"And it's all going to be your fault"

oramar · May 13, 2008

You know, I've been thinking....
Dangerous pastime, apparently, because the more I think about this, the madder I get. I am not doing my blood pressure any favors here.
I have been a member for a while now, read these threads even before I became a member, and I have noticed a disturbing trend. I am wondering if anyone else has as well.
It all our fault.
I don't care what happens, who does it, who causes it, the nurse gets blamed. Management backs up the customer-cum-patient, admin backs up the managers, HR backs up the admin.
So, I dreamed this little warning label of sorts up for all those wide-eyed, fresh-faced nurses-to-be out there. I wish someone had told me what I was getting myself into.
Dear Soon-to-Be Nurse:
A Friendly Warning. It's all going to be your fault.
After school, you'll get a job. You'll be ready to take on the world. Get ready. It's coming.
You'll get asked for medical advice by every family member, friend, relation, acqaintance, and person you don't even know that gets wind that you are a nurse. One of 4 things will happen:
1) You will advise them, they will not follow the advice. They will not get well. And it's all going to be your fault.
2)You will tell them that you would rather not advise them, that they need to consult their regular doc. They won't do it amd that won't get well. And it's all going to be your fault.
3) You will advise them and the advice will not help and the y will not get well. And it's all going to be your fault.
4) You will advise them, they will get well, pass along the advice to a friend, who had a DIFFERENT problem, and he will not get well. And it's all going to be your fault.
You will go to work. You'll go in to meet your patients for the day (or night). You'll smile and be perky. They will complain because they just found out that they have a dreaded disease and they don't want to be smiled at. And it's all going to be your fault.
You'll go in to see your next patient, still upset by the reaction of your first, and are a little less upbeat. They will complain because they have had a bad day and they think that their nurse should be happy just to serve them. And it's all going to be your fault.
The doctor did not order the pain medicine that Patient Number 3 ordered because the patient is a known drug abuser who is only in for his fix. The doctor explicitly states in his orders that he is not to be called for orders for pain. That patient refuses to accept this. And it's all going to be your fault.
Patient Number 4 is NPO, and Aunt Katie can not understand why he can not have something to eat. After all, he's hungry, and you are starving him to death. All the other nurses fed him. You're just mean. And it's all going to be your fault.
The doctor comes in to see Patient 4 and finds him wolfing down pizza that Aunt Katie brought him because she knows what he needs better that you do. They snuck the pizza in as you were coding Patient 5. Patient 4 now has to reschedule his surgery since he ate. And it's all going to be your fault.
The doctor will call the supervisor to tell her how incompetently run this floor is and how no one ever does what they are supposed to do. The supervisor will pacify the doctor and the patients and family. She will tell you to be more careful in how you present yourself, because the patients perception of you, while not measurable, is important. Never mind that you have done everything by the book, to the letter, and that, Oh yes, nuber 5 is alive, thank you. No, no, we have to work on our image and smile, smile, smile, (except around patient 1) even though you may have just herniated your umbilicus doing compressions, because our patients have a perception. And if it goes to heck, it's all going to be YOUR fault.
No, the above did not happen. Maybe I am just jaded. That's why I got away from the bedside, and why I am getting my NP. I want to be a manager that has my nurse's back. That will say, "No, Mr. Loudmouth, you may NOT have 4 cheeseburgers. You may NOT call my nurses foul names. You may NOT help yourself to any and everything on this floor like it was your own personal mini-mart." If I ever acted the way I have seen some sups act, "Well just watch how you present yourself.", I would hope someone smacked me!
Flame me if you want to. I really do think newbies should be warned about things. I think they should be trained how to handle it, not sold up the river. Maybe this would also help with the shortage. Just maybe. Thanks.

there is a truth to this and some days it will be exactly like this but not always

AngelfireRN, MSN, RN, APRN · May 13, 2008

One that DID happen to me-assigned an orientee (as a traveler, which was not supposed to happen) and she did not give her meds. Why? She was hanging out in another patient's room, that was not evenassigned to us. I had told the NM about the girl not giving meds. Her response? "Just watch her." So I gave them myself. The meds were late, AND she did not get the "experience". (she had been a nurse 10 years). And it was all my fault.

I got blasted. She got employee of the month.

aeauooo · May 13, 2008

Patient's colonoscopy prep is inadequate because they refuse to drink it and it's your fault.

A couple of years ago I got chewed royally out by a GI doc because my patient had only taken a few sips of her Golytle.

When he had finished reading me the riot act, we went in together to look at the patient.

She projectile vomited right at his shoes.

THAT was not MY fault!

suanna · May 14, 2008

All pre nursing students should but required to read your post. You summed up the current state of nursing to a tee. I would be best if the up and comming nurses at least knew what to expect.

bollweevil · May 14, 2008

THIS is sooooooooo true!!!!!!!
I would also add...
1. Patient B wet the bed because you were to busy with other patients or urgent needs(or in patients terms...eating bon bons at the desk), and it is all your fault ("when mom says she has to 'go' it means now!....uhgg!).
2. The ice is melting to fast...it is your fault! Momma likes her water COLD!
3. It is our fault we can't tell people when the doctor will be in to see them!
4. Despite bed alarms and ambu alarms and putting that patient in a window room at the nurses desk...if they fall it is our fault!
5. If you have to actually do the ol FEDERAL and STATE laws of confidentiality and deny someone information...oh LORDIE is it your fault!!!!!!!
BTW...this is NOT jaded...it is a real fact...I have had these complaints and the last one, I actually got my life threatened and YES...they were waiting outside of work to come get me as I walked to my car!!!!!

I hope you filed a police report. Next time, just transfer them to your supervisor. Say one time that you are sorry and would love to help but cannot and that you have to hang up because someone is about to fall. Tell them to call back and ask for the nursing supervisor. Meanwhile, tip off the super to await the call. In other words, don't try to win their agreement. Just tell them honestly that you are sorry but can't help and you need to go and refer them and be done with it. You can also tell them to call the doctor for info. :yeah:

bollweevil · May 14, 2008

A couple of years ago I got chewed royally out by a GI doc because my patient had only taken a few sips of her Golytle.
When he had finished reading me the riot act, we went in together to look at the patient.
She projectile vomited right at his shoes.
THAT was not MY fault!

I wish I could have seen that! What was his response? :lol2: :yeah: Sounds like he deserved it.

bollweevil · May 14, 2008

One that DID happen to me-assigned an orientee (as a traveler, which was not supposed to happen) and she did not give her meds. Why? She was hanging out in another patient's room, that was not evenassigned to us. I had told the NM about the girl not giving meds. Her response? "Just watch her." So I gave them myself. The meds were late, AND she did not get the "experience". (she had been a nurse 10 years). And it was all my fault.
I got blasted. She got employee of the month.

How could a traveler be employee of the month?

Why was she in the patient's room?

Did you tell her she was supposed to do meds?

At what point did you contact the NM about her?

How were you supposed to watch her? :bugeyes: Sounds insane.

aeauooo · May 14, 2008

I wish I could have seen that! What was his response? Sounds like he deserved it.

He didn't actually apologize to me, but he was very polite to me afterwards.

I managed not to laugh, but I think the family of my patient got it.

AngelfireRN, MSN, RN, APRN · May 14, 2008

How could a traveler be employee of the month?
Why was she in the patient's room?
Did you tell her she was supposed to do meds?
At what point did you contact the NM about her?
How were you supposed to watch her? :bugeyes: Sounds insane.

She was not the traveler, I was. I could not be the employee of the month as a traveler.

She knew that she was supposed to do meds. She was walking around with the MARs. She was more than 2 hours behind on the meds. I was coding a lady (we coded her 3 times that morning), or I would have caught it sooner. She got booted out of the code because she just kept standing there telling everyone else what they should be doing, while doing nothing herself.

As soon as I found her in that room, clear at the other end of the hall, and found out that the meds were not done, that was when I told the NM.

She said the patient was "attached" to her. He had asked for her to come in there. He was clear at the end of the hall, bedridden, and had she not gone in there, he would not have known she was eve on the floor.

How I was supposed to watch her was never established. The NM backed her up, said we were promoting "relationship-based care". So, in other words, schmoozing is more important than an antihypertensive, a pain med, or an antiarrhythmic.

tk3100 · May 14, 2008

My definition of nursing is all the stuff that no one else wants to do. And you are directly responsible for the outcome of all of it. Not always, of course. But more and more as time goes by.

nurturing_angel · May 14, 2008

My definition of nursing is all the stuff that no one else wants to do. And you are directly responsible for the outcome of all of it. Not always, of course. But more and more as time goes by.

This is so true. I tried to restock the OR after a emergency C-Section once and found several areas of the floor to still have blood on it. I complained to my manager. The solution? Now nursing has to check the housekeepers to make sure work is done correctly!

:banghead:

Jeffthenurse · May 14, 2008

It is true, nurses are guilty first and then have to prove their innocence. It American courts, the defendant is innocent and the prosecutor has to prove them guilty. As a nursing instructor, I always told my students about this and then showed them how good documentation and assertive behavior can often stop the nonsense.