PennyWise

Once, I was on a travel assignment in Baltimore, and the staff nurses had an issue with me from the start. Reason: I had my own stethoscope. Some of the phrases directed at me: "Gee, aren't you just the boyscout RN coming in all prepared with the high tech equipment." "What? Are you trying to pretend you are a doctor or something now?" "Why would you buy that? You will never be reimbursed for it. I only buy whatever it takes to be in compliance with the uniform policy. They don't pay enough for frills like that." Shortly after I was off orientation (lasted two weeks, the average orientation time for travel RNs), I was informed I would be charge nurse for the majority of my shifts. Then, there was a staff meeting in which the staff nurses were told they were not conducting proper assessments. One Nursing Supervisor quipped "All but one of you don't even have stethoscopes. How are you assessing lung sounds and heart rhythms? Do you put your ear up to their chest or something?" The comments directed at me intensified for a couple days, then died out as the administration started nailing people for poor documentation and for being out of uniform (no stethoscope). I did not renew my contract at that facility.

Way back when, I was a landscaping supervisor. I often tried to venture out into other fields, I was only doing landscaping because it was what I had done when I was younger, I did not like it at all. One winter, I landed a job in a quality control lab with a company that did a lot of chemical contracting work. It was my DREAM JOB. Walking distance from my apt., a good bit better pay, benefits including vacation time and retirement, indoor work away from the snow, it was everything I was looking for in a job and my plan was to work for this company until I retired. I got along with my co-workers, the boss never had any critical comments for me, I was doing quality work at a good pace and of course I followed all the common sense "good worker" rules: arrive early, never stay late unless they asked me to, stayed well within the confines of m lunch break time limits, in perfect compliance with uniform policies. After three weeks I was let go. They sited "unsafe work habits/practices" as the reason. Someone had seen me walking down a flight of steps with "heavy boxes" in my hands (a safety no-no in this place, they had transport elevators you put stuff on so you never had to carry anything up and down stairs). The truth was, the box I had been carrying was only slightly bigger than a shoe box and it was empty. The only reason I was even carrying it was because another tech had walked upstairs with it, emptied the contents, and I was taking it back to the supply room to be refilled. I called everyone who would listen to explain the story: shift supervisors, the manager, HR. I even tried to get in touch with with the company president. It was to no avail. Those who bothered to listen, and they were few and far in between, gave me a prepared answer and informed me there was nothing they could do for me. In fact, I believe one supervisor did say "Maybe you just weren't a good fit. I'd move on." Well, years later (like, three years) I got the truth. I ran into one of the supervisors who bothered to try to help me. He had left the company not long after I did, but under his own circumstances. It turns out, the contract my unit had been working on was cancelled by the company. Why the contract was cancelled was never discussed with the employees, but it was heard through the wind that the client had missed a couple payments on the contract. The company had over hired expecting this contract to last many years and was left scrambling to find work for the people who were left in the lab. Some people had to take short term part time work until something opened up elsewhere that was full time. Others, like myself, who had limited time with the company, were simply let go because there just wan not enough work to go around. Keeping us, the newer workers, would have meant forcing a number of other people into part time status. These are people who had been there for a number of years, owned homes in the area and had proven their value. All of us who had been let go were given "You're not a good fit" and "Your work habits were not what we are looking for" explanations. Not that your M/S unit had a cancelled contract or anything. But, I think it goes to show, the behaviors of companies/employers is unpredictable and never well explained to us, the employees. They have their reasons for doing things and don't feel obligated to explain them to us. Don't waste your time trying to apply logic to their actions. You'll never have all the details or the whole story to work with so..........you'll never completely connect the dots.

I like working New Year's eve, don't mind working New Year's day. Its just not my holiday, not my thing. I don't go out drinking or partying or anything, but I feel trapped in my apt. because if you do go out to do anything (shopping, eat dinner out, w/e) it's crowded and noisy. So, I don't go out and end up sitting in my apt. I enjoy going to work instead, get a day of work out of the way, let people who want to go out do so.

Ah, OK. My problem is, I like the list that is presented in the original post, but can't find it anywhere. I've got a lot of other lists of criteria, but none that are anything like this one.

LOL. Well, if thats the case, I can't use it. Not allowed to reference Wiki for my papers. My teacher says anyone using Wiki will receive a zero on the paper and asked to move to the back of the class (she is kidding but you really can't reference them).

The criteria the TC used to distinguish what a profession is...........where did that come from? I can't find it.

Eeeh sonie, why my hospital is SO OLD.........it was around in those days when hospitals didn't just get whatever they wanted. They had to earn things. It walked to school, it didn't get to take no bus.......AND UPHILL BOTH WAYS. My hospitals parents didn't buy it no TV and video games..........it played baseball in the street with a stick and a rock, used cow flops to mark the bases. And my hospital didn't misbehave like today's young hospitals. If it did get outta line, it'd get beaten on the behind with a bat that had spikes, then would be sent to its room without dinner and would have to live on water and bread for three weeks........................

I do have a set schedule, but that is extremely rare in the hospital setting. I have it because I am in school and like my days to land a certain way. I go to school on Mondays, and I work night shift. So, I work Thurs-Fri-Sat night shift every week (12s). That gives me the day before, day of and two days after my school day off. Mind you, I don't get this schedule simply because it is convenient for me. I get it because it is convenient to my unit manager. Those three days, night shift, are hard to cover. I'm filling in a need for them. Its not as if, say.....if I went to school in Fridays I could ask for T-F-S-S off every week. Just wouldn't be granted.

Yeah........like, in Alaska............when they go through the 30 days of night...............when is nightshift? Do you work 30 days straight? I bet nurse burnout is AWFUL in Alaska.

We have more than one princess on our unit. Three actually, and they are all friends AND they are all friends with the DON. Untouchable in everyone's eyes. Then there is me who calls them out on the mat and tells them "no" when they want unreasonable accommodations. Yes, they play the popularity game and tell everyone I'm not a "team member" and I'm a grumpy old nurse "who eats their young"...........but their attempts to bother me are toothless, all bark. Maybe I'm a little suicidal or something, but I don't think the 5% are as capable of enforcing their wishes as they/others think. I tell them "no" just the same as everyone else, enjoy the temper tantrum show and move on having stood up for myself. In short, I call their bluff. So far, none of them have been holding a hand as good as they proclaim to have.

That pretty much sums it up. The longer version: They exist because we let them. The amount of attention and effort is takes to redirect an individual like this is taxing and demanding. Eventually, it is just easier to let them have their way because there are just other, more important things you need to attend to. Why does it take so much? Because they are calculating and persistent. Selfishness rules their though processes and actions. They are manipulative to the core. I place many of these individuals in the same category as sexual predators and serial killers. Think that is too dramatic? Consider this: If you were to take a rape prevention class, the first thing they tell you is "Its not your fault, the person who did this to you is wicked and built for taking advantage of people." Sexual predators can walk into a room full of people, not say a word to anyone, and pick out the 2 or 3 individuals who are vulnerable to their plans. Its as if every neuron they have is directed towards getting an advantage over other people. Same goes for serial killers, they know who will put up a fight, who will fall for the tricks and who won't. How does this group of princes and princesses take advantage of us? They use a rarely talked about but very present (like the pink elephant in the room no one is talking about) human trait against us. It is our natural tendency to treat well liked, charismatic people differently. Ever notice how some people can tell a joke, and no one reacts, even if the joke is hilarious. On the other hand, someone who is "popular" can tell a bad joke and everyone will laugh, because they want to share a moment with the person. Same part of human nature gets triggered when these nurses do their thing. First, they make everything a popularity contest. They work hard at getting on everybody's good side, whatever it takes. They are bubbly, understanding, into the same music you are, have the same hobbies you do...........blah blah blah. Just like a car salesman, they win as many people as they can over. They are seeking favoritism and preferential treatment though, not friends (much like the drug addict seeks narcotics). Then, slowly but surely, they start asking for this and that accommodation. At first, no one notices, its no big deal because we love working with them. Eventually the accommodations become expectations. One day, you look up, and this person you used to like so much has turned into an intolerable brat who is more demanding than anyone should ever be allowed to be. Good luck turning things around once they get to this point too............may as well be telling the heroin addict "you must stop now." On the bright side, there is a solution. Just as sunlight kills the vampire and Superman has to worry about kryptonite, these nurses have their thing they fear. That thing is assertiveness. Assertiveness is like garlic, a little bit goes a long way. If they are held accountable and are expect to perform just like every other nurse, from the start, the behavior never gets to pick up enough steam to be effective. You'd be surprised at how these people react to being told "no". I do it all the time, actually get some enjoyment out of it. They'll be sitting at the nurses station, scanning Pintrest or Facebook and ask me to do them "a favor" (answer their call lights, get the stuff they printed off the printer for them, w/e) and I always say no. They are like children who have had their Christmas toys taken away. Some throw tantrums, others get embarrassed and go into hiding for close to an hour. The reason so many of these nurses exist though is, the assertiveness must be consistent. Just as when you are dealing with a staff splitting patient and each nurse, from shift to shift, must be consistent in their reactions..........so too must the leadership on the unit be with the prince/princess nurse. This is where we fail, and the monster is created. They are like children who know dad will OK something but mom won't.....and they act accordingly. Charge Nurse B must follow Charge Nurse A's lead when refusing to accommodate them, and the manager must be on board too. How often do you see nursing units where everyone is full on board and consistent?

Other than CC numbers, address and birthdate.................I don't tell them a thing. It's none of their business.

I agree with the double assertion that there is a double standard. I've had females sit right next to me and talk about the very explicit details of their love life. Too much detail and imagery. I'm not made "uncomfortable" easily and I was........... Now, take the same situation, but make it two men sitting next to a female nurse discussing things. Even if they don't care to admit it, many people see this as a completely different thing. Not saying I believe you to be this way, but believe it or not, a lot of the write ups concerning lewd jokes/harrassment come from.........guess who? The biggest culprits of the exact same behavior. Why? Because people see how they act, assume they are OK with that sort of joke/conversation and proceed accordingly. I would have told the nurse to stop showing me pictures, then go from there depending on his response. I've had nurses tell me my humor makes them uncomfortable.........and I appreciate it and respond by curbing the jokes. On the other hand, if I were one of these people who responded by ignoring your warnings or calling you a prude........then there is a problem that requires mediation from management.

I believe, when used properly, 12 hour shifts have many advantages over 8hr shifts: The unit only has two shifts to staff, not three. This makes for easier scheduling. There are less reports (hand-offs) to perform each day, meaning the chances of there being errors resulting from communication break downs are reduced. Each worker has more days off than on, giving them ample time to attend to personal issues and to enjoy their "life at home" and many other things. Problem is, this only works if the 12hr shifts are "used properly". I don't think when 12hr shifts were introduced, they were intended for people to get more hours. For nursing, they work fine if you stick to working three shifts a week. Do anything more than that, and you are greatly increasing your risk for burn out and fatigue. Hence your chances of making an error or becoming frustrated are much higher. Too many nurses choose 12hr shifts simply to help squeeze in working another job or more OT. While I'm sure their intentions are not to get burnt out and to be less of a nurse, that is exactly what happens. Working so many hours without the extra days off is poison, and no matter how well they think they have it under control, eventually the poison starts affecting them. This is why I won't work a second job despite the fact that I'd like to save enough money to buy a house, and I don't work OT unless it is beneficial to me (and never two weeks in a row). When you decide to work 12hr shifts, you have to plan for resting time.

I am a Pittsburg Pirates fan. Not a very good team, but they do their best with what they have. Unfortunately, a culture of losing has taken over the organization. At times, it seems the baseball gods are making it their creed that we never become winners. It doesn't matter how much talent we have on the field, how hard they play, how well the manager manages or if the GM is making the right moves or not. We lose, either way. Only thing that changes is how bad we look while we are losing. I think LTC has a "culture of burnout" much like my favorite baseball team has a culture of losing. LTC facilities foster an environment that promotes poor moral, burnout and poor coping mechanisms. Some people cope by being married to their jobs and letting their personal lives fall apart. Others turn to drugs and/or alcohol. Some lose their compassion or motivation and stop trying to make things work. The list of symptoms created by the LTC working environment is endless. Yes, excessive call offs and having to take a "mental day" every single month is one of many coping mechanisms nurses in LTC rely on. This is, of course, assuming the call offs are simply mental days, as you seem to believe they are. When being critical of this behavior though, keep in mind the essential point they teach you in nursing school when you are dealing with an individual who is relying on "Ineffective Coping Mechanisms". That point is: Do not take someones coping mechanism away from them without giving them an adequate replacement. It's a nice way of saying "Don't take away the drug addicts drugs unless you can treat the withdraw." So, I understand you think the behavior should stop. What do you propose to do about it? How can the environment be changed in such a way that the "mental days" are not so necessary? You made it clear there are many nurses doing it, so I can't help but draw the conclusion that its the system, not the people. This is not a case of nurses being lazy or selfish, as you implied (maybe unintentionally). This is a case of a facility wearing down its staff to the point where they have to take extreme measures to protect themselves. Even if you worked with each individual nurse and gave them counseling to the point where they could handle the environment as is, it'd have to be an ongoing process. You'd have new nurses coming in who would need counseling, most of the nurses already there would have to continue theirs............ Or, you could change the environment so that it is not so toxic. Sort of take a "Treat the disease, not the symptom" approach. I'm sure the administration of the facility are well aware of the problems and how to fix it, but they don't. [nudges shoulders] I wonder why? I'm willing to guess its because they are not willing to spend the money it would take and they, to put it bluntly, are not interested in being that invested in the patient's care or their employee's well being. So, the problem continues on, with the symptoms being held in check by attendance policies. Its the cheapest, easiest solution. To sum it all up: The problem is the facility and it's lack of compassion (for both the patients and it's workers), not the nurses who are put in a position of having to take mental days.

Ah, I guess there have been studies. lol

I wonder if there are any official studies done on this? I'd be interested in what they have to say. IMO, the burnout from M/S units and LTC facilities would probably lead the list. The problems these places face are too many to list. Other specialties have their own problems to overcome, but these two areas deal with that and more. For me, it comes down to unsafe staffing. The M/S and LTC facilities are given ratios that are TERRIBLE. So, even if everything is in place and all is going well, they still are practicing under unsafe conditions. Then, you have the days where staffing is not ideal.......and they get pushed even further over the ledge. Now most people would read this and say: "Well, everyone deals with poor staffing, not just M/S and LTC." To a point they are right. What people who have not worked in the environment don't understand is, there is a level of respect given to other specialties that is not given to M/S and LTC. So, say for instance, the ICU is short staffed. The Nursing Supervisor will do everything and anything to make it right. Patients will be pushed out of said ICU onto step downs (and M/S) before they are ready, people will be floated here/there in a way to accommodate the ICU...........there is much more effort to right the ship than with other units. On the other hand, if staffing is unsafe on a M/S unit, the attitude is: "Well, you are M/S, high patient ratios is what you do because you can't handle high acuity patients." No extra effort to fix it or accommodations made. Never mind that there are patients on the M/S unit who are well out of the scope of what level of functioning a M/S patient should be. Heck, my preceptor at my very first job used to say to me "I don't know what they are doing sending us these patients who need monitoring. Used to be, I could handle a load of 8 or 10 patients without a hitch. BUT.....all but one or two of them were patients with simple medical needs. They'd all get up, go to the BR on their own, needed very little help with anything other than having their pills handed to them. These days, we have 6 patients, but two of them should be in the ICU. So, we basically have an ICU assignment plus four more to watch. It doesn't work." I see her point these days. My current unit is terribly understaffed, but it is not M/S or LTC........so when we are really in trouble, the powers that be care enough to at least attempt to fix it. Not so on my old M/S units. Thats why they burn out so fast.

I currently work nights, mostly because that is where I am put, not necessarily because it's where I want to be. My manager is free to use me on either shift, as long as I have the days I need off for school. It's a trade off. My motto for comparing the two shifts is: "Days are busier, nights are harder." Mind you, "harder" is not only talking about the shift's work involved. There are many threads on here about the difficulties people who work nights regularly face: Insomnia, oversleeping on days off, lack of energy/motivation on off days, social isolation, weight gain, increased tobacco use, sometimes even depression. Me, if all is equal and I have a choice, I'd be on days. I don't care that the shift is a good bit busier. I'd feel like a normal person as opposed to some zombie who is denying their own body's impulses.

I have to disagree with the comments that nursing is more stressful than school. Not because I don't think nursing is not stressful, but because I don't think the comparison is really fair. "Is nursing as stressful as nursing school?" is like saying "Is doing your taxes as stressful as driving on the highway when there is construction going on?". They really are that different in my mind. Nursing school is first and foremost designed to get you to a point where you will pass state boards first attempt. Everything else is secondary. The state boards are designed to predict whether or not you have the "critical thinking" skills to be a nurse. It can not however predict if your personality is a good match, if you have the physical means to handle the pt. lifting/moving, if you are good at managing your time well enough to handle a full patient load. So, the stresses encountered in school, while being prepared for the state boards, are completely different than those faced by a staff RN on the unit trying to handle a full patient load. Whether you find one or the other more stressful has more to do with what kind of stresses and challenges you deal with better. Me, I agree being an RN is more stressful, but nowhere to the same degree the people who have posted before me say. I found school very stressful and just plain annoying. There seems to be some virus that has infected a great many nursing program coordinators, and the symptoms of this virus are disorganization, anxiety and inablility to stay focused. Every program I have attended or talked to others about is poorly managed and chaotic. They are hard for all the wrong reasons. I don't deal with this style of incompetency well, it angers me, hence I find school very stressing.

Oh my lol. I guess maybe I am being a bit grumpy. You are so right. The conversation from the class I'm talking about here had me.........annoyed. On the other hand, the people who used to sit there in class talking about their family member's sickness had me wanting to slit my wrists. I guess there is a bright side then. I've gone from inflicting damage on myself to being annoyed. Guess thats progression.

Its a good mix, age wise. Most are 25 to 35yrs. I'd say.........eh, 50% of the class falls in there. The other half is a completely even mix of older and younger. I know of a few who are divorced, and all but one of them is still single. For the most part though, I don't know their history/story.

OK. Now I follow you. The use of the word "dependence" matters here, I agree (in hindsight). I meant "abuses". I think my slip came from the term "alcohol dependence". Its considered a bad thing either way. Not the same for the anti-depresents. You can be "dependant" on them but not be abusing them. Am I following you? IDK. Actually, I'm glad this happened. I can avoid the same mishap in my presentation. "How about the hypothesis that someone who abuses Ativan likely has an addictive/drug-seeking personality, and would go on to abuse or divert drugs regardless of their Ativan addiction?" Yeah, I think thats the direction we are taking. But we are only talking about people/students who are actively abusing. Another poster above said something about "those at risk" being eliminated from schools. Like the term "dependence" and "abuse" meant a lot above, the term "at risk" means a lot here. Just because someone is "at risk" doesn't mean they should be targeted, at least thats not our stance. We are focusing strictly on those who are currently abusing drugs, while in school.

I don't know why you would have trouble with it. Abuse of anti-depressants and anti-anxiety meds is not new and is well documented. This is far from a new theory/view. Unless one is taking these meds under the direction of a physician, the risk for abuse is great. When one can not get the doses/frequency they desire from their PCP, they turn to other drugs that are not prescribed. That story is common and far from new. If you are looking at it from the standpoint of someone going to the PCP, being prescribed the med and taking it only as prescribed........meh, risk is definitely reduced. On the other hand, most nursing students I knew who were taking Xanax and Ativan or w/e were not taking this route. Most were running out of their meds less than half way through the month because of all the "extra doses" they allowed themselves to take. Then they'd be left to suffer through the rest of the month with none or with having to find more. And we have not even gotten around to the ones who have the meds but were never prescribed them.

Mmmm, yes and no lol. There is research on students who begin using drugs while in school. We are reading up on that to identify whether or not one can say there is a large number of students who have no prior records or history of use who being using while in school. We suspect this to be the case actually, and if we are right then we will propose a number of different theories on how to help the problem. "many of those at risk would be selectively removed in the school phase" may or may not be a part of our proposed solution. Better support systems so students do not feel the need to turn to drugs might be another. We aren't that far yet.

I finally broke down and called my local BON. This is pretty much what they said. Another poster above also said the drug screens and background checks were for the clinical sites not the school. Thats exactly what my BON said. The answer I got: Schools have nothing at all mandated to them concerning who they can admit to the program. Any policies they have in place with regards to drug screens and background checks are implemented by the school by choice. Indirectly though, the state does control entry into nursing school programs through two avenues: 1. The drug screens and background checks required by the facilities that accommodate clinical hours for the school. If a student can not pass either of these two requirements, they can not complete the clinical course work. 2. The rules governing who can sit for state boards. If someone has something in their background that would prevent them from being allowed to gain licensure, why bother going through the schooling? These are very indirect means of control though.