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Pinky89 6,560 Views

Joined: Jan 10, '13; Posts: 22 (50% Liked) ; Likes: 58

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  • Nov 23 '15

    As an old, seasoned nurse, now retired I have watched nursing get harder and harder, working with sicker and sicker patients with less resources. How long can this continue? I've read lately about nurses who need antidepressants and anti-anxiety meds just to be able to come to work each day. And we all nod and say that's just how nursing is now. I read about nurses who cry and dread each day that they have to come to work, working in fear of making a mistake. The horror, a human being might make a mistake. And then I read other nurses who say, "we should never make mistakes, we should triple/quadruple check everything we do because the poor patient should not be harmed in any way, ever." What utopia do they live in? And yet we have to drop everything that we are triple checking to run and get a family member an extra pillow or a soft drink or risk being reprimanded.

    What other career puts such a burden on it's members? I can't think of any that routinely have members dreading to come to work and needing medications to get through a shift, maybe airtraffic controllers, or combat soldiers. I don't know.

    And then we tell ourselves that we should be happy that we're lucky to have a job. Really? What is so lucky about this?

    I started nursing 40 years ago on a busy labor and delivery unit. I was afraid at times. But there was a support system from the top down. Director of nursing, nursing supervisors, head nurses (they weren't called managers back then) and the shift charge nurse, everyone pulled together. I miss that. I left hospital bedside nursing 10 years ago because of the lack of support and teamwork, and the increasing focus on the patient "experience" versus a positive outcome of disease or injury.

    I don't have an answer, well I do but for some reason, nurses I have known don't want to talk about solving problems for their profession. We're great at solving everyone else's problems but not our own. How long can this continue? I feel sorry for new nurses and for my older colleagues as well.

  • Nov 22 '15

    Those who say her actions were "pathological" sound desensitized from years of nursing. Setting and maintaining boundaries are important, but what I read in her article is a caring compassionate nurse who did the right thing at the end. I would not want any of you nay saying robotic nurses taking care of me or my family.

  • Nov 21 '15

    Quote from llg
    Exactly. The OP would not have gotten in trouble with her boss had she reported the situation right away. She could easily said, "This just happened. I tried to not accept it, but he insisted ... and I couldn't get away from it. What should I do?" Such a report would get no one in trouble. It would get them help and support from their management. To keep a possible policy and ethical violation a secret is far more dangerous.
    It would depend on the supervisor or manager. There are a few, fortunately only a few, managers, supervisors and even coworkers who are vindictive and would gladly "throw a fellow nurse under the bus," to try to prove their own "superiority."
    I do not believe that I have ever been offered money from a patient/patient's family, I worked in an area hard hit by the loss of a large company and many of my former patients were uninsured and working two or three jobs to just survive. I have accepted small, inexpensive, tokens of appreciation. One was a refrigerator magnet that I received many years ago and still makes me smile when I see it. I treasured the notes sent to the unit and the unasked for positive feedback to my manager. These are all more valuable than gold.
    Would I have accepted money, no, but, those of you who were the most critical, please cut this younger nurse some slack, he/she is still learning. In fact, all of us, young to the profession, seasoned professionals or retirees, should never stop learning.

  • Nov 21 '15

    Quote from elkpark
    I would actually prefer to have a nurse who understands and maintains appropriate professional boundaries, and would consider it kind of "icky" if a nurse followed me to another part of the hospital to check on me. And even the OP knows that she did something wrong (professionally "wrong" as well as, most likely, a violation of her employer's stated policies) -- that's why she knows she shouldn't mention it to any of her coworkers.
    Developing a healing atmosphere and a healthy relationship with your patient is essential for that person's health and well being. So, are you saying that this nurse should not be as attentive, as caring, as compassionate as she is, because that is crossing a "professional" boundary?
    Clearly the family members did not consider it "ICKY".. I'll ask for Pinkey as my nurse please.
    The thought that you find it detestable is a sad state of the trend of nurses today. The only possible, and questionable "violation" is the acceptance of money, if it were over her allowed amount set by the hospital. Other than that...

  • Nov 20 '15

    OP, it's fine. You did fine.

  • Nov 20 '15

    Quote from MrNurse(x2)
    So my question is, if it is so unprofessional, why do doctors, lawyers and accountants take gifts such as sporting event tickets, gift cards, souvenirs and yes, even cash as gifts? Nurses are so irritating when it comes to supporting one another. Why must we continually berate, chastise and have an overall nasty tone to each other?
    I completely concur with your assessment. We are no longer professional, when we are so willing to "throw our coworkers under the bus." Other professions do not seem to do this.

  • Nov 20 '15

    My hat is off to you, Pinky. You seem like such a kind, giving, kind hearted nurse. I became a nurse, but shortly after getting my license and actively applying for work, I became a patient. Being on Allnurses helps me to still connect with you nurses. Nursing runs through my veins and is very dear to my heart.

  • Nov 18 '15

    Quote from Been there,done that
    Yes.. I said it was unprofessional.

    Standards of Practice state:Nurses use professional judgment to determine the appropriate boundaries of a therapeutic relations
    nurses do not exchange gifts with clients
    The relationship differs from a social relationship in that it is designed to meet the needs only of the client.
    Even suggesting the husband give kudos by a survey violates that standard.

    Professionals do their job, go home and forget about it.
    Now that I am retired, elderly and although still cogent, but not in the best of health, should I or a loved one need to be hospitalized I would prefer the nurse who was able to connect with her patients. It is sometimes impossible to "just go home and forget about it."

  • Nov 18 '15

    The general reaction to this person's post is one of the fundamental problems in nursing as a career...a bunch of you jumped all over this nurse for giving in and accepting a monetary gift from a patient's family. (S)he tried to politely decline the gift but was afraid to insult the family member. (S)he ended up doing something positive with the cash, rather than keeping it. Are we all perfect? No. Are we all so good that we don't need to learn something new? Absolutely not. We are all human, we make mistakes, and we care about others. A bunch of you also mentioned that this nurse also went to check on the patient in the step down. There is nothing wrong with this either. It only crosses lines if addresses and phone numbers are exchanged and long term friendships are formed. Some of these posts sound like a group of jaded, burned out people to me. Embrace this (presumably) younger nurse for his/her caring, refreshing, unburned out attitude. He/she is a credit to our profession.

  • Nov 18 '15

    Quote from llg
    If the family really would not take the money back, she could have -- and should have -- reported it to her supervisor immediately. Also, she could have told the family that she would be turning the money over to the management if he did not take it back.

    There is nothing wrong with caring ... or giving a patient or family member a hug ... etc. But taking the money is wrong and she should not have done that. Period. If she was incapable of getting the family to take it back, she should have gone to her supervisor and asked for help in doing the right thing.
    Apparently you forget that some cultures would be highly offended if she did not accept the gift. Her donation to the charity supporting research on her patient's illness was the correct choice and the one she wisely made.
    There was no need to jeopardize her professional future by reporting this issue to "management," a management person that may either not understand other cultures or be vindictive.

  • Nov 18 '15

    [QUOTE=llg;8790560]No, I didn't forget. The nurse needed to tell the patient than in this country/culture it is considered inappropriate for her to accept such a gift ... and if he will not take it back, she would be obligated to pass it on to her supervisor. She could/should say this with utmost kindness and respect and reiterate how much she appreciates his generosity.

    And as for not telling her supervisor -- that's risky. It would be unlikely that a supervisor would get a person in trouble if they went immediately and reported, asking for help in resolving the situation. But to take money from a patient and NOT tell makes it look as though she encouraged the gift -- and might be taking money from other patients and families as well. Hiding it is the worst offense in this case.[/QUOTE

    My nursing education was in a large, metropolitan, very diverse area. Our nation has become even more diverse today. It sounds demeaning and disrespectful to cultures that differ from one's own to "remind" the patient's husband that s/he was not of his culture or nationality. What happened to this nurse is unusual, as most patients or families usually just show gratitude with words, or letters of appreciation. However, unusual situations arise everyday. Under the circumstances I still feel what she or he did was correct and the money apparently went to a good cause.
    Reporting this to her/his manager was completely unnecessary and could compromise this nurse's future at that hospital. What would "telling" her/his manager accomplish? Would the manager take the patient's husband to task for giving the gift, in turn possibly insult the gentleman's belief system and breach confidentiality between nurse and patient/patient's family.

  • Nov 18 '15

    OP, I would not let any one on this page that is not treating you medically or psychologically to say that you have a pathological disorder. Also, I would not let anyone tear down your self esteem and nursing practice by calling you unprofessional. However, I will say that as a nurse it is necessary to draw a line between providing compassionate care to your patients and overstepping boundaries as a professional. Many excellent nurses that I work with struggle with this. While I wouldn't believe everything that was said in this thread, I would suggest that you read some of the comments and take them into consideration.

  • Nov 18 '15

    So my question is, if it is so unprofessional, why do doctors, lawyers and accountants take gifts such as sporting event tickets, gift cards, souvenirs and yes, even cash as gifts? Nurses are so irritating when it comes to supporting one another. Why must we continually berate, chastise and have an overall nasty tone to each other?

  • Nov 18 '15

    We are human and at times we become attached to a patient. I think this may happen more so when we are new and idealistic, but even when we are older and experienced someone may come along that touches your heart. They obviously felt the same way when you came to visit. I wouldn't tell anyone ie your coworkers about the money and giving it to charity was a good idea when he wouldn't take no for an answer. You may even want to confess, but I don't advise it in the real world someone can be too open and honest and it can be used against them as you can see just from some of the negative responses you are getting here! My advice just let the guilt go and leave the patient in God's hands as you've done all you can.

    You may never face a patient/family giving you money again. If it happens just suggest they do something for all the staff instead like pizza or cookies, something that can be shared with all the caregivers.

  • Nov 17 '15

    Of note, I am specifically not posting this to the NICU forum since NICU nurses already know this stuff (and probably take it for granted). Rather, I think many of the non-NICU nurses might find these quirks surprising, shocking, and amusing. So without further ado....

    Ways the NICU is its Own Little World

    To bathe our patients, we literally place them in the basin that adult nurses use to wet their washcloths. Many NICU nurses have not done the 'roll the linens under your patient' technique since nursing school, because you can lift your patient with one hand. When our patients are acting out, we can swaddle their arms up next to their bodies like a straightjacket, but we don't have to document on restraints q 2.

    A 'big juicy vein' in the NICU resembles a capillary in an adult. It is not uncommon for NICU nurses to use rubber bands as tourniquets. And we especially love starting lines in babies' heads. In fact, you can walk a pale, bald baby around a NICU and hear nurses say, 'Look at those veins-you sure he doesn't need an IV?' Although the veins are tiny we're lucky when we start IV sticks because you can literally hold a light up to your baby's limbs and see all of vasculature.

    You can also use a flashlight to find a pneumothorax; a pneumo will glow when you hold a bright light up to a neonate's chest. Babies are basically tiny glowworms. We draw almost every lab the same way you a check blood sugar. We poke a capillary bed (in the heel of the foot rather than the finger), and scoop the blood drops into a tube, literally drop by drop. The technique goes squeeze, drip, scoop, repeat.

    We use straight-up sugar as a pre-med for lab draws, art sticks, and circumcisions. Babies are so sucrose-naïve that a 20% sugar solution (less than the concentration of sugar in soda!) serves as an anesthetic.

    A systolic blood pressure of 50 is acceptable, a heart rate of 60 is dangerously low, and we don't become truly concerned about blood sugar until it drops below 25.

    It is perfectly acceptable to cuddle your patient in your lap while you sit and chart. It also isn't offensive if your patient grabs your boob. Our tiniest blood pressure cuff will fit around your pinky finger. The concept of IV push doesn't exist. Every bolus is given over a syringe pump, which 'pushes' the syringe for us at a controlled rate.

    For an 'advance feedings as tolerated' order, a generous feeding advance would mean the baby gets an additional 8 mL of milk or formula q shift.

    A 1 lb baby is small, a 3 lb baby is medium, and a 5 lb baby is large. On the rare occasion that we get a term baby on the unit (i.e. 8 lbs) we practically consider them a toddler. We can, however, have babies up to a year old on the unit if they've stayed with us since birth. We sometimes have kids who can smile, giggle, and get to watch the Wiggles on DVD. It isn't shocking to find two patients sharing a single bed.

    Calling our patients "honey," "sweetie," or "darling" is encouraged, and greeting your patient by saying "hey handsome boy" will not result in a lawsuit. It's totally acceptable in rounds or report to use the phrase "he had a big poop."

    It's a whole different world down here, and we wouldn't have it any other way.