It sounds to me like they did their job exactly as expected of them. I would challenge the author to work for a significant period of time in a busy triage area. Then measure how much of her soul she keeps to herself when faced with the unrelenting pressure of having to stay sharp at all times to recognize, in her 5 minutes of allotted time, someone who is legitimately soon going to be at death’s door. Plus the pressure of having of having 2 and 3 patients register for every 1 she can triage, plus keeping an eye on the 10% of the patients in the waiting room that she is actually worried about, plus get blankets and pillows immediately, like the good Waffle House waitresses that Press-Gainey has sold to typical hospital administration we need to be. Also couple that with having to explain for the 4th time that “no, I can’t get you any water until the doctor sees you”, “No, I can’t tell you how much longer it will be.” (Actually I can give you a pretty good idea but I am not allowed too. My fault as well I am sure.) Lets see how many times the author can get beat down on a daily basis by angry and irrational patients for things like wait time, lack of beds, inability to administer immediate and effective care, things utterly and completely beyond her control.
___ “They sat at their desk and ordered food…”
-Oh my God the horror! I wonder if the author, by chance, happened to notice, with her astute, learned and keen observation, how many times the nurses were offered breaks from their supervisors? If she was at any place I have ever worked at during the busy period, (which can last an entire 12 hour period I might add), the answer would be none. I am with a previous poster on this. I will make no excuses and no apologies. I am there 12 hours and if I need to eat or go to the bathroom, I WILL! If that means eating in front of the patients or getting up for 5 minutes, too bad and I don’t care how it looks. My feeling is that if a hospital administration does not wish to provide the time and the staff to provide for very basic and fundamental needs, I will do what I must to keep myself sharp.
___ “…talked on their cells…”
-I know that using cell phones in that setting looks terrible. But where I work, we are not allowed to take incoming calls nor make outgoing calls for non business purposes from hospital phones. We are there for 12 hours and yet it seems that it is completely unreasonable that we be able to call our loved ones and wish them a good night, check up on them or whatever. The same types of conversations I am sure the author would be having with her precious “GEM” were she to be in a similar situation. Oh but wait, we are “Soulless” aren’t we? Why should we have any reason to care about our own precious “GEMs”?
___ “…and told jokes within feet of my daughter who was in agony…”
-I know it may be rough for you and your daughter, but we are not the sick ones. Does it look appropriate from your perspective? Certainly not and I respect that observation. But it does not mean that we have to grind through a 12 hour shift with furrowed brow and a scowl either. Personally, as far as I am concerned, my sense of humor is the only thing that keeps me sane in the insane world of ER nursing.
___ “How could anyone, let alone a health professional, be so insensitive?”
-To say that the nurses were “insensitive” is base ignorance. The author may interpret her observations of the nurses as being insensitive, but that is how she chose to interpret it. I suspect the reality of the attitudes of the nurses she observed that night were far from it.
___ “As a healthcare consumer, I was bewildered and angry.”
-So I guess that her expectation, at the interpersonal, nursing level, forgetting for a moment the medical-legal/administrative/physical space constraints already alluded to, were that the nurses that she observed were supposed to cry on bended knee in sympathy in front of her and her daughter? That they were supposed to go 12 hours without eating? Without breaks? Without checking in with their loved ones? That they were supposed to leave their own humanity in their cars?
One wonders if the author, as well as being a member of the faculty branch of nursing, also sits in her high and white tower and wonders why nurses burn out after such a short period of time.
___ “As a nursing instructor, I was horrified. And as a member of the nursing profession, I was embarrassed and ashamed.”
-As a member of the very same nursing profession, I too find myself embarrassed and ashamed on occasion about the conflicts that I continually face in my practice about the service I desperately want to provide and the constraints handed down to me from above with which I am able to provide them. But I am one very small wheel in the very huge health care machine. I have also learned, bitterly I might add, that the squeaky wheel does not get the grease, the squeaky wheel gets replaced for a more “team work orientated” wheel.
___ “These were my colleagues.”
-I would hardly include the author of this one sided, unsympathetic and subjective rant a “colleague”. I can think of many other names to refer to her as. But I won’t write them here.
___ “This was America in 2008. No one should be treated like we were that night, no one.”
-To the author: Guess what dear? What you experienced IS the reality of health care in 2008. The “Care” in Health Care” is being slowly squeezed out of this industry in favor of efficiently and earnings per share. The nurses are merely on the front lines of this mess. Personally, I am appalled that someone in your position does not see how the public perception of the nursing profession as a whole is being whored out, en mass, for the short term gains of the corporate culture we are all finding ourselves more and more embroidered in.
___ “Fifty-eight minutes and 45 seconds later, her surgeon met us in the waiting room. Grace had a perforated appendix and I had missed it. All those signs and symptoms and I had missed it. Her belly was full of pus, she was septic, and I had missed it. Some mother, some nursing professor, and some advanced practice nurse I was! Her dad tried to make me feel better, the staff on the floor tried to make me feel better. Finally, her surgeon told me "to just stop it. You're not helping anyone." I joked that "I run for mother of the year all the time." But I was appalled: How could I have passed off appendicitis for the flu? How could I have discounted her pain for just being dramatic?”
-Funny, after reading the entire article, the daughter could have very well switched the words ‘nurse’ with ‘mommy’ in describing her experience with her mom prior to going and seeking help. I wonder how the author would have felt if her daughter had done that?
___ “So, yes, I was one of "those" mothers. I tried hard not to be but about 24 hours into our stay, I gave up. While I tried to be nice about some things, I wanted what I wanted and I wanted it right now. Bless their hearts, her nurses never yelled at me.”
-I always find it interesting how one can place the most precious thing in their life, their child, into the hands of a complete stranger and then be so utterly demanding and downright mean to them. It never ceases to amaze me
___ “If they talked about me behind my back, they were very discrete.”
-I am sure the author is very correct about this particular assumption.
___ “I have a new passion for making sure none of "my" nurses ever act like the ones I observed in the ER.”
-I also hope that for the sake of the nursing profession, the author and those in her profession also put more time and emphasis in teaching professional stewardship as some of those very same nurses she is teaching will undoubtedly be replacing the head-bobbing-yes-man, corporate minions that currently occupy nursing administrative positions today.
| | No. 35 |
Apr 11, 2008, 10:11 PM
Re: Nurse sees worst, best of profession during daughter's ER visit Originally Posted by workingforskies “…the worst was they didn't care about my daughter. They didn't care about the young woman across the room, also crying in pain, also waiting for hours. They didn't care about the young man who came in bleeding profusely.”
-WOW! What an incredibly singular line of perspective the author is using. Does she actually think that no one cared??? It sounds to me that she was in a busy ER on a (typically) busy day. What are the nurses supposed to do? By law, they cannot diagnose and they can’t treat without a physicians order. Every place has different protocols about abdominal pain in triage. Some places hire a doctor and the back up staff to be in triage to at least start the medical process of basic diagnosis and pain management. Some places don’t. But I guess in the eyes of the author, the fact that the facility that she visited does not is the fault of the triage nurse.
___
“The initial nursing triage staff did the bare minimum required of them; they did it without a smile or a touch of concern. They did it quickly and efficiently and soullessly.”
-It sounds to me like they did their job exactly as expected of them. I would challenge the author to work for a significant period of time in a busy triage area. Then measure how much of her soul she keeps to herself when faced with the unrelenting pressure of having to stay sharp at all times to recognize, in her 5 minutes of allotted time, someone who is legitimately soon going to be at death’s door. Plus the pressure of having of having 2 and 3 patients register for every 1 she can triage, plus keeping an eye on the 10% of the patients in the waiting room that she is actually worried about, plus get blankets and pillows immediately, like the good Waffle House waitresses that Press-Gainey has sold to typical hospital administration we need to be. Also couple that with having to explain for the 4th time that “no, I can’t get you any water until the doctor sees you”, “No, I can’t tell you how much longer it will be.” (Actually I can give you a pretty good idea but I am not allowed too. My fault as well I am sure.) Lets see how many times the author can get beat down on a daily basis by angry and irrational patients for things like wait time, lack of beds, inability to administer immediate and effective care, things utterly and completely beyond her control.
___
“They sat at their desk and ordered food…”
-Oh my God the horror! I wonder if the author, by chance, happened to notice, with her astute, learned and keen observation, how many times the nurses were offered breaks from their supervisors? If she was at any place I have ever worked at during the busy period, (which can last an entire 12 hour period I might add), the answer would be none. I am with a previous poster on this. I will make no excuses and no apologies. I am there 12 hours and if I need to eat or go to the bathroom, I WILL! If that means eating in front of the patients or getting up for 5 minutes, too bad and I don’t care how it looks. My feeling is that if a hospital administration does not wish to provide the time and the staff to provide for very basic and fundamental needs, I will do what I must to keep myself sharp.
___
“…talked on their cells…”
-I know that using cell phones in that setting looks terrible. But where I work, we are not allowed to take incoming calls nor make outgoing calls for non business purposes from hospital phones. We are there for 12 hours and yet it seems that it is completely unreasonable that we be able to call our loved ones and wish them a good night, check up on them or whatever. The same types of conversations I am sure the author would be having with her precious “GEM” were she to be in a similar situation. Oh but wait, we are “Soulless” aren’t we? Why should we have any reason to care about our own precious “GEMs”?
___
“…and told jokes within feet of my daughter who was in agony…”
-I know it may be rough for you and your daughter, but we are not the sick ones. Does it look appropriate from your perspective? Certainly not and I respect that observation. But it does not mean that we have to grind through a 12 hour shift with furrowed brow and a scowl either. Personally, as far as I am concerned, my sense of humor is the only thing that keeps me sane in the insane world of ER nursing.
___
“How could anyone, let alone a health professional, be so insensitive?”
-To say that the nurses were “insensitive” is base ignorance. The author may interpret her observations of the nurses as being insensitive, but that is how she chose to interpret it. I suspect the reality of the attitudes of the nurses she observed that night were far from it.
___
“As a healthcare consumer, I was bewildered and angry.”
-So I guess that her expectation, at the interpersonal, nursing level, forgetting for a moment the medical-legal/administrative/physical space constraints already alluded to, were that the nurses that she observed were supposed to cry on bended knee in sympathy in front of her and her daughter? That they were supposed to go 12 hours without eating? Without breaks? Without checking in with their loved ones? That they were supposed to leave their own humanity in their cars?
One wonders if the author, as well as being a member of the faculty branch of nursing, also sits in her high and white tower and wonders why nurses burn out after such a short period of time.
___
“As a nursing instructor, I was horrified. And as a member of the nursing profession, I was embarrassed and ashamed.”
-As a member of the very same nursing profession, I too find myself embarrassed and ashamed on occasion about the conflicts that I continually face in my practice about the service I desperately want to provide and the constraints handed down to me from above with which I am able to provide them. But I am one very small wheel in the very huge health care machine. I have also learned, bitterly I might add, that the squeaky wheel does not get the grease, the squeaky wheel gets replaced for a more “team work orientated” wheel.
___
“These were my colleagues.”
-I would hardly include the author of this one sided, unsympathetic and subjective rant a “colleague”. I can think of many other names to refer to her as. But I won’t write them here.
___
“This was America in 2008. No one should be treated like we were that night, no one.”
-To the author: Guess what dear? What you experienced IS the reality of health care in 2008. The “Care” in Health Care” is being slowly squeezed out of this industry in favor of efficiently and earnings per share. The nurses are merely on the front lines of this mess. Personally, I am appalled that someone in your position does not see how the public perception of the nursing profession as a whole is being whored out, en mass, for the short term gains of the corporate culture we are all finding ourselves more and more embroidered in.
___
“Fifty-eight minutes and 45 seconds later, her surgeon met us in the waiting room. Grace had a perforated appendix and I had missed it. All those signs and symptoms and I had missed it. Her belly was full of pus, she was septic, and I had missed it. Some mother, some nursing professor, and some advanced practice nurse I was! Her dad tried to make me feel better, the staff on the floor tried to make me feel better. Finally, her surgeon told me "to just stop it. You're not helping anyone." I joked that "I run for mother of the year all the time." But I was appalled: How could I have passed off appendicitis for the flu? How could I have discounted her pain for just being dramatic?”
-Funny, after reading the entire article, the daughter could have very well switched the words ‘nurse’ with ‘mommy’ in describing her experience with her mom prior to going and seeking help. I wonder how the author would have felt if her daughter had done that?
___
“So, yes, I was one of "those" mothers. I tried hard not to be but about 24 hours into our stay, I gave up. While I tried to be nice about some things, I wanted what I wanted and I wanted it right now. Bless their hearts, her nurses never yelled at me.”
-I always find it interesting how one can place the most precious thing in their life, their child, into the hands of a complete stranger and then be so utterly demanding and downright mean to them. It never ceases to amaze me
___
“If they talked about me behind my back, they were very discrete.”
-I am sure the author is very correct about this particular assumption.
___
“I have a new passion for making sure none of "my" nurses ever act like the ones I observed in the ER.”
-I also hope that for the sake of the nursing profession, the author and those in her profession also put more time and emphasis in teaching professional stewardship as some of those very same nurses she is teaching will undoubtedly be replacing the head-bobbing-yes-man, corporate minions that currently occupy nursing administrative positions today.
Oh my gosh I wanted to say everything you said here but I was tooooo lazy to do all that typing. RIGHT ON  glad I left it for you to do because I would not have said it soooo well. I have taken care of nurse educators and their families and they are usually very difficult, no knowledge of the real world, unrealistic expectations. Of course they never have a clue what I am actually thinking. The problem is they don't know anything about the actual practice of bedside care, some call it an Ivory tower. Very few bedside nurses would have missed all the alarming symptoms this young girl was giving off like a ambulance siren. The mother in this case missed it because she is more an educator than a nurse. Of course if I had cared for her and her daughter I would have never given her an inkling that I thought a blind and deaf bedside nurse would have caught on to what was happening, that would be too cruel.
| | No. 36 |
Apr 11, 2008, 11:20 PM
Re: Nurse sees worst, best of profession during daughter's ER visit
God, can you imagine having your mom forcing you to get up out of bed and walk around after an abdominal surgery? Leave that stuff to the RNs.
Don't know about you but where I work, good luck with that. If it wasn't for family members ambulating, feeding, making them use the IS, it simply wouldn't happen consistently enough to prevent complications post op.
| | No. 37 |
Apr 12, 2008, 09:44 AM
Re: Nurse sees worst, best of profession during daughter's ER visit
Before it was posted by Brian, it was emailed to me by an outraged coworker.
As I read the article, I could appreciate the mothers point of view as a layperson, HOWEVER, she wasn't a layperson. She is a NURSE! Her viewpoints made me wonder if she ever spent time in an acute setting....or when her last practical applications of nursing where done.
As a NURSE and MOTHER, she should have been an advocate for her daughter/patient-if she felt so strongly, her opinions could have been made known to triage, physicians and the charge nurse on the floor. Obviously, they were not. I work in an ER, ACUITY WILL ALWAYS RULE THE INTAKE AND AVAILABLE BEDS! Unfortunately, abdominal pain will always be secondary (even in a kid) when there are viable sob, cp and strokes coming through the door. We can't know what was going on in that ER, and obviously she didn't ask(NO MENTION MADE IN ARTICLE).
While I feel sorry for her daughter's plight, at least she had a knowledgeable, albeit (quiet) mother to care for her. As a healthcare professional, if I felt my child's/husband or anyother person I was sitting next to was in serious danger (based on my experience) YOU WOULDN'T BE ABLE TO SHUT ME UP!
It is no secret to anyone working in a hospital that there is not enough staff on the floor to do everything required. I am sure the education was provided, however, whether or not a patient complies with hourly incentive spirometry, walking, breathing, movement or anything else is completely up to them-or in this case their guardian. I expect any good parent to take the time and effort necessary to make their own child well.
What really bugs me about this article and this particular nurse is that her writing points to us in a negative way-zeroing in on nursing, as opposed to the problems with healthcare. No staff, no beds, no insurance, improper use of the ER, and a million others. This was the perfect opportunity to address these issues, along with her personal disappointment that nurses DON'T HAVE THE TIME to do the little things anymore. SHE BLEW IT! The general public needs to be aware of these challenges. She just added another blow to our image-who cares if we hurt ourselves, don't eat, don't drink, don't pee, feel sick, get emotionally drained....one of our own doesn't....why should anyone else?
Physician heal thyself? Teacher educate thyself!
Maisy
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