Nursing Work Ethic

[luvbug9956]

I had an interesting discussion with my husband this evening about the differences between nursing and other professions. My husband is a contractor and has had a lot of experience with "bad employees". I was talking about how HARD it is for someone to get fired in the nursing profession.

I love that nursing has a sort-of unwritten policy regarding education vs. discipline. For example, if a med error is made, most of the time it is the job of management to re-educate and determine what happened rather than discipline the nurse; I mean, we are all human and make mistakes...our mistakes just tend to have an impact on peoples' lives and health!

What I have a huge problem with is the tendency for this to extend to issues with work ethic! I have worked with many nurses who have:

1. horrible attitudes and tend to display these attitudes in public spaces (i.e. the nurse's station)

2. attendance issues (calling in repeatedly or just not showing at all!)

3. refusal to comply with policy or changes in policy

When speaking with my husband, who manages people, these are all fireable offenses in his line of work, or at least disciplinable (is that a word??). Yet, in nursing this just seems to be par for the course! I am all for the educational approach with nurses who make honest mistakes...I completely disagree, however, with how much some get away with in other areas! I can't believe that in an office setting, an employee would get away with yelling at another one in front of customers without at least getting a stern talking-to! I mean, are we really that desperate for nurses!

Being someone with a good work ethic, I find that those with bad work ethic negatively affect my job. When I first started nursing, I thought that this was a problem with my nurse manager on that unit, but I have seen it time and time again with other managers in other departments. Just wanted to vent!

[Babarnurse]

Those are all dismissable at the hospital I work. So, it may depend on the hospital? In fact, the hospital I work at has a VERY strict call in policy. Dr's excuse or not, it doesn't matter. I think they are on the "too strict" side, because people do get sick. I also have a problem with management not addressing the "problem" children and making blanket policies that impact everyone.

[Daytonite, BSN, RN]

I don't know where you're working, but in many of the hospitals where I've worked some of that stuff just didn't fly. I was also a nursing supervisor and manager. I spent a good deal of time tracking employee attendance and in one particular facility we had behavioral objectives that had to be addressed with every single employee as part of a customer service program. I've had to fire a few for bad attendance. Believe me, I knew the disciplinary process to the letter. Part of my job was making sure that policies and procedures were followed. Sometimes it's hard to achieve that when everyone is working independently with individual patients.

If you just read some of the posts on the various forums you will get a flavor of how rebellious many nurses are. Some, I think, feel they are beyond the rules. I have no idea where that idea came from. Some poo-poo customer service if you mention it. In one facility that I worked the employees mockingly referred to the customer service inservices that they had to attend as "charm school". It may be part of the American way. I don't know. But, I can tell you that these employee behaviors are going to be enforced only as much as the manager behind them enforces them. I worked for one DON who was a "by the rule" kind of person. But, I've been in other places where it was a more laissez fair attitude. A lot of people want no part of management. Read some of those posts on allnurses. There seems to be disdain for leadership. Rebellion again? Fear of how others will treat a person in a leadership position because they've been participating in that disdain? What it does, I believe, is allow people who want to be in management get those positions whether they have any ability for the job or not since people are needed to fill those roles.

I'm more in favor of rule following. Anarchy results if rules aren't followed. Then, you get into situations of every man for themself. Of course, my mother was a combination of Judge Judy and Dr. Laura thrown together and I grew up in the 50s and 60s with parents who didn't think twice about grabbing a belt and whacking us when we didn't obey.

[jojotoo, RN]

I'm more in favor of rule following. Anarchy results if rules aren't followed. Then, you get into situations of every man for themself. Of course, my mother was a combination of Judge Judy and Dr. Laura thrown together and I grew up in the 50s and 60s with parents who didn't think twice about grabbing a belt and whacking us when we didn't obey.

Sounds like you lived at my house! I know that if we said we were too sick to go to school, that meant you stayed in bed all day - no TV, no reading, no listening to the radio. We were actually glad to go back to school. But don't you think that WE have the better work ethic because of it?

[fakebee]

One of the things that I think encourages bad attitudes, poor attendance, slovenly appearance, and substandard work ethics is the fact that

nurses are paid based on experience not on performance. I have this discussion all the time at work. I believe if you can take any patient that rolls in the door(balloon pump, LVAD, ECMO, CRRT) you should be paid more than someone who refuses to learn these assignments and remains comfortable in their realm of GI bleeds and COPDers. Likewise if you demonstrate that the patients you take care of have a lower incidence of line sepsis, aspiration pneumonia, and ventilator acquired pneumonia because you use aseptic technique, perform proper oral care and follow protocols that insure good outcomes than the bookreaders who keep the head of bed flat, miss their dressing changes(too busy), or allow their patients mouths to crust up like a shipwrecked sailor drinking saltwater. Nursing tolerates laziness and poor care in the name of the nursing shortage...I was taught in the Army to set high standards, check behind people and reward high performers, motivate marginal ones and retrain or release those who just can't or won't make the cut. Please don't tell me nursing isn't like the military- I can't think of another profession where teamwork and high standards are so crucial to successful outomes. Everyone has to contribute in a positive manner. Rant over:balloons:

[icuwant2rn]

One of the things that I think encourages bad attitudes, poor attendance, slovenly appearance, and substandard work ethics is the fact that

nurses are paid based on experience not on performance. I have this discussion all the time at work. I believe if you can take any patient that rolls in the door(balloon pump, LVAD, ECMO, CRRT) you should be paid more than someone who refuses to learn these assignments and remains comfortable in their realm of GI bleeds and COPDers. Likewise if you demonstrate that the patients you take care of have a lower incidence of line sepsis, aspiration pneumonia, and ventilator acquired pneumonia because you use aseptic technique, perform proper oral care and follow protocols that insure good outcomes than the bookreaders who keep the head of bed flat, miss their dressing changes(too busy), or allow their patients mouths to crust up like a shipwrecked sailor drinking saltwater. Nursing tolerates laziness and poor care in the name of the nursing shortage...I was taught in the Army to set high standards, check behind people and reward high performers, motivate marginal ones and retrain or release those who just can't or won't make the cut. Please don't tell me nursing isn't like the military- I can't think of another profession where teamwork and high standards are so crucial to successful outomes. Everyone has to contribute in a positive manner. Rant over:balloons:

:yeahthat: :yeahthat:

[anonymurse]

I love that nursing has a sort-of unwritten policy regarding education vs. discipline.

I don't know how things are now, but when I was in the Air Force, personal accountability extended to the point that if your troop flunked his training twice, he was history and you were invited to explain how such a thing could happen to the Wing King in person, the guy on top of the local dogpile of 5,000 or so military members. Now imagine if you were orienting a new nurse and you knew the CEO of the hospital would call you on the carpet over that nurse's successful fit with the organization. I think that's the way it ought to be, the personal accountability extending to those you're responsible for, above all, those in training. The real enemy anywhere is the "I got mine" mentality. But when the Big Dog feels his responsibility to his trainees keenly enough that he is willing to set aside time to examine each training failure himself, you have the potential for--let's call it a positive accountability cascade.

[Daytonite, BSN, RN]

Sounds like you lived at my house! I know that if we said we were too sick to go to school, that meant you stayed in bed all day - no TV, no reading, no listening to the radio. We were actually glad to go back to school. But don't you think that WE have the better work ethic because of it?

Well, actually, we hardly ever saw my father because he was either working or sleeping because he had to go to work. I think seeing that kind of behavior is what drives the work ethic home. My three brothers are the same way--working from dawn to dusk. On their days off they're still doing some kind of work around the house or in the community. I also think that there's an ADD gene in the family. Some of their kids (2 of 2 different brothers) were diagnosed with it and on Ritalin for years.

[dorrybnursing]

I work in a nursing home and all of the behaviors that you mentioned occur on a regular basis. We even have "no call, no shows" that somehow keep their jobs. One day management came by to tell us (those of us that showed up for work) that 45% of the staff had called off on a particular day. I said of course if this is tolerated it will continue to happen. Some how they don't get the correlation.

[Tweety, BSN, RN]

I disagree that it's par for the course in nursing because that insults the whole lot of us.

I will say that there are a couple of people that would be fired were there not a nursing shortage. One comes in 30 minutes late daily. No excuse, no kids, no reason other than laziness. Another has a real bad attitude and gets frequent complaints from coworkers and patients. Oh, and another tech that has abused attendance policies.

Other than the above the rest of us are working are butts off every day.

[luvbug9956]

I totally agree that most of us are VERY hard-working and I am sorry if it came off that way that I was putting down the rest of us hard workers, but don't you find that the few that are not seem to have a very poor influence over the rest of the team, causing lower morale and frustration?

[Havin' A Party!, ASN, RN]

What Baba said.