Are we allowed to be people before nurses?? (long)

DusktilDawn · Aug 23, 2005

Stidget99, I hear ya :icon_hug:

Asking for a 10 minute wait to receive report is not unreasonable nor is it unprofessional, insisting on sending that patient anyway is. In fact it can be considered advocacy for the patients you were already responsible for by asking for a 10 minute wait. Your facility has a responsiblity to provide a working environment that facilitates your ability to provide care for your patients, not impede it.

Slamming you hand against the pyxis in frustration could be considered unprofessional but with what was going on in perspective to the situation, extremely minor. Leaving a situation to decompress is professional.

Your manager's expectations that anyone is able to 100% professional 100% of the time is unrealistic. Nobody can be 100% all the time, it's not possible, we do the best we can. The use of "my" nurses implies that you are property and I personally find that offensive and unprofessional.

Your manager's expectations that emotions need to stay at home. Personal issues and emotions involved with those issues in one's personal life does need to stay at home. However does she believe that you should not care about how well you do your job, demonstrate compassion to your patients, passionately advocate for your patients when necessary, and yes demonstrate all the professional qualities a nurse should have along with the corresponding emotions.

Your manager's belief that "It is the expactation on this floor that pts come up "now" irregardless of what else is going on" is also unreasonable. If you had a patient that was deteriorating fast sending an admission could impact that deteriorating pt's condition. The house supervisor knew your situation and had agreed that you could let her know when you would be able to take the pt earlier in the shift, I don't understand why she changed her mind later.

Your manager's statement "it is the expectation on that pts get up to the floor and that personal needs did not take precedence over that" is also unreasonable. Personal needs? What is her defination of personal needs? If it involves short staffing and an unreasonable workload that is not a personal need, that is actually a safety issue that SHE should be addressing.

Your manager bringing a "yes ma'am" minion in a meeting with you who was not even there during this situation, also inappropriate. Who was there to protect your interests or validate the situation on the unit at that time?

Do not go into this woman's office alone. Have a trusted representative of your choosing with you (union rep if you are unionized). Refuse to further address this issue otherwise.

mandrews · Aug 23, 2005

I guess this is just a vent.
I worked the weekend, noc shift. I was team leader. Four nurses, 26 very needy pts and our only aide injured her back and went home after a trip to the ER (she was gone by 2015).
The house supervisor told me that she had two admissions waiting on us. This was around 2030 or so. Shortly after 2100, she told me that she got "one of the other floors to take one of the admissions".
I had 2 units of PRBCs and 2 units of FFP to get up on 2 different pts. Also had one pt who is in w/ end stage liver CA who was intent on getting up to the BSC every 10 minutes or so.....she was not safe to transfer on her own. In addition, another pt needed an NGT dropped (which is not my strongest skill). Another pt's continuous pulse ox was constantly alarming (sats dropping to low to mid 80's and pulse dropping down into the low 40's). These issues along w/ the call bells going off every 5 mins or so.....I told the house supervisor that I would not be able to receive the pt until 2330. She didn't say anything except to let her know when I would be able to take the pt. I thought we had an understanding that the pt would come shortly after 2330.
I once again (right around 2315) told her that I was still overwhelmed - still passing 2200 meds. Right around 2320, I was in the Pyxis room, asked her to come in and witness a med. As the two of us were walking back into the room, the unit sec told me that ER was calling to give report on the admission. I told her that I could not take report at that moment. The house super told me, once we got into the Pyxis room, that the pt HAD to get up to the floor, they had been waiting 2 1/2 hours to come up. I re-iterated once again, that I absolutely could not take report, would be ready ~about 10 mins. She said that the pt must come up now....PERIOD.
I got angry, slammed my hand against the Pyxis window to close out my name and left to go to the bathroom to decompress. I admit that I was very angry/frustrated/overwhelmed. No excuses but I am a person before I am a nurse.
My manager called me back in yesterday morning. The gist of the conversation was this: "It is the expectation on this floor that pts come up "now" regardless of what else is going on." She had the day shift team leader sit in on the meeting. She asked her if she was wrong in assuming that the top priority is to get the pts up to the floor. And the day shifter told us that she has to juggle taking care of 5 pts and still is able to get pts up to the floor. I am sorry but it is totally different on the day shift. More staff available to help out (i.e. 3 aides plus at least 6 nurses on each day shift).
She told me that "it is the expectation that pts get up to the floor and that personal needs did not take precedence over that".
She told me that "my" nurses will be professional at all times...PERIOD. At this point I asked if we were allowed to get frustrated, angry, or show any emotion at all. She re-iterated that "my" nurses will be professional 100% of the time and that emotions needed to stay at home.
Now I have to go back and talk to her again today. I am not sure that I will be able to hold my tongue. I am so angry for everything that has happened. I am a kick butt nurse. I get frequent "WOW" cards from my pts. I am an excellent morale booster. I am forever trying to be positive in spite of the high stress on the unit. My co-workers can always ask me for help and I am there.
I don't know if I should just go in and give my notice. Let her terminate me. Just sit there and take the crap that she has to shovel out.
I need people to give me their take on the situation. Am I wrong? Am I just being a wench-bag?

LOL! You are not a wenchbag! :rotfl:

Try to cool off as much as you can before the meeting. Don't do or say anything you might regret later.

Before I thought of quiting I would have to think about whether or not I like working there. Is it safe? Do you feel comfortable? You sound a little burned out which makes me think this type of incident might happen frequently.

Were you given a chance to explain why you were so busy? Could the house supv or one of the other nurses not start the admission for you? At my hospital the supv would have done the admit and told them you would be their nurse and they would check on them until you were able to.

I hope things get better.

melissa

CrunchRN, ADN, RN · Aug 23, 2005

I don't have any advice, as I am not a hospital nurse, but I do want to say thatI agree with you. You are trying so hard to give good care and meet everyone's needs and expectations and if you say that the admit needs to wait that should be respected. The hand slam was a little inappropriate, but certainly understandable and they should just cut you a break. I wish that day nurse would have said that she understood the frustration you felt, and that although she handled it differently that she had felt that herself. Then your manager would have had to see things a little differently. Please know that many do support you and are thankful (very thankful) for nurses like you.

stidget99 · Aug 23, 2005

Am I just burned out? Strong possibility I think. I am ALWAYS stressed out at work.

But at the same time, things are just crappy there. We are told one thing re: staffing. And then when we ask managers to follow thru on what they said, they tell us that we have to do it...even if it is totally contrary to what was said a week ago.

I love nursing! I love taking care of pts! I love making a positive impact on their lives or even their end of life.

I just don't seem to handle the stress too well lately. I think that they put us through hell knowing that we are a committed bunch and we will kill ourselves to provide the absolute best care possible. We will deny our own needs (i.e. emptying our bladders, eating dinner, keeping ourselves hydrated) just so the pts have the very best.

Burn out. Something to think about.

teeituptom, BSN, RN · Aug 23, 2005

I will give you two options

One take up golf it will help you to relax and focus

two become an ER nurse and then you can send the patients to the floor. It is always better to give than recieve.

Make it three options, the third is be either a patient or a family member of a pt in the ER, waiting on a admission room , or a nurse to take report, while laying on a nice hard as a board ER stretcher.

TiffyRN, BSN, PhD · Aug 23, 2005

Been there, done that and I hate to tell you but you can't win this argument. If you love your job just suck it up and listen to their complaints, nod nicely and promise to do better in the future. They don't want to hear your explanations, trust me; after all Suzy Q or Nancy Nurse (or whoever) never had those issues, she always takes the admissions, takes care of her patients and bakes cakes in the microwave for all the visitors!! Sorry, but you won't win this argument with the managament. I would refuse to go to another meeting outnumbered, insist on having as many on your side as they have on theirs. I was in one of those outnumbered meetings that that's for the birds.

I do kinda like Tom's suggestion that you consider working ER for a while. I've always felt it helps all employees (of every sort, in every profession) to see both sides of situations like that. Such as, I think it really benefits nurses to work all shifts at least for some period of their life. I personally have never worked ER but I know they have incredible pressures on them also and they don't get to call for a few extra minutes to put off another patient.

I'm lucky, my job rarely requires me to admit (like I've done 3 admissions in about 3 years). After years of doing an average of 1-2 admits a shift (before this job) this is a dream.

SmilingBluEyes · Aug 23, 2005

well it sounds as if you have a very unsupportive manager. The question becomes: do you want to continue as you are?

If not maybe it's time to job hunt.

If possible, take a short time off and lay it out on paper:

the pro's and con's of staying in your present situation. Be brutally honest, doing this when you are in a calmer state of mind.

You will soon see what the answer is, if you do this exercise in a reasonable, well-rested state of mind. I do it all the time to make major decisions in my life. It works.

Bless your heart. Take care of yourself-----so you CAN care for others when called upon to do it.

beesnest · Aug 23, 2005

You are absolutely right, but you are not going to win. In fact, arguing with them will weaken your position by branding you as someone who bucks the administrative rulings. So now you need to think about if this is an isolated rotten night or if you need to make some changes, maybe just change your mind set in some way, or even change your job, it's up to you. 10:1 they will not change the way they do things.

mattsmom81 · Aug 24, 2005

Are you an area that has a Safe Harbor for nurses?? This at least gives you some protection should anything bad happen to your patients while you are stretched beyond your ability. some areas have a form stating 'assignment under protest' I've heard. Of course, the hospital could still fire you (especially if you are an at will state) But you will be on file as objecting, so your license will be safe. You will likely get a rep as a troublemaker...most outspoken patient advocates do.....

Facilities don't care when their nurses are overwhelmed, but they should. Short staffing is linked to poor patient outcomes. I don't know what its going to take to get hospitals to stop bullying their nurses into taking more admissions even when they can't safely care for the ones they have. In fact, my NPA states I should never accept an assignment I know I am incapable of providing adequate care for. Catch 22 isn't it??

Seems like no matter what the nurse is screwed. I feel your pain.

Thunderwolf, MSN, RN · Aug 24, 2005

I've worked in settings where Managers are great and supportive and settings where they are cold and heartless. It depends on the manager. I also agree that you will not win in this case. The manager bringing in her "yes" person into the meeting was disrespectful to you and sets you up to fall. Unfortunately, do gooders and hard workers are resented sometimes by some who may find it threatening to themselves (as evidenced by the 100% unemotional, apathetic, professional expectation). I also feel your pain. Others gave you good suggestions. Suck it up and move on, complain and stick out to be knocked down, or to move on to another area to work for your own peace of mind. It's a shame that good nurses have to be put in this type of position.

I wish you the best in your decision.

jkaee · Aug 24, 2005

Others have given you good advice, all I can add is that I know how frustrating it can be to be so completely overwhelmed and then a supervisor comes on up and adds even more to your load. It doesn't sound as if you have strong supervisor or manager support, and I don't think that you will be able to change that. I commend your good work ethic and your loyalty to your job and patients, but I have learned that NO job is worth making yourself crazy over. If you are burned out, if you can't handle the pressures that your job is giving you on a daily basis, it may mean it's time to move on. At least look around and see what other options are out there, it may help just knowing that there are other things you can do, even if you aren't ready to make a move yet.

Also, like someone else posted, if there's anyone you can bring with you to this 2nd "meeting", I strongly advise you do so. It's never a good idea to be alone in those situations. If not, then go prepared, and take notes during the meeting. Ask for everything in writing. If they see you mean business and can't be pushed around, they may not try to push their weight around as much.

Good luck to you, and let us know how you are doing. :icon_hug: