ManicRN911

All nursing jobs are "hard" in their own ways. Continuing education in my opinion, is the least "hard" thing that may be a requirement for a nursing job. They say the best thing about nursing is that there are so many different types of jobs we can do. I don't know if any of them are easy, but you just need to find where you are happy.

The patient thinks they are hurting you when they demand that you don't enter their room again, but you feel so relieved despite the ego bruise. I do feel bad for the coworkers that now have to provide care.

I emphasize with the frustrations OP expresses. Working in an inner city ED, we have many frequent flyers that every staff member is quite familiar with. Having to spend time on someone who comes in every night with the same complaints and demands can make you feel abused and manipulated. I agree with dirtiehippiegirl, they are often less than nice. In fact, my experience has been that they make up a large percentage of the most demanding and abusive patients I have had, demonstrating "learned helplessness", will not be cooperative until they get what they want (such as food or pain med), and just plain old nasty treatment towards staff. They continue to behave like this despite countless hours of staff trying to communicate therapeutically and all the other buzz words you'd like to use. The reasons behind their behaviors do NOT make it easier to care for them for most of us. If it makes it easy and frustration free for you to know all the reasons that led the patient here and acting like a meany then that's great for you. When you have a heavy assignment, have a critical patient(s), are short staffed, been putting off that bathroom stop for the past 4 hours, and have a ton of charting to catch up on, to be verbally (or physically) abused and threatened and manipulated, by the same patient who made your shift harder last week, does not inspire empathy in many people. Most of us do suck it up, and do not let it interfere with the care we need to provide these patients. And no, not all of the non-compliant or frequent flyers are nasty to us, some are as sweet as can be and just trying to get by. I highly doubt those patients are the ones that led to OP's frustration even thought they do use up as much resources as someone who isn't nice. OP did not send this post as an email to the hospital administrators, she posted on AN forum as an outlet for her frustrations hoping to connect with others who have lived this frustration. I find it hard to believe that anyone can honestly say they don't form opinions about their patients. I think the use of the word "judgement" has skewed the concept. It leads us to relate it to their being a negative outcome due to judging someone just like in a court. What everyone is calling "judgement" is actually just our personal opinion we have developed about someone or something. We keep those opinions to ourselves most of the time and do what we need to do. I do find it makes me feel less abused to remind myself that this life the patient lives, is not one that anyone "chooses". I do not think of them as victims either (unless they are actually a victim). I treat all patients as real life human beings, and I'm sure OP does too. I also remind myself when I need to, that this is a problem I CAN'T fix and should not look at it as one. Nurses want to make things better. It is discouraging when you are not able to, it can make you feel helpless and overwhelmed. Encouragement from OP's peers is what this nurse needed. Helpful advice like dirtyhippiegirl's post and empathy for or acknowledgement of OP's frustrations would demonstrate more support for nurses and nursing. This is just my opinions based on my own personal experiences.

I was going to post something similar to this. If you feel that you were reprimanded (verbally or otherwise) for your actions in the care of this patient, then you absolutely should move it up the chain of command. At my hospital, I would file a grievance with HR if I felt that I was not being heard by management. A letter to the DON can be very effective. If there was something else that you should have done or they felt would have been a better action in the care of this patient, then this should have been a learning opportunity. Unfortunately, those who suggest you find a new job, know this type of environment too well. It is toxic and could end your career (either by their lack of support of and passion to belittle nurses leading to you holding blame, or making poor decisions in the future, or by your own burn out). The best thing I ever did was leave my first nursing position. I was scared to leave and start out new all over again, but now I work for a much better hospital where RRTs are encouraged to be called by anyone and nursing mistakes are taken seriously enough to find ways of preventing the same mistake in the future through research and education. I also am not one to push the "find a new job" advice that seems very popular on all nursing forums. But I truly feel that everyone on here that has advised you make the change, really cares about you and has your best interest. This story strikes a cord with every nurse (or other healthcare worker) that felt they did the best they could with what they had, just to get crapped on by management, administrators, coworkers, providers, or whoever after the fact, yet none of these people were available during the event to be of any help. RRTs were looked down upon at my first nursing job. In fact, if you wanted to get the resident bedside quickly but they were not listening, you could tell them "then I will be calling an RRT" and they will magically appear at bedside in mere moments. At my current job, they had to do a lot of education to get it out of the doctors' heads that "it looks bad" to have an RRT called for their patients. An RRT is NOT bad practice, and it does not indicate that a provider should have done something else. It shows that there was a change in patient status that needs to be addressed ASAP. Our RRT is staffed 24 hours/day by RNs that were hired specifically for RRT. They continue to follow patients that RRTs are called for throughout their stay. They go from floor to floor just to check on the the staff, see if they have any questions or concerns about anyone in their care. The reason I wrote all this is because if you do choose to go up the chain of command, you should not just take a complaint, you should always have a suggestion for improvement. This will let them know that you are not just some miserable employee who can't take criticism, but you are actually an invested nurse who cares about the future of your hospital and are willing to be part of improvement.

I have thought about this topic a lot actually. To answer the question, do I tell the staff that I am a nurse? No, but I do not hide it either. It usually works itself into the conversation organically somehow. Either by casual conversations with staff or by my questions and/or responses. I also do not say anything about my profession when I am the family member. While at the hospital for my grandmother during her last days, the nurse came into the room to pull my grandmother up in the bed -which me and my family had done ourselves earlier. The nurse noticed that we had pulled her up. My mom blurts out "Well she's a nurse!" as she points at me. I could feel my face get bright red with embarrassment. I could practically feel the nurses mental "eye roll". I practically snapped "MOM!" and let her know not to do that again. The nurse found it humorous after my mom said "Ooh, I'm sorry, she hates it when I do that". (Side note: mom's reasoning was because she thought the nurse wasn't happy about it, I didn't get that impression at all though.) My reasons for not wanting to disclose the status as an RN: my experiences with my own patients and their family members. Usually the patients or family members that make a big announcement of being a "nurse", are dismissive of the staff, act hypercritical of their treatment, and yet their complaints have usually shown a lack of knowledge in a particular area. Yes, yes, I know, opportunity for education! Right? Well you can try, but how do you teach someone who already knows everything? On the other end, the nurses who do not make a big announcement of their chosen profession when entering the building, have been some of the most pleasant encounters I've ever had and very appreciative of everything. Of coorifice, we do end up realizing they are nurses by their questions or vocabulary or just casual conversation. I have had the L&D nurse manager as my patient, (we were already acquaintances so there was no need for introductions). She did not pretend to be an expert in my field and I did not make assumptions about her knowledge. Having a patient "verbalize understanding" is something we chart so I see nothing wrong with anyone bringing up their knowledge about any topic we are discussing. I do believe that I have encountered situations where a patient or family member informs us of their job as an intimidation tactic. Although, I'm not worried that I have been doing anything wrong or incorrectly, I am worried about their perception of such. I do not appreciate being treated as though I'm taking a test while trying to do my job and take care of my patient. I am doing my best to make a patient comfortable, so I do not understand why someone is actively trying to make me uncomfortable. My coworkers and myself have found that most pts and family members who exhibit this kind of behavior, usually state "I work in healthcare". (I could start a whole other thread about that). Further questioning brings to light that they are not in fact an RN, LPN, CNA, Tech, Dr, or anyone else actually involved in patient care or has the knowledge that we do. Which is why they state they work in "healthcare" instead of saying what their job actually is. These aggressive behaviors are why some nurses get that anxious feeling when told their patient in rm X is a nurse. I see nothing wrong with the idea of "taking care of our own". What does that mean in terms of a difference in care? It means I might go all over the hospital to find you a pillow when the ER is out of them. It means I offer to grab you a coffee when I run out on my break to get myself one. Things like that, to make your stay a little bit more comfortable. It does not mean that I give subpar treatment to patients who are not nurses. The idea that is what the OP meant is insulting. But if you want to refuse my extra offerings based on the principle that all patients should get the same treatment, feel free.

I just wanted to piggyback on this great advice! My first nursing job (at a Magnet Hospital on a Med-Surg/Tele floor) was hell all due to the bullying. I left after 8 months and a new place felt I had enough experience to hire me. I was so angry about the behavior of my coworkers and manager at my first job. Even more angry at myself, for letting them get to me and not doin anything about things they said and did. I was 30 years old, a mother, a veteran, and am not easily intimidated, but because it was my first nursing job, I was scared and did not know how I should have handled things. So much regret. So when I started my second job as a nurse, there were still some bullies but it was not nearly as bad as the first job. I decided to handle it much differently. I asked for help to clean up a quadriplegic patient that also needed sacral wound care. No CNA available so I asked my co-worker who was also one of the night supervisors if she could help me. I forget what she said exactly, but she gave me a hard time and in front of our co-workers. So I said "I asked for help not for a bunch of attitude. If you can't help or don't want to, then just say that". You know what happened? She smiled and said, "let me finish up this chart and then I'll be right there." After she walked away, another nurse came up to me, was super excited, and said "I can't believe you said that to her! She always talks to everyone like that and no one says anything! I'm so glad you didn't put up with it." The bully ended up becoming one of my work friends after that. But I let her know that she can't talk to people like that. She seemed to settle down somewhat.

I've been an RN for 7 years, and been dealing with my bipolar disorder for the last 15 years. I would not recommend sharing your diagnosis with your bosses or coworkers. Unfortunately, it's a diagnosis that is very misunderstood by many healthcare workers. In a world where "bipolar" is used as an adjective describing someone with unpleasant, annoying, and even psychotic behaviors, instead of only used as a medical condition, there IS a stigma. People say things like, "I can't stand Mary, she's like totally bipolar!" It has become an insult. It disgusts me. You would never hear someone say "I can't stand Mary, she's like soo diabetic!" I have found that many great nurses have mental health conditions such as bipolar. I feel like having bipolar, it has given me great empathy towards others and drives me to give the best care possible at all times and connect with many patients, and putting them at ease when they feel they usually would feel like they are being "judged". No, I do not disclose my diagnosis to my patients either. You must remember that you have to take care of yourself first in order to be able to provide great patient care. Keep on top of your diagnosis with regular dr appointments and find people that you can share your problems with that will support you. Have a safe plan in place. Someone that can recognize your symptoms when you may not. You can apply for intermittent FMLA in place to protect you from being fired for missing too much work. (Refer to your HR to ask how you do that. It's usually through a bird party company so you still are not disclosing your Dx to your employer). Your medical history is private and no one's business at all. You have no obligation to tell your employers. Good luck to you. I started out on a busy Med-Surg/Tele floor on nights. The ratio was 8 patients for every 1 nurse at night. I hated it! Most of the staff and the nurse manager were just toxic. I left as soon as I got enough experience for a better job for me. I now work in a very busy inner city ED and love it! Bipolar or not, staying in a toxic environment will greatly affect you mentally and possibly physically.

This honestly sounds pretty crazy to me with the ratio and low pay rate. I notice your post is from 3/14 so I was curious as to what your outcome was. One suggestion I still have is to request a day to shadow a nurse on the floor. This is not accepting the job but you follow a nurse for the day and just "watch". This gives you the opportunity to ask the working staff questions too!

I am so sorry that you are having this experience. I know how disheartening it can be as a new RN. Wasn't it so exciting when you finally graduated and then passed the boards? All that hard work just to be miserable, and being treated badly while working your butt off. My first job was the same. Most of my coworkers were the stereotypical "bullies" nursing has a bad rep for. So was my nurse manager. When I think back, I can't believe I put up with it for even a minute without filing a grievance. Fear was the culture as well as back stabbing. I got out as soon as I could. I ended up leaving that hospital completely. I did not want to leave the hospital initially but that turned into me not wanting any part of that hospital. Now my biggest question when I interview is "How do you handle mistakes an employee makes?" First job: being insulted, talked down to, or even screamed at over the simplest things. Like taking one of the phones home by mistake. (Yeah, I was back the next day and there were plenty of other phones to use, but make me feel like a piece of crap who should lose my job if I don't bring it back right now!). Current job: mistakes are a learning experience for everyone. One of my coworkers had a major Med error and everyone in our chain of command including the CNO were very supportive she says. I pray for you. Hopefully as you move on, you will remember this experience and make sure you never contribute to making anyone else feel like you do now. That is one promise I have kept to myself and am proactive in trying to make things better by joining committees. Good luck!

I worked in a large inner city hospital on the Observation Unit for almost 5 years... until recently. Our obs floor is run by the Emergency Department. They moved the unit to a different floor to add beds. Now the obs floor is on a Med-Surg/Tele floor. In that process, they had to transfer the nursing staff to be part of the inpatient floor (Obs patients are not considered inpatient. Observation is considered outpatient despite a patient "being admitted" to obs and staying overnight in the hospital). I chose to stay in the Emergency Department, which we all spent many shifts on already when they were understaffed. Working on the observation floor was a unique experience but it is not for everyone. From what I know, many of these Obs floors can be very different from one another. Congratulations on having two job offers as a new RN! That is amazing. Making the decision on where you want to work can be terrifying and even more difficult without prior knowledge and experience of what you're walking into. So many different things factor into what is considered a "good" job that goes way beyond pay and schedule. Plus, sometimes the type of work you are doing is not what you expected -no matter how many questions you ask beforehand. For example, when I accepted my job on the Obs unit, I was told that we would occasionally be boarding inpatients when there were no rooms, and occasionally be pulled to the ED. Turns out, occasionally meant "all the time". I loved my job because I had amazing coworkers, which I hate to say, has not been the norm since I started nursing. The job itself was not loved by many. We hired many new grads on our floor that did well but eventually left once they had enough experience. I don't believe they learned so much from Obs itself but their exposure to the ED. One of the NPs I worked with did Infusion before she was an NP and loved it. It sounds to me like you are leaning towards the outpatient chemo job. Sometimes our gut reaction is the right one. I was nervous about whatever first job I took setting the tone for my career too. But if you are a highly motivated person, you can make the change. You will know if you like this job (whichever one you choose) within your first year. That is still early enough for you to choose another path. Plus gives you a year of experience! I was always exhausted after clinical days on inpatient floors. I stayed exhausted as a new RN on orientation and could not imagine doing 12 hour shifts vs 8. But now I love doing 3 12s and can't imagine having to work 5 days/week as a nurse. No matter what kind of nursing it is! (I think I could do a 4 day week though). You can request to shadow a nurse for a day at each unit to see what it's really like. -Sorry this was so long. Good luck!