I had a situation occur at work and I'm torn about how to react to it. Very busy hospital med/surg floor with max patient load of 5 patients for each nurse. 5 nurses working the floor, 3 of one race and 2 of the other. there is one "clinical supervisor" who's the same race as the group of 3. the secretary is also the same race as the group of 3. (so that's 5 of one race, and 2 of the other)
Throughout the day there are admissions and discharges. The secretary assigns the patients based on who has discharges to keep the staffing numbers equal, there is no attention paid to acuity or work load (this is a normal occurrence for this floor). Frequently there are times when a nurse will go down to 3 patients because of discharges, while everyone else stays at 5, and that nurse will get back to back admits within minutes of each other. The clinical supervisor on this floor does not assist with admits (not even to put isolation equipment in patient rooms).
On this day, 1 of the nurses, from the race group of 5, goes from 5 patients to 0 patients within a few hours. That nurse is only assigned 1 new admission, that does not arrive until after shift change.
Another nurse, of the race group of 5, starts with 4 patients... discharges 1 and receives a transfer early in the shift... this nurse stays at 4 and is not asked again to take any more admits. (The secretary is observed and overheard pulling this nurse aside saying that she knows that she won't give her any more patients)
One of the nurses of the race group of 2, starts with 4, admits 1, discharges 1, and is asked to take another admission although according to "turns in line" it should be the nurse from the other race group.
The second nurse of the race group of 2, starts with 5, discharges 1, admits 1, and has one pending discharge near the end of the shift. 45 minutes before shift change, the clinical supervisor says to this nurse "can you just take report on the new patient coming up" (This will put this nurse at 6 patients which is over the max patient load. This is this nurses first day off of orientation, this nurse is a new grad). The nurse takes report, is attempting to discharge the one patient, the clinical supervisor is "nagging" them to ensure that isolation equipment is in the room, the secretary assigns the patient to this nurse on the board. And when the patient arrives on the unit the nurse is told "your patient is here" even though this nurse was told all they had to do was take report.
I'm sorry if the story is hard to keep up with. I tried to keep it as simple as I could, while still getting the important details across.
Is the new nurse being "bullied" by the clinical supervisor and the secretary? Why didn't the nurse that went to 0 patients have to take more than 1 admit? Why was the nurse from the race group of 5 skipped over for admits (there is never attention paid to acuity of patients only numbers)? Is it racism because of the difference in treatment of the two race groups? AND if you were a manager would you want this brought to your attention? If you were the one bringing it to your managers attention what would the best way be, in order to not sound whiney or indignant?
Again I apologize for the length of the post, just trying to paint a picture.
It is wrong. Whatever else is going on in terms of underlying culture, mismanagement, lateral violence and such I don't know.
Of course secretaries should not assign patients to begin with.
I left a job once in which the "new nurse" (and there were no new graduates - just new to the team/unit) was treated unfairly as a means of "proofing yourself worthy to work there" . Meaning - they would give that nurse the worst possible assignment and offer no help. They would help each other and commonly go down a patient or have a light assignment while the new nurse was slammed every time.
After I realized that this was the culture I left quickly. I do not wish to work in such an environment no matter how prestige.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Couldn't purposefully overloading a nurse, who is already overwhelmed and intimidated, be an example of "negative, aggressive behavior"?
For the record... I am not the new nurse.
Oh, good lord! Is it a frequent occurrence that the new grad gets more patients than everyone else, or was it just that one time? Is there more to the story here . . . Perhaps something even you don't know about? One of the nurses who wasn't asked to take a late admit was going home to pack her bags and fly three thousand miles to her mother's funeral? The new nurse is being challenged to improve her time management or assessment skills because someone sees potential to be developed? One of the nurses who didn't get a late admit was going to go home and get four hours sleep so she could come back later and work overnight or perhaps be on call? One of them was working overtime?
Given a one time example , it's hard to say whether anyone was being bullied or discriminated against because of race, but without knowing more I'd have to conclude it's just someone overreacting.
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I am not the new nurse. I was not asked because I would have said no lol. The new nurse on the other hand does not have the confidence or assertiveness to stand up for themselves YET. This was their first day off orientation. Although, this nurse seems to fit in well with the unit and has a good rapport with everyone.
The secretary yelling is an ongoing thing. Secretary yells, bosses nurses around, and has nasty attitude at times. Nobody seems to care though. The atmosphere on this unit tends to be loud and unprofessional. I can go on and on about the secretary and the PCTs but that's for another post lol.
Would it make a difference if the manager was male vs female? or part of one race group vs. the other? What if you knew that the manager was already having issues with one group? Would manager appreciate this particular situation being brought to their attention or would the manager see it as petty?
It seems to me that you're looking awfully hard to find bullying, racism or unfairness of some type.
Specializes in med-surg, mother-baby, teaching, peds.
I totally agree with concerns expressed about client outcomes secondary to mismanagement of resources ( a secretary making nurse assignments-the clinical director is not taking responsibility) and lack of effective leadership. Call behaviors inducing unfair treatment, racism or whatever you like but these actions still create an atmosphere of competition and derision rather than teamwork and caring. There is no doubt clients/their families and add line staff (housekeeping, phlebotomist, transporters, nurse aides, etc.) will pick up on this which affects the conditions such populations must endure as well. Remember the old adage 'the fish stinks from the head on down' well this rings true in these circumstances. Sounds like such work environment is caustic not nurturing and must be stopped.Type an anonymous letter but do not sign it and send it to HR, this way you do not risk bringing attention to yourself. Good luck.
When the same group of staff works together for a length of time, little clic's are formed. This can lead to the situation at hand. However it bothers me that you divided the group by race. I'm not a minority, other than being a woman but that seems wrong. Did you think about other reasons for their actions or jump right to race. I think what they did is not right but make sure you have the facts. Nursing can be a small community in a lot of ways, you never know who knows who. A label can follow you thru out your whole career. Not trying to be harsh. Just a word of wisdom. You worked hard for for you degree, protect it.
This is a tough call based on the information provided. I agree with the others who say that a one time situation is hardly enough to base a decision like this.
Racism...consider this, and I mean really consider this, when minorities get together in a group to talk or to have lunch, or what have you, its often looked at as why are they segregating themselves, or what are they up to. But, when the majority get together to talk or have lunch or what have you, no one ever gets suspicious, ever. Why is this? I'm assuming that each of these groups is likely one minority of some sort and the other majority of some sort. Depending on the make up of the unit, it could be just that the coworkers who lunch look out for each other, not necessarily that they are trying to keep the other racial group down. Or it could very well be that the racial group is holding each other down. Whatever, there are much bigger fishes to fry first before tackling the race question without concrete, patterned evidence.
NanikRN
392 Posts
OK, I know it's a slip and I know what you mean...
But this is funny
conscientious vs conscious. 😀