Criticized by the media...(long)

[RN in pink]

Recently my hospital has been the subject of criticism in the newspapers and internet blogs and subsequently being investigated in the media. All the stories are very one sided, and not all of the facts are correct. While the doctors and administration have been the target of most of the controversy, it's been difficult to read what people think of my hospital. There is so much I want people to know and understand.

For example, we are one of the busiest emergency departments in the whole state, and the busiest in the area. We have opened up extra treatment areas in order to accommodate the steady increase in patients. Recently we have been setting up beds in the hallways, and holding up to 20 admits.

Our doctors often do more for our patients than many other hospitals for several reasons. First, many hospitals refer their patients to us for follow up care and treatment. Second, our patients are very demanding and when they don't receive what they want when they want it, they demand to speak to the charge nurse, start yelling and making a scene, and even call the hospital administrators. Doctors shouldn't give into patient demands, but in this society and culture it happens a lot. We reward people for their bad behavior. They make a scene, they get their narcotics, or their CT scan, or seen faster. They shouldn't but they do. Our doctors should remember that they are the ones who went to medical school and are completing or have completed a residency. They are the ones with the medical knowledge, not the patient.

Complaints have been made and are under investigation about sending patients to the lobby who should be in a bed. The reality is, we don't have enough beds for everyone who needs them at any given time. Sometimes a patient has to wait a few minutes or a few hours before they get a bed. During that time, they are being treated. We will take them to x-ray, to CT, draw blood, give PO meds, do EKGs, put in IVs, give fluids and IV medications. When we are able to shuffle people around, we move them to a more appropriate area.

The acuity of our patients has increased and many times we work in a 3:1 ratio. Stroke patients are 1:1, but often we will have two other patients. I became a nurse to help people, and in between the medication refills and viral illnesses that take up so many of our resources and time, we are able to weed out the sick and provide them with the care they need

.

I care for my patients, but I do not have the time to hold their hand and listen for long periods of time and coddle them. I don't have pillows and some nights we don't even have blankets. I try and show them I care in all my interactions no matter how short they are. But yes, I do get short with my patients from time to time. That's because while I'm a nurse, I'm human and a person can only take so much verbal abuse from a patient before getting annoyed. And it's because most nights I don't get to go into the break room and eat my lunch, or drink water, or even pee. Many times I snack while charting, although it's against the rules. I choose to nourish myself so I can think and be patient so my patients remain under the care of a sane and safe nurse. I would take any of my friends and family members to my hospital, and I have. I've driven the 20 miles to go to my ER.

Can we do better? I don't think there is a doctor, nurse or hospital that couldn't use improvement. Should we do better? Yes, and we try and better ourselves through education and change. Are we able to do better? Not always because resources are limited and it takes a lot of creativity and patience to create something out of nothing.

So what is the point of posting this? Because I need to hear that it's going to be ok. I need to know other people have been there. Because I need to hear that we aren't bad nurses just because our rooms aren't spotless and we aren't always bubbly and cheerful. Or maybe I need to be told we are bad, and should be ashamed. And because I needed to know that maybe someone read this and knows how I feel, since us nurses have been caught in the crossfire without regard to the consequences.

If you read this and got this far, thank you for listening.

[P_RN, ADN, RN]

Your rooms should be at least clean. What we did was make incident reports for every complaint that we got for our horrid carpet they put in our patient rooms.

Hey we got renovated within the year. Otherwise I don't see how you can take ownership of much else that is all out of your control. Hospitals get full. There's a recession on and there may not be budget for expansion that you obviously need. Do your best to be the best Nurse you can be.

[juliaann]

What we did was make incident reports for every complaint that we got for our horrid carpet they put in our patient rooms.

Carpet in patient rooms sounds like such a terrible idea! Yuck.

[CNL2B]

This sounds like somewhere I used to work, in another state. It was a horrible place. There wasn't enough to go around -- in any department. Not enough nurses, not enough beds, not enough supplies.

I am going to tell you that I DO NOT THINK YOU ARE A BAD NURSE. If you are like the nurses I used to work with, YOU ARE AN EXCELLENT NURSE. Anyone that can keep their head up in that kind of pressure cooker has a high level of proficiency with what they do. You have learned to do what you do faster, more efficiently, and with less. After what you've been going through, boot camp would probably be a piece of cake.

I'm not sure how long you are going to last though. That's a lot to deal with, and it will (if it hasn't already) wear on you. Those that do it for years and years have my utmost respect. Sometimes, there is no choice. Jobs are hard to come by sometimes, and in non-urban areas, sometimes there aren't that many hospitals to choose from, unless you want to move.

In your nonexistent spare time, it might be beneficial if you tried to make some suggestions to effect positive change. Think about doing it for yourself to make your own work environment better. Not saying it will do any good -- the only thing that has been predicted is that things are going to get tighter. But, who knows?

[PMFB-RN, RN]

I think I used to work in your ER :) You sound like a good nurse doing her best. I don't have any suggestions for what to do about the media. Look on the bright side, maybe all that bad press will make fewer people come to your ER, thus allowing you time to give the kind of care I am sure you would like to give (any just maybe get a chance to pee:)

[dlatimer]

I am hoping that all the media attention will focus on the real problems. You are not alone. I have been there. When I was asked for suggestions I politely explained how increased staffing would increase patient, family and physician satisfaction and decrease nurse turnover. I explained how nurses can't perform their best when they are under constant stress. If a nurse, or anyone for that matter, can't have pride in their work, then they lose motivation to do their best. We must all stand together. If we don't the hospitals will reduce nursing to automatons with a corporate culture present in GM, BP, and the banking industry. Those guys are really productive, huh?

[mwboswell]

Network with your local ENA chapter or state council. Discuss with them, see if they will step up to the plate for you in support of the work you DO perform under such harsh circumstances.

[RN in pink]

I have to say, what keeps me coming back are the nurses I work with and the sick patients we see. You couldn't ask for a better team. And with all the various disease processes going on, it's a great place to learn and care for patients in need. Luckily our new manager is very open to suggestions and fight the powers that be for our benefit. The idea of expansion has been in the works for a long time, but you know how it is, budgets are being slashed everywhere. I see people leave and many come back, which gives me the impression that it isn't much better anywhere else.

[Magsulfate, BSN, RN]

Before I read any of the replies, I just want to say something. I see all of this works you up, and the reason why you get this worked up? Because you're A GOOD NURSE. Point blank. You care. It upsets you that you are forced to live down your own nursing standards. Your standards are high and when you can't meet your own personal standard goals,, then you might find yourself wondering what the heck you're doing there.

I understand where you're coming from because I've been there. It's hard. But even though I don't know you, I can tell that you have passion about your profession. This is awesome! Please don't let this get you down. Please don't get jaded.

Remember, it will get better, even if you have to go some other place to work. It will get better. And ALWAYS remember the reasons you became a nurse. Remember those moments where the patient is truly thankful. Remember when you really DID make a difference and know that there are MANY MANY more to come.

Mags

[Ruby Vee, BSN]

it sounds like a pressure cooker.

the media isn't always as non-biased as they like to believe they are. they probably started investigating your hospital because someone's mother had a bad experience, and therefore they're looking for problems and not for the excellent care you and your colleagues are providing despite the shortages of supplies, equipment and staff. hang in there. this, too shall pass.

[SharonH, RN]

Wow, your hospital often doesn't have pillows or blankets and your rooms aren't clean. That sounds like a nightmare and some changes definitely need to be made. If it takes media scrutiny to make that happen, then it is a good thing.

Additionally you admit that you are often short with your patients after suffering verbal abuse. I bet if I were to ask one of them, they would say they are demanding and short because the nurses are mean and ignore them unless they make a scene. Which came first, hard to say. The point is that a now vicious cycle has been set in motion that will not be broken unless someone breaks it and that needs to come from your administration.

I feel bad for you. It's pretty obvious you work in some sort of county or public hospital and those are always the hardest to "fix" because of lack of funds and care from the public.

[Altra, BSN, RN]

Two of the 3 ERs where I have worked do not stock pillows. Ever. At the 3rd ER where I work prn, pillows walk out the door with discharged patients at an almost comical rate. With the frail elderly or children who come in via EMS, you can sometimes sweet talk them into leaving the pillow, or hang on to a pillow that comes in being used as a temporary splint. But EMS has every right to hang on to their costly supplies as well.

Blankets - you can never have enough blankets in an ER. I have never been in an ER where it wasn't routine to run out of blankets twice a day until the next linen cart arrives.

BTW - I'm referring to my experiences in private non-profit hospitals, not county or public facilities.

OP, I can only imagine how the media criticism must sting. This bothers you precisely because you are a good nurse. Stay strong. Know that you are doing the best you can with what you have.