This is a bit of a vent, but a timely one. I love working with a very diverse team on a busy med/surg floor. As we are now in Spring, we have many new orientees and again I have been asked to bring a few of them along as a preceptor. Every year it just strikes me how more and more irritated I get with some basic professional behaviors that normally don't tick me off this bad, but really get my hackles up when I find myself saying to a new nurse "well, the professional way to handle this is..." Sheesh! I shouldn't have to even have that conversation with a new grad when observing behaviors and interactions with our existing staff! Here are my top two for Spring 2015:
1. Our shifts are 0645 - 1915. I have worked nights and days and still CAN'T STAND IT when it comes to being on time for either shift. If you are coming off shift, I get that sometimes patient care delays being ready for report, BUT when you are the oncoming nurse, there is no excuse. "On TIME" means ready to take report right at 0645 or at 1845.. It does not mean, "I clocked in at 0645, but let me set my bag down in our locker room and get my stuff and fill my water bottle/coffee cup/etc."
2. It is isn't appropriate to have your smart phone out on the floor. I don't care if you were using the calculator function, or the drug look up. Those tools are available on our mobile carts and are provided by our employers (which BTW, you SHOULD be using resources provided and approved by your employer per most P&P!) But let's be honest, there is a different "tap" to being on FB, twitter, or texting than there is to using a tool. As a school teacher friend of mine once said to me, "I tell my students that I always know when they are texting on a phone. It just seems unnatural that you have been looking at your own crotch for that long while smiling, smirking, and laughing."
Nurses who get away with things just because they know or are family members of higher ups.
I worked somewhere, this guy didn't get his TX license but they let him work there even after his temp license expire. Of course any other job would've given him the boot, but because he had family ties, he was able to stay (making better money than I was making, which I thought was bs too). He did secretarial duties but it irritated alllllll of us off since he was able to stay until he got his TX license. He didn't even know IF he was going to get his license.
The knowing someone thing can allow some people to get away with much more than I ever dreamed...but I have witnessed it as well.
Seeing nurses throw each other under the bus for anything while NEVER seeing docs do the same to their peers even when I have seen some boneheaded decisions or under-thought orders.
I have heard docs throwing their peers under the bus during rounds a few times...
Inappropriate conversations and excessive cussing. It drives me crazy on my unit the types of conversations people have at the nurses station and they are not quiet about it where you know patients and their families can hear. News flash no one wants to hear about how drunk you got the other night, your sex life or the fight you got in with your boyfriend. Your in a professional setting save it for when you are not a work.
The problem being the staff that seem to be indivisibly linked to their phones. Their definition of "down time" is if everyone else is already running around like maniacs, and a patient will die if they don't get off their phone, they may put it on hold for a few until someone else is available. I'd like to think we are all capable of acting like adults when it comes to this issue, but in my experience, if phones are in use on the unit, there is always a few that abuse this privilege to the expense of their peers. I've yet to see it not abused, and I am one of the staff that gets to pick up the slack since I leave my phone in my locker.
I'm with you. I work as a Medicare Reimbursement Specialist in an LTC facility. I have my own office, but I still leave mine OFF in my drawer or purse and cut it on only during breaks.
My husband recently had a TURP done and I was staying with him in PACU. Anyone who knows anything about these procedures knows CBI is necessary for 24-48 hours post op to ensure against clotting off and blockage of the urinary stream.
When hubby's irrigation solution (running by gravity) got low, I pressed the call button. No response. This was around 10 pm, so evening shift. I waited around 10 minutes, and noticed the irrigation solutions was VERY low. I went looking for his nurse. Where did I find him? Around the corner, at a nursing station that was not being used on the other side of the PACU, in the dark, playing a game on his iPhone. And yes, I knew it was a game because I walked up behind him and could see the screen. By the time I (and he) got back to my husband, his irrigation bag was bone dry, and I was in tears (mostly, I think from exhaustion...it had been a very long day). He was apologetic, and fortunately nothing came of it, but all I could do was think...this is PACU....what if someone was coding, or bleeding out, or...... I was very unsettled and told this nurse my concerns. His reply? "I thought the bag would've lasted longer".
Mine is (coming from a LTC perspective) hearing nurses tell inquiring family members, "That's not my patient (or resident)", and walk away.
No, they may not be under your direct care, but in my mind, it is ANY nurse's responsibility to help family members get to who they need to see, or the information they are looking for, or their family member taken care of. I've heard nurses tell residents who simply want water, or a snack, or directions to the dining hall, "go ask YOUR nurse". One could simply say, "Let me see if I can find someone who can help you". To imply that you don't know anything (at least to me), or don't want to do anything to help makes nurses appear lazy at best, incompetent at worst.
Around the corner, at a nursing station that was not being used on the other side of the PACU, in the dark, playing a game on his iPhone.
Ooooh, I would have been SO pissed! Nothing short of dereliction of duty. I have my cell with me at work, but only because some of the ER bays haven't been rigged with phone lines yet. It never comes out unless I need to get the doc's attention STAT!
I'm with you. I work as a Medicare Reimbursement Specialist in an LTC facility. I have my own office, but I still leave mine OFF in my drawer or purse and cut it on only during breaks.
My husband recently had a TURP done and I was staying with him in PACU. Anyone who knows anything about these procedures knows CBI is necessary for 24-48 hours post op to ensure against clotting off and blockage of the urinary stream.
When hubby's irrigation solution (running by gravity) got low, I pressed the call button. No response. This was around 10 pm, so evening shift. I waited around 10 minutes, and noticed the irrigation solutions was VERY low. I went looking for his nurse. Where did I find him? Around the corner, at a nursing station that was not being used on the other side of the PACU, in the dark, playing a game on his iPhone. And yes, I knew it was a game because I walked up behind him and could see the screen. By the time I (and he) got back to my husband, his irrigation bag was bone dry, and I was in tears (mostly, I think from exhaustion...it had been a very long day). He was apologetic, and fortunately nothing came of it, but all I could do was think...this is PACU....what if someone was coding, or bleeding out, or...... I was very unsettled and told this nurse my concerns. His reply? "I thought the bag would've lasted longer".
Honestly, I think you were a bit overly emotional about this, but one man's sin does not systematic abuse make.
Well, you have a point, VANurse; maybe I was overly emotional. After all, I was only concerned that my husband not have to undergo unnecessary treatments for avoidable post-surgical complications. You would have reacted differently? You're right, one nurse breaking the rules doesn't mean they all do; but generally in a PACU, patients are 1:1 or 1:2 for a reason: they need pretty significant observation to ensure proper recovery. I was speaking to things that can happen when people get engrossed in their phones at work, and how that could, if allowed without checks and balances, affect patient outcomes.
Well, you have a point, VANurse; maybe I was overly emotional. After all, I was only concerned that my husband not have to undergo unnecessary treatments for avoidable post-surgical complications. You would have reacted differently? You're right, one nurse breaking the rules doesn't mean they all do; but generally in a PACU, patients are 1:1 or 1:2 for a reason: they need pretty significant observation to ensure proper recovery. I was speaking to things that can happen when people get engrossed in their phones at work, and how that could, if allowed without checks and balances, affect patient outcomes.
I think the point was that there are obvious emotional aspects involved that can affect our perceptions when loved ones are involved. I won't defend playing phone-games while on duty, but the situation may have been much more innocent than how you perceived it. Maybe this nurse was on his break and he genuinely thought that the irrigation solution had more time, an honest mistake.
When I worked in acute care NOC shift I often took my "breaks" (if you could call them that) in the form of finding a dark corner and reading my kindle for a few minutes in those rare moments when all seemed quiet. I didn't take my breaks in the "official" break rom too often because I wanted to be somewhat available if a patient needed me. To a family member or visitor who happened to see me at one of those moments, sitting near the nurses desk with my kindle out, I'm sure it could very well appear that I was engrossed in my mobile device and neglecting my patients, though that would've been far from the truth.
Not saying your assessment of the situation was necessarily wrong, just saying appearances aren't always what they seem.
I went looking for his nurse. Where did I find him? Around the corner, at a nursing station that was not being used on the other side of the PACU, in the dark, playing a game on his iPhone. And yes, I knew it was a game because I walked up behind him and could see the screen.
People trying to talk to you when you are trying to hear report. Or when there are multiple conversations going on during report which is distracting.
I was trying to give report on one patient to a nurse getting report from someone else on three patients when I was done. Everyone under the sun kept interrupting. It was infuriating (mostly because my entire day existed exactly the same way - nonstop interruptions mostly from coworkers who should have manners enough to wait until I'm walking away from the conversation I'm already having before butting in). Anyway, the one waiting to give report on her three patients got frustrated over me taking so long on just one, she barged in the room to "jokingly" say I'm taking forever and need to hurry it up. I told her if people would stop interrupting us, I'd be done already. She got the point and apologized. But honestly.... Telling another nurse to hurry up with report is not okay. And interrupting report with things that can wait isn't either.
NursesRmofun, ASN, RN
1,239 Posts
The knowing someone thing can allow some people to get away with much more than I ever dreamed...but I have witnessed it as well.