Going "Above and Beyond" UGH

Nurses Relations

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At my hospital, there has recently been a push for nurses to "go above and beyond" when providing patient care. They send out emails, put up little signs and posters, and will occasionally show up in the unit and ask people how we have gone above and beyond today. It has really rubbed me the wrong way. First, because it's ridiculous to set such an ambiguous standard. But mainly, it's because I think it is probably impossible for a nurse to actually do something that would be considered "above and beyond." Let me explain.

As nurses, we have an incredible amount of responsibility for our patients. We are responsible for providing infinite aspects of bedside care. We are responsible for providing emotional support for both patients and their families. We are responsible for providing education to each patient about his or her medical condition, medications, any necessary procedures, and instructions for after discharge. We are responsible for keeping them both safe and comfortable simultaneously. And, we are responsible for communicating with each patient's specialists, surgeon, nutritionist, respiratory therapist, PT/OT and whoever else, and coordinating care between all of these people. And of course there's more.

These responsibilities are all part of a standard nurse's job description. We are expected to do each and every one of these things for all of our patient's every shift, and if we leave just one of them out, we have fallen short, and can even get written up. This isn't me complaining about being too busy or having too much responsibility. I love my job, and enjoy the patient population I get to work with. But with all the different hats nurses wear, it seems to me like anything I do for my patients, no matter how difficult it is to accomplish, or how much time it takes, is just me doing my job.

Nurses can't go above and beyond when caring for their patients...it's like trying to travel at the speed of light!

Anyway, it's been grating on my nerves. Partly because it's coming from administrators who have either never taken care of patients, or haven't done it in decades. And partly because I'm being asked to meet an unattainable goal. Any thoughts?

If y'all have any "going above and beyond" examples, please share.

2 times I can think of going above and beyond, and it's because I really liked those patients.

On Xmas day my patient was admitted with a bad gi bleed the day before. Her family was driving all the way from Minnesota to see her in the hospital and she had 3grandchildren. She was so upset she wouldn't have gifts for them. I used my gift cards for the gift shop and bought her 3 stuffed animal key chains so she would have something. It was. 10$ of my own money but she was awesome and appreciated it so much. And the smoke she had when she have those gifts was awesome.

Another patient wS terrified to go to surgery and had no family. I bought her a small floral arrangement to have when she came back to the room.

Had stuff like this been forced onto me to do, it round have list the meaning on my end and the patients.

There's something we've got going for us.. We out earn the PT RT, and radiology techs.[/quote']

Sor t y we may out earn the radiology techs but not the other groups on a national average. Our fight is not with these groups, they should be our respected pe r rs. Our fight is with hospital /facility administrators manipulating nurses to run these places with bare bone resources, little if any room for advancement, unsafe work practices.

I am a veteran nurse who has seen how things have evolved negatively and yet we think the fight is with other healthcare groups. An f as long as we dont recognize the smokescreens our issues are not addressed. This is an old trick, throw scraps and eep them fighting between themselves, and the puppet masters never have ro be confronted.

2 times I can think of going above and beyond, and it's because I really liked those patients.

On Xmas day my patient was admitted with a bad gi bleed the day before. Her family was driving all the way from Minnesota to see her in the hospital and she had 3grandchildren. She was so upset she wouldn't have gifts for them. I used my gift cards for the gift shop and bought her 3 stuffed animal key chains so she would have something. It was. 10$ of my own money but she was awesome and appreciated it so much. And the smoke she had when she have those gifts was awesome.

Another patient wS terrified to go to surgery and had no family. I bought her a small floral arrangement to have when she came back to the room.

Had stuff like this been forced onto me to do, it round have list the meaning on my end and the patients.

Thank you sometimes the best nursing is kindness.

No one will every be able to understand these kinds of things but nurses. I applaud you for caring for those pts. How do any of us document humanity practices?

There's something we've got going for us.. We out earn the PT RT, and radiology techs.[/quote']

Sorry, we may out earn the radiology techs but not the other groups on a national average. Our fight is not with these groups, they should be our respected peers.

Our fight is with hospital /facility administrators manipulating nurses to run these places with bare bone resources, little if any room for advancement, unsafe work practices, and poor compensation for the responsibility we carry. THIS IS INTENTIONAL.

I am a veteran nurse who has seen how things have evolved negatively and yet we think the fight is with other healthcare groups. And as long as we dont recognize the smokescreens our issues will continue not to be addressed.

This is an old trick, throw scraps and keep them fighting between themselves, and the puppet masters never have ro be confronted.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Hospitals and pharm companies don't go through tough times the same as other industries.

Have you ever worked at a facility that started cutting out things (essential things i might add) and nursing incentives or education and then they have a nursing poor mouth meeting to let you know wages will be frozen bc of the economy not faring well. But they are builiding some new building or wing or center.

Also Docs are still being paid without disruption to their lives. These are smoke screens, they are selling us a bill of goods.

I worked for the 3rd largest pharm co. in the world located in Texas or the clinical part, which is new. Bonuses were given out like candy on halloween during the worst part of the country's economy problems(quarterly) . Those managers lived like kings, huge benefit packages, overinflated salaries, company cars when their jags and Porsches needed a breather. We hve relation rooms, a breastfeeding room on every other floor. A large lounge area for every floor with free beverage dispensers(soda, coffee, tea etc breakfast qyick snacks, lrge screen LED TVs in each of the lounges

We had catered lunches for every meeting and nice quarterly picnics.

The largest group that worked there were not nurses, they well male project managers, nurses were supporting cast.

Nurses week in May were an extraordinary. And the gift were not from the dollar store or well wishes.

You had to compete by just emailing your name in for different events, which they could have given to eveyone because they were so loaded. Basketvall tickets, NBA,baseball tickets, concerts anything imagining happening in a huge city they had access to and has us compete for them. If it were activities for kids and families, a lot of us single nurses would put our hats in and just give them to ou coworkers that had kids. It was a very supportive environment for nurses to look out for each other because we were not vying for scraps, so thete was no need to be mean to one another.

It has been the most profesional nonstressful environment i have ever worked in. I observed the dynamics of why this was working and took very careful notes. It was not Utopia but it was an expeience evey nurse should have.

The whole time i was there i thought of nurses doing the hard physical labor things, as well as nurses dealing with life and death issues every day. I felt guilty bc i felt every nurse is deserving of these things and more when you look at if we dont exist you the facility does not exist.

People for the most part dont think they are going into nursing to get rich, but in that same vein we dont see ourselves as the hired help, but we act like hired hands.

The culture of nursing will not change until we force change.

A lot of hospitals/ facilities have cut out education days, funding for seminars when that was a natural part of the job. Now they have us convinced that to expect anything is not wanting to keep up with your professional goals...which is bs.

We have the power to change things that we define as essential to our practice, as well as to be compensated as well as other professions bc we deal with lives.

It does not heip the cause to grin and bear it.

If things effect the community at large where wages have to be frozen, benefits cut then it should effect everyone at every level except the least amongst us like housekeeping, nursing assistants, and staff already affected by the worst wages.

If the president is not frezzing his wages which will not hurt him/her anyway then dont ask me to be a good team player and understand because I WILL NOT.

Unions did not come out of people being treated fairly, and they are not a perfect machine, but hey are a bargaining voice for groups not being treated fairly. In a lot of places we have been indoctrinated to believe that unions are evil beasts and we parrot this language like it is the voice of God at the same time our needs are not being met, nurses are afraid to go to work bc of chronic understaffing when pts are much sicker, and we pray to get through a shift.

I can not nor will i work under constant stress, so i am constntly going to greener pastures, but it does not mean i have forgotten my peers and their struggles.

If administations were fair, appropriate, and had the best interests of patients and staff we would pull together during tough times but that is not going on.

We take our livelihoods and pts lives in our kands every time we step on a unit in a facility that disregards the profession and count on us to pull off miracles. Working chronically short, long hours, benefits being bare bones.

This is a sidebar but why do healthcate workers have the worst benefits of most professions? Should it not be the opposite? Can't blame the ACA for that bc it has ben going on for the almost 30yeas i have been a nurse.

This is the truth working for non direct healt companies i have ben compensated better, benefits were a lot better and i managed to get paid to finish a mastets degree outside of nursing and they picked up the full tab, no conditions attached BECAUSE IT WOULD BE A BENEFIT FOR THEM. Imagine that investing in higher education for your employee. I finished my masters in 2010, so yes Viginia there is a Santa Claus.

If you act like hired hands ou will be treated that way.

Men are a different culture and they have high expectations in their professional lives and they are treated a lot better because they dont except less.

This job that suppored me getting my 2nd degree, the largest population there are men, and many were working on 2nd degrees or dvanced professional training and it was strongly encouraged. You see they could market this to clients about pesonnel having a f vanced degrees or training.

Hospitals or direct care facilities use to encourage growth, then decided this was a way to save money.

Where have all the internships gone?

We have the power to change the dynamics in nursing and the climate in healthcare by our shear numbers. It would be a longterm fight.

My question is what is happening that we dont see the need to focus this power in changing things? Is it too hard? It is not harder than what you do and the conditions you work under. Is it because we are afraid?

The unknown is always frightening and the people at the helm will not embrace any changes that will challenge the status quo, and many facilities will gibe you that contrite ultimatum, if you dont like it here you can leave because they know that we are not wired for knowing how to harness our on power, so they will find an agency nurse or someone to take your place. But that is the reason that organizing as a group can be powerful. Have any nurses done it and been successful?

ABSOLUTELY. ...things are not perfect, but they are better when nurses are a collective group. Ratios are important, staffing is important, compensation, advancement benefits,and many other things.

Nuses by their very natures are not greedy. We go in the other direction and have to retrain ourselves into understanding our value, and being ok with having expectations. Again if we don't see or treat ourselves like hired hands then no one will. We can no longer aford to let others define our identities, or our worth.

Teachers and other helping professions are having the same struggles, yet people that work for APPLE would laugh at their employers if they underwent some of the things these ESSENTIAL professions put up with.

I say this, practice like Florence Nightingale but have expectations like people from APPLE.

Good luck to us all on our journeys.

Paragraphs. Please.

Paragraphs. Please.

Yes ms landers

Specializes in Corrections, neurology, dialysis.

This tradition of "going above and beyond" has already set the bar too high. Patients already think they're in a hotel. It is my observation that the more we do for people, the bigger ******** they become.

This tradition of "going above and beyond" has already set the bar too high. Patients already think they're in a hotel. It is my observation that the more we do for people, the bigger ******** they become.

Every pt is not warm and fuzzy nor is every nurse.

Sounds as if you have some displaced expectations.

It is always a HUGE concern when healthcare. personnel start referring to pts as *******.

Specializes in Corrections, neurology, dialysis.

Oh because I'm the only nurse who has ever thought that. Ok.

Oh because I'm the only nurse who has ever thought that. Ok.

No nurses get frustrated everyday 30yrs in nursing working in private and public i have never heard a NURSE refer to pts as *******......i can't defend that.

I am certain you have a vocabulary that is bigger than that.

I have been called names that you can not fathom as well as by there family members referring to me as everything except a nurse(and i am no saint), but if things are so bad that i had to refer to pts by that name.....i would walk away with no regrets.

I will advocate for nurses until hell freezes over, BUT i will never condone nurses venting abusive name calling

of pts. It crosses all kinds of lines.

And FYI,

i would not stand quietly by and allow pts to refer to nurses as ********.

So if you are offended by my comments then toughen up,

I talk alot about having a professional identit for nursesy, defining their value, expecting administrations to respect us and that post was offensve and repulsive to ALL NURSES who are trying to change the dynamics that are being played out in healthcare. And people like you undermine those efforts.

If those are your feelings and frustrations about pt care GET OUT, FIND A MORE SUITABLE PROFESSION

Feeling a certain way is not the problem, but saying them out loud is.

This forum is not your private diary, and that's where your response need to go when or if you are going to refer to pts as *******..

Ethics, I agree with you completely. I do not take issue with any other professionals and would not begrudge them their fair compensation. Like you pointed out, the issue is with the systems and how they have evolved. Everything is relative.

Ethics, I agree with you completely. I do not take issue with any other professionals and would not begrudge them their fair compensation. Like you pointed out, the issue is with the systems and how they have evolved. Everything is relative.

Thank you for just for the validation....our fellow peers are not the culprits.

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