"Toto, we're not in Kansas anymore!"

live4today, RN · Dec 20, 2003

Hi Tiki Torch

I love your quote! :)

I suppose you will have to weigh the benefits FOR YOURSELF in whether to stay at that facility, or give it up for now until you can move to another location to work, and where your options aren't so limited.

It's no fun working anywhere where your license is put on the line all the time. It isn't worth losing your license over if a mistake happens that can affect your working as a nurse.

I wish you well in your decison. :nurse:

Agnus · Dec 20, 2003

Originally posted by Tiki_Torch
I'm having trouble with an inner conflict at my new nursing job and I'd appreciate any input that could help me resolve it.

I have moved from a job (in another state) where the the philosophy of care given was pretty much state-of-the-art. My new job (the only place within 80 miles) is nearer to the care given 30 years ago. There are other things they do like fudging documents and such that I find morally distasteful.

I'm not a real goody-two-shoes but this place makes me nervous at times. Everyone is so flippant and complacent about things and although I'm trying to tell myself, "This is just the way things are here." I still feel visceral tightenings when I learn of something new that rates rather high on the cringe scale.

Has anyone ever worked at a place which was "a step backwards" from their previous job who could give me tips on how to resolve my inner conflict? My preceptor assures me that "This is the way things have always been here and they will never change." I also get this feeling when talking to the Nurse Educator and Supervisor.

Any comments would be appreciated.

Am I being to sensitive?

Thank you!

A facility does not need t state of the art to be a good facility. However, what you describe is NOT the opposite of state of the art. It is an entirely different issue.

"fudging" documents is first and fore most an illegal act in all 50 states.

A flippent attiude is dangerous in nursing

The attitude that this is how it has always been and it will never change is a red flag to me that any attempt towared change will not bode well.

I can guess you will quickly be seen as an outside interloper if you make any attempt to change anyting, to act differently even as an individual or to improve anything. You will be swiftly dealt with.

You are getting this message from the top on down. Heed it.

Tiki_Torch · Dec 20, 2003

Thank you CheerfulDoer for you input!

I also love your quote and it seems very relative to my current situation... In nearly every life moment, I like to ask myself, "What can the interaction with this person/situation teach me -or- what can I contribute to the advancement of the person/situation I'm presented with?" I have a belief that we are all here to help one another get through life, and I also don't think anything happens by chance... I have always been able to learn something (knowledge, patience, compassion, empathy, joy, whatever) in each situation.

I got this new job less than 3 months ago and when I realized how backwards the place was my first thought was, "I must have been placed here to somehow help this place grow more into the 21st century?" but now I'm wondering if I'm to learn something like, "There are places in this world that will always be backward and that I am to learn how to more appreciate the more state-of-the-art, compassionate, forward-thinking people like the ones I used to work with."

I'm rambling! It just breaks my heart to know how much better the patient care could be and yet to know that the patients here will never get that care. Biggest sigh ever... :rolleyes:

Thank you again CheerfulDoer. I appreciate knowing you care enough to try to cheer me up. You really are a cheerful doer!!!

Tiki_Torch · Dec 20, 2003

Thank you Angus, I'm quite sure you are right... I must either put up or shut up.

Alas, this is where my conflict comes in. I am finding it difficult to put up with it and have learned not to say anything much about the way they practice medicine and nursing here.

My patient advocacy gene is in total turmoil. My only option is to drive an hour and a half on the interstate to another hospital and I dread that like the plague. That long ride is starting to look better though but my husband doesn't want me to do that kind of driving.

Thanks again Angus for the reality check!!

Hellllllo Nurse, BSN, RN · Dec 20, 2003

Originally posted by Tiki_Torch
I'm having trouble with an inner conflict at my new nursing job and I'd appreciate any input that could help me resolve it.

I have moved from a job (in another state) where the the philosophy of care given was pretty much state-of-the-art. My new job (the only place within 80 miles) is nearer to the care given 30 years ago. There are other things they do like fudging documents and such that I find morally distasteful.

I'm not a real goody-two-shoes but this place makes me nervous at times. Everyone is so flippant and complacent about things and although I'm trying to tell myself, "This is just the way things are here." I still feel visceral tightenings when I learn of something new that rates rather high on the cringe scale.

Has anyone ever worked at a place which was "a step backwards" from their previous job who could give me tips on how to resolve my inner conflict? My preceptor assures me that "This is the way things have always been here and they will never change." I also get this feeling when talking to the Nurse Educator and Supervisor.

Any comments would be appreciated.

Am I being to sensitive?

Thank you!

Hey Tiki Torch, I'm going through the same things right now. My facility even calls itself "state of the art" lol. It is a new facility, but equipment is old, refurbished equipment. Things are done the same way they were 20 years ago. It is a dialysis unit.

The pts do not know enough to question anything.

Last week, I was charting and saw that no one has charted since Sept on quite a few pts, whom I know have had things going on w/ them that need documentation.

I know how you feel. Cheerfuldoer and Agnus gave some great advice. Just cover your own you-know-what. Chart what you need to chart. You can't change a place like this. If you try, you will just be labled a trouble-maker, and nothing will change, anyway.

My pt advocate gland and my high-standards gene are having a really rough time, too.

gypsyatheart · Dec 20, 2003

I recently went through a similar experience. I ended up resigning from the place, because I could not tolerate the lack of standards, the fact that I KNEW things were being done so incompetently! Patient care was negligent, my nursing license at risk, and I, too, was met w/the attitude "well, that's just the way it is here, has always been, will always be, isn't ever going to change...". I couldn't reconcile my work ethic with their low standard of care and I left. Best thing I ever did!:roll

Good luck in your decision, it was relatively easy for me because I had several opportunities in my area, even though it did give me a lot of turmoil to leave within a few weeks of starting that job, I knew I ultimately had no other option!

renerian, BSN, RN · Dec 20, 2003

I am working in home health right now and I feel like I walked into a time warp.

renerian:eek:

Tweety, BSN, RN · Dec 20, 2003

If it were me, I wouldn't do anything that made my guts uncomfortable.

As for stepping back in a time warp, if you change your view to the patient and realize that basic care, assessment, etc. doesn't change from one place or time and the rest is just stuff, perhaps that would help.

Rapheal · Dec 21, 2003

I like your term "The cringe factor". lol

The best way I can do my job when being influenced by the Romans- is to ask myself this "Now when the state board asks you why you did this or didn't do this- What will you say Beth?" Motivates me to keep my perspective.

Agnus · Dec 21, 2003

Originally posted by Tiki_Torch
Thank you Angus, I'm quite sure you are right... I must either put up or shut up.

Gosh I hope I didn't come across that harshly.

It is always nice when new blood can come in and make a difference in a place gone stale. But the conditions you describe are not ones where change could easily be introduced.

I am afraid if you follow your gut you will suffer. And because you have good instincts, if you don't follow it you will suffer.

A delima I have no answer for.

If it is any consolation, I too live in a rural area. The closest hospital has a reputation simular to what you describe though I have no first hand experience. It is tiny with administration and nurses that are shall we say not up to par.

I drive on the interstate an hour one way. depending on weather traffic etc can be 1 1/2 hr. My DA is not thrilled about the drive.

On the other hand he does not drive it; I do. He would prefer I work at the rural hosp.

I have to do what is right for me. I actually find the drive is an time to unwind. On those days when I am inclined to carry baggage from work home I can work it through in the car so that I am not bringing it home, and visa versa.

I sometimes listen to educational or inspirational tapes, make plans, listen to music, problem solve etc. It kind of serves as some me time, without interuption.

Tiki_Torch · Dec 22, 2003

i can't thank you all enough for your posts!!! it feels sooooo great to know people sincerely do care!!!

i ended up having an "epiphany" yesterday after much thought on this subject and reading your thoughts.

i found the website of the hospital that's rather far up the interstate and was truly impressed with them. they are an ana magnet hospital, they describe their uint as "family care centered", they participate in nih trials and other studys including infant massage, they describe their nurses as "patient advocates first and foremost", and a multitude of other things that made me salivate! this is the type of place i want to work!

like many places these days, they "prefer" bsn prepared nurses. i have my adn and all but 3-4 classes lacking of bsn prerequisites. the town i live in has a rather famous university with a bsn program which includes a rn-bsn track.

so, i've decided to just sit back and keep my mouth shut, contact the university about what i need to do to get my bsn, and work on it like a mad woman. hopefully in a year or so i'll have my bsn and will apply to the place down the road... if i can stand it that long! the bsn has always been important to me and i've been working on it sporadically since 1991... maybe this hospital's philosophy is the impteus i've needed to get my hiney in gear and finish the bsn.

there you have it. between your words of advice and my deep comtemplation, right now i feel that what i'm to learn from the experience at this hospital is:

(1) finish the bsn i've wanted for so long

(2) gain a deeper understanding of how some hospitals simply are

(3) gain greater appreciation for hospitals with up to date and interested nurses, physicians, administrators, etc.

(4) be able to use my knowledge of this hospital if/when i should find myself at the other, more desirable, hospital (because many of the patients at the hospital here are transferred to the one up the road when they are more critical than this place acknowledges it can handle). i just hope my employment at this local hospital will not count against me when i apply to the other one!!!

thanks again to everyone for their input, and angus, i didn't find your post "harsh", i found it straight and to the point. rest assurred everyone, i'll not do anything that will jepordize my license.... when i put a patient in restraints (which i never do), i'll be documenting it; if i don't check a code cart i will not simply write in some "lock" numbers in the book; i will continue to position patients in the most proper way for their comfort and development and will keep sound and light low when the patients are in my care; i'll ask for pain medication even if the physician says "no"; and i'll keep reading my nursing journals, do ceus to keep my certification up to date, and continue learning and keeping up with the changes in nursing and medicine even if my co-workers tell me i'm crazy for "wasting my time with that nonsense". i could go on and on but i won't.

suffice it to say you are all a great, truly great bunch of nurses and my heart explodes with love for you all!!!

:kiss