PICURN

If you can find any of the old Laura Gasparis Von Frolio CEN review VHS tapes, she is awesome. Some of the information may be a little dated, but a lot of the fundamentals and the way she explains things is wonderful!

I worked in those conditions 12 years ago. As an ER nurse, I had no idea how to care for floor holders. I would work 12 hour shifts that would turn into 15 without eating, drinking or bathroom breaks. I'd get home, throw my backpack on the floor and had a hard time deciding which I needed more-to eat or pee. It was always full and there were times EMS would wait almost an hour for an ER bed. We did a code in the hallway one night because we had nowhere else. I had 2 TPA patients and 2 other patients all at the same time. I felt like a MASH nurse. After being at work an hour, it felt like a whole shift. I held on for a year in those conditions. Thankfully I worked with a great bunch of nurses. But I had to leave to save my own sanity. I have learned that I'm the only one who can look out for me. The hospital certainly isn't. It has gotten to the point that healthcare truly is a business, not interested in real patient care, but in bottom lines. It's really hard when you care about your job and the people you work with, but if you get your coworkers together to fight for better conditions and it doesn't work, you need to do some thinking. I ended up out of ER for 10 years and finally was able to go back to it. Now I do flight. One patient and 2 crew members. Can't beat those staffing ratios! Besides, maybe the media attention will put enough pressure on the hospital to actually do something. Invite the CEO and Board of Directors to shadow you for a part of a shift. It may give them a little perspective.

I don't have kids but worked on the Navajo Rez in AZ. I can tell you there that the housing is fair, generally the nurses are pretty nice, but the biggest complaint was the school system. Many of the non-native staff home schooled their kids. It was a great experience working there and wouldn't trade it for the world, but be prepared for 3rd world conditions. Many don't have running water or electricity, or have to wait for family or friends to bring them to a clinic or hospital and sometimes wait days to get a ride. Generally I felt well accepted, but there is still some prejudice. The grandmas were usually the sweetest things. There is a small hospital on the Hopi Rez and they are very nice people. The San Carlos Apache Rez was much more challenging, but I hear that White River is a little better. Hope that helps you a little.

I worked contract with the Navajo/Hopi area. It can be pretty remote, but usually the staff was pretty cohesive. We joked that a beer run was 2 hours one way. Most of the people there were pretty nice. Sometimes you'd find some racism. Most of the patients were pretty tough and stoic. Rarely was anyone whiny. It's weird to be by far a minority. Gives you a new perspective on things. I felt pretty safe there. Because of the laws there, there wasn't much crime against Non-Natives. Lots of alcohol related violence even though it's a dry reservation. Lots of drinking of hairspray. Glad I did it. Still working with Reservation Hospitals as a flight nurse.

I agree that safety was an issue and things needed to be done, but there is a chain of command. Maybe the better route would have been to discuss the situation earlier with the charge nurse first and talk about a plan of action. If that didn't happen or things worsened, then call the house supervisor on your own.

Many hospitals in the last several years have developed Codes of Conduct which every staff member including Physicians are required to sign. You should see if that is true for your facility. If it is, some places have real repercussions for violating the Codes. No one should have to work in a hostile work environment. If it continues, you definitely should take it up the chain to your Manager, Director of Nursing or HR. The other sad thing you need to learn is that if you are in a non-team oriented environment, don't be as accessible and eager to help. It will only burn you out when things aren't reciprocated. I've been there and done that. I have also worked in environments where everyone does act like a team and it does make you feel good to be able to help everyone else. I know it's hard not trying to be the perfect nurse, but it's called self-preservation. One thing I have done in the past is find one or two other nurses who are in the same boat I am and we team together to help each other. Good luck. Just know that not every place out there is like that.