"And it's all going to be your fault"

[AngelfireRN, MSN, RN, APRN]

You know, I've been thinking....

Dangerous pastime, apparently, because the more I think about this, the madder I get. I am not doing my blood pressure any favors here.

I have been a member for a while now, read these threads even before I became a member, and I have noticed a disturbing trend. I am wondering if anyone else has as well.

It all our fault.

I don't care what happens, who does it, who causes it, the nurse gets blamed. Management backs up the customer-cum-patient, admin backs up the managers, HR backs up the admin.

So, I dreamed this little warning label of sorts up for all those wide-eyed, fresh-faced nurses-to-be out there. I wish someone had told me what I was getting myself into.

Dear Soon-to-Be Nurse:

A Friendly Warning. It's all going to be your fault.

After school, you'll get a job. You'll be ready to take on the world. Get ready. It's coming.

You'll get asked for medical advice by every family member, friend, relation, acqaintance, and person you don't even know that gets wind that you are a nurse. One of 4 things will happen:

1) You will advise them, they will not follow the advice. They will not get well. And it's all going to be your fault.

2)You will tell them that you would rather not advise them, that they need to consult their regular doc. They won't do it amd that won't get well. And it's all going to be your fault.

3) You will advise them and the advice will not help and the y will not get well. And it's all going to be your fault.

4) You will advise them, they will get well, pass along the advice to a friend, who had a DIFFERENT problem, and he will not get well. And it's all going to be your fault.

You will go to work. You'll go in to meet your patients for the day (or night). You'll smile and be perky. They will complain because they just found out that they have a dreaded disease and they don't want to be smiled at. And it's all going to be your fault.

You'll go in to see your next patient, still upset by the reaction of your first, and are a little less upbeat. They will complain because they have had a bad day and they think that their nurse should be happy just to serve them. And it's all going to be your fault.

The doctor did not order the pain medicine that Patient Number 3 ordered because the patient is a known drug abuser who is only in for his fix. The doctor explicitly states in his orders that he is not to be called for orders for pain. That patient refuses to accept this. And it's all going to be your fault.

Patient Number 4 is NPO, and Aunt Katie can not understand why he can not have something to eat. After all, he's hungry, and you are starving him to death. All the other nurses fed him. You're just mean. And it's all going to be your fault.

The doctor comes in to see Patient 4 and finds him wolfing down pizza that Aunt Katie brought him because she knows what he needs better that you do. They snuck the pizza in as you were coding Patient 5. Patient 4 now has to reschedule his surgery since he ate. And it's all going to be your fault.

The doctor will call the supervisor to tell her how incompetently run this floor is and how no one ever does what they are supposed to do. The supervisor will pacify the doctor and the patients and family. She will tell you to be more careful in how you present yourself, because the patients perception of you, while not measurable, is important. Never mind that you have done everything by the book, to the letter, and that, Oh yes, nuber 5 is alive, thank you. No, no, we have to work on our image and smile, smile, smile, (except around patient 1) even though you may have just herniated your umbilicus doing compressions, because our patients have a perception. And if it goes to heck, it's all going to be YOUR fault.

No, the above did not happen. Maybe I am just jaded. That's why I got away from the bedside, and why I am getting my NP. I want to be a manager that has my nurse's back. That will say, "No, Mr. Loudmouth, you may NOT have 4 cheeseburgers. You may NOT call my nurses foul names. You may NOT help yourself to any and everything on this floor like it was your own personal mini-mart." If I ever acted the way I have seen some sups act, "Well just watch how you present yourself.", I would hope someone smacked me!

Flame me if you want to. I really do think newbies should be warned about things. I think they should be trained how to handle it, not sold up the river. Maybe this would also help with the shortage. Just maybe. Thanks.

[BinkieRN, BSN, RN]

I have not noticed that when it comes to nurses it's always their fault but then again I'm new, check back with me in a year or two.

[futurecnm]

You do sound a bit jaded, that is coming from a new graduate. However, maybe you are taking it as a personal thing when people are just not always nice. I'm sure dr's are asked for medical advice a lot too, and often it is their fault!

But thanks for the uplifting post! :)

[Antikigirl, ASN, RN]

THIS is sooooooooo true!!!!!!!

I would also add...

1. Patient B wet the bed because you were to busy with other patients or urgent needs(or in patients terms...eating bon bons at the desk), and it is all your fault ("when mom says she has to 'go' it means now!....uhgg!).

2. The ice is melting to fast...it is your fault! Momma likes her water COLD!

3. It is our fault we can't tell people when the doctor will be in to see them!

4. Despite bed alarms and ambu alarms and putting that patient in a window room at the nurses desk...if they fall it is our fault!

5. If you have to actually do the ol FEDERAL and STATE laws of confidentiality and deny someone information...oh LORDIE is it your fault!!!!!!!

BTW...this is NOT jaded...it is a real fact...I have had these complaints and the last one, I actually got my life threatened and YES...they were waiting outside of work to come get me as I walked to my car!!!!!

[AngelfireRN, MSN, RN, APRN]

You do sound a bit jaded, that is coming from a new graduate. However, maybe you are taking it as a personal thing when people are just not always nice. I'm sure dr's are asked for medical advice a lot too, and often it is their fault!

But thanks for the uplifting post! :)

It gets a bit more that just taking it personally. I hope it never happens to you, but the sad truth is, it probably will.

Hope I haven't scared you away!

[jessiern, BSN, RN]

Yep, that's it. nurse=scapegoat for anything that goes wrong on the floor

[Antikigirl, ASN, RN]

LOL...another notation....to become a nurse, you must grow two more sets of arms/hands, run faster than a marathon runner but are allowed only your speed walk...get that crystal ball in top shape...work on your telepathy and empathic abilities...and achieve the bladder of a camel! Oh and yes...be waterproof, because you have to let all of these things roll of your back despite being a human being that may...just may...get frustrated or upset...that will not do according to your managment/patients/MD's.

Get your teeth done, cause that smile needs to be a permenent feature...but if you accidentally try to smile to that patient that doesn't want it...well then you are mean (oops, my crystal ball broke again!).

[floatRN]

I feel the same way as you. Thanks for posting. Glad I'm not the only one who is fed up with this!

[smk1, LPN]

As a bright eyed bushy tailed new grad with 2 days experience (ha!) , I have to say that even though it is scary to read a lot of "beware" posts, it also is a bit of a reality check. At the very least it helps others who are not having a similar experience (yet) to be thankful that they work in a better environment than others.

[Hospice Nurse LPN, BSN, RN]

Jaded? Maybe.....but oh, so true! Thanks for posting!

[Tweety, BSN, RN]

No flames from me. You speak the truth.

Patient crashes and is sent to ICU and it's your fault.

Patient complains at being woke up at night and doc writes and order not to wake them at night, and you do to avoid a crash and burn like above. Patient complains and you give poor "customer service" and it's your fault.

Doctor can't come in to discharge a patient until after 3pm and the patient asks every 5 minutes when the doctor is coming and can't you control the docs schedule. Patient is angry and it's your fault.

The patient gets the wrong dinner he ordered and it's your fault.

Patient leaves AMA to smoke, signs the form, and isn't on the floor when the doc comes and it's your fault.

Patient's colonoscopy prep is inadequate because they refuse to drink it and it's your fault.

I could go on for days! LOL

[Antikigirl, ASN, RN]

Oh yes, but wait!!!!!!

Positive spin...

Be waterproof not just because of what you have to have roll off your back...but the tears given to your front as you hold and comfort.

Get those extra sets of arms/hands for all those hands you wish to hold when things get rough with a patients family.

Get that crystal ball in check for not only the things you were supose to see...but the appreciation that was not told to you.

and revel in the fact that being your best and actually getting through to a patient and their families was YOUR FAULT! :)

See...I am not jaded, I am a flaberghasted and sympathetic realist! LOL!