No advocate in management

limey · Jul 24, 2011

WOW!!! Sounds like the CIRCUS :jester: I work in!!! Only I work in LTC. Get this!!... Patient refuses to take shower, which he has the right to refuse. Refuses to go to bed and after it's midnight continues to argue with the staff. Next morning when administration comes in after they have had a good nights sleep, not giving a rats a_ _ about how things may be going at work, listen to the patient claim that the nurse and aides refused to let him go to bed when he was tired. The administrator believes him and starts in on the night staff about how he could see to it their license is pulled for refusing to let the patient go to bed. CAN YOU BELIEVE THIS??? Our administration is made up of a bunch of idiot :clown:s!! Both of your situations have happened numerous times where I work. Where is the administrations knowledge and responsibilities that they are to have before they even think of taking the position they are in now? I think the people who hire these clowns and the clowns themselves should be required to start at the bottom of the pole and actually work these positions (nurse aides, etc..) so they know and understand what we do. Just my :twocents: .

lacunawestward · Jul 24, 2011

Exactl! I feel like that happens as well... Confused patients are believed over us. I feel like management is almost paranoid about what goes on on night shift here in the last bit and I really can't think of any incidents to spark it. I'm sure this might be common but ive gotten word that we are installing sensors on our badges and in the rooms to monitor where we are when. I am all about patient safety but 1. You want us in the rooms more? Reduce our duplicate charting please and thanks. Im tired of staying sometimes an hour late to chat the same crap over and over. If I charted some of this stuff during the shift, I'm not sure I'd actually see my patients very often.

But anyway I just feel more than unappreciated now... I feel like I am not trusted.

tokmom, BSN, RN · Jul 24, 2011

Are they locators so you can find each other a bit more easily? That is what we have and it's nice to be able to find a nurse when you need one.

I think I would leave and find another place to work. Your schedule is crap and if they don't care, what do you do?

I guess you could go above your manager and ask for help, but if you are aren't union, that is sort of risky.

kcmylorn · Jul 24, 2011

This has been going on for at least 10 years, but never as bad as it is now, It goes on in EVERY speciality- Ive done beside nursing on an exclusively neuro unit in a big university hospital, so I can hear what you are saying, those are heavy( dont move on their own, Trach'ed and Peg'ed) patients. The last 5 years Ive been cardiac stepdown- same thing but different flavor- 6 post open hearts all on tele with tubes out the ying yang. We can all be consoled by the fact that the greedy big boss houdelium CEO, his board of DICKtators, financial CZARS are in offices some where, sitting on their good for nothing backsides, clueless as to the damage 'THEY ARE' responsible for, not dropping a bead of sweat, earning a multimillion dollar salaries, not giving the patients in their hospital, you, me or any other bedside nurse a second thought, or the nursing unemployment rate. All is good as long as it doen't mean a cut in their salary. If their salaries were cut to more reasonable levels, just think of how many nurses could be employed. Just think of the farreaching effects that would have on the improvement in patient/nurse ratios and therefore quality patient care. Sitting around picking their noses, wishing the electric Co's and water Co's and Drug Co's don't raise their rates is a waste of time, but slashing top brass salaries to put that revenue back into the healthcare institution is in their power. It's all a question of their personal will. The waste in healthcare is at the top. All the more reason that the federal government should step in and take over the running/managing the healthcare systems in this country. These private sector financial people have overwhelmingly proven they are not responsible enough to be depended up on to competently perform THIER job descriptions anymore. As for nursing management- for get thier help/support. They are scared for their jobs and have no convictions any more- if something happens to a patient, they blame the staff nurse assigned to that patient, like Igor to Frankenstein- Oh Yes master, I took care of that nurse. The managers should have their licenses take away from them- what responsible safe(reasonabley Prudent) decisions are they making??(Do No Harm??)

RN58186 · Jul 24, 2011

Wow! I read this thread and I realize how lucky I really am. First of all, in Canada we have socialized medicine so it isn't about profit for the hospitals. That's not to say some of our CEO's aren't paid horrendous salaries, and that units don't run short staffed because of budget. I think those are pretty much the norm no matter where you are.

However, my manager is awesome. When it comes to her nurses, she is like a mama bear with her cubs. Nobody messes with her nurses. She won't give any of us a horrible schedule that she wouldn't work herself. She insists that our rotations must be, in her words, "humane". If a pt or family member is yelling at a nurse, or has a complaint, or generally not being fair to us, she is more than happy to have words with them. A pt that is confused won't get it from her, but she's more than ready to let us come into her office and "dump " on her. If I am in charge and make a decision, whether she agrees with us or not, she will back us up. I have gone into her office, said "this is what happened, this is what I did and this is why I did it" and her response is always the same "Thanks. If I have questions I'lll talk to you, but if there is any flak, I'll take it from here". Any doctor that leaves one of her nurses out to hang is not going to want to show his/her face for a while. She'll have them in her office so fast they won't know what hit them. Lay off nurses because of budget? No way. She'll refuse, and if they push her too hard she'll quit herself. Is she perfect? No. She has a propensity to say "You're fired" (always joking, but some people have taken offense to it). She can talk first, think later. But if she does, she'll apologize later. The dept head keeps her around because the morale on the unit is great (we know we have back up), she does manage to meet budget targets (just not at the cost of her staff) and she has stuck around. In my first 4 years on that unit we went through 6 head nurses (as they were called then). She values her staff. A few years ago, we needed to hire a bunch of nurses. She called another nurse and myself into the office, handed us each a stack of resumes and said "Start reading. I need to hire 4 nurses before you guys leave today and I don't have time to go through these". She totally trusted us, and hired the ones we thought would be good for the unit, and complimented the two of us when the ones we suggested not only were hired but worked out to be great nurses. Most of us who work for her know we are very lucky. I have looked at other jobs over the years, but I highly doubt I'd find a better manager. So for now I am staying.

xtxrn, ASN, RN · Jul 24, 2011

Hello, healthcare

It's been like this for years. Management has to answer to administration and administration answers to the accountants and attorneys. It's sad. I actually started nursing school when it was about patient care, and by the time I got out, DRGs had started, and the beginning of the end was in full force (they'd been thinking about the Diagnosis Related Groups for a while- and decided that you pay for the diagnosis- not the patient needs...encouraging hospitals to kick people out before they were ready, to compensate for the ones who were more complicated- idiocy).

How I dealt with this (granted, it was apparently easier to get jobs then in the south,where I was) was to mix things up and change specialties. I know many can't do this. But, it doesn't hurt to check- if you like the hospital, maybe a different department??? Just an idea :)

kcmylorn · Jul 25, 2011

The whole key to this is: socialized medicine. Remove the private profit from the mix and we can have HEALTHcare again, not Macy's and Walmart with the competitive edge. RN58186- it must be absolute heaven where you are compared tohere in the states. Our military and VA healthcare facilities are run very similar to what you describe and they run beautifuly. No greedy mongrel sitting in a big office counting his multimillion dollar salary while the patient care goes to hell in a handbasket. Did I read right- socialize medicine hiring 4 nurses OMG- Look American healthcare what Canadian Healthcare is doing- hiring nurses!!( I can say that I was born in Canada and I'm seriously considering moving back after 50 years)

lacunawestward · Jul 25, 2011

I'm actually applying for jobs in and out of the hospital. It is sad but I dont enjoy it like I used to. We turned some of our privates back into semis and I don't think the matrix was adequately changed so frequently I'll have ten patients. I know it's worse in other places I'm sure but I still haven't gotten used to taking care of ten Neuro patients ESP when you have one trying to beat you up, hourly pen morphine on all your surgery patients (um pca pump please?) etc. I just feel also like I don't have time to thoroughly know my patients. I miss knowing my patients and being able to do real things for them outside of regular duties bit now there is a flow sheet for this and a falls risk sheet for that and an hourly rounding sheet for that. As for the tracking system I'm really not familiar with it yet. I've just heard heresay so far. Thanks for the words of encouragement

RN58186 · Jul 25, 2011

The whole key to this is: socialized medicine. Remove the private profit from the mix and we can have HEALTHcare again, not Macy's and Walmart with the competitive edge. RN58186- it must be absolute heaven where you are compared tohere in the states. Our military and VA healthcare facilities are run very similar to what you describe and they run beautifuly. No greedy mongrel sitting in a big office counting his multimillion dollar salary while the patient care goes to hell in a handbasket. Did I read right- socialize medicine hiring 4 nurses OMG- Look American healthcare what Canadian Healthcare is doing- hiring nurses!!( I can say that I was born in Canada and I'm seriously considering moving back after 50 years)

Yeah, I am not sure I could work in the American system. Our system is far from perfect, but I never want to be caught between what my pts can afford vs what they need. Never is there the question about how much profit did we make this year? If a pt needs an MRI, they get it. Yes, we have waiting lists. Yes, the system can be slow. But I also know that if someone needs something in a big hurry it will happen. Life threatening situations do get handled quickly. I have a cousin who worked in the States for a while, but she has come home. She told me about having to account for the 4x4's used to do dressings so that the pt is appropriately billed for them. I almost choked - I am a nurse who tends to open more than I need "just in case". Someone concerned about profit would hate me.....

My province (Alberta) recently announced that it will be hiring 300 RN's almost immediately. Most of them will be new grads from Alberta schools, but they are mostly full time or high FTE positions. In our last contract the provincial health superboard agreed to hire a certain percentage of new Alberta grads into regular positions. It is a work in progress, but slowly happening.

It is difficult for someone to get a foot in the door now, most positions go to people already in the system, but it isn't impossible.

Yes, I know I am lucky. I have a job I love, a great manager, and no worries about what my pt can afford. I will never leave.... :)

annmariern · Jul 25, 2011

Wow! I read this thread and I realize how lucky I really am. First of all, in Canada we have socialized medicine so it isn't about profit for the hospitals. That's not to say some of our CEO's aren't paid horrendous salaries, and that units don't run short staffed because of budget. I think those are pretty much the norm no matter where you are.
However, my manager is awesome. When it comes to her nurses, she is like a mama bear with her cubs. Nobody messes with her nurses. She won't give any of us a horrible schedule that she wouldn't work herself. She insists that our rotations must be, in her words, "humane". If a pt or family member is yelling at a nurse, or has a complaint, or generally not being fair to us, she is more than happy to have words with them. A pt that is confused won't get it from her, but she's more than ready to let us come into her office and "dump " on her. If I am in charge and make a decision, whether she agrees with us or not, she will back us up. I have gone into her office, said "this is what happened, this is what I did and this is why I did it" and her response is always the same "Thanks. If I have questions I'lll talk to you, but if there is any flak, I'll take it from here". Any doctor that leaves one of her nurses out to hang is not going to want to show his/her face for a while. She'll have them in her office so fast they won't know what hit them. Lay off nurses because of budget? No way. She'll refuse, and if they push her too hard she'll quit herself. Is she perfect? No. She has a propensity to say "You're fired" (always joking, but some people have taken offense to it). She can talk first, think later. But if she does, she'll apologize later. The dept head keeps her around because the morale on the unit is great (we know we have back up), she does manage to meet budget targets (just not at the cost of her staff) and she has stuck around. In my first 4 years on that unit we went through 6 head nurses (as they were called then). She values her staff. A few years ago, we needed to hire a bunch of nurses. She called another nurse and myself into the office, handed us each a stack of resumes and said "Start reading. I need to hire 4 nurses before you guys leave today and I don't have time to go through these". She totally trusted us, and hired the ones we thought would be good for the unit, and complimented the two of us when the ones we suggested not only were hired but worked out to be great nurses. Most of us who work for her know we are very lucky. I have looked at other jobs over the years, but I highly doubt I'd find a better manager. So for now I am staying.

You are so lucky, I have had several of these managers in my career, probably why I'm still doing this for a living; they are never shy about calling you in when you are in the wrong and letting you know it, but they had your back. Muck in and help when needed. End of story. You may not have liked them, but you had endless respect for them as fair and so did everyone else. A dying breed. Now we have corporate muppets, who have no idea what we actually do, but they did it it with less staff, blah blah; have they spent a day even shadowing one of us to see firsthand? No, they couldn't care less. They have degrees up the wazoo, and zero commonsense, and they make it clear, they say what they are supposed to to the management, and they keep their jobs, because after all if pt satisfaction is low....must be our fault right? These are the managers that keep their jobs here; the one you describe, is gone in a flash. How sad for both nurses and the pts.

irishrnbsn · Jul 25, 2011

Don't forget about LITIGATION as a reason for these problems. The last place I worked we had a very tall and intimidating man who would come in with "chest pain" and be found to be positive for cocaine each time. Because we were a large hospital system you could see by looking in his visit history where he would simply go from campus to campus sometimes being admitted, sometimes not - what he wanted was a prescription for pain medications. I don't understand, to me, if we have determined what the chest pain is from, we have worked him up multiple times, the obvious hospital shopping he does is documented then why is he continually admitted and then allowed to treat the staff like crap and scare them? I think its because if we turn him away and he has a heart attack then we are sued and the hospital would probably settle out of court. People need to start taking responsibility for their own actions and stop blaming others.

Also, now with the government deciding what they will reimburse for based on HCAPS, we have to make the patients happy no matter what. Have you read the questions on that thing?! People need to realize that being a patient is NOT the same as being a guest in a hotel or a customer at McDonald's. I know you want your MRI results now, but that is simply not realistic. We need to stop giving in to this "I want it NOW" mentality. Patients act like it is so unbelievable that their DR won't be in at 8am like they would like. If a Doctor has an office and then 15 patients in the hospital HOW are they supposed to see all 15 of those patients between say 8 and 10am AND sit down and have a 30 min conversation with each one? Peoples expectations are out of control as are the hospital administrators. If I am in a room cleaning up a patient who's orifice just exploded by myself because you decided to take all the NTs away, then how am I supposed to get Mr. Jones down the hall the orange juice he wants within what HE thinks is a timely manner? Perhaps I should give him you extension number and see how you deal with being called all day long.

Ugh. I am just so over nursing. I am an educated person, I don't deserve to be abused the way I am by patients, their families, MDs, other employees of the hospital and then turn around and have the system I work for tell me I should have done this or that. I know the patient is 1st, but do we not deserve respect as well?