So in 15 years of nursing I've had many evaluations of my abilities as a nurse. What has kind of just started making me laugh is that when it gets to the critique part this is constantly what I get told (other than my constant bad habit of being 1-3 minutes late), "We can see that you care a great deal about your position and your patients, but..,,,1) try to focus on small goals. 2) be willing to let others help you more. 3) ensure that you ask for help when you are overwhelmed. 4) try to delegate more often.
My inner voice just laughs. Um, isn't caring what you pay me to do? Are you trying to say my constant complaints about the lack of organization in your organization are "caring too much"?! Well the boo *** hoo, that's on you dumb butts. 1) I WOULD LOVE TO FOCUS On SMALL GOALS! But when you come to work and 30 minutes in you already have people telling you all the alarms that are going off, small goals go out the window...it is just me constantly trying to put out fires, there are no goals other than hopefully no one gets killed or hurt.
2) I would LOVE it if other people helped me. But when their vwrsion of "help" is to see me drowning and to walk up to while I'm overwhelmed to see what they can do...well not super helpful. I can read orders and just start doing them...why can't other people? Just getting in there and helping is helpful....asking if you can is just a time suck.
3) Asking for help when I am overwhelmed....well I have. And the charge is usually "to busy to get to it just then (or ever)” "I can try to help in awhile if YOU haven't managed to get to it before then.” So why do I even ask. Or I ask a CNA that "hasn't been shown how to do that yet". (Good CNAs deserve nurse pay.) So why even waste my time asking?
4) Try to delegate....see my answer #3.
It just cracks me up! So your criticism of me is that I care and I'm tired of being abused? Huh, such a bad nurse I am (eye roll like a teenager.) Just shut up and give me a decent raise.
I'm a nurse who feels I haven't done a good job with time management if I have to delegate. I often fall into the trap of feeling like I have to figure everything out and accomplish it all myself. I have to remind myself that asking for help and delegating when I really need to is okay. I've had to take the same advice you were given and apply it.
If you are hearing the same feedback over and over, maybe it's worth listening to.
Why not set your clock 5 or 10 minutes earlier so you can get to work on time? The few times a year I walk in late, I feel like I'm behind rest of the shift.
I disagree that other nurses should just jump in, read orders, and do things without checking with you. Not only is that disrespectful of your autonomy and your relationship with that patient, IMO, it could cause errors, like a med or treatment getting done twice because you two didn't communicate. Also, the other nurse didn't get report on the patient, so they may not have the necessary clinical info to make sound decisions.
If you ask for help and are met with resistance, then go to your manager and tell her that.
In my recent situations asking for help was more difficult as all the other nurses were just as "overwhelmed " as I was, including our supervisor, who BTW, was also taking assignments. Time management can be an issue for some. However, urgent situations that come up with a patient, bad timing for admissions, and time sensitive tasks don't know what "time it is". I also agree that a unit that is not well organized adds an extra burden to one's ability to work efficiently, such as supplies not evenly distributed or stocked, other departments such as pharmacy for example, don't answer the phone and you end up having to call multiple times, results from the lab aren't entered in a timely manner, and so on. Short staffing in multiple departments have a ripple effect on everyone, and there are times when other department's needs force you into a corner when your butt is already backed in as far as it will go. Not their fault, but when ER's or PACUs are backed up and demanding you take their admission/transfer before you are ready, add to the chaos.
Therefore, when a nurse has criticism in writing on his/her record for "time management" issues and the manager knows full well there are not enough staff, I think that's not fair, and frustrating as hell for the nurse. That sort of thing has made me loose respect for that manager as you want to say, "How about you take a few shifts and then tell me about time management?”
I'm a nurse who feels I haven't done a good job with time management if I have to delegate. I often fall into the trap of feeling like I have to figure everything out and accomplish it all myself. I have to remind myself that asking for help and delegating when I really need to is okay. I've had to take the same advice you were given and apply it.
If you are hearing the same feedback over and over, maybe it's worth listening to.
Why not set your clock 5 or 10 minutes earlier so you can get to work on time? The few times a year I walk in late, I feel like I'm behind rest of the shift.
I disagree that other nurses should just jump in, read orders, and do things without checking with you. Not only is that disrespectful of your autonomy and your relationship with that patient, IMO, it could cause errors, like a med or treatment getting done twice because you two didn't communicate. Also, the other nurse didn't get report on the patient, so they may not have the necessary clinical info to make sound decisions.
If you ask for help and are met with resistance, then go to your manager and tell her that.
Asking for help in an inadequately staffed department is beyond the problem. You are telling the manager what they already know. In places like the ER, you don't have to get report on a patient to help (naturally you may ask why they are here), you start the I.V., get labs, start meds.. They're everyone's patient if they aren't stable.
When STEMI's and strokes have come in, I've just put monitors on people, I don't have to know whose patient it is, I've got the I.V., I have the MAR open to get the aspirin..and just let the nurse know your giving the meds.
In the end, I don't have to work at a job like that where there is shady work conditions (multiple call-ins every day, nurses getting 2-3 extra patients, managers doors are shut, giving the pretense that they're not in there.)
It's true! I have been told that " I care too much," I get behind with charting and, therefore, am late moving on to the next task because I am listening to a patient. That although I obviously put patients first, care about their safety, and well-being, and try to support them, after all, I do work in Oncology; I need to not take on so much for them as it can mean I play catch up in my charting.
Suppose the charge nurse or manager can take a step back and look at the assignments. In that case, it is often the fact that the work is unbalanced and it's not just the actual treatment therapy that needs to be considered in the assignment planning, but the person needing the treatment.
I will say in reply to your comments about wasting your time asking what a colleague can do to help you. Please try not to look at it this way. You may be very overwhelmed and so busy it should be obvious to you what another can do to help, but when you think about it, that's impossible without your input on what would be the most helpful to you.
There would be no point in me starting on some orders to find that you were waiting on some other information to complete them, or waiting on a BP or a phone call first. Take a breath and think, oh excellent, someone IS offering their help; what a blessing, and assign them what will help you then.
Believe me; I have worked enough to know it's never offered at times.
Specializes in Surgical Specialty Clinic - Ambulatory Care.
All these responses are interesting.
I have never gotten more than a 3% raise. The best 'raises' I've gotten are when I quit and go get another job....which is kinda why I quit every 2-3 years. My last quit and new job increased my salary by $10 an hour, but usually it is just $3-5 increase (which is better than the $1-2 increases would get staying.)
I don't really care to endear myself to anyone or organization. I tried earlier in this career to do that. It doesn't really help. I'm not suppose to have the solutions, that is what management and upper management is for. When I give my opinion of what would help (add staff, lessen the work load) I usually get told that is not an option. We have to do with what we have....well that is what is leading to the crap care we are giving.
I don't like to be forced into choosing to sacrifice time with my family, my body, or my bladder versus doing right by my patients. I always get told I do excellent patient care, of course I do, but I what is happening is that these organizations are abusing my caring nature and willingness to sacrifice myself for others to profit off of as I work myself to death and neglect my family. So no, I don't really give a *** about staffing shortages and will totally quit without giving it a second thought if my manager doesn't grant my vacation requests. I'm not a child, if I gave 1 week notice of a request, sure that would make me the problem. I give notice 6-8 weeks ahead of time, management better not tell me no the week before. You have 2 weeks from the time I submit my request to respond, less if I bought plane tickets (and I will let you know if I did), no response from management means I have it off. I did my part, do yours.
I sure as *** am not getting there early. I already regularly have to cut lunches short and stay late. Management can kiss my *** with that 1-3 minutes I am late in.
Medicines and orders are administered via computer and a scanner. There is little to no chance of double admin if meds are passed appropriately, so yes, it is perfectly safe to just look at orders and help. Maybe look at the order and say, "Hey, so n so, if you have not passed meds to RM 12 I can do that.” It is more helpful than the dumb open ended question of "What can I do to help?” If you are a nurse you can plainly see what needs yo be done, TELL THEM WHAT YOU WANT TO DO TO HELP! Way more helpful than the other way around. And if you are the kind of nurse that finds people picking up and doing stuff without asking disrespect it is probably because you are a control freak.
My point was, don't be brittle with someone trying to be helpful because they asked you what you need. You are going to alienate people with that harsh outlook. How lovely if a nurse, who I am sure also has plenty to do, could look at your overwhelmed distress and know which task would be the most helpful to you at that time, but if not and another busy nurse is being nice, don't cut off your nose to spite your face because she took another 15 seconds from you by asking what you need. Let's be sensible, not judgemental. Maybe that nurse is also having a rough day but still kind enough to care, and here you are thinking they are " sucking your time". Wow!
Specializes in Surgical Specialty Clinic - Ambulatory Care.
KAREN CREWE said:
My point was, don't be brittle with someone trying to be helpful because they asked you what you need. You are going to alienate people with that harsh outlook. How lovely if a nurse, who I am sure also has plenty to do, could look at your overwhelmed distress and know which task would be the most helpful to you at that time, but if not and another busy nurse is being nice, don't cut off your nose to spite your face because she took another 15 seconds from you by asking what you need. Let's be sensible, not judgemental. Maybe that nurse is also having a rough day but still kind enough to care, and here you are thinking they are " sucking your time". Wow!
Look, you seem nice, not trying to bust your balls or anything, but it is apparent that your 38 years of experience have been vastly different than my 15.
I have worked at 10+ facilities, travelled, and worked in 6 different care settings/specialties. I have had to know how to take care of patients with 4 hours of orientation to a hospital. I worked ER for 8 years. I'm not trying to be a snot when I say it is not helpful to go up to someone overwhelmed and ask them if you can help them. I'm saying that it just doesn't work. It's like knowing that someone who just got told they had cancer can't hear the rest of the plan of care. You know they didn't get it all and you know that people get embarrassed to ask again when they know you just told them. So you anticipate this, educate, wait a while, educate again, wait a while, educate again. You anticipate they will forget so you write down clear notes, have print outs, and have a plan to call them in a few days after they get home to see if they have questions.
When a nurse is overwhelmed the same thing is happening. They can't think it through, they have a list in their head but can't get it out. It is easy enough to look at another nurses' team and orders and say "I'm going to pass your meds in this room, okay? I see this room has a dressing change BID, I have time to get that done right now.” Both of those responses ANTICIPATE what is needed and taken them of the overwhelmed nurse, which allows the frozen part of overwhelm to pass. Asking a nurse if you can help when s/he is to overwhelmed to come up with a response is just going to get you an automated "Uh, I don't know.” Or "I can't even think what needs to be done right now.” Which inevitably leads to the response of the person asking to say the next dumbest thing ever, "Well if I can help let me know.” before they walk off leaving the overwhelmed nurse hanging out to dry.
I have never gotten more than a 3% raise. The best 'raises' I've gotten are when I quit and go get another job....which is kinda why I quit every 2-3 years. My last quit and new job increased my salary by $10 an hour, but usually it is just $3-5 increase (which is better than the $1-2 increases would get staying.)
I don't really care to endear myself to anyone or organization. I tried earlier in this career to do that. It doesn't really help. I'm not suppose to have the solutions, that is what management and upper management is for. When I give my opinion of what would help (add staff, lessen the work load) I usually get told that is not an option. We have to do with what we have....well that is what is leading to the crap care we are giving.
I don't like to be forced into choosing to sacrifice time with my family, my body, or my bladder versus doing right by my patients. I always get told I do excellent patient care, of course I do, but I what is happening is that these organizations are abusing my caring nature and willingness to sacrifice myself for others to profit off of as I work myself to death and neglect my family. So no, I don't really give a *** about staffing shortages and will totally quit without giving it a second thought if my manager doesn't grant my vacation requests. I'm not a child, if I gave 1 week notice of a request, sure that would make me the problem. I give notice 6-8 weeks ahead of time, management better not tell me no the week before. You have 2 weeks from the time I submit my request to respond, less if I bought plane tickets (and I will let you know if I did), no response from management means I have it off. I did my part, do yours.
I sure as *** am not getting there early. I already regularly have to cut lunches short and stay late. Management can kiss my *** with that 1-3 minutes I am late in.
Sadly, low raises of 3% or less are pretty standard overall. As you found out best way to get a raise is to switch employers. Maybe endear was the wrong word as I don't believe in sucking up. Basically you've said your piece about the problems and disorganization and management has made it clear they won't fix it so I would let it go or you will just further antagonize them which won't help if you plan to stay there.
I can feel your anger and chip on your shoulder re the working conditions and the situation you are in and how it is impacting your relationship with your family. You are in a difficult position as the main breadwinner, while you have a young child at home; but you are not alone. Nowadays, many women find themselves in that position, a lot because they are single or divorced mothers. But in your case you have a stay at home husband that is retired that helps out if I remember right from past posts. And at my job there were a couple nurses with stay at home dads that could help with childcare, but there may have been relationship pressures as usually the mother wants to be with her children when they are little, yet the nurse makes the most or dad was out of job and mom had lots of student loans to pay off. However some of the nurses at the hospital would work the weekend program so they could stay with the children during the week and just work 2-12 hour shifts Fri, Sat or Sat, Sun. Down south isn't there the Baylor program for this option?
It doesn't matter to me if you are late to work. And if your employer doesn't mind that's great! As to vacation didn't you say you had problems getting time off for a vacation last year or was that a different employer or maybe I'm confusing you with another person? I think there should be understanding and flexibility and realizing that we are human with personal and family needs etc. I was only commenting on the corporate changes of penalizing even a minute late that a lot of corporate healthcare systems do. If yours doesn't that's great! I really resented it and all the other micromanaging BS.
My point was, don't be brittle with someone trying to be helpful because they asked you what you need. You are going to alienate people with that harsh outlook. How lovely if a nurse, who I am sure also has plenty to do, could look at your overwhelmed distress and know which task would be the most helpful to you at that time, but if not and another busy nurse is being nice, don't cut off your nose to spite your face because she took another 15 seconds from you by asking what you need. Let's be sensible, not judgemental. Maybe that nurse is also having a rough day but still kind enough to care, and here you are thinking they are " sucking your time". Wow!
I don't think the poster was being brittle with an innocuous person coming up to them asking if they need help. She is speaking about the person who has experience, knows the nurse/nurses are overwhelmed (and it is not just a one day occurrence) and knows staffing is crap. ie there's multiple call in's and they didn't plan or prepare accordingly, and thought the lowly nurse was going to pick up the slack.
we have all had different experiences, and I am sure prefer different approaches, I am not an old lady or one who cannot think on her feet. It certainly has not been a bed of roses, especially here in the USA where attitudes are very different. I have had more shifts than I can remember where I would have loved just one nurse to ask me if they could help. I started very young and have watched the evolution of nursing, the training, and the circles of life where we start to re-do things we decided were no good 15 years ago. Maybe there is no right or wrong and maybe what I am feeling is the frustration in your posts that makes it sound like you are being critical of people willing to offer help. Remember when statements are made that sound critical to others, they remain whether you intend it or not. All I am saying is to take the help offered without criticizing how it's offered. The nurse offering the help is likely not the problem, it's the management of designated care and lack of experienced support. Good to debate though!
I disagree that other nurses should just jump in, read orders, and do things without checking with you. Not only is that disrespectful of your autonomy and your relationship with that patient, IMO, it could cause errors, like a med or treatment getting done twice because you two didn't communicate. Also, the other nurse didn't get report on the patient, so they may not have the necessary clinical info to make sound decisions.
If you ask for help and are met with resistance, then go to your manager and tell her that.
I was going to say something similar. I think that, in addition to the above, you are expecting too much of your co-workers to expect them to just jump in, read orders, and start doing them without first asking you (and you said they do ask you if they can help you).
I don't know RN scope of practice in Texas, and I don't know RN scope of practice in the specific setting you work in - I think these are things to be aware of along with your facility's policy if you are the nurse who is given a patient assignment and various co-workers (you don't specify the types of licenses or credentials that the co-workers who are offering to help you hold) come up to you to offer to help you.
Specializes in Surgical Specialty Clinic - Ambulatory Care.
Susie2310 said:
I was going to say something similar. I think that, in addition to the above, you are expecting too much of your co-workers to expect them to just jump in, read orders, and start doing them without first asking you (and you said they do ask you if they can help you).
I don't know RN scope of practice in Texas, and I don't know RN scope of practice in the specific setting you work in - I think these are things to be aware of along with your facility's policy if you are the nurse who is given a patient assignment and various co-workers (you don't specify the types of licenses or credentials that the co-workers who are offering to help you hold) come up to you to offer to help you.
My general experience is that another nurse asking to help is an verbal courtesy, like a greeting, and not an actual offer to assist. The best actual assistance I ever got was working in the ER, but that is because people don't tend to ask as much in the ER, they just do.
But I guess I'm glad other people are experiencing the offer to assist is a verbal greeting thing...although I really don't know how that is possible as I've worked in a lot of states and facilities, but good for you. Overall I'm just burnt with the bureaucracy and the lies. I'm so disillusioned with this profession that I honestly don't know how others find value in the crap we call care in the USA. I'm sad that I've wasted so much of my life in it and if I could drop it and make the pay I do now, I would try something else in a heartbeat. But ,financially, I have a decade left and probably more.
I'm not being boastful, I'm a good nurse. I have lots of cards, letters and recognition for my abilities and I hate it.
I have never gotten more than a 3% raise. The best 'raises' I've gotten are when I quit and go get another job....which is kinda why I quit every 2-3 years. My last quit and new job increased my salary by $10 an hour, but usually it is just $3-5 increase (which is better than the $1-2 increases would get staying.)
I don't really care to endear myself to anyone or organization. I tried earlier in this career to do that. It doesn't really help. I'm not suppose to have the solutions, that is what management and upper management is for. When I give my opinion of what would help (add staff, lessen the work load) I usually get told that is not an option. We have to do with what we have....well that is what is leading to the crap care we are giving.
I don't like to be forced into choosing to sacrifice time with my family, my body, or my bladder versus doing right by my patients. I always get told I do excellent patient care, of course I do, but I what is happening is that these organizations are abusing my caring nature and willingness to sacrifice myself for others to profit off of as I work myself to death and neglect my family. So no, I don't really give a *** about staffing shortages and will totally quit without giving it a second thought if my manager doesn't grant my vacation requests. I'm not a child, if I gave 1 week notice of a request, sure that would make me the problem. I give notice 6-8 weeks ahead of time, management better not tell me no the week before. You have 2 weeks from the time I submit my request to respond, less if I bought plane tickets (and I will let you know if I did), no response from management means I have it off. I did my part, do yours.
I sure as *** am not getting there early. I already regularly have to cut lunches short and stay late. Management can kiss my *** with that 1-3 minutes I am late in.
Medicines and orders are administered via computer and a scanner. There is little to no chance of double admin if meds are passed appropriately, so yes, it is perfectly safe to just look at orders and help. Maybe look at the order and say, "Hey, so n so, if you have not passed meds to RM 12 I can do that.” It is more helpful than the dumb open ended question of "What can I do to help?” If you are a nurse you can plainly see what needs yo be done, TELL THEM WHAT YOU WANT TO DO TO HELP! Way more helpful than the other way around. And if you are the kind of nurse that finds people picking up and doing stuff without asking disrespect it is probably because you are a control freak.
I don't blame you for changing jobs, The point you make about pay increases is interesting.
I work nursery/NICU, so things are a little different. We are better staffed than most other units in the hospital.
I am not a control freak. Since my care includes the baby's parents, I like to maintain a relationship with them. Continuity of care is important, and so is making their baby's first few days memorable and special. Sometimes I've made a plan with the mother to help her with a breastfeeding difficulty or to ensure the father can be present for the first bath. If someone jumped in, they might not know our plans and might handle things differently than the way I had managed the parents' expectations. It's not a huge deal, but I try to follow through on what I've set them up for.
As far as getting to work a few minutes early, I do that for ME, not for my employer. I have a better shift if I have a few minutes to put my bag down and get my head in the game.
I refuse to start work before I clock in unless there is a code or some similar crisis.
I treat others the way I want to be treated. I prefer the open ended question, so that is usually the way I phrase it. A nurse knows what the priority task is among her patients is (a baby needing its blood glucose checked would come before one needing a bath) and what would help her most. It isn't always the obvious thing.
BeenThere2012, ASN, RN
863 Posts
In my recent situations asking for help was more difficult as all the other nurses were just as "overwhelmed " as I was, including our supervisor, who BTW, was also taking assignments. Time management can be an issue for some. However, urgent situations that come up with a patient, bad timing for admissions, and time sensitive tasks don't know what "time it is". I also agree that a unit that is not well organized adds an extra burden to one's ability to work efficiently, such as supplies not evenly distributed or stocked, other departments such as pharmacy for example, don't answer the phone and you end up having to call multiple times, results from the lab aren't entered in a timely manner, and so on. Short staffing in multiple departments have a ripple effect on everyone, and there are times when other department's needs force you into a corner when your butt is already backed in as far as it will go. Not their fault, but when ER's or PACUs are backed up and demanding you take their admission/transfer before you are ready, add to the chaos.
Therefore, when a nurse has criticism in writing on his/her record for "time management" issues and the manager knows full well there are not enough staff, I think that's not fair, and frustrating as hell for the nurse. That sort of thing has made me loose respect for that manager as you want to say, "How about you take a few shifts and then tell me about time management?”