A Job That's Cut Out for Me

[HairyMurse]

Hey everyone, I'm sure this topic has been posted, but I'm not even sure what to search for.

Basically--I am wondering where to work and what specialty would be best for me--given my personality.

I hear a lot of horror stories of patient satisfaction scores, and of nurses who get chewed out over a patient's frivolous formal complaints, by their managers.

I don't know if I can handle that. I am a very tell-it-like-it-is kind of guy. I don't want to work somewhere like this, where I have to cater to a patient's every ridiculous request (including their families requests), and hide the honest truth in fear of getting reprimanded/fired if they don't want to hear it.

Is there any hope for me? Which specialty would you recommend? ER., ICU? Which area of the country...etc

Thanks much!

[RegularNurse]

Thank you for having foresight into your personal attributes prior to picking the wrong job at the wrong employer. Nursing needs more people like you.

Location: A major metropolitan area, preferably in the Northeast of the US where people communicate directly- bordering on abrasive. Voicing an opinion in this part of the country will not get you in trouble, but expect an equally direct reply.

Specialty: ER. Patient and staff turnover is high; often too high for personal feuds to fester into calamity.

Over and out,

RegularNurse

[HairyMurse]

Thank you for having foresight into your personal attributes prior to picking the wrong job at the wrong employer. Nursing needs more people like you.

Location: A major metropolitan area, preferably in the Northeast of the US where people communicate directly- bordering on abrasive. Voicing an opinion in this part of the country will not get you in trouble, but expect an equally direct reply.

Specialty: ER. Patient and staff turnover is high; often too high for personal feuds to fester into calamity.

Over and out,

RegularNurse

Thanks! Abrasive and to the point is my style! (Of course I would never treat anyone disrespectfuly). I have a hard time biting my tongue, however.

[HouTx, BSN, MSN, EdD]

I agree with PP - it's always an advantage to consider one's own limitations when selecting an employment venue....

That being said, there is no where in the USA that you're going to be able to avoid the current major focus on 'customer satisfaction' because it is tied to reimbursement. Managers are being held accountable for their department's HCAHP scores, so I'm sure you realize that if any issues arise, it will be YOU that ends up under the bus.

I also have a bit of a problem with your labeling of patient/family requests as "ridiculous". Nursing practice is differentiated by a holistic approach. As nurses, we know that those 'ridiculous' requests are frequently representative of an underlying need or fear... e.g. frequent trivial requests for attention in order to make sure that the nurse is available and ready to help me at any time; complaining about my ill child's meal because I desperately want something I can control. It's communication 101 - pay attention to both the message and the meaning.

BTW, in my organization, our EDs have very low turnover & teamwork is highly valued. As a new nurse, you have enough hoops to jump through - don't set them on fire.

[Here.I.Stand, BSN, RN]

I think a lot of it has to do with the individual unit culture and manager as well. I work in an urban Midwest hospital, for an incredible nurse-leader. We do focus on the patient and family first, but not to the point that it impinges on *nursing* judgment and *nursing* care. If families are disruptive, we are encouraged to have security remove them. If the pt is in with a gang-related injury, we restrict visitors and cell phones stay locked up no matter how much they pout. The charge nurse, nursing supervisor, and security staff are very willing to advocate for their staff.

I have been here 3 yrs, and literally the only time we have heard "patient satisfaction" was with the encouragement to advocate for adequate pain control for our pts. Our neurosurg team naturally wants to limit sedating meds, but according to the surveys that has come at the expense of adequate pain control.

Most people, in my experience, do tend to calm down once they understand that everything we do is for the patient's well-being. Can't have 20 people in the ICU room (assuming the pt is not on comfort care only)? It's because the RN needs to quickly access the pt and the equipment. Can't give the dysphagic stroke patient plain ice water? It's because SLP's (the expert's) exam shows that the patient will inhale that water, which can cause a life-threatening pneumonia. Upset that we are waking them q 1 hr to engage them in conversation and check their strength in each extremity? It's because that is the only way we can know hour-by-hour if the patient's brain is swelling, pt is experiencing an intracranial vasospasm etc. Nothing we do is to be mean, to make them miserable, or because we don't care.

I've also found that delivery is everything. You've heard that phrase, "it's not what you say, it's how you say it"? You can be firm without being nasty.

[RNOTODAY, BSN, RN]

* operating Room