sequin121

If this happens at our facilities, the patients are essentially told that we enjoy a diverse culture among our staff and patients and that we hire based on qualifications, not race. We also let them know that all staff are competent to care for them and that we do not assign staff based on patients' racial preference. We encourage them to support that philosophy but if they can't, they need to see treatment at other facilities, in the future.

I agree. Someone who feels they need their manager to intercede in conflict doesn't show the maturity one might like to see. It's important that you be able to work with your team and that means resolving issues, at the source. You need to be direct but kind and use "I" statements. ie...when you address me, in that tone, I feel insulted or embarrassed, etc. Many people talk without filtering and don't realize (Many times) the impact their words have on others. And if we don't tell them and hold them accountable for those behaviors, they won't change. Also, if you are asked to give an example of a time you resolved a conflict and felt good about the outcome (or something similar), be careful that you don't just feel good about a conflict resolution where it appears you "win". Having both parties feel good about the outcome of a conflict resolution is certainly best. Good luck!

I work in a facility where perceived concerns regarding patient safety and workplace disruption are encouraged to be documented. Having said that...it is couched in a just culture where the focus is problem solving and process improvement. When there is perception that every issue brought to someone's attention is punitive, nothing is accomplished. This would be an ideal time for some education and team building between these departments. We all think we're the busiest and most overworked so we plant our feet and do nothing to move forward. A department shadowing and a shared leadership approach where the staff representatives form a team where professional and constructive dialogue is welcomed might lead to process improvement and a better understanding of each depts.unique needs. Just a thought.

A basic foundation in medical terminology is very important. Then you'll realize the entire healthcare profession speaks in acronyms. :)

Perhaps your husband is feeling a little insecure about you going to school, becoming a professional and what that means for your marriage going forward. Maybe you'll meet someone else? Maybe you won't want him because now you're smarter and have important work outside the family? Who knows? But he seems to be (intentional or not) sabbotaging your plan. This is not unlike men who sabbotage women who are trying to lose weight. If they start looking better...they may leave. This education is important for you and I'm sure he knows it. But he also needs to know that HE is important to you. And reassure him that you need him, that he still has value and that he's safe. I think another post mentioned that men are just little boys. I don't agree with that but men are men. And they seem to do much better when they can do a little care taking of their spouse. They need to know they'll be needed. Time to talk and cuddle....it will work out. Good luck!

I agree that this behavior is inappropriate and should not be tolerated. I also agree that standing your ground..whether that's walking away or saying "excuse me, if you'd like to speak to me, you must lower your voice", etc. is appropriate. However, stopping this behavior must start at the top of your organization. There must be a culture where EVERYONE is held to the same behavior standards...including physicians. This should be reported to your CNO/CEO/Medical Staff Services/Medical Director...whomever it takes to address this behavior and hold docs accountable. And where was the medical doc who was looking through the chart? He put up with that also?? Ugh!

At the very least, could we PLEASE get the abbreviation correct? It's HIPAA...not HIPPA. Thanks...:)

This is not an usual situation, unfortunately. Picture taking, posting pictures and information to facebook pages, etc seems to be done with little to no thought. Do I think most of these nurses are disrespectful or malicious? No! I think they just don't think. And having camera phones, at the ready, makes these mistakes so much easier. In my opinion, cell phones should stay in the locker (unless required for your job) and only accessible at breaks and lunch. That all being said...here is my two cents. Your relative made a mistake...an error in judgement. Life didn't end and there was no bad outcome to the patient. Was it wrong? Yes. Was it the worst that she could do, as I nurse? No. My thinking is that her hospital felt the same way or they wouldn't have given the resignation option. Frankly, I'm glad that she is feeling this nervous and remorseful. It shows that she recognizes the error and likely won't make it again. Isn't that the lesson we want from any mistake? At my hospital, all reference checks come through the personnel dept. and they only give dates of employment and job title. Your relative may want to check her hospital's reference policy before she goes job hunting. Also, even though she would reflect as a voluntary resignation and doesn't HAVE to disclose the reason for termination, it is wise for her to be honest during the interview process. The nursing community can be quite small and if she was hired and her new employer heard this information from someone else, it would be worse for her. I think she can work again as a nurse but as mentioned, in this column, it's a tight market. Good luck to her!

We do not tolerate disruptive behaviors from anyone, in our facility. We have defined service standards to which everyone is trained and held accountable. We also add these behaviors to our evaluation process. 50% of the evaluation is based on the essential functions of the job and 50 % is based on essential behaviors. It's not enough to be a "good nurse", if you are a "bad person". We take these very seriously. We also have addressed the medical staff and their behavioral expectations. We have very good medical directors of our specialties so if there is a disruptive physician, they are dealt with through the medical staff services department and ongoing issues could result in loss of privileges. Also, if we have patients and families who have ongoing abuse issues towards the staff (many times these are repeat patients with repeated behaviors), our CEO will send them a letter after discharge "Inviting" them to seek treatment elsewhere, in the future. Not at our hospital. The key is having the support of your CEO, physician group and DON in developing and maintaining a culture of respect. The Joint Commission has addressed this. In July of 2008, TJC issued a sentinel event alert (#40) entitled "Behaviors that Undermine a Culture of Safety". Part of that alert indicates: There is skills-based training and coaching for all leaders and managers in relationship-building and collaborative practice, including skills for giving feedback on unprofessional behavior, and conflict resolution. This is pretty clear in it's intent. Also, hospital management should encourage a culture of support to hospital staff which allows them to set boundaries with what they will accept from physicians and other personnel. Of course, this boundary setting would have to be done firmly and politely and in a way that de-escalates the situation....not escalates it. Good luck!

As frustrating as families can be and as annoying as it is to have them in the room while you're working, I fear we'll see much more of this. Considering the publicity about hospitals that make mistakes and harm patients to hospital specific patient outcomes being available on the internet, the customer is much more aware, nervous and demanding. They may see themselves as the only advocate that their family member truly has....unless, you can change that perception. Being proactive in building relationships with patients and families, involving the family in small things related to the patient's care and showing that you respect their concerns will be more helpful, in the long run. You can't control every situation but you have total control in how you react to it. You can take the power or give your power away. When you get angry and sarcastic with families, you are making the issue personal and you have given them your power. Kindness and tolerance are great attributes....even when your tongue is bleeding from biting it so hard. :)

I have never heard of this either and it seems rather unsupportive of staff to allow a patient and/or family member to come in and berate staff because they are upset with the care. If administration was hypersensitive about this issue because there was an attorney involved, why not handle it through risk management and/or the legal department? In my humble opinion, all this meeting accomplished was to validate and empower the complainant and demoralize the staff. When you are confident about your level of care and the committment of your staff...and if you feel you "do the right thing"...you don't have to worry so much about legal issues. I'm sorry to hear that this happened to you and your team!

Oh my gosh! I have never seen so many new nurses be so critical of my profession. Perhaps you are all correct when you say you have chosen the wrong profession. If so, please leave as soon as possible for your own sanity as well as the sanity of our patients and your colleagues. Did you honestly think you could work as a nurse and not help meet patients' needs? Those needs may include cleaning a behind or bringing water. And doing those "waitress" things are just part of working as part of your team. I can tell you (although you may not be seeing it now) that what you are doing everyday has more impact on peoples' lives than a lifetime of waitressing. If you are not motivated by the thought of making a difference in people's lives and are more motivated by your own needs, then this is not the profession for you. This is not to say that you shouldn't expect an environment where you can do your best work. You should have management teams who advocate for your needs just as you advocate for patients' needs. If you are not in an environment where that is happening....then you need to find a place where it will happen. You also need to be assured that as your skills and confidence grows, you will gain more respect from physicians. However, you don't get respect without commanding it. You are medical professionals who are educated and have much to offer. Don't allow anyone to take that from you. I don't know what city you all are in and how many options are open to you professionally. But life is way too short to be this miserable. I wish you all the best...

I am sorry to hear of your second board failure but am happy that you are not giving up! It's been many years since I've taken NCLEX but I've noticed that the stress levels related to testing are still the same. So much rides on this one exam....it's rather intimidating. I agree with your colleagues who have suggested staying with one plan, focusing on the critical thinking and staying positive. You may also want to examine whether you suffer from a little test anxiety and perhaps work on some meditative or breathing techniques to assist you. If you indeed have to wait 90 days to retake boards, I would suggest you work, in some capacity. (I didn't see any reference to current employment, in your note) I found that being able to relate my clinical experience and knowledge to the NCLEX questions as helpful as studying books. Good Luck!

I must agree that this should be a lesson learned. But I must add that it is NEVER appropriate to consume any amount of alcohol before taking care of patients. While you may not have felt you were impaired, you can't always be sure of the slightest impact alcohol may have on your judgement. Also, had there been a bad patient outcome, even if your alcohol consumption had nothing to do with it, the fact that you had alcohol before work could emerge during any type of investigation and you could have increased the liability on yourself and your company. What distresses me even further is your refusal to take responsibility for your own behaviors. You are a 44 yr old, professional woman with 3 children yet you feel you need someone to remind you not to drink before work? You need the company not to serve wine at dinner because YOU made a bad decision?? Owning your role in this situation is important in learning the lesson. Stop blaming others and "Nurse Up"!!