Newbie with mileage

FlorenceNtheMachine · Dec 31, 2012

I think it is easy to idealize it when you are a student! I do!

I try to keep my prisms and rainbows to a minimum in the workplace. It can annoy others when the new person rides in on their unicorn ejecting sunshine out of their rear.

But keep on, it sounds like you have life experience. Give all as long as you can! Good luck to you, job satisfaction comes from within I think.

ZenLover, MSN, RN, NP · Dec 31, 2012

I agree completely Florence. I probably have annoyed some with my "rainbows" in the hospital. Which is funny, because outside the hospital I prefer to be a loner with very few but close friends. My sense of humor hits on a darker side for most...so it is almost funny that I would be that annoying rainbow anywhere at anytime. LOL

dudette10, MSN, RN · Dec 31, 2012

I used to feel the way you do in nursing school, and I would venture a guess that most nurses did. Then, the reality of the floor hits. I think it's good to keep your idealism of how to care for patients because you will use what little downtime you have with the soft skills of nursing and digging deeper into their needs to advocate for them. That said, I have to defend/explain the "I'm not a servant" posts, from my own perspective. When you are trying to prioritize patients' needs vs wants for multiple patients--and depending on their functional level and the availability of self-service areas on a unit--a patient requesting a juice not available on the floor or a wish for potatoes instead of rice on their dinner trays requires a call to dietary, and their delays are misdirected toward you. The request for another pillow from an ambulatory patient when all of the pillows on the floor are being used by bedbound patients requires a call to supply, and their delays are misdirected toward you. That's frustrating, and that's where a lot of the "I am not a servant" posts come from, in addition to serving the family members in the room with similar requests.We all want to be the nurse you describe, if I can be so bold as to guess at the mindset of other posters here, but the work environment and chaos sometimes prevents us from being what we want to be, and we vent about it in terms that not-yet-nurses don't understand. Don't, however, lose your idealism. As long as you temper it with reality, you can do the best you can without completely losing your mind. Oh, yes, you'll have a nasty shift where you just need to get it all out, then return to your regularly scheduled program. Good luck!

BrandonLPN, LPN · Dec 31, 2012

I think people are mostly just venting. Especially in the hospital, it can be maddening when pts and families act as if they are staying in the Four Seasons or something. That's our entitlement culture for you. But I (and most of us) have no problem "serving" people when they need it. Sometimes, when I have a family staying with a very ill or dying pt I will ask the visitors if I can do anything or get them anything. Sometimes that's a very "nursey" and therapeutic thing to do.

ZenLover, MSN, RN, NP · Dec 31, 2012

You make a good points dudette10. I don't think the way the system is set up is always ideal for nursing and I imagine it could be a source of huge frustration to feel powerless to change that, even if your first priority is to advocate for your patient. Spending years in admin has taught me some hard lessons. It is like being told you are hired to be a painter, you are given tons of space to paint and you are told the paint can found somewhere, but they don't know where...supplies are not even addressed. I can get that...but those few quiet moments at the bedside at the moment drowns that out for me. I hope it always does. Ideally providing great patient care and being a great nurse would mean being their for everyone I work with too though, so hopefully I figure that out quickly as well and will be an approachable shoulder to vent with. Thank you again for making some great points.

wish_me_luck, BSN, RN · Jan 1, 2013

Bahahaha, Florence, the riding in on a unicorn with sunshine coming from their rear cracked me up. Thanks for the laugh! :)

AnonRNC · Jan 1, 2013

Patient conditions in my specialty area can range from incredibly stable and boring to on-the-edge, minute-to-minute critical. I recently had a light assignment with very stable patients. I was happy to have time to offer ice water and extra pillows to the visiting parents.

BUT:

1. They did not expect those things, nor have a sense of entitlement about them, and

2. I did not have another patient with urgent needs.

Nurses get upset and and post the kind of posts you refer to when they are being pulled from patients with urgent medical needs to provide customer service to other patients' visitors so that the patient 'experience' surveys will look good.

Additionally I would add this. If you put nursing tasks on a continuum from holding a hand to running to code - with everything else in between, you'll find that each nurse is most comfortable at a different point on that continuum. While I do have compassion and empathy, my vision of myself as a nurse looks more like running to a code. ALL of our tasks are important to our patients, and it's okay if we each have a slightly different focus.

roser13, ASN, RN · Jan 1, 2013

...but those few quiet moments at the bedside at the moment drowns that out for me. I hope it always does.

That's the problem with preconceived notions (and we all had/have them).

What if you almost never get those "few quiet moments at the bedside"? Will you still be able to feel that you provided excellent patient care?

What if the only times you see each of your 6-8 patients in a 12 hour shift is a 5-minute assessment and to quickly administer meds throughout the shift? Will you allow yourself to acknowledge that you did the best that you could with the assignment that you were given?

Having lofty ambitions is admirable and certainly not wrong, but you must be prepared for the reality that is nursing. Lurking here is a great way to equip yourself with realistic expectations. Realistic expectations help you transition from student to nurse without losing confidence in yourself.

ZenLover, MSN, RN, NP · Jan 1, 2013

I guess it is hard for me to answer that Roser13. My most recent experience was on a Cardiac Stepdown unit in a Level 1 Trauma hospital. Nurses are assigned 4 patients at most, 3 if one is on dobutamine drips or is a *pink* patient that require more assessments. They try not to assign 2 pink patients to a nurse, but if she has two then they try not to assign her anymore. In that scenerio you very often have time for at least a 5 minute conversation and you kind of have to for your assessment in terms of knowing if they are still "with you".

On a med-surg floor where you are assigned 6-8 patients...you are right, at this point I probably would struggle greatly and will have to cross that bridge when I come to it. Hopefully I would find some way to get the job done, drown out the outside noise and focus on patient care though it definitely wouldn't look the same. That is why I am leaning towards palliative care. Maybe I am not cut out to do what you do, but I may have to with this job market. It is what it is and we can only do our best.

chinacatRN · Jan 2, 2013

I've worked LTC for the past 2 years and many times I've felt like a servant. In nursing school, I felt like you do - and there are those nurses you can tell who are on the verge of burn out and they're having a bad day and everything is making them upset.

But no matter where you work - LTC, med-surg, PINS, ICU, Cardiac, whatever - you have one or two of those patients or residents who is very attention seeking and/or needy.

I've had residents who hear me pass by their rooms and call out, "NURSE!" just so I can come in and grab them a tissue. When they are completely capable of wheeling themselves over or even just reaching over to get it themselves. That's when it becomes irritating and ridiculous. Or, in LTC mostly, you get those residents who become irritated when they can't be pushed back from dinner IMMEDIATELY even though they're perfectly capable of wheeling themselves back and are careplanned to wheel themselves back because they need the exercise. Or there's patients/residents who want you to move the curtains around half a dozen times or find the correct channel on the TV. When lots of these types of things happen in a shift, then I feel like a servant.

I don't feel like a servant when someone needs a pain med or when the CNA needs help transfering or cleaning someone up.

I agree that sometimes people just need to vent. Sometimes you're pulled so many different ways and there's so many things to do and the next thing you know your shift is over and you've realized you've haven't eaten anything or even taken a bathroom break in the last 12 hours. That's when it's difficult to take. Especially when it happens often. I don't know about hospitals, but in LTC it's especially frustrating because (during the day shift anyway) you have the DON doing nothing - you look in there and she's sitting at her desk, unwrapping hershey's kisses and staring at the computer screen, yet you and the CNAs are running around like crazy trying to take care of everyone and answer the call lights. It's frustrating when capable people are sitting on their behinds while you're running around.

beeker · Jan 2, 2013

I want to share some thoughts and hopefully get some back from all of you about how a nurse ideally wants to practice. I will be graduating with a BSN-RN in less than a year, but have 15+ years experience with healthcare and extensive personal experience with loved ones passing on. I have battled self esteem issues and demons of my own, I have done my best to be a good friend and help those struggling along as well....I have cried alone and been a shoulder. I know in comparison I am not "old"...but definitely have days that I feel it. Life experience is an incredible teacher is my point I suppose.
With that being said I am a little taken back when I see a lot of threads where nurses complain about feeling like servants or like a waitress to their patients. I understand feeling sad if you feel disrespected or if you feel pressure from people who don't know better to work in a way that is against your top priorities at the moment. I am however all about holistic treatment and my biggest battle will be that I probably have too much empathy. I know what it feels like when you want to be healthy and your body is presenting an argument and you suddenly realize you have no control over the argument at the moment. I know what it feels like to be a family member desperately wanting your loved one to be okay and it just isn't or won't be so...it can make you crazy and behave in ways you normally would never. I guess my point is that ideally I want to be a nurse that doesn't just deliver meds, but works to the best interests of my patients and I think that should include helping them in any way, the situation, the family or whatever should come up to the best of my ability and time. I know I won't have time for everything, but if it makes a patient feel better to have her legs rubbed while she cries to me about the fact that she can not be home with her grandkids...I am okay with that and feel compelled to do so.
I guess I would like to hear some of the more experienced nurses thoughts on the feeling of being a servant. Personally I feel privileged and it makes me feel good to provide someone momentary comfort in an awfully stressful situation. I have no problem with it. Is there a line however? Does my thinking have me in danger of burn out? I definitely felt burn out in my previous life of dealing with "paperwork", fighting insurance companies and feeling like I was more of a problem than a solution. So perhaps burn out has more to do with your personality and what drives you? My clinical instructors encourage me and say that nursing is sometimes a gift you are born with. Some of the students and floor nurses I have worked with have made comments to me about burning myself out with such thinking and that providing massages or too many snacks to a needy patient is not necessary. They laugh and say "better you than me" or get angry and say that because I was too nice during their shift the patient will now expect more of them later and they just don't have the time I do. I don't want to make anyone's job harder...the point is to help, everyone.
Perhaps being a newbie and not working yet I don't get it? What is a good stance to take when practicing? Is there a balance to be taken and perhaps I am going overboard? I want to be a nurse and the very best I can be the rest of my life....not burn out in 5 years. I am thinking palliative care might be the best place for me, so perhaps it is about the population of patients you work with?

Your perspective will change eons with a year or two of nursing experience under your belt. The firt year really does change you, and not in a good way.