ainz

Nurses and doctors are really hung up about giving pain medication. My wife was recently in the hospital and asked for her pain medication as soon as the time came around, because she was in some serious pain. The nurses acted like she was drug-seeking and abusing the pain meds. Perhaps they are afraid a person will turn into a raging drug addict from a 3 day stay in the hospital. Talk about overeacting. Or maybe it is the added inconvenience and subsequent irritation when the RN has to stop what they are doing to administer a prn medication. Don't nurses and doctors realize their attitude is quite apparent to the patients and families? I guess to realize that you would have to give a damn to start with.

Being a RN, hospital administrator, and relatively healthy, it has been quite some time since I experienced being in the hospital as a family member where no one knew me or what I did. What an eye-opener!! I just spent 3 days with my wife while she was a patient. I sat back and observed and was the "family member." I could go on and on but will make some general statements about this experience. It started with the nurse who was starting my wife's IV and dropped the sterile IV site dressing on the floor, she picked it up and proceeded to place it on my wife's IV site. When I kindly and gently asked her not to do that her reply was "well we do clean our floors." I thought she was joking but she was not. Generally, the nursing staff was rude. All but 2 of the nursing staff that worked with us behaved in a way that communicated to us that we were an irritant and a bother. I was appalled and disappointed in my chosen profession. Everything was about the nurse, how busy they were, how overworked they were, how short staffed they were, how they insisted we must follow the hospital policies that no one bothered to explain, etc. etc. During the few explanation of procedures that we received, when we attempted to ask a question the nurses would talk over us and seemed annoyed that we had interrupted their lesson to us. They talked down to us. I could go on and on. Nurses--it is not about us, it is about the patient. It costs nothing to smile, have a good attitude, and focus on your PATIENT'S needs and not your OWN while you are at work. What is going on with healthcare in this country?

Nursing is a great career. I have never really done anything else other than the jobs I had to do to work my way through nursing school and a couple of tours in the army as a medic. After 24 years and hindsight, I would probably do the same thing again. As I am sure you are aware, having some sense of balance is key to most anything. These days, just in my opinion, nursing (collectively speaking) has become somewhat unbalanced because nurses seem so focused on themselves and less on their patients. Great career, great choice, much flexibility in schedules, area of practice, setting of practice, and much opportunity for advancement. You are really only limited by your imagination and desire. Good luck. We can always use another mature, professional person to join us.

I believe some state boards vary a little concerning how they go about handling these things but I believe there are also many commonalities. Don't know how long you would have to wait before you heard anything, can be a while. Not sure if there is some sort of statute of limitations or not, might have your lawyer check into that. The record will not show any action against your license until official action has been decided on and that should not occur without a hearing. You should be notified in writing of the charges the board is bringing against you. These charges should be very specific and reference the particular provisions of the nurse practice act in your state. You should also receive notice of your hearing date at that time as well. That is if they decide to have one. Good luck with it. Narcotic errors are serious business, especially if someone reports your error to the board. My experiences have been this usually does not occur unless there is suspicion of diversion. My experiences are also that state boards of nursing do not play around with this kind of thing and many have a representative from the state attorney general's office present during the hearing to see if there is anything there to warrant criminal charges from the state as well. It can get pretty ugly. Good thing to have an attorney present and representing you. Again, good luck. If you have been diverting drugs, seek treatment immediately for your own good, license or not.

It used to be said, "They'll never replace the horse."

There are many many male OB doctors. They have never given birth, they examine young, modest women who are delivering their first child. What's the difference in a male doctor and a male nurse in L&D???? OB was my favorite rotation in nursing school. I inquired about employment in L&D at that hospital (a Baptist hospital). They told me they did not hire men into the L&D department. That is discriminatory. If I were applying today for a job in L&D and was told that I believe I would file a gender discrimination suit and challenge it in court.

Need a little more specific info on the disciplinary action before I can comment, or anyone else for that matter.

Customer service is not just another way to tell the staff to shut up and take it. What a narrow-minded statement to make (sorry if anyone is offended but come on!!). Nursing staff that are asked to engage in effective (key word here) customer service or service excellence techniques are not being thrown to the wolves. It is capitalism, free-market economy where supply and demand and competition rule!! WE even have laws that preserve our ability to compete--antitrust laws. The advent of the 3rd party payor system (worst thing that ever happend to healthcare in the USA) generated some expectations that have brought us where we are today concerning customer service. Healthcare staff expected the patient to follow orders, do what they were told, and fit into the way the hospital does things. The money to pay for the care was not coming out of the patient's pocket so they did it without question. Now that consumers are more educated, healthcare insurance is super expensive, consumers are waking up and saying wait a minute, I am paying alot for this so I am going to go where people treat me right with good service, as with any other business. You would not go to a shop or restaurant where the staff were rude to you!! So we are having to deliver a quality product with a smile just like everyone else in a competition based economy. As for patients, or customers as they should rightly be called, abusing staff, it should not be tolerated. I am a RN who has been in administration now for 7 years or so, and I do not tolerate this. I recently banned a family member from the facility for abusing the nurses. Did and will call the police and press charges against them again. So come on guys. The attitude of the poor down-trodden, unappreciated, unrecognized, oppressed nursing staff is tired and old. Stand up and realize the power you have and use it. If we don't have satisfied patients/customers they will go somewhere else for their care. Where do you think that paycheck you get regularly comes from anyway?!?!

For a previous post: administration listens to doctors because they bring in the money, has nothing to do with a union. That is private physicians who admit patients and send patients for outpatient tests/treatment. Physicians that work for hospitals say as a hospitalist, pathologist, or other "house-based" work also can have administration's ear because of their network of other doctor friends and colleagues who admint patients and generate revenue (make money) for the hospital. Nurses now have a window of opportunity to really get some things changed. Don't know if the union is the way to go or even necessary. Nurses truly are generators of revenue, they make money for the hospital. Problem is, most nurses I talk to about this kind of thing do not understand enough about our complicated and fragmented healthcare financing system to realize this. Administration sees them as expenses, or rather continue to tell the nurses they are expenses so as not to "awaken the sleeping giant." Nurses truly are generators of revenue for the hospital. How? The need for nursing care is the only justification for an acute care hospital stay!! Without the nurses the hospital could not keep patients in the hospital, not just from a care delivery point of view but from a getting paid point of view as well. When nurses realize this they will understand the power that nurses truly have. It trumps the physician's power as well. Perhaps a union is good only as a vehicle to rally nurses together but it is unnecessary to deal with administration. I am in California and I can tell you the hospital administrations are scrambling around in a panic over the staffing ration laws. Nurses are hard to find. When you can find them you pay dearly. Nurses are at a distinct advantage at this point in time. NOW is the time for some real gains that will last. It's not just about staffing, it's about all issues that face nursing. However, we must temper the demands. For instance, the staffing rations are putting some burdens on the health system that I think have been unanticipated and can be disasterous for everyone so in this way it is a bit extreme. However, on the other hand administrations have been screwing over nurses for some time now. NOW nurses have the needed leverage (in California anyway) to make some real gains by sort of coming with an olive branch and saying to administration, "are you ready to sit down and be reasonable about some things?" Don't know that you need a union for that.

In my humble opinion, there is no excuse for abrasiveness or being rude. I have been in healthcare for 24 years and started in the ER as an army medic and then RN. After several years in the ER and critical care areas I considered myself "seasoned" or experienced and wasn't abrasive then and am not abrasive now. Working in the ER or critical care area does not give a human being a free ticket to justify being rude, controlling, and arrogant. Let us call it what it is. Much of it is a petty control and competition issue that seems to continue to plague nursing thus contributing to making it very unpleasant especially coupled with the other issues nursing faces today. I am currently working in hospital administration as a chief operating officer in charge of clinical operations including the nursing department. I have yet to be able to find a valid reason why an experienced ER nurse should be rude to another nurse, patient, or doctor. Simply no excuse.

Not much detail in the answers. Typical political rhetoric.

Wow!! Lighten up NurseBychoice!! However, your suggestion to visit ana.org is an excellent idea. 1. At least an associate degree to be a RN. 2. Average salary is around $45,000 per year. Demand is high for RNs. 3. Job description's framework is based on the nursing process which includes 1)assessment: gathering and analyzing data and identifying patient problems 2)formulating goals for outcomes and interventions designed to achieve those outcomes which is the plan of care 3)implementing the plan of care 4)evaluating the effectiveness of the plan of care which leads you back to step 1 and the cycle repeats. 4. Many books written on this--a long story. 5. Job is very important. The need for nursing care by an RN is the only justification for a person to be in the hospital as an inpatient.

Yes, a dress code should be written and enforced. I have seen hospital after hospital that relaxes their dress code and within a year people are wearing all sorts of things. The public, our customers, expect a certain look from people who hold themselves out to be "professionals." If the customers don't come you don't get a paycheck.

All of this comes together and affects nurses' working conditions. Nurses do not work in a vacuum, these issues affect everyone. The doctors hit the nail on the head just fine. When are nurses going to do something about complaining about being overworked and understaffed? It really is tired. Nurse staffing laws I don't think are the long-term answer. If the system cannot handle it economically or if the nursing shortage causes hospitals to not be able to meet it then the law will be repealed or simply not enforced and nursing will have major egg on its face. Some big victory for the CNA, NOT!!

Gee guys, no wonder we can't attract and/or keep younger, more inexperienced nurses in the profession. If I had to work with either of you (v-tach or cadeusus) I would need some serious counseling and question why I ever became a nurse. Come on!!

I hated it when people said "so, you're a male nurse huh?" Or "nursing must be a stepping stone for you while you go to medical school." And the greatest cliche-like communication to us "male" nurses are the covert suggestive remarks that we must be gay.

Everyone has to start somewhere, why not the ED? All of this "serve your time on med/surg" mentality is ridiculous in my opinion. Things have a way of working themselves out. If a nurse, new grad or not, wants to work in the ED and has the motivation to learn the skills then give them the opportunity. If they like it and can learn it then that's great. If they don't like it and can't learn it then they will move on. Same thing for an experienced med/surg nurse.

I live in southern California and one of our state legislators is introducing a bill that prohibits the sale of violent video games to children. He claims to have some research that shows a link to violent behavior. He also says that some of these games are based on the same simulated training used in the military and police training programs. I do not know if this is true or not. It seems to be common sense that this could cause a tendency for violence but I am not sure. My nephew, 8 years old, plays these games often. I have observed his behavior shortly after playing a violent video game and how he interacts with the other kids, he is more aggressive. Just my anectdotal observation. I have 2 children, 6 and 3 with another on the way. I will not allow them to play violent games. Why take the chance when there are so many other things for them to do? As for seeing an increase in violent behavior I am not sure. When I worked in adolescent psych (7 years) back in the early 90s there was plenty of violence without the video games so don't know if there is a correlation. I would just think there would be.

When I worked in psych nursing I had an associate degree and was a RN. The patient care attendents had masters degrees in psychology and essentially were the equivalent of a CNA in the med/surg hospital and they made what a CNA makes. The field is saturated with psychology majors and no real jobs for them. The hospital was begging for RNs so I applaud your decision to pursue nursing. I think your degree will help you quite a bit once you get into the workplace. The nursing degree will provide a general knowledge base for you with psych as one of several rotations. Your psych major will provide you with an educational edge that your nurse colleagues will not have. The experienced psych RN will have the skill needed to be successful due to on-the-job experience. As far as the course work helping you, you have to meet all of the prerequisite requirements of the school of nursing. If your degree satisfies those then great, if not, you will be taking more prerequisites. Good luck. It is a great field and you should do just fine. Good psych nurses are hard to find. Once you receive your RN and start working, I encourage you to pursue the psych certification and the addictions nursing certification. Great credentials to have.

One of my favorite topics. I spent 7 years in psych nursing. Got into it because when I went back to school the psych hospital was offering great shifts that accommodated my school schedule well. I came from critical care nursing and shared the view of one of my colleagues who said that going from critical care nursing to psych nursing was like going from a Porsche to a VW Beetle. What an arrogant and narrow-minded statement to make!! When I first started I thought it was a cake-walk. Nothing to do but sit around and talk to the patients and give out meds. Was I ever wrong, it was a classic case of "I did not know what I did not know." There is a specific set of skills needed to be a successful psych nurse. People that are patients in the psych hospital are usually very emotionally and mentally vulnerable and the words you use and actions you take have dramatic effects on these patients' decisions and thus their outcomes. I found it to be like any other area of nursing. You must identify the things you need to learn and sharpen your assessment skills. Most critical care nurses can't tell schizophrenia from schizoid-affective disorder or a personality disorder from psychosis. Just like most psych nurses can't interpret cardiac rhythms. One problem I observed is that nurses new to the psych area tend to interject their own opinions and make many value-laden and judgmental statements thereby interfering with the patient accomplishing what they need to accomplish in their own mind. It is a fascinating area to work and very rewarding. It takes a great amount of skill to be able to discern behavior and determine if it is harmful or not to the patient. Many social factors involved. We can talk more if you like. I certainly miss psych nursing, I enjoyed more than any other area I have worked.

Oh yeah, and the doctors usually park for free right next to the entrance, most of the time in a covered parking garage. Why you ask? Because administration views the doctor as a money-maker and the nurse as an expense. Until this changes little else will.

I'm telling you guys it's not about employees and their safety etc., etc., it is all about the money. Do the math. $5 per day in a 400 car parking structure that runs, say 80% capacity 365 days per year. That is $584,000 year of income to the hospital. How quick do you think administration will be to give up $584,000 income with virtually no expense tied to operating it other than the electric bill to keep it dimly lit and operate the gates and perhaps a minimum wage (or close to it) attendent.

How do you define "safe?" How do you define "decent working conditions?" Exactly what do you have in mind that constitutes a financial package that is a reflection of the RN's practice with the proper respect? These are broad, general statements that does not take a rocket scientist to figure out. Yes, to remedy the nursing shortage we must retain our nurses. That is the easy part. When you begin asking bedside nurses to specifically define safe care, decent working conditions and good financial packages the variation begins. Don't mean to sound sarcastic, but . . . come on, we all know this, how about some specific suggestions.

I worked in dialysis for a year and a half some time ago. There were several "little old ladies" that came to dialysis and they loved it because it was their time to socialize with the others and watch TV. They loved the attention they recieved. I got very close to one lady, she lived alone, we were all she had in this world. She was found dead in her house one day by a neighbor who checked on her because we called when she failed to show up for dialysis. I cried and mourned her death like she was a close family member. It hurts bad. I think it is OK to become attached to your patient, I think we are in trouble if we loose that ability or become so cold that we refuse or cannot connect with another person.

I agree HBS- I think unrealistic expectations or unclarified expectations are the main contributor to divorce. Seems the marriage gets into trouble when one party feels like the other party is not living up to their end of the "contract" or bargain. It does not matter if they are a nurse or in nursing school or any school for that matter.