13 THINGS YOU CAN DO......SO JUST DO IT!

[rncountry]

Peggy, Have done some of those things already. I do not tell people nursing is a poor choice, but if asked I do give a picture of reality. Good and bad, the ups and the downs. Then each must choose for themselves.

I have also written to newspapers, somethings are published, some are not. I have an article coming out in the New York Times on June 24 in the womens health section that they are doing. It has to do with being an activist and what got me to that point. My one hope with the article is that other nurses will see it and will start making some noise too.

I have talked to my administration where I work, they know that I am involved with activism. My nurse managers, and case workers are behind what I do, regular administration on the other hand is a bit frightened of me. When I sought permission from corporate to have my picture taken for the Times article, the look that came across my CEOs face was absolutely priceless. It was a look of stark horror. And no I didn't get permission to do a photograph on the unit, even though the place I am currently working is a good place to be, and I told the reporter that. Did the picture anyway, just did it outside of the hospital. Personally I don't think that administration really does want to listen, doing so gives nurses power they don't want to give up. What did I learn through this? That look of stark horror on my CEOs face said volumes to me. They are scared of nurses who are activists because they know what will happen if there are enough of us! They know and they will run away from it until they can't anymore. I have always been outspoken regarding appropriate patient care and it has upon occasion gotten me in trouble. Thing is getting in trouble only made me dig my heels in more. I am not willing to let issues of money or some corporate type covering things up, come in front of patient care.

I have also written many times to legislators. I would wager that you have, that Julie has, that Christina has, I know Michele has, Barbara has, trick is to get more of us to do it. I'm sure there are many on this bb that has. Now we need to encourage everyone to take it to the next level. BE MORE PUBLIC! You bet the money is there to do what we need for patients, how much profit is enough profit? This is a question that has to be asked.

Anyone reading this PLEASE DO YOUR PART! Let us not focus on the various things that divide us, but the things that can bring us together. We all see things from our own perspective, but each of the 13 things(barring sharing spectrum) are things each of us can do regardless of whether we are union or not, whether we believe in unions or not, regardless of what our area of practice is.

So here we go, the next few years are going to prove interesting for nurses. Much of what we get will depend on what nurses do. So to all of you who read this, hope to see you participating in some way. It is going to make a difference if we can move the momentum our direction!

[Tiara]

Good for you JT. I also e-mailed the author of that article. I'm sure a lot of my stuff ends up in the trash but every once in a while you write something that makes cerebral contact!! Yes!!!!!!!!

[rncountry]

Nursejane, I think I've been outspoken most of my life actually :) part of my personality. To answer your question, yes in a nutshell. First time I was mandated to work over I had just recently returned to work from maternity leave. My baby was about 9 weeks old. At the time I was not married, I did not marry this baby's father(thank God!) and I was a single parent, with two older children from a previous marriage. I had punched out to go home when I was stopped at the door and told I had to stay. I was actually flabbergasted because I didn't know that someone could tell me I had to stay. This was five years ago. I refused to stay. I was the sole source of my childs nourishment, and I was not going to have my baby going hungrey. I was bullied by the DON to stay, my job was threatened, she threatened to report me for patient abandonment, I was unprofessional, I was not a team player, what about my patients, you know the whole routine. I still refused to stay and told her to go ahead and fire me right there and then if she wanted to. She didn't fire me. A couple weeks later I was written up for unprofessional behavior because I was urging the other nurses to refuse to work mandatory overtime as well. A couple weeks after that I left and went to another job. This was in LTC.

A couple years ago I was terminated from the facility I was working at,after I reported falsification of charting and patient abuse. The administrator had tried to sweep it all under the rug. At the time the DON that was falsifying charts, had been allowed to resign her position and go to another larger facility for $15,000 more a year. So that position was open, the ADON was gone,( her license suspended for medicare fraud at another facility)and one of the MDS coordinator's(I was the other) had also left before she could be fired when I found her falsifying charts as well. That left me and the staff development coordinator as the only nurse management in the building. Because of my position I was the one running the nursing dept. It was a holy mess. I continued at this facility because it was located in the area I grew up in and still live in so that I took care of people I had known my whole life. People who had been friends with my grandparents, and I felt I could not abandon them. The two patients that had been abused were roommates. One was 105 years old, could not move on her own, and would offer staff "a million dollars to leave her alone" this woman ended up with a fractured clavicle, a facial laceration and facial hemotoma. Her roommate, mid 80's also unable to move on her own, or verbalize had a soccer size bruise in the middle of her chest that was black. Having worked neuro ICU before I went into LTC I surely recognized a blunt trauma injury. It fell to me to do the investigation. I did all the appropriate paperwork and followup, but was explictly told by my corporate nurse consultant that I was not to report it, that the administrator would report it as that was his job. It didn't get reported and didn't get reported. We were well past our 5 day window for legally reporting, and way past the same for reporting falsification of charting. When I confronted the administrator over it and he still did not do anything than I knew I had to do it. Within 3 days I was suspended pending investigation, and I was accused of patient abuse myself. I had stepped in between two combative residents and from that I was accused of abuse. I was suspended on a Thursday and then terminated over the phone the next Saturday. I was reported to the Consumer and Health Industry, the state agency over nursing homes, as well as the state board of nursing. I sued under the whistleblower protection that Michigan has. I was in an attorneys office on Monday. This happened in Dec. 2 days before my oldest childs 15th birthday and 10 days before my youngest childs 3rd birthday and of course Christmas. I filed for unemployment, they fought it, but I won anyway. Took 2 months to get it. Yes, by this time I was married a couple years, but my husbands paycheck didn't come close to supporting us. Or at least I didn't think so at the time. Nine months later still without a job, we had learned to live on a lot less than we had. At that time the states investigation of my license was to the point that I had to sit down with an investigator for the state board. It was a 4 hour interview. At the end of it she flat out said she would recommend that no sanctions were placed on my license, that it was obvious that I had been retaliated against. Within two months of this the facility settled on the lawsuit. My personnel record was expunged and I went on with my life. After attorney fees and taxes out of the settlement I got $4000. It was like blood money to me. I bought my sister a much needed car and gave her what little was left over to put in her account to go to college. Question is, would I have done this if I did not have a husband to support us? I can easily say yes. Because I have to be able to look at myself in the mirror everyday and know that I am a worthwhile human being. To know that I took my role as a patient advocate seriously. I didn't work for 15 months. Once my license was no longer in jeopardy I was able to find a job. I didn't look right away because frankly I had some healing time I needed. Going through this experience was extremely difficult.

Yet, even this is not what really turned me into an active activist. For a very long time I was ashamed to tell anyone about this incident because I feared other nurses wondering if I really was an abusive nurse. What really turned me into an activist was my dad getting ill and the care he received being extremely poor, and understanding the reasons behind it like most in the lay public would not. When things were bad and I needed time off work to go from Michigan to Tennessee to see him and deal with what was not happening with his care, I was told I could not go, that the facility was expecting state inspection anytime and I was needed there. I was the MDS coordinator there too. I can't even describe the amount of anger I felt. I had been working long hours and much overtime to bring this facility up to par to where it needed to be in terms of its MDS, they had not had anyone doing them for two months before I started, I had busted my hind end there! And now they were going to tell me I couldn't take care of my own dad??? My decision was made quickly and easily. Told them I was leaving, that I wouldn't be back, and punched out at 1 in the afternoon. Left for Tennessee the following morning. By the time I got there my dad had gone through emergency surgery on his left leg to attempt to do a bypass because he had a blood clot that had been there for 6 days. And his physician knew something was wrong with the leg, but when an xray had not shown a mets of the CA he had he had been sent home with no DX of what was actually wrong. The only reason that he had even gotten anything done was because I had called the physicians office, identified myself as a nurse and then raised holy hell. His CA was in the brain, he was on decadron for 6 weeks and NO ONE thought about a blood sugar. NO ONE had even looked for the side effects of this med. His sugar was over 500 when he was admitted. He had all the sx of diabetes. I just didn't know it in time because until it got bad my dad hadn't shared. He didn't want to worry me. While he was in the hospital, Baptist Memorial in Memphis, his nurse had 12 to 14 patients. This was regular staffing. After surgery with bloody sheets he had been incontinent on, and covered in betadine, he laid on for hours before my stepmom got someone to bring her items to bathe him with and clean sheets. She did his care. In the nearly two weeks he was there he got personal care from staff twice. Everything else was done by my stepmom. This was not something he would allow me to help with. It made him uncomfortable. Nine days later I came back to Michigan because my kids had to start the school year. He was still in the hospital. 2 days later his lower leg was amputated. My dad was such an active, viberant man! To have this happen to him just killed me. To make it even worse to me was that he was a Christian Scientist, and had sought treatment only because he had another daughter at home that was 13 years old and he wanted to live long enough to see her graduate and in college. He stepped outside the religious belief system he had, that he grew up with and this is what he got. I'm crying just writing this now. It kills me inside. Three weeks after his surgery he was at the Dr. office having been told that they would need to take more of the leg as it was not healing, go figure with diabetes, when suddenly he grabbed his chest and said oh God it hurts and slumped over and died. The thought was either he threw a PE or had a triple A. My only consulation was that he had not lost his mental capabilies, because that was what he feared most. I thanked God that I had been able to see him before this happened, and never regretted walking out on my job.

After this I didn't even look for a job in nursing. I was actively looking for a job outside of the profession. During this time frame I got an email about the Million Nurse March discussion taking place on this BB. And I threw my anger and frustration into that. It didn't turn out the way I thought it would, but I will continue on anyway. I will never shut my mouth about care again. I am the major breadwinner in my household now. I have three children. I make about $10 dollars more an hour than my husband, and even if I didn't have him I would do what I am doing. What happened to my dad hit very close to home, and there are alot of someone dads out there. I realize that not everyone feels the way I do, and it is difficult to get nurses to quit being afraid. I look at it as they need us more than we need them. If enough nurses simply said no more than what would they do? Fire us all? Who is going to nurse patients? Management, administration? We have the power if we would only realize it. They know that too, and will continue to use tactics to scare us, until we really understand that in the end it doesn't matter if we would stick together. What would happen if every nurse on a unit simply refused to work any overtime? Are they going to fire all of them? Who will replace them? I know this is long, but I am so passionate about this issue! To the couple things I felt were pertainant of the 13 things from this article I would add,

1. Refuse mandatory overtime, encourage all the nurses you know to also refuse. STICK TOGETHER!

2. Refuse an unsafe assignment.

3. Refuse to allow an unlicensed person to do things that licensed people should be doing. Don't allow your license to be used to cover someone that does not have the background knowledge to do things a nurse does. When working with a tech simply tell them that you will do those things, thank you.

I do each and everyone of these things. I actually fell into the job I have now, as I said I wasn't looking. I took an agency job as a favor for a friend and ended up where I am working. I really like it, the staff to patient ratios are good, they don't use mandatory overtime, found that out when I told them upfront before I worked a day on the floor that I would refuse it. I have twice refused an assignment that I felt was unsafe based on the patients acuity in my group. They broke it up better among all of us. And I do not allow any techs to do anything that would have to be covered under my license. I worked for this place, longterm acute care, for three months as agency when they offered to buy out my contract. I accepted losing $8 and hour because they are a good place to hang my hat. They know I won't accept any mandation, that I won't accept an unsafe assignment and that I don't allow techs to do anything beyond personal care. Yet they were still willing to hire me on as staff. They could have kept me as agency and just never used my services again. Took me a long time to find this type of place and I'm happy there. Because of the way it functions we really don't have staffing issues. We occasionally use agency, but no one sqauks about it. It is looked at as necessary to provide the standard of care the company has. We have many tach to vent patients that are there to wean over long term. We do major wounds, longterm infections etc... anything that is acute care but require more than a couple days that are allowed with regular hospitalization.

So, Nursejane that is my story. I would not hesitate to be active in making healthcare more patient and nurse friendly ever again. Rather I had a husband or not. It comes down to teaching my children that you do not have to allow someone to walk all over you, and to stand up for what you know to be right. It is a lesson that I cannot teach if I don't live it myself. Whenever I get frustrated in my endeavor's I just remember what it was my dad always told me. Something he lived his own life by. Can't never did nothing. I ran across a quote about a month ago I also thought was good. Quit telling everyone it is raining, and build the ark! I want to help build the ark. I ask each nurse to participate in that building in whatever way they can.

Thank you for reading this very long post!

[PeggyOhio]

-jt,

I see your perspective. I feel the article is useful as a tool to try to overcome the apathy and condescending attitudes of some nurses. It is maddening that more nurses aren't more vocal where it counts.

But I also feel that the west coast and east coast have felt the "pain" hospital restructuring has inflicted on nursing for a longer period than some other areas of the country. And are therefore more pro-active at this point in time.

Here in Ohio, the current Youngstown strike is the only one that I'm aware of for a very long time. I have heard that there is an impending strike in Akron next week. So it is getting closer to home.

Or maybe it's a union vs. non-union thing. Maybe nurses that have union backing are more apt to "draw the line" than those nurses in non-union facilities, who may feel powerless.

Perhaps if I worked in a unionized facility I wouldn't feel like some kind of zealot freak!

And then there is the learning curve. Once you decide to become an "activist", it is kind of trial and error. That is why your experience and insite is so invaluable on this BB -jt. :)

I went to talk with my Representative again last week. This being my second trip. I didn't get to speak with him either time,he being out of town.

But I spoke with his "aide" or whatever. This person is a nurse. She hasn't practiced in a long while she admits. But the perspective she gave me was somewhat disheartening.

Her perspective is Health Care is a business and as such will respond to the market conditions. The consumer is the ultimate market control. If they reject the goods or service provided the business has to respond or be driven out of business.

But how do you say to the ambulance driver don't take me to Hospital X they stink, I only will go to Hospital Y. How does a consumer make an educated choice.

Maybe we should have Federal legislation requiring hospitals to publicize their nurse/patient ratios, average time it takes to answer call lights, number of medication errors per 100, how well the patients understood their illness and treatment on discharge, yada,yada,yada.

Come to think of it I think they tried something like that. Businesses around here did surveys of local hospitals trying to put consumer pressure to bear. I don't think it accomplished much.

Her advise was, become a PA!

[ June 11, 2001: Message edited by: PeggyOhio ]

[Tiara]

rncountry: I will be looking for that issue of the New York Times, and I am looking forward to your article! Good for you!