Listen, Nurse

P_RN, ADN, RN · Sep 4, 2001

"what is more important than the patient?"

patient? only nurses seem to recognise we have them......

they are clients, customers, etc. and we aren't care givers....we are nursing service line.......would you like fries with that?

the last day (night actualy) i worked i had fifteen patients. in 12 hours...not counting the no bathroom break, the no meal break (nights didn't get it) that is 48 rn minutes per "patient."

but......was that 48 min. at the bedside?....you know not...

it was 15 min for report....

45 mins to get meds ready......

about 20 minutes to give them.....

so ok then there were the 8 post ops.....they probably deserved more than 48 mins in a shift.....

being as they all had epidurals which required q 1h assessment after the routine post op vital signs (q 30x2, q 1x2 --->q4 if stable...but stayed at q 1h for them).

and they itched, they vomited, their pain med needed adjusting.

there was the patient who had her entire hip and upper femur removed d/t ca and had it replaced with a cadaver femur and a thotal hip.....she needed moving to a private room.....guess i got to do that......

oh i forgot to mention that the 8 post ops were also new admissions, and i got to do the 30 screen admission...in addition to the regular assessment screens. now there were 6 laptops available.....1 had a torn screen...so 5.....the tech had to chart so that left 4....guess what...the wireless modems didn't always work in the rooms...so you could get half way into an assessment and poof gone.......so it was done outside the room or in the nurses station.

to me...yep the patient is #1 in importance......without them i wouldn't have a job........but.......without me...after moving that bed i never worked again....herniated disks, chronic pain, numb left leg, .....they replaced me the next day and then fought any claim for medical i asked for......

me, the nurse important?

nope nursing service line...would you like fries with that?

SharonH, RN · Sep 4, 2001

That's very nice but..............

Sometimes there isn't even one minute. Not even one. When I think of the nights I go all shift without even going to the bathroom or missing dinner, this little poem(while well-intentioned) annoys me. Give us the benefit of the doubt, most of us are not insensitive but overwhelmed. Totally.

kcsun3 · Sep 4, 2001

Is it possible to say "no"? What I mean is, what are the ramifications in your average hospital setting if, when you are given your assignment for a shift, you refuse an unsafe patient load? Is it common to experience retaliation or termination?

Please understand that my previous question (what exactly is more important than the patient) was asked out of a genuine desire to understand the demands placed on nurses by the system that take them away from caring for patients. There is something inherently wrong with a system that routinely overloads and prevents nurses from providing patient care.

Steph

The Student Nurse Forum

http://kcsun3.tripod.com

**canoehead, BSN, RN** · Sep 4, 2001

I assume that at the point you say no everyone is overloaded. So not only do you get disciplined for insubordination you will also leave your coworkers with a double assignment. That is bad karma if I've ever heard of it. Plus, you probably already listened to report to see if the assignment was really as bad as it seemed- and worth the hassle of refusing. Well, that means you have accepted those patients in care and you can now be charged with abandonment on top of it- now your license is in jeopardy.

So now you realize that in the moment of receiving the heavy unsafe assignment there is probably not a lot to do. In fact if you do all this and then realize what you were getting into and back down- you've just put yourself at least an hour behind, and on top of that everyone is pissed. So no help for you that shift, plus the extra hour of meeting with your manager in the morning. :rolleyes:

kcsun3 · Sep 4, 2001

Canoehead,

So let me get this straight...in order to legally refuse an unsafe assignment, you have to do so *before* you receive report? How are you supposed to evaluate if your assignment is unsafe without all the pertinent information? Who made that crazy law?

If *everyone* is overloaded (which as I understand it is pretty common), why doesn't *everyone* say, "No, not risking my license or the lives of my patients today, thank you very much..."

Also, in terms of karma, why project blame onto staff who refuse truly unsafe workloads when the blame should be directed at those who schedule staff and patient loads, etc.? My priorities are, in order of importance: self, patients, co-workers and at the end of the list, administration. I cannot choose how other people respond to unsafe staffing, just how I respond...but I will not jeopardize the welfare or safety of my patients to make my co-workers or the administration happy.

Suppose I won't be making very many friends or working in a hospital for long, huh? *g*

Steph

nick cen · Sep 4, 2001

That poem may be cute and all that - but it has absoluteley no bearing on what we do. As long as you practice with that kind of thinking in mind (and it seems a lot of nurses do) we will continue to be treated as unimportant, second rate cogs in the health care machine. Let's starty putting ourselves first. that doesnt mean you can't be kind and caring to patients. But, until we stop fighting amongst ourselves and band together with a united front, we will always be complaining about the same things for the next 20 years.

WriteStuff · Sep 4, 2001

I cannot imagine embarking upon a Nursing Career in this day and age and surviving (for even four years) with the "idealistic" mindset I started out with thirty years ago!!

Yes, I am still actively working in the profession, but come from the "days" when the medical profession WAS NOT yet about "big business."

There indeed was a period of time when as a new graduate Nurse I COULD deliver all of those wonderful "extras" (time spent with the patient just listening, back rubs, reading mail to them, fluffing their pillows, and on and on), not to mention advocating for them in whatever way necessary and expecting it to materialize in their behalf............BUT, when "big business" and "corporate" America invaded the hospital setting, and the medical profession became inundated with the "rules" that apply (in the corporate world) - simply "caring" and desiring to do the best job I knew how, was quickly sacrificed on the altar of the ALMIGHTY BUCK.

It then became the "mantra" of: deliver quality care, while we strip you of the means to do so (staff, supplies, support systems, etc.) and DO NOTHING that "smacks" of spending our dollars!!

We now "worship" the system that would have us SAVE MONEY, as opposed to the once genuine, viable, effective system of caring for the sick.

Bonnie Creighton, RN, MHCA

Mental Health Consumer Advocate

Minnesota

CatnBrian · Sep 4, 2001

Originally posted by panda_181
I am going into 4th year nursing, and this was in one of our labs in first year. I love this thing, it really makes you think about how you are caring for your patients. In the rush of everything, would one minute really kill us?

Listen, Nurse

I was hungry and could not feed myself. You left my food tray out of reach on my bedside table, then you discussed my nutritional needs in a nursing conference.

I was thirsty and helpless, but you forgot to ask the attendant to refill my water pitcher. You later charted that I refused liquids.

I was in financial difficulties and in your mind I became an object of annoyance.

I was a nursing problem and you discussed the theoretical basis of my illness. And you did not even see me.

I was thought to be dying and, thinking I could not hear, you said you hoped I would not die before it was time to finish for your day because you had an appointment at the beauty parlor before your evening date.

You seem so well educated, well spoken, and so very neat in your spotless unwrinkled uniform. But when I speak, you seem to listen but do not hear me.

Help me, care about what happens to me, I am so tired, so lonely, and so very afraid. Talk to me - reach out to me - take my hand. Let what happens to me matter to you.

Please, nurse, listen.

---Roth Johnston, RN

Let me know what you think!

Amanda :)

CatnBrian · Sep 4, 2001

I hear what all you are saying but quite honestly most of these replies sound like a big pity party. Yes, nursing is hard. Yes, there are days when you know there is no way you will get everything done by end of shift. But hopefully that's not everyday or I would suggest looking at some time management strategies. Every profession has those days that are overwhelming. I have those days as well, but they are not every day. I do have time to care for my patients. I must admit that the hospital I work for enables their nurses to have this time by assigning each nurse 5-6 patients and a CNA. I am very thankful for that. If I ever felt like I was simply pushing papers all day I would find somewhere else to work because that is not why I became a nurse. I would like to believe that we who chose the nursing profession did so out of compassion for others and the willingness to help. Sometimes when I do something very little like hold my pt.'s hand and ask how things are they seem astonished and tell me how wonderful I am at the end of my shift. And it really didn't take long and did not set me behind in any other areas of work. I notice that as long as they feel that they are truly being paid attention to they are far less demanding than if they feel they are being ignored, which in the long run saves me time. :rolleyes:

FlwrKitRN · Sep 4, 2001

I agree with the sentiment of this poem. We need to treat every patient as an individual.....as we would like to be treated if we were in their situation. The truth is, if I can, I do!

But when I am working as a charge nurse (answering questions, starting IV's that noone else can, dealing with doctors & taking care of the general problems associated with charging) with a full load of patients and have to be a lab tech, pca, & unit secretary....well, I guess I just haven't figured out how to do it! Maybe we could take the time to care for our patients if "the powers that be" would staff in a way to facilitate caring. Just staffing with enough PCA's to do ADL's would help!

I care so much that most of the time I end up staying several hours after I'm supposed to get off in order to catch up my charting. This is because I took the time to talk to that anxious patient or talk to that patient with break-thru pain that couldn't be medicated yet or....I could go on and on because I do care and want to give the best care I can!

MQ Edna · Sep 5, 2001

The poem is sappy and annoying at best. It is an insult and serves to shift the blame of inadequate care where it doesn't belong: on the nurse. We all work with staff who less motivated and compassionate than most, but they are fortunately the exception. This idiotic piece of "literature" should be immediately s***-canned by any nurse or student. Who would have the audacity to circulate such degading garbage?

Rhonna · Sep 5, 2001

I love this poem! I read several of the replies and disagree with the one speaking of not having enough time. I know how hard it is trying to do the work in a short amount of time. But a nurse's priority IS the patient and as soon as it isn't it's time to make a change. Godspeed with this poem!!!!!