AT ISSUE: What is the culture of your floor?

[CaLLaCoDe, BSN, RN]

Here I was last night charting, finisishing up all the loose ends...the I's and O's, the MD visits at the bedside, the patient's goals towards wellness that had been addressed. And to my left down the hall I hear a phrase from a new nurse to our department: "Are you O.K.?" I notice a patient outside her room nearest to the new nurse. A bit disoriented, not very steady on her feet, blood on her gown located on her right middle and a red spot on her wrist. I immediately go into action.

I calmly ask her where she is going, how she might do better resting and getting needed rest. And I reorient her to her room. With blood on her person, I'm thinking all the ways I can swiftly apply pressure to the wound and elevate it, call for assistance, get her nurse to attend, and clean the water on the floor at her bedside. And do it all in a kind light hearted sort of way. You know, put the fire out.

Now, the new nurse does nothing to help out whatsoever. So I tell her to call the central station to direct help to the patient's room by the aide and the nurse assigned to this patient. Help arrives and I voluntarily start the new IV.

I know this is the culture of my floor. Every nurse looks out for the patient's on the floor, no matter if they are his or hers. It is just like that. Do in kind as you would like your fellow nurse to do in kind for you.

The new nurse doesn't quite get it yet, perhaps. Possibly she did not share this culture of care with other nurses at her prior place of employment. I am of the opinion she will catch on. Sink or swim, right?

I just am so grateful that we have a culture that works togethor making sure all patients are cared for whether the nurse assigned is not present. Patient's safety first right?

Well, on this board I read about nurses who do not help in time of great need. Sometimes they put knowing the name of the patient in trouble over helping another colleague at the drop of a hat. Or have the feeling that since the patient is not mine, what business is it of mine to get involved.

I wonder what culture you face on your floor. Are you happy with the culture? What steps have you taken to change the culture if any?

[ktwlpn, LPN]

I'm in LTC-our new philosophy (we have new admin) is "This is a 24 hour facility" Everything used to be the responsibilty of the day shift-now all staff are expected to be familiar with P and P and do whatever needs to be done.That said-I don't leave a mess for the oncoming nurses-but I get to a good stopping place,give report and leave.However if I see a resident in trouble anywhere in the facility no matter where I am headed I'll stop and help them out.Ditto for lost looking visitors or co-workers....Kudos for you for helping out that patient-I don't think I would have gone so far as to put in a new line but I would have gotten her back to her room,gotten her comfortable and told her assigned nurse what I found...

[EmmaG, RN]

I think there tends to be more of what you describe on off shifts (everyone looks out for all patients), if for no other reason than we have fewer nurses and limited resources to back us up.

As far your new nurse, it's hard to say. She may well have the 'not my patient' attitude. But perhaps she just froze; perhaps she is so intent (and maybe overwhelmed) learning to prioritize and care for her own patients, she hasn't reached a level where she feels comfortable doing more; perhaps she doesn't want to 'step on toes'.

I think the best thing to do would be to show her by example, and even talk with her in a non-accusatory manner explaining how your unit functions as a team to care for all patients.

[hikernurse]

Maybe the new nurse just wasn't sure where to go with things?

We have a great unit, too. People are very willing to jump in and do what needs to be done. We usually have 2-3 nurses in a room (NICU) and if a baby needs something whoever is closest handles it. We're pretty familiar with the other patients in the room since we spend so much time in there and that makes it easier, I think.

The nurses are friendly to talk to and that also makes the job very pleasant.

Our experience in the unit ranges from brand-new grad to nurses with decades of experience (some of them have worked longer than some of the new grads have been alive, LOL) and the nurses with more experience are very willing to jump in and teach. There is not the spirit of having to prove yourself before you're accepted. The charge nurses are also willing to step in where needed--to help start IVs, PICC lines or to sit in the room so the nurse can go to the bathroom.

It is also very rare that we don't get all our breaks and a full lunch :).

[Tweety, BSN, RN]

When push comes to shove in emergencies we help each other out. Otherwise most of us are too busy doing our own thing to notice. I stress to my coworkers that if they need help it's up to them to say something because I might be too busy to notice. But in an emergency we all chip in. We had a two-hour code a few weeks ago and I was so proud of the team of nurses and techs I worked with, not one didn't help out.

[itsmycalling]

I cannot tell how good it is to hear that there are nurses out there who are happy in their job and can rely on their co-workers for assistance! I understand the need to vent- and this is the perfect forum to do so, however, as a first year nursing student I was beginning to wonder whether or not there are actually happy, fulfilled nurses out there. Thanks for your post- it means more than you know!

[pagandeva2000, LPN]

In my clinic, (most) of us help each other out. If we see that another nurse is overwhelmed, we will take away some charts, if a nurse speaks a language fluently, she will take the patient so that both, the nurse and client are more comfortable. The med-surg floors seem to be different...every man for himself and there are many cat fights. I am about to begin working there per diem just to get some med surg under my belt and honestly, I am really scared to death. However, I would rather gain that experience where I work and know the demons I have to deal with rather than go somewhere brand spanking new and screw up royally. Kuddos to your nurses that stick together!

[annmariern]

That is the way it should be; sadly the culture on my floor has turned into every man for himself. I was on my way out the door, purse in hand when I heard stat pages to one of our rooms. I went in along with my CNC, to find an angry daughter, a freaking out cnc, and a pt with a massive nosebleed, and a bemused cardiologist stat paged to the room by the freaking out nurse. That pts nurse was charting at the station; never got up for a second. According to the dtr, the nosebleed was hours old and "she did nothing". I have been pulled out of my 10min in 14 hrs break because my iv pump is beeping, 5 ft from the station where 3 other nurses are gossiping. After 20 years, I am having to relearn the fact that I have no control over the behavior of my colleagues or what happens to their pts and all I can do is the best for my pts and shut out the rest. Sad, but not doing so is driving me nuts.

[loriangel14, RN]

The hospital I work at is totally a team atmosphere. We all look out for each other and if coworker is overwhelmed or falling behind we help out.I have actually been scolded for not asking for help. For example, the other day I was just going to coffee break and one of my pts rang and wanted to use the toilet.I started to go into her room and one of my coworkers said"what are you doing? Get to coffee. I'll do that".Of course we would all do this with the knowledge that the others would too. Assistance with anything is just a request away. No one sits down as long there is still work to be done and no one stays beyond end of shift. I LOVE MY JOB!!!!

[BeachBayNurse]

Maybe the new nurse just wasn't sure where to go with things?

We have a great unit, too. People are very willing to jump in and do what needs to be done. We usually have 2-3 nurses in a room (NICU) and if a baby needs something whoever is closest handles it. We're pretty familiar with the other patients in the room since we spend so much time in there and that makes it easier, I think.

The nurses are friendly to talk to and that also makes the job very pleasant.

Our experience in the unit ranges from brand-new grad to nurses with decades of experience (some of them have worked longer than some of the new grads have been alive, LOL) and the nurses with more experience are very willing to jump in and teach. There is not the spirit of having to prove yourself before you're accepted. The charge nurses are also willing to step in where needed--to help start IVs, PICC lines or to sit in the room so the nurse can go to the bathroom.

It is also very rare that we don't get all our breaks and a full lunch :).

Sounds like a great place! In my few years of nursing, I have never seen that type of attitude in an ICU setting.

[BeachBayNurse]

Not sure if it is just me, but the attitude of the manager seems to really set the tone for the attitude of the staff towards teamwork. I had the displeasure of floating to a unit where I heard the manager making fun of one of her staff. Fifteen minutes later, she walks around wondering aloud why all the nurses are spread out all over the floor, why noone wants to sit together?

[TazziRN, RN]

i've seen all different attitudes. when i first started working er nights, we helped each other. we were a very close-knit group. pms did too, but not as much. days.....if you weren't part of their clique you were on your own.

after i went into recovery and went back to work, i was almost always on my own.

second er: most people helped each other.

current job: there are three of us that back each other up without question, even when we're off, but the others refuse to participate in that.