Going "Above and Beyond" UGH

[SubSippi]

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.

[morte, LPN, LVN]

I have not found AN being friendly to spaces....they did have paragraphs just not the spaces between.

Paragraphs. Please.

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 *******.

Maybe time to find a different career path?

I work in an urban ED... and I definitely have patients to whom the orifice moniker aptly applies. Thankfully, not many, but... oh yeah, for sure.

I do my best to provide quality care but that doesn't mean that they're not orifices and they certainly don't get the genuine and sensitive part of me... all they get is the minimum required to address their chief medical complaint.

[klone, MSN, RN]

Yeah, a lot of my patients are *****. I'll say it. I'm still a damn fine nurse, I treat them ALL with respect and I will bristle at ANYONE who suggests I need to "find another line of work."

[Ethicsrn4life]

I work in an urban ED... and I definitely have patients to whom the orifice moniker aptly applies. Thankfully, not many, but... oh yeah, for sure.

I do my best to provide quality care but that doesn't mean that they're not orifices and they certainly don't get the genuine and sensitive part of me... all they get is the minimum required to address their chief medical complaint.

If you work in a large urban ED, we know what groups of people you are referring to as orifices.

I am an old fashion nurse who believes that people should be able to identify me as a nurse regardless of the pt i am caring for.

What job is perfect? You can think and feel whatever you like

Because you clean the words up does not justify just the lack of knowledge you have about human behavior under stress but i think this is a pervasive trait in your character by posting calling pts orifices and giving them minimum care.

We all have frustrations that we have to deal with and i can not defend your behavior one bit.

There are so many of us who are trying to change the dynamics of the culture of nursing where we are seen as advocates, and a respectable profession and for you to come along an undermine the relentless efforts that we are trying to make it simply makes me ill.

There is nothing that i and other nurses have not seen or experienced on our carerrs that we can reduce people to orifices abd provide the most minimal of care because of a lack of profesional boundaries that you learn in nursing 101 and practice throughout our career.

I said it to the first post that referred to pts as ******* abd i will say it again just walk away if this is how you feel. People leave their jobs everyday for different reasons. And tht kind of venom towards pts is DISPLACED if you see them as orifices abd can state you give them th minimum care. I don't see the pt as the problem it is you.

I rarely experience not being able to see both sides of an issue, but in this I CAN NOT CONDONE NURSES CHOOSING A PROFESSION DEALING WITH PEOPLE'S LIVES AND NOT DEALING WITH THEIR FRUSTRATIONS IN AN APPROPRIATE MANNER. SORRY THERE IS NOTHING YOU CAN SAY THAT WOULD MAKE THIS MORE PALATABLE.

I wont address this particular post again or anything similar because it is not defendable.

[RainMom]

There are **** in all walks of life. Sometimes they end up in the hospital.

[Ethicsrn4life]

Yeah, a lot of my patients are orifices. I'll say it. I'm still a damn fine nurse, I treat them ALL with respect and I will bristle at ANYONE who suggests I need to "find another line of work."

There is nothing you can do about a feeling or a thought it is human, but their is something wrong with referring to pts as *******s. .

But my first priority when i see something like that is to make sure i speak out about the inappropriateness of posting something like that on a professional site

I pray that you are a fine ethical nurse because we desperately need them, but i have NO problem saying if you are not leave the profession because pts dont need nurses who can not be respectful advocates and caregivers despite their behaviors.

I am not saying pts should be allowed to treat nurses disrespectfully or abusively, and their was no mention of that. Whar was implied was their entitlemement. So a pt's entitlement should not garner them being called nasty names. A skilled nurse knows how to deal with thess situations in a respectful manner or ask for help.

if they can not deal with the frustrations of pts' behaviorr ask for supervision or try a new profession.

And you will find that in every profession dealing with people this behavior is intrinsic..

So you certainly may bristle, but perhaps taking a personal inventory of yourself would be more appropriate. It is something all of us have to do from time to time. Remember you put that post out there and i am not the kind of nurse that will not address something so inflammatory. It is very personal.

[Natkat, BSN, MSN, RN]

Here's the thing. I really don't care what you think.

I love it when a nurse is getting ready to canabalize me she throws "nursing 101" in my face. Funny thing is it's almost never nursing 101 but something learned on the job or something they pulled out of their own orifice.

And why is it always a she? I've never had a male nurse test me like that.

[SWM2009]

This is a pathetic way to justify your personal limitations as a human being and a nurse.

If you work in a large urban ED, we know what groups of people you are referring to as orifices.

I am an old fashion nurse who believes that people should be able to identify me as a nurse regardless of the pt i am caring for.

What job is perfect? You can think and feel whatever you like, but i think you are showing your character by posting something like this.

Because you clean the words up does not justify just the lack of knowledge you have about human behavior under stress but i think this is a pervasive trait in your character by posting calling pts orifices and giving them minimum care.

We all have frustrations that we have to deal with and i can not defend your behavior one bit.

There are so many of us who are trying to change the dynamics of the culture of nursing where we are seen as advocates, and a respectable profession and for you to come along an undermine the relentless efforts that we are trying to make it simply makes me ill.

There is nothing that i and other nurses have not seen or experienced on our carerrs that we can reduce people to orifices abd provide the most minimal of care because of a lack of profesional boundaries that you learn in nursing 101 and practice throughout our career.

I said it to the first post that referred to pts as ******* abd i will say it again just walk away if this is how you feel. People leave their jobs everyday for different reasons. And tht kind of venom towards pts is DISPLACED if you see them as orifices abd can state you give them th minimum care.

I rarely experience not being able to see both sides of an issue, but in this I CAN NOT CONDONE NURSES CHOOSING A PROFESSION DEALING WITH PEOPLE'S LIVES AND NOT DEALING WITH THEIR FRUSTRATIONS IN AN APPROPRIATE MANNER. SORRY THERE IS NOTHING YOU CAN SAY THAT WOULD MAKE THIS MORE PALATABLE.

I wont address this particular post again or anything similar because it is not defendable.

Wow. No one is talking about calling patients orifices to their faces. This is a message board and venting is par for the course.

[Ethicsrn4life]

Wow. No one is talking about calling patients orifices to their faces. This is a message board and venting is par for the course.

Yes it is a message board and i understood that it was not being said to pts faces, but this is a profesdional board and i will defend pts even when we use inflammatorty name calling.

Words are powerful and i understand that if we feel the need to call pts ******* bc we are frustrated and admit giving them miniimun care it should be addressed very strenuously.

It is interesting that other nurses have not addressed this as something quite negative and displaced anger calling pts names and one post admitting to giviing them minimum care.

I do not see any humor in that.

It does make me wonder about the care they receive when nurses have that attitude and can't separate their frustrations from the needs of the pts.

I take nusring care very seriously and my first job is to be an advocate for the pt and i will defend it with vigor.

I make no pologies about it because its was quite inflammatory and charateristic of nursing taking the frustrations out on pts...this is a sytemic problem in nusring that should be address on all levels.....,so yes WOW.....i was appalled that it was posted like that.

Pts should not be referred to as ******* even in the intimate circles of nursing.

Whatever happened to the art of spelling out a frustration and dealing with it, rather than reducing pts to nasty name calling.

And in the other post saying with pride they will get minimum care

I am fine with venting but this crossed a line.

[duskyjewel]

Oh my gosh, ethics, I work hospice inpatient, and my sector is usually regarded as one of the more compassionate in health care. Let me just say if you're this upset over a message board post, stay away from our nurse's station once we finally get the chance to sit down and talk about the PITA boomer drug addict in room 8 or the crazy families that want feeding tubes and IV fluids on patients with pitting edema in all four limbs, but no pain meds.

We're human. We vent. We release the unhealthy stuff with each other so we can give the best to our patients. Get over yourself.

[Natkat, BSN, MSN, RN]

Yes it is a message board and i understood that it was not being said to pts faces, but this is a profesdional board and i will defend pts even when we use inflammatorty name calling.

Words are powerful and i understand that if we feel the need to call pts ******* bc we are frustrated and admit giving them miniimun care it should be addressed very strenuously.

It is interesting that other nurses have not addressed this as something quite negative and displaced anger calling pts names and one post admitting to giviing them minimum care.

I do not see any humor in that.

It does make me wonder about the care they receive when nurses have that attitude and can't separate their frustrations from the needs of the pts.

I take nusring care very seriously and my first job is to be an advocate for the pt and i will defend it with vigor.

I make no pologies about it because its was quite inflammatory and charateristic of nursing taking the frustrations out on pts...this is a sytemic problem in nusring that should be address on all levels.....,so yes WOW.....i was appalled that it was posted like that.

Pts should not be referred to as ******* even in the intimate circles of nursing.

Whatever happened to the art of spelling out a frustration and dealing with it, rather than reducing pts to nasty name calling.

And in the other post saying with pride they will get minimum care

I am fine with venting but this crossed a line.

Sounds like you are having a bad day. I'm sorry to hear that. Is there anything I can do to help you today?

[SWM2009]

Yes it is a message board and i understood that it was not being said to pts faces, but this is a profesdional board and i will defend pts even when we use inflammatorty name calling.

Words are powerful and i understand that if we feel the need to call pts ******* bc we are frustrated and admit giving them miniimun care it should be addressed very strenuously.

It is interesting that other nurses have not addressed this as something quite negative and displaced anger calling pts names and one post admitting to giviing them minimum care.

I do not see any humor in that.

It does make me wonder about the care they receive when nurses have that attitude and can't separate their frustrations from the needs of the pts.

I take nusring care very seriously and my first job is to be an advocate for the pt and i will defend it with vigor.

I make no pologies about it because its was quite inflammatory and charateristic of nursing taking the frustrations out on pts...this is a sytemic problem in nusring that should be address on all levels.....,so yes WOW.....i was appalled that it was posted like that.

Pts should not be referred to as ******* even in the intimate circles of nursing.

Whatever happened to the art of spelling out a frustration and dealing with it, rather than reducing pts to nasty name calling.

And in the other post saying with pride they will get minimum care

I am fine with venting but this crossed a line.

I don't even know what to say. I think the assumptions you are making about nurses and the care they give based on a vent post are very wrong. Oh well, fight on I guess.