ern91

Find a different environment in which to work. Not all depts., hospitals,etc. will have this problem. It depends upon the management and what they promote/tolerate. I have worked where the behavior you describe was rampant and also where it was not. I have found, in my 16 years of experience as a nurse, that finding the right job is kind of like finding the right life partner. You kiss a few frogs before you find your prince/princess.

First born,alcoholic father. Dysfunctional family, both sides with a side of mental illness thrown in.

How does your facility handle med rec? Our way is so time consuming and it doesn't seem to make sense to me. Maybe I'm being a bit naive with this next statement but here goes....... I can't believe JCHAO wants nurses to spend so much time on something like this. Maybe someone other than a nurse could do this? Pharmacy tech, Unit Secretary? I remember when this was the physician's responsibility. I work for a hospital with a very cumbersome computer documentation system (Meditech) and the ER version of this system is not nurse friendly.It takes a long time to do med rec on pt's with multiple meds, and the nsg home pt's lists are 3 and 4 pages long. I understand the importance of med rec, I just think pts would be better served if the nurse wasn't tied up with so much of their time spent on data entry.

Well, if it was just a huge hiccup, they wouldn't have to pay. The doc (or other qualified person ) would so the screening, tell them it was a hiccup and then they could go home. No payment for the triage or the screening. This is provided it was triaged as non urgent. Now if the triage nurse makes this pt urgent, the doc can downgrade if need be.Then we go back to square one and the pt doesn't pay.

When the panicky parent arrives with the child who has a non ugent or semi urgent condition, the parent is told it is not an emergency. thus relieving the parents fears, but also allowing them to pay and stay or go to the clinic in the am. This ,of course , is at night. During the day, the person has the option of being seen in our express care area, which operates 11a to 11p.They still have to pay because it is not a complaint that needs to be seen in an ER. We operate with a 5 level triage system and the people this pertains to are classified as non or semi urgent. All of those classified as urgent are seen the main ER and not asked for payment up front. They are asked for their insurance copays or partial payment as the situation allows. Many doctor's offices send their pts to the ER during the daytime which I find a huge part of the problem contributing to the already broken health care system. I have also found, after 15 yrs inthe ER, that doctors send their Medicare patients to the ER quite regularly and the complaints are usually not an emergency. As this has been a practice in my community for awhile, I can't comment on the initial reaction of the public. I worked in a county trauma center when this started a couple of years ago, and of course the county hospital did not have this policy. I did see a bit on the local news about a mnth ago reporting that the county hospital was finally going to implement this. Haven't heard how its going, but I'll bet they had to beef up security!!

About 2 years ago, some hospitals in my city moved towards getting payment from non emergent pts before they received treatment in the ER. The pt would get triaged, then receive a "quick medical screening " from a qualified medical professional. This varies from a PA,NP to a physician. If the examiner feels the person does not have an emergency, he/she is directed to the business office for payment. The person then pays a fee(varies from hospital to hospital but usually around 150.00) if they decide to stay for treatment. Does your hospital do this and how does it work?

A secretary delegating an assignment to a nurse is a lawsuit waitng to happen. I'm sure your state board of nursing would have something to say about that. Speak to your director as soon as you can . It would help your case if you have a copy of your nurse practice act in hand to show her/him the rule that applies. If nothing is done to change this, get another job pronto!

The hospitals in which I've worked hired all GNs at the same hrly rate. Raises were given based on the scores of annual performance evaluations. Management positions held by both ADN and BSN degreed nurses. Iv'e experienced horrible managers with so many letters behind their names they almost needed two badges..... I've had great managers with ADN degrees only. It took me 4 years to get my ADN because I started later in life(30's), I was married with 2 young children and had to work while in school,I couldn't afford the tuition at a 4 yr university . I had no desire to go into management and still don't because of the politics involved. I make good money, more than my supervisors because I get a shift diff and overtime. In fact, I recall several nurses telling me the downside of the management position they accepted was a decrease in pay. The staff nurses I've worked with didn't care if their fellow nurse had an associate's degree or a bachelors degree. We all did the same job. There are alot of BSN nurses out there who learned how to be nurses from ADN's I can just imagine the animosity and resentment among nurses if it becomes standard practice to pay more for someone's ability to get a higher degree, then have them work alongside someone busting their butt just as hard (or harder) and getting paid less. There are too many issues already that divide the nursing profession without adding another

I Work At An Hca Facility In Houston. Haven't Seen Anything Like You Describe Yet. Maybe The Larger Facilities Are Getting Hit First. We Here Are All Hoping For Some Positive Changes But We All Know They Won't Be For The Nursing Staff. Never Is.

we also do ekgs at triage. we have 3 bays with stretchers, etc. we also do the ekgs on anyone c/o cp. and i do mean anyone. even children and young adults with no h/o cardiac. we are an accredited cardiac facility and to meet the reqiurements, we get the ekg w/in 5 minutes of triage time, run it to the doc who then gives further orders. we start a cardiac workup from triage then place pt in a room if available. we aren't allowed to make clinical judgements regarding atypical cp, such as being reproduceable, increases on movement, inspiration etc. can be very frustrating sometimes, but can also discover a heart problem someone didn't know they had.

Same here. Have wanted to work in this field for a long time. I think the only way toget info about available positions would be through networking but since I never hear of any positions, I figure people stay in those jobs for a long time.

We operate with a 5 level triage system. Levels 4 and 5 to the waitingrooom(semi urgent and nonurgent). Most level 3 (urgent) go to waiting room if there is no available bed. We also try to keep one major room open for any level 2's or 1's (emergent and resuscitation) that may come in. Of the level 3's in the waiting room, they are roomed based on the individual acuity in that particular group.

1:4 here. If one of those is critical, drops to 1:3 or 1:2 for as long as necessary. Hallway patients aren"t allowed.

I've been reading this this thread and the replies for 2 days now and all I can say is the majority of the replies serves to indicate the OP'S negative experiences are true. Oh....exuse me... let me qualify that. In my opinion , the majority of the replies.......... Some of you sound like the nurses he's describing. Whether you believe this or not, I've worked with people in our profession who are quite capable of,and have, behaved as he has described. Ya'll (and you know who you are) are mean. To the moderators of this forum: Thank you for allowing such colorful debate

Amen. So why is this so? Is it because hospitals are basically corporations? You always hear about the 20 yr executve who leaves a position with not so much as a backwards look at a loyal employee who gave blood,sweat,and tears for 20 yrs, probably put his or her personal life on the back burner and now looks in the mirror saying "what the hell happened".I wish I knew the answer to why nurses are considered so unimportant to their own management, to society for that matter. Maybe if the profession were to get more respect in the media. Whenever you see knick knack type statues depicting a nurse, they are usually cute little cartoon type characters. T-shirts have funny little sayings on them about nurses. Television shows portray nurses as secondary to the importance of doctors, usually big busted bimbos who spend their shift trying to get into the pants of the hunky doctor. I don't think unions are the answer either. unions aren't what they were years ago, no matter what the profession. I tried to get a union rep to come to my hospital a few years ago and was told I had to prove a certain percentage of the nurses wanted it. Only about 2 percent of the nurses in that hospital signed up. The rest were scared of a backlash from management. I feel so bad that I have such a dim view of my profession, but I love what nursing means to ME and I stay.

A bad relationship.....despite all the abuse, you keep going back for more.

You have cheese enchiladas and a margaritas for breakfast.

]I too have been a nurse 15 years and find the same attitude you have found littlecheese. ]as a matter of fact, I have that attitude. There are sooooo many reasons. Hospitals are ]corporations, society is more litigious than ever, our government believes people don't need to be responsible for their own lives, accreditation agencies are constantly adding ]paperwork and policies to our practice, management that is inexperienced. I could go on. ]Some things I have found that make a difference; ]1. Buy the best equipment you can and always have it available. ]2. Self scheduling. ]3. Offer bonuses and monetary incentives for nurses who go the extra mile ]4. Do not tolerate (or foster) animosity between shifts. ]5. Have a monthly staff meeting in which all you do is praise; do not talk about anything ] negative. ]6. Communicate with other members of the management staff so you are all on the ] same page. ]7. Have individual meetings with staff where] they can talk about anything without ] repurcussions. Anything. ]8. Do not tolerate abuse from patients even if it means your satisfaction scores] go down. ]9. Do not tolerate abuse from physicians. ]10. Find ways to make your staff's jobs easier. ]11. Do not understaff ] ]Above all, be the kind of person your staff can trust. Unfortunately, if you succeed in doing all these things, you will probably be out of a job. Administrators don't seem to want middle management to care this much about staff.

After 14 years at a Level 1 trauma center in a major medical center I went to a "slower paced"community hospital. At the trauma center was the team approach. Up to 50 pts with 4 nurses and 2 cnas.Sometimes there was an extra nurse who did the admissions and discharges but that nurse couldn't do all of them so the other 4 helped with that as well as pt care. This was also a teaching facility so we had the added responsibilty of making sure the residents did no harm. Thter was never a limit to how many pts would be in this area. If the acuity warranted it, they were brought straight to the pt care area after triage. The trauma and critcal medicine were also sqeezed in after stabilization in major rooms. There was no primary nurse, we all took care of all the patients . I did this straight out of school as a gn I might add. Pt's stretchers were touching, no curtains that worked, males and females side by side in a huge ward called The Holding Area. I can remember pulling pt's stretchers out into the main corridor so I could get to the bedside to do pt care.I just THOUGHT I got my butt kicked . Now I have 4 patients at the community hospital and I am the primary nurse with 1 tech for 17 rooms. I do everything myself for my 4 pts from start to finish and i come home more frustrated and tired than I did many nights when the team took care of those 50 pts.There are many different ways to make this type of nursing safe. I'm sure other nurses in this facility can help you with that. I never saw a nurse get into trouble that used good nursing judgement, critical thinking skills and followed all the policies and procedures.The nurses I knew over the years that got into major trouble ,whether it be legally or with the facility would have gotten into trouble anywhere because they just did the wrong thing, no matter what. I wish you much luck. Send me a pvt email anytime, RNCCRN

my sentiments exactly. it won't get any better

This is great!!!! And just where do the Paramedics rush to? Where the nurses are!! Seriously though, it's all about understanding exactly what each profession brings to the health care table and why. I've known people in both fields that are outstanding at what they do;and I've known people in both fields that are not so outstanding. Neither could give optimum care to a critical patient without the other, just as a doctor could not give optimum care without a nurse. I bet your buddies already know this, mingez and I'm sure most of your joking is all in good fun as you say. Don't be surprised ,however, if you run across those few who's comments don't ring so funny. There will be a handful who will be jealous of your nursing knowledge (and salary). Ignore....it's not about you.

I should also add that I have never heard of or seen a female nurse refusing to care for a male patient in regard to catheterization, bathing, or any other exam of a personal nature.

I really can't say if i would or would not feel comfortable performing tasks as a male nurse, as i have never been one. What I can say is that I never even entertained the idea that I might not have to perform certain nursing duties because of my gender, nor did I ever imagine anyone else doing so. If any nurse has an issue with performing a duty for any reason, they certainly have the right to speak up. However , in my experience, this particular issue has been taken advantage of by younger male nurses especially. I begin to wonder who really has the problem.Are nursing programs emphasizing this issue now that more men are becoming nurses?

I'm interested in knowing if anyone has the issue of male nurses refusing to perform certain nursing functions simply because they are male. Having worked in a large teaching hospital and smaller community hospitals, there seems to be a huge difference. In the teaching hospital, male nurses did everything a patient needed, regardless of gender. In the smaller community hospitals, the male nurses sought out female nurses to take care of all manner of female patient's hygiene, all gyn exams ,and anything else a female patient needed. Have we become such a litigous society that we base our practice on gender? Do you find yourself taking care of your male colleagues patients as well as your own simply because they are afraid to touch their female patients?

Male nurses are no different than female nurses other than they have an exuse not to assist in gyn exams or place catheters in female patients