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.
When I worked in the inpatient setting, night shifts, weekends, holidays, working through lunch every shift, were normal and expected- stuff that would be considered above and beyond in many other professions. Now I've worked in outpatient for several years and still appreciate the luxury of being able to pee when I need to.
It's not that I don't do things that are above and beyond now. I just don't do flashy and glamorous stuff like planning prom for a dying kid, or brag about what I do (though i probably should).
From an administrative perception, what about the nurse that goes to work on her day off to assist the other nurses when they're in a bind? That is going "above and beyond." She is not required to go to work on her day off. That is just one example of the many that I can provide.
I feel every shift that doesn't end in me strangling a random administrator is a day I've gone above and beyond.
Congrats... your's is the prize quote of the thread!
Every facility I've worked in has their version of this "same ol' management BS."
And I know we all know that there's few in those ranks that could handle even the basics of the floor staff's responsibilities. (Can we say... "hypocrisy"?)
You should cover their signs with signs that say that the whole thing is kind of insulting to nurses who were already making an effort and bad for morale (serious suggestion). Or when they ask you what you have done, ask what they have done (obviously not a serious suggestion). Or put on a big smile and let them know you have a great opportunity for them to go above and beyond, then bring them to a patient with gross feet and say the patient wants a foot rub from an administrator (semi-serious suggestion).
Specializes in Infusion Nursing, Home Health Infusion.
I found it borderline insulting. I'm a sucker for food, but I never went. A reward for my hard work was sleeping on my days off, not getting up and going to work to eat with the very people who made my work life miserable.
I wonder if we work for the same organization. We had that program and I had the same thought. I would have preferred a Nordstrom gift card or anything away from the hospital too!
When an RT spiked a humidification bottle incorrectly and I had to clean up a giant puddle under and around my patient's bed, in the near-dark, at 3 AM, without waking him...
Sigh. The patients and administrators TRULY never know how the night shift goes "above and beyond" for them. No pin awards for that biz!
Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
When an RT spiked a humidification bottle incorrectly and I had to clean up a giant puddle under and around my patient's bed, in the near-dark, at 3 AM, without waking him...
Sigh. The patients and administrators TRULY never know how the night shift goes "above and beyond" for them. No pin awards for that biz!
And why is it that when RESPIRATORY (or Medicine or Surgery or PT) makes a mess, NURSING has to clean it up?
And why is it that when RESPIRATORY (or Medicine or Surgery or PT) makes a mess, NURSING has to clean it up?
Oh don't even get my started about respiratory. I have had so many RTs try and push me around about something they felt was a crisis from their, albeit important, but limited perspective. It happens along the lines of "aren't you going to......." Or "don't you think you should.....?" Okay. I'm a person who is open to suggestions, but when it comes to patient care, I kind of have a leg up on everything that's going on with my patient. Even if I'm "just doing dialysis" I am monitoring everything that is going on with the patient. So you can do that thing thing you're doing and leave me the hell alone.
Oh, and one more RT story and I'll stop. Now this might have more to do with the fact that I am in Texas and not because the person is an RT. but anyway I was taking care of an ICU patient sedated, on a vent, who was HIV positive. In these modern times, that's not all that uncommon. The RT was looking at her with snoot in the air and the conversation went like this.....
RT: oh I think it's just sad".
Me: (Feigning ignorance). What do you mean?
RT: that's she's HIV positive.
(Um, heller! She's sedated but she can still hear you, jerk.)
Me: oh it's not so bad. They have great medication available now. She'll probably live a very long time and probably die of something else before she even develops AIDS.
RT: no, I mean that she has something that could have been prevented
Me: (looking around at an ICU full of people with heart disease, hypertension and diabetes). Everybody in here has something that could have been prevented.
Lady, you can take your self-righteous, morally superior attitude and find another line of work. Maybe your church needs you, but we don't.
This thread's given me great ideas. My hospital uses an annual peer review performance evaluation that coworkers, one physician, and myself evaluate my performance over the preceding year. I'm going to write down every instance of my going above and beyond for patients, their families, and my coworkers and reference that list on my next year's evaluation!
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SHGR, MSN, RN, CNS
1 Article; 1,406 Posts
When I worked in the inpatient setting, night shifts, weekends, holidays, working through lunch every shift, were normal and expected- stuff that would be considered above and beyond in many other professions. Now I've worked in outpatient for several years and still appreciate the luxury of being able to pee when I need to.
It's not that I don't do things that are above and beyond now. I just don't do flashy and glamorous stuff like planning prom for a dying kid, or brag about what I do (though i probably should).