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.
After reading a lot of the comments I agree that it does look a lot more like preferential treatment than anything else. I posted the question because I have been on this unit for a while (over 2 years) and continually see the same behaviors. There have been many times where the term "racism" has been thrown around on the unit, from both sides.
There have been instances where nurses from the smaller race group were observed working well together, they were quickly separated onto different shifts and no longer able to work together... Cliquish behavior was the reasoning. Although, when this is openly seen by the larger race group nobody bats an eye.
I think I said earlier that the environment tends to be loud and unprofessional, and sometimes hostile. There have been times where a (group B) nurse has written up a (group A) pct for failing to do what they were asked (outwardly and openly saying no do it yourself, while they sat at the desk), management reprimands the nurse. Different (group B) nurse asks (group B) secretary for some kind of paperwork, secretary is rude and unprofessional, nurse writes up (files formal complaint) secretary, nurses are told to approach the secretary better.
Yes, these are examples of things that happen everywhere... the constant struggle between nursing and pcts, but sometimes on this particular unit it is very hard to ignore the racial divide.
Actually,the second nurse has had 7 patients for the day.she started with 5, discharged one, got another, and then was getting one more. These are people we are talking about, not apples. Patients need discharge instructions, admitted patients need assessment and orientation to the unit. The nurse who currently had no patients shoul have taken the new admission and settled the patient.to have a unit secretary make assignments is absurd. And lastly, we are not waitresses only responsible for our tables only. To place an assignment on a new nurse just off orientation was mean and a setup for possible patient dissatisfaction or worse error.
This does not seem out if the ordinary to me. Although not teally "fair" alot of units function this way! Inthink you might be the one thinking entirely too much about race.
This does not seem out if the ordinary to me. Although not teally "fair" alot of units function this way! Inthink you might be the one thinking entirely too much about race.
I would never tolerate getting 5 admissions in one day while another nurse gets zero. It seems really out of the ordinary to me, though as I said earlier, I don't know for sure whether this is just cronyism or racism.
And nurse delegation is completely out of the scope of a unit secretary. She should not be assigning nurses to new patients. That requires clinical judgment.
Exactly; who let tht slide?? Why would u throw a new nurse to the wolves; and allow any other nurse; new; seasoned; black; white or green walk around with just ONE patient. How does no one notice the desparage n the assignment???...
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
I would never tolerate getting 5 admissions in one day while another nurse gets zero. It seems really out of the ordinary to me, though as I said earlier, I don't know for sure whether this is just cronyism or racism.
And nurse delegation is completely out of the scope of a unit secretary. She should not be assigning nurses to new patients. That requires clinical judgment.
I don't think we have enough details. Did this happen once, or every day. Did the nurse with no patients have other responsibilities at that moment -- rewriting a policy, putting together an inservice, doing an evaluation on her recent preceptee? Was the nurse with no patients a floater? Had she become ill while at work and was being eased out of the workplace to go home and rest or to visit the ER? Did she just get a call from her father's cardiologist? From her oncologist?
Before you get all excited about favoritism, cronyism, racism or bullying, it helps to have more information.
Again I apologize for the length of the post, just trying to paint a picture.
This is a classic example of nurse on nurse aggression done covertly and surreptiously. It is a definite way that nurses are known to act wrongfully to other nurses by dumping a large assignment or one that is too difficult to handle. The why question is irrelevant. I don't care if you love your race or moral beliefs or whatever it is. Nurses are not allowed to do this and it can be reported to your state board, FYI. There are many ways in which nurses can manipulate this into being and it is just flat out wrong. The victim of this abuse has no life after work because of the mental and physical exhaustion. Staffing only looks at the number of nurses to patients not how they are divided up. I have had this happen to me over a matter of ethics. This was many years ago when this problem was not identified. Assignment delegation though is a key way to show favoritism, hurt someone or get rid of someone undesirable.
It is a real shame that people in the medical field are not team players. All these people who are champions of tolerance and cultural diversity are such hypocrites where it comes to their own ideas, race and beliefs. So much for tolerance. Why doesn't the nurse with zero patients get up and help their team? It would be one thing if you have no patients and are lending a hand with the admission process or involved in patient care. It is another thing to be sipping coffee, chatting with friends, checking out Facebook, resting or texting whilst someone else is running around. My biggest contention with this scenario is that it is near impossible to ask for help. If that patient is not that nurse's responsibility, the nurse in charge of that patient is limited in what they can ask help for without being falsely accused of poor time management or getting 20 questions. "Is this necessary right now?" "Why are we doing it this way?" blah, blah, blah. Just get up and help!!!
I am an English speaking lighter skinned person and I am a minority in my community and hospital. I'm not making this up. Of the nurses in our unit, myself and one other nurse are totally English speaking Americans. The rest are from other countries. The skin color is not my problem. The language issue very much is. Discussing medical decisions and pertinent data in Spanish is near unconscionable to me. But it happens daily. The patients demand it. They refuse to speak English. No other nationality is given such preferential treatment. I understand in other communities where Hispanics are immigrating that they are being forced to learn English. Here, if you don't speak some Spanish, it is horrible the treatment one gets from patients and staff with that one issue of communication. In addition, it is difficult to get a job without being bilingual. It is so hard to constantly be in need of a translator. My children have been cussed out and reported to management for not speaking Spanish in their respective jobs here. It is rude to the Americans that have graciously opened up this country to immigrants fleeing a very bad situation. Without any regard for what has been done for them, we are being treated like foreigners in our own country. And the nurses who are bilingual at times have no regard for these facts.
This sounds like a hot mess; and a horrible unit to work on. My unit has everything from new grads to nurses w30+ yrs experience; and none of us would b floating around w 0-1 pts "helping" while others had 4-5.
Again; sounds like a horrible workplace situation w an obvious clique. Sad.
I've experienced the treatment you mentioned by members of my own race. the nursing supervisors were just showing favoritism for their buddies. It was wrong, made for a poor work experience. I didnt stick around there for long - I moved on to something much better ðŸ˜
Why on earth is the unit secretary assigning admissions? This is a charge nurse function based on an assessment of the unit acuity and needs, and current RN assignment. This should not be a secretarial decision. It has all to do with patient needs. How do other units assign admissions?
This lady is right. 100% discrimination & perferental treatment.. The Secrtaarty should not be allowed to assign. The clinical Supv. should & she seem just as twisted. Keep good records of dates & names & fo tl her manager & go up chain of command. They are too wrong.
It is rude to the Americans that have graciously opened up this country to immigrants fleeing a very bad situation. Without any regard for what has been done for them, we are being treated like foreigners in our own country. And the nurses who are bilingual at times have no regard for these facts.
beachbum2000
8 Posts
After reading a lot of the comments I agree that it does look a lot more like preferential treatment than anything else. I posted the question because I have been on this unit for a while (over 2 years) and continually see the same behaviors. There have been many times where the term "racism" has been thrown around on the unit, from both sides.
There have been instances where nurses from the smaller race group were observed working well together, they were quickly separated onto different shifts and no longer able to work together... Cliquish behavior was the reasoning. Although, when this is openly seen by the larger race group nobody bats an eye.
I think I said earlier that the environment tends to be loud and unprofessional, and sometimes hostile. There have been times where a (group B) nurse has written up a (group A) pct for failing to do what they were asked (outwardly and openly saying no do it yourself, while they sat at the desk), management reprimands the nurse. Different (group B) nurse asks (group B) secretary for some kind of paperwork, secretary is rude and unprofessional, nurse writes up (files formal complaint) secretary, nurses are told to approach the secretary better.
Yes, these are examples of things that happen everywhere... the constant struggle between nursing and pcts, but sometimes on this particular unit it is very hard to ignore the racial divide.