Bill E. Rubin

I agree with those who say to let it go. No winning those battles, unfair as the are. Who would want to work on such a unit anyway? As one poster said, it's one thing to sprawl out with a blanket and pillow with your tongue hanging out and snoring, vs just nodding off while charting or when you don't have anything to do. Working nights is unnatural and most of us have demands that keep us awake part of the days in between as well. Even at best, it's rare that a night shifter is getting 8 hours of quality sleep in between shifts. So you proved that you are a human being. If you worked with actual human beings as well, they'd have simply prodded you awake, or if appropriate, suggested you take a break or something. And yes, I work mostly nights and, thankfully, I work with human beings.

Thanks everyone! I've lost some of my steam since my last post, but here goes: "Yes, I know you'd like your Ambien, as is evidenced by your pressing the call light seventeen times since the last time you spoke to me about it. As I mentioned before, you did not have an order for Ambien, so I requested it from the physician who was kind enough to write you for a X1 order for it. However, until the pharmacy approves it, I can't give it, and if they have approved it by now, I may not have noticed, since, quite frankly, I am a little more concerned about my other patient's blood pressure of 190/87 right now. I'll get to your Ambien when I get the chance. Please stop annoying everyone else on the floor who passes by your room to tell me you'd like your Ambien."

I had a vent I was all excited to share.... and found the thread to be closed. :-(

I'm guessing the pt is on a heparin gtt (or argatroban or some such) and the night nurse was looking for a PTT? There is usually a therapeutic goal and an institutional policy about when to draw a PTT if it's therapeutic vs sub/supra therapeutic (12 hrs vs 6 hrs). It's something that will be second nature to you as you get more experience. Of course I could be wrong. Keep your chin up. It takes so long to get your confidence up, and an interaction like the one you described can undermine your self confidence at this vulnerable time.

A dear relative of mine is really struggling to provide care for her demented husband... a tough situation for her given her advanced age and mediocre health. However, I had to laugh when I received an email that her husband was hospitalized for a "urinal track" infection.

The hospitals really aren't that interested in protecting us healthy people from getting sick. They are concerned with us getting infected with the virus and by the time we show symptoms, have already spread it to frail, sick patients who could die from it. That's why they require the masks (whatever the source of the above link, Massachusetts General Hospital does not require vaccination and does not intend to, but requires a mask for those who refuse). The shot of course isn't perfect, and some strains may mutate beyond coverage, but it prevents many cases of flu, and thus may save a life or two of a vulnerable patient.

Actually, my big Boston hospital doesn't require it, but strongly encourages it and does require opt-outers to wear a mask after the first case of flu hits the hospital. I think it's a reasonable request to protect the patients (and staff from each other). As someone mentioned earlier, we are required to be immunized against MMR, hepatitis, etc. I happily get my free flu shot every year.

I second all those who say sending praise to the supervisor (or hospital administration). Nothing beats a highly public "thank you" that gets seen by the nurses' peers and management.

You are not alone (though it feels that way sometimes). I left a 20+ year as a software engineer/architect to be a nurse. I consulted part time while going to my accelerated BSN program, and now I work as a nurse making about 2/3 the salary I made at my last full-time software job (and I was underpaid at that job because I was on the "ground floor" and had amassed 200,000 shares of stock in the company.... which became worthless when the company went out of business).

Whoa, dude, why the hostility? Mike has a valid point. He witnessed what appeared to him controlling and jealous behavior and just said that in hindsight, he wondered whether getting the pt alone for further assessment would have been warranted. That's not bullying, that's advocating, mate.

Seriously? Who comes up with this rubbish? I love how so many different institutions force the "I have the time" onto the scripts as if saying so makes it so. I'm sure that so many different institutions' patient satisfaction surveys have a common complaint that says "the nurses never seem to have enough time to answer my questions" (or to do whatever it is the patients/families want the nurses to do). So rather than address the problem of nurses that don't have time, we just tell them to say that they do and "poof!" problem disappears. I'm praised for my ability to make connections with patients. This comes from close observation of what a particular patient is about and tailoring my approach to fit the patient. Any one-size-fits-all approach just kills that. I think I'm going to start a new career and be the Scott Adams of the healthcare world and start a comic strip to be the "Dilbert" of the health care industry. I can come to this web site for a never-ending supply of material from stupid scripted sayings to mandated uniforms... Hmmm....

We had a pt with a long and complicated illness who was just the nicest guy and always appreciative of everything that was done for him. All the nurses loved him and couldn't do enough for him. He also has a good sense of humor.... I walked by his bed while going to care for his roommate when another nurse was dressing his foot. He had a toe missing and a hole where the toe was, osteomyelitis in the foot... Anyway, as I walked by and looked at his foot, I said, "Holy foot Batman!" Got a laugh out of him.

Seriously?? Thank you for jumping to conclusions. In fact, you are incorrect. My wife works full-time, though my MIL is retired, from another country and is staying with us now to help take care ofthe kids at times. We actually pay her for this. Her ability to help is limited, and the help comes with a high cost (and I don't mean the money), but it's what we can afford to do at the time. When we just had the toddler (when she was still an infant), I was home alone with her after working night shifts, which means I slept only if and when she napped. In fact, what we used to do was that I would take the subway to work at night, so my wife would drive our daughter to her job. After my night shift was over, I would take the subway to her job and drive the car home; feed our daughter and entertain her until she had a nap. Now, the toddler is in day care twice a week. The 6 month old is home every day. From day one I have been an active participant in both daughters' care. When they were newborns, given that my wife was breastfeeding, I would be the one changing the diapers. I guess you have your stereotype about what men have done with respect to childcare in your life experience, but I do kind of resent your labeling me with your own stereotype.

I'm a day-night flipper, sometimes more than once in the same week, much to the amazement of my colleagues. My secret is chronic sleep deprivation, secondary to the presence of 20 month and 6 month old daughters in my house. I can fall alseep pretty much anywhere at any time, though I never get more than 5 hours of sleep (and that's when I'm lucky!) I don't usually have much trouble falling asleep in the mornings after a night shift, but if I'm awoken around noon, sometimes it's hard to fall back asleep, and I might lie awake for awhile (usually falling asleep just early enough to be in a deep sleep when the alarm goes off). My mother in-law has that mentality about my being lazy for not jumping out of bed at noon to help around the house (as if 2 or 2-1/2 hours of sleep should be enough for me in between 2 night shifts). And she is a retired psych nurse who worked nights.... But they had cots and used to nap for a few hours every night.

Started my ABSN at age 45 and finished it at 46.

Most of the companies I worked for are still in business and have not "gone under." Laying large numbers of employees was just a part of doing business, and people who got laid off usually were due to not being liked by the right people in management rather than by any "numbers" you talk about. Unless you work in sales, numbers are often abstract in terms of productivity. Some of you have clearly worked in some dysfunctional nursing units, but childish/high-school-like behavior is not limited to nursing units. I have experienced it firsthand. As to my nursing unit, I have experienced some cattiness and my share of marginalization due to my gender and the age I started nursing, but by and large, it's a functional, reasonable group of people whom I mostly enjoy working with. I have worked in great teams in the corporate world as well, though ihave seen childish, vindictive behavior just to take people down, either for professional gain, or to be more "in" with the "in" crowd. Dysfumnction, pettiness and childishness are not limited to nurses.

I still maintain what I said. I have worked in the corporate world for over 20 years in all levels of hierarchy from entry level to senior management, in eight different jobs in seven different companies, not including the consulting gigs and family businesses. I've seen even worse backstabbing in the corporate world. And often the backstabber suffers no consequences while the victim of the backstabbing might lose his/her job, because peoples' jobs are cut at the drop of a hat in the corporate world. One other thing that's different. Once, when I was working in my large Boston hospital, there was an announcement made that due to budgetary problems some 200 jobs were being eliminated. Given the size of the hospital, this number was quite small, yet in the email making the announcement, it was stated that most of the jobs would be eliminated through attrition, meaning people who left their jobs simply wouldn't be replaced. Others would be transferred to existing job openings. The end result was that twenty people would be let go from the hospital which represents a fraction of a percent of the workforce. In the corporate world, if the company is publicly traded, it was commonplace for a company who was actually profitable to lay off say 10% of its work force just to raise the stock price (it still baffles me that laying people off raises the price of stock, but many times it does, if spun correctly). Allso, this is rarely announced to employees, but is just dropped on them, usually on a Friday, with no notice, and employees are escorted by security out the door once they are told they have been laid off. I'm not naive enough to believe that my hospital is a charity and that the bottom line is not important, but the fact is that it is a much more humanely run institution and that people never lose their jobs just for the helluvit to make some extremely rich people even richer. But it is run with some modicum of conscience and that the people that work for the institution are at least given some thought as human beings when making sweeping decisions some of the time, whereas in the corporate world, most of the time, no thought is given at all to the negative impact on peoples' lives. None whatever. Anyway, this cold cruel reality of the corporate world permeates the culture and makes people cold and cruel to each other when times are tough. Dysfunctional workplaces whether they be a dysfunctional nursing unit or corporation are terrible places to work. The type of dysfunction in nursing units tends to be more of the passive aggressive thing that is more the female style, and the type in the corporate world tends to be more the smile in your face and stab you in the back style. Men as well as women in the corporate world can be gossip-mongers. I have been the target in one job of some unfounded gossip that really negatively affected my standing in my position and made me paranoid that I was going to lose my job in a recession when many people were being laid off (thankfully I did not lose my job, but it made my life miserable until I found a new job).

Interesting thread... I worked in corporate America for 20+ years before I became a nurse, and it is different, though I wouldn't call one better than the other. I've seen just as much gossip, childish behavior and backstabbing in the corporate world, though in nursing, there is more passive-aggressiveness, likely due to it's being female dominated. But to those who gush about corporate culture probably haven't worked in a company that was going through downsizes, as that brings out the absolute worst in people. Someone may be all smiles to you, but if there's a choice betwween them losing their job and you, they would much rather it be you and will sometimes stab you in the back just to make you look worse and more expendable to managagement.

I meant medical education, not medical career, sorry, editing posts with my blackberry doesn't seem to work.

I haven't read all the posts yet, but I'd guess that the poster must be very early in his medical career (I assumed the friend to be male, because that particular flavor of trash talk sounds male to me). If he actually spent any time on a teaching medical floor, he'd be too busy laundering his underwear to spend such idle time with facebook flames. My experience with med students is much like what others have said here.

It would depend on how desperate I am. For a long-term job, it's important for me to have a job that requires no driving. All major hospitals in Boston are accessible by public transit from my house with varying commute times. When I was looking for my first job, I considered some hospitals outside the city that I would have to drive to, but they would have only been temporary until I got a job in Boston. Thankfully, I didn't have to do that. My commute is about 45 minutes by bus/subway, 30 minutes by bicycle and 20 minutes by driving (during off-peak hours... I only drive on weekends or nights sometimes when I choose to).

$8.00 nights, $4.00 weekends (so $12.00 for weekend nights)

I think they are useful to the newbies and male nurse wannabes because men in nursing is such a tiny minority, many men considering going into nursing don't have any role models to look to to ask the "dumb" questions. So the forums, FTMP are a place for those questions to be asked, and you'll see most of the threads are started by newbies.

The extent to which some physicians disrespect nurses can be an eye-opener at times. Combine this with the fact that many MD's may be spinelessly covering their own butts against litigation by blaming the nurses. I was once sitting in rounds when an pt (not mine) who was about to be discharged came into the room, all agitated. It seems that a clinician was in his room showing him the results of some imaging study and explaining them to him while a visitor was in his room who happened to be a coworker of the pt's. The clinician was female, and the pt identified her as "a nurse or doctor." The attending MD left the room to talk to the pt and returned telling the team that "some nurse" had done the aforementioned act and that the coworker in question blabbed the information at his place of employment and that it had ramifications for the pt's job. While it is possible that it could have been a nurse, it is highly unlikely given the act (what nurse would do such a thing unless asked to by.a pt??) And more likely to be either a member of the medical team or a consult (I.e. An MD of some kind). He said he was going to file an incident report. While an incident report is warranted in this case, his dismissing the culprit as "some nurse" rather than "a clinician" just made my blood boil.

Here in my Boston hospital, on my medical unit, we typically have 3 pts during the day and 4 at night. We don't have any PCAs/techs on my floor (though the medical unit down the hall does have PCAs and has the same ratios as we do). Our pts are pretty sick most of the time. The MICU typically has 2:1, don't know about the other ICUs.