Cynical? Realistic? or both?

hipab4hands · Sep 4, 2004

I have noticed that in many many threads at least one person, and usually more are being called "cynical" or "jaded". This one is for the experienced RN's out there, those of us who have been around the block a few times....
are we cynical? I call it being realistic.
Nope. You're being realistic. If you work this job long enough, you'll get
to the point where you can predict human behavior.
For example, since this is a holiday week end, I already knew we would get a lot of requests for meds (especially pain meds) at the last minute. I went to work and that's exactly what happened. We had all these request from people on a Friday afternoon starting at 430pm from people who had been ill for weeks and now were leaving for the week end. My favorite excuse from patients demanding meds immediately, was their plane was leaving in 2 hrs.
My response to these patients was that they needed to call a few days ago, especially since they knew they were going out of town, not after the medical offices had already closed. They now had the choice of going to the ER for their med or doing without it.

Dixielee, BSN, RN · Sep 4, 2004

We were talking about this same thing last night at work. I have been doing this 30+ years and just when I think I can't see anything else that people can do or say, out pops a new variety of stupidity! I may be cynical but it is bred from realism. Truth is stranger than fiction, so they say, and I believe it to be true. I see more and more people who are not willing to take responsibiltiy for any of their own preventative treatment. I see folks who come in by ambulance with back ache, headache etc requesting pain meds. When asked if they have a ride home if we give them something for pain, they say, oh yes, they have someone coming, or someone is in the waiting room. Why in the heck couldn't that person just bring them in the first place? You get the ones who are allergic to all the non narcotic treatments such as NSAIDS, Imitrex, benadryl, etc...but they can sure take dilaudid, demerol and morphone. They can't take codeine, but they can sure take Percocet or oxycontin.

Or you get the ones who were at their PCP or another hospital the day before, never got their Rx filled and are at your facility for more treatment (meaning better meds). Or the ones who were dx with acid reflux, but won't take their meds and come in with belly pain. Same can be said for many who have been dx with legitimate problems, hypertensiion, reflux, PID, gall bladder disease, etc. but either never followed up with a surgeon, never took their meds, or continued behavior to exserbate their situation. Then they come to the ER and get another million dollar workup. It is expensive and frustration, and is costing the system millions of dollars a year. BUT, if we don't do the full workup, and something slips thru the cracks, the hospital risks lawsuits, not because of neglegence, but because of patients not taking responsibility. We are always hearing about patients rights, well we need to focus on their responsibility as well. I get sick and tired of seeing the same people float in and out of the ER with the same complaints who are doing nothing to help themselves.

Certainly I do not mean those with legitimate complaints who need ermergency intervention. But those folks many times get less than the care I would like to give them because I am wrestling with a drugged out teenager who is combative and taking half the staff to manage his "crisis".

I love being a nurse, but the liability is getting to more evident and the risks to life and limb is getting more dangerous.

Realistic? Yep, I think so. I will be looking at different options in nursing over the next few years. I love traveling and will continue for a while, but I am going to settle down in a few years and raise goats!

DallasRN · Sep 4, 2004

Cynical or jaded or realistic? Hmmm...let me think.

All three. After 25 years, plus those years of nursing school, I've seen too much not to be any or all at different times. What's bad is when they all happen at the same time as they did for me a few years back - resulting in my exit from the hospital world. Except for financial reasons, I've never regretted that exit, either. I work for myself now so some months are good, others...well, let's just say I've learned to really like grits cooked 30 different ways! :chuckle

I guess more than anything, I get frustrated seeing so many of the "young" nurses on this forum (and others) fighting the same battles we fought all those years ago. Just now, in another thread (Emergency Nursing, I think), someone was talking about not getting dinner breaks. Someone came along with the response that "ER Nurses are a different breed" and went on to say that this person should not expect these breaks, etc., etc. I'm still itching to reply to that thread! These are unpaid breaks these people are entitled to, yet someone - anyone - condones staffing situations that allow this? Think about this. If one person "gives" the hospital 30 minutes a day at a rate of $20.00/hour, that computes to $2,500/year per staff member. Assuming a staff of 8 nurses/24 hours, that computes to $20,000/year based on 50 weeks. And that is just the ER staffing. Other nurses on other floors are not getting their breaks either. So lets say a staff of 200 in the hospital...now we have a savings in free labor of $500,000/year? Correct my math if I'm wrong - seems huge to me, but that's what I have. Now, in another thread, Klondike, I believe it was, asked if nurses would work overtime without overtime pay and the overwhelming response was "NO!" Absolutely not. Overtime or I'm not working, etc. Excuse me folks, but we collectively condone doing without our unpaid breaks, working for the benefit of the hospital...yet get up in arms about no OT pay?

And those are just small examples. So yes. I'm cynical and jaded because years back...back around the time some of you were just being born...some of us were fighting these same battles and not only are we not winning, we've backed up in many respects.

And what does this say for us as a professional group when we allow hospital administrations to railroad us into these types of situations? Now that I work in the business arena, I see things quite differently. People go to lunch. Extended lunches sometimes, though they may be "working" lunches or business meetings. They leave on time. Walk into any office building around 10 AM and see the line at the deli with staff taking their morning break with bisquits and coffee! Sure...there occasional end-of-month pushes that might require a "short" lunch or staying late...none of us can object to the exception...but to make this type of stuff the rule rather than the exception causes me to have a great deal of cynicism about our profession.

I need to be quiet now. I'm gonna get myself in trouble. And you know, I'm betting I reply to that ER thread before the weekend is over! It's been on my mind all day. :uhoh3:

veetach · Sep 5, 2004

You girls are so right!! Susan, I am just about to take a small hiatus from the ER to go full time on an implementation team for a new ER computer program. We have been working part time on this project for about 8 weeks and I must say, I feel almost guilty for being paid for doing this as opposed to practically killing myself while working in the ER.

We go to lunch on a relatively normal schedule, if we work at our desk through our lunch break we leave early!!! :eek: You can go to the bathroom without being sceamed at, no one demands food, blankets, something to drink, a bed pan, a cigarette or some pain meds....NOW!!!

and on Friday afternoon, you can go home and look forward to a weekend. I had forgotten what a weekend was, but I am finding out that I can do laundry, clean the house and still have time to relax because I am not working 3 12 hour night shifts before my day off!

I am seriously going to venture into some other outlet for an RN in the future, I can feel it coming......... :)

Shotzie · Sep 6, 2004

I, too, think we are both. And we have ample reason to be so.

I am no longer in the ER but I remember many nurses being jaded and hard.

So hard, they could not give the kind of care they needed to give because they couldn't see the needs of the patients. While I was always very troubled at that kind of behavior I could understand why they were that way.

I also knew ER nurses who had excellent skills yet could still do their job with concern and empathy.

I think we have to constantly be wary of losing our caring side in all the stupid stuff we see.

ER nurses are some of the best out there. They are also some of the biggest sharks in the pond too.

rnmi2004 · Sep 6, 2004

I think ER nurses have a LOT of stress! What better way for them to vent a little bit of that stress than at a message board where they can "complain" amongst other ER nurses who understand that they are just blowing off steam and not expressing a cynical or jaded attitude. Those who would like to label them that way just dont' understand what they go through. I don't think it is fair to categorize any ER nurse based on what they post on a forum that is meant to be an outlet for frustration.

Trauma Columnist · Sep 6, 2004

As an experienced ER RN - I am pretty cynical - but like all the rest - it is because we have seen what people can do to themselves and others. You just shake your head. I've given up asking "why??"

NiteShiftNut · Sep 6, 2004

if we weren't cynical and realistic we probably wouldn't last long in this profession. a dark sense of humor helps, also. you can't see everything we see, put up with the situations we put up with, and come out on the other side without at least a somewhat cynical view on the majority of the human race. jmo

medsurgnurse, RN · Sep 6, 2004

Jaded

or maybe realistically jaded.

we come in to nursing thinking we can make a difference in the lives of patients, after a few years we realize the futility of it, become jaded, and therefore realistic about what we can accomplish.

akvarmit · Sep 6, 2004

I am just a new ED RN (but had many years as an LPN elsewhere). I just wanted to add that I can see myself changing since starting in the ED. I don't think I'm becoming cynical - I think I'm learning about society and humanity. (survival skills?)

I'm amazed I can listen to some of the wild stories patients tell, and stand there with a straight face and say "Uh, huh....well, the doctor will be in to see you." All the while, my mind is screaming "You came in for THAT?" or "You did WHAT?"

I also notice it with my family. When my teenagers whine "Mom, I cut my foot...." my first reaction would have been, oh my gosh, let me see...... Now I'm like "Uh, huh...... If you can walk across the living room to show it to me, you're gonna be okay."

See what I mean? :rolleyes:

Dawn in PA

veetach · Sep 8, 2004

LMAO Dawn, I do the same thing. :chuckle "If you can walk on it then it isnt broken" :chuckle

Greetings from your neighboring county, (Franklin County PA)!!!