Sheez! She's back and venting AGAIN!!

[missrose]

I am a travel nurse.... this is my 14th contract.

Today, my unit manager called me into her office and offered to cancel the remaining three days of my contract. (GASP!!) Yes, she gave me the option of completing three more shifts, or cancelling. I declined to cancel, of course. I listened to her concerns, and I apologized and explained myself.

I am a brutally honest person. While I am very aware (and proud) of my skills as a nurse, I am also very aware of my short-comings... I sometimes (only in extreme moments, I swear!)have difficulty keeping my mouth shut when I feel my patients aren't getting the best care they deserve. I am not very diplomatic. That is why I am not a good charge nurse, nor do I aspire to be one. I am a floor nurse.

Recently, I had a patient who wasn't doing well. I called the hospitalist and he showed up within minutes. I was busy.... so very busy. He wrote orders and placed the chart in the "orders rack", where the unit clerk and Charge Nurse would then enter the orders in the computer and transcribe the orders so that they could be administered. The problem was I didn't get the order.... until four hours later!! When I went looking for the chart, I found it STILL in the "orders rack", not yet entered or transcribed. I was very upset and I said with complete exasperation, "This order was written FOUR HOURS AGO!! And it's a "NOW" order! This system doesn't work!!" Well, the unit clerk (not our usual experienced clerk, but a "float" from another unit, took my words personally and left the nurse's station in tears. I had no idea I had upset her, let alone that she was crying, until about half an hour later when the charge nurse came up to me and said, "You made my unit clerk cry." Bad timing to inform me of this... so I said, in an annoyed tone and again, I am being brutally honest here) "What?! I made her cry? Gosh, I didn't realize I was so powerful I could make someone cry! It wasn't her fault! The doctor didn't flag the chart with the little red tab indicating "NOW"! This system doesn't work and I am just frustrated and I should make out an Unusual Occurance Report for "Delay In Treatment" but I DON'T HAVE TIME!" And I walked away. The fact is... this was NOT an unusual occurance. Their system of transcribing orders frequently results in unnecessary delays. I realize this is a serious observation, but it is the truth.)

So... When the unit clerk returned, I apologized to her and told her that I was not upset with HER... but with the system and the doctor's failure to flag the chart. I apologized to her twice. I was very sincere. I felt terrible for upsetting her! I felt much worse for my patient, who thank God, experienced no ill effects from the delay.

My co-workers have expressed their appreciation of my team efforts. When asked by a co-worker, I will gladly attempt a difficult IV start, even if I am terribly busy myself, even though it's not my patient. I will take the time to search out that beeping IV machine and fix the problem, even though it's not my patient. I'll take another nurse's pager so she can break for lunch, even though she's not my designated "break budy" but her break buddy is overwhelmed.

But I will not look the other way when someone else isn't doing their job correctly. Even if it's a doctor. Little flags on the chart!! Just push the tab over!! Make your intentions known! Help us all do our job by pushing a little tab!! Sound petty? Well, it's not!! How simple can it get? (yes, I said all these things... quietly.... but emphatically.... but in earshot of the charge nurse, I readily admit. I felt exasperated.... I felt like crying myself!)

So back to the unit manager's office.... When called into her office and asked about the situation on Tuesday, I explained the above scenario to her and she said, "I heard you say that you only have "four shifts left". I am willing to call your company now and cancel your contract." I told her I didn't want that at all and that my frustration comes from not being able to deliver safe and quality nursing care because I find their system frustrating. I assured her that I would complete my contract and be less vocal with my frustrations. I sincerely apologized three times in about 10 minutes. I also told her that I don't feel I am bringing negativity to the workplace, but that I am actually being infected by the negativity of my fellow nurses. (Oh, she didn't like that... and I regret those words... kind of... because while true, a bit too honest?)

Ohhh..... I have never NEVER experienced this kind of .... oh what's the word I'm looking for.... MAYHEM on a nursing unit. I can't fix it, I can't change it.... though I must tell you, that my suggestion for changing their method of documenting their blood sugars and insulin administration has resulted in a facility-wide change!!! How's that for wonderful contribution?! Woo Hooo! change is gooood!!

Thank you for letting me vent.... again!! I guess the million dollar quesiton is.... what does one do when a doctor writes a "Now'" order but doesn't flag the chart correctly? I get too frustrated! Must be my OCD! OCD can be a good thing sometimes.... SOMETIMES! Agreed?

[Soup Turtle]

You may have been frustrated, but what good did yelling about it in front of the unit clerk do?

It sounds more like "flying off the handle" than brutal honesty, to me. (just being honest!)

[missrose]

You may have been frustrated, but what good did yelling about it in front of the unit clerk do?

It sounds more like "flying off the handle" than brutal honesty, to me. (just being honest!)

You're absolutely right... hence my post.... A confession of my frustrations and lack of professionalism..... which sadly, grows each passing year.... only five days left until vacation!! Thank you for your honest input.... again... that's why I visite allnurses! I want to recover and grow PAST my negativity! I STILL believe I can!

[suanna]

I know just where you are comming from. I spend my shifts running around doing the Unit Clerks' work, the N.A.s' work, Pharmacys' work, Housekeepings' work, and when I have time I try to fit in a little nursing care. When I finaly get caught up I have been known to vent a bit- I want safe patient care!, not the dead minimum but as good as it can get. I then get the "try to have a more positive attitude" lecture from the unit manager. Give me the power to fire staff who won't do thier jobs or maybe a gun and I'm sure my attitude will improve! As long as the nurse is ultimately responsible for all aspects of the patients care and is expected to pick up the slack when the other departments don't do thier jobs the only thing I can do is rant a bit every now and then. When the managers see the problem as the nurse is bitching too much when patient care is compromised rather than the fact that patient care was compromised its obvious that fixing the problem isn't going to happen. All we are left with is venting.

[Drysolong]

As a fairly new nurse (a little over a year) I would not enjoy working with you on a personal level, but I would love learning from someone like you.

[canoehead, BSN, RN]

You can work with me anytime, but boy, we will set the air on fire with our squawking!

I'd say your choices didn't work out for you but 4 hours delay in any order is unacceptable.

[EmmaG, RN]

Recently, I had a patient who wasn't doing well. I called the hospitalist and he showed up within minutes. I was busy.... so very busy. He wrote orders and placed the chart in the "orders rack", where the unit clerk and Charge Nurse would then enter the orders in the computer and transcribe the orders so that they could be administered. The problem was I didn't get the order.... until four hours later!!

I know you don't like me, but I have to ask. If you had a patient who wasn't doing well, and knew the doc had examined the patient and written orders, why did it take four hours to realize nothing had been done? Not trying to start anything with you, just trying to figure this out. Edit to add: are travelers allowed to enter orders in that hospital? (I ask because so far I've worked two hospitals that didn't give me access to do so)

[TrudyRN]

I know just where you are comming from. I spend my shifts running around doing the Unit Clerks' work, the N.A.s' work, Pharmacys' work, Housekeepings' work, and when I have time I try to fit in a little nursing care. When I finaly get caught up I have been known to vent a bit- I want safe patient care!, not the dead minimum but as good as it can get. I then get the "try to have a more positive attitude" lecture from the unit manager. Give me the power to fire staff who won't do thier jobs or maybe a gun and I'm sure my attitude will improve! As long as the nurse is ultimately responsible for all aspects of the patients care and is expected to pick up the slack when the other departments don't do thier jobs the only thing I can do is rant a bit every now and then. When sees problem as the nurse is bitching too much when patient care is compromised rather than the fact that patient care was compromised its obvious that fixing the problem isn't going to happen. All we are left with is venting.

You must simply stop doing anyone else's job. You must take stock of the true situation and dtermine realistic goals for care. You cannot be all things to all people. It just isn't realistic in today's workplace.

Just do your own work and allow the work of everyone else to pile up. Someone will eventually get t he message. If asked about it, just say you normally empty the trash, groom the horse, and feed the hens but you were very busy with 18 patients and didn't get to those .

Just say and do "NO". I dont' care if it means the patients have to wait longer or do without some niceties. The owners and insurers don't care. Why should you? Do the required care only and stop working 12 jobs for the pay of one - unless you enjoy being a martyr. Get tough.

As for OP - Try to learn to not have any real expectations of others and not depend on others. Weren't you already aware of the order if you called the doctor? You could have done it, perhaps, without the secretary ever touching the chart.

Also, do learn to be nice. I have seen many times that being nice is preferable to being the best nurse. rudeness and lying/stealing/falsifying seem to get more people canned than being a bad nurse, except maybe serious med errors. The boss offering to cancel your contract should give you serious pause. I wish you well. I used to be a lot like you - voicing my frustrations and thereby upsetting people, even though not personally meant. It doesn't matter. You can be right and still lose. So just learn to be nice, settle for "good enough" instead of striving for perfection because, as stated above, you will be swimming upstream in today's vicious workplace. I know it's not easy but give it a try. God bless you.

[bagladyrn, RN]

You're absolutely right... hence my post.... A confession of my frustrations and lack of professionalism..... which sadly, grows each passing year.... only five days left until vacation!! Thank you for your honest input.... again... that's why I visite allnurses! I want to recover and grow PAST my negativity! I STILL believe I can!

Must be something in the air this week for us travelers! I've had one of those weeks also. In fact I'm still composing a "vent" post in my head. Usually I can keep my tongue at work, though when I can't I will try my best to get the person in a private place to sound off. (I once grabbed a doc by the front of his shirt and pulled him into the med room to have my say - extreme circumstance). My other method for dealing with this is to call an old nurse friend when things get really bad and tell her about it - along the lines of "You won't believe the ridiculous thing that these people do!" Helps to vent to someone who understands but has NO connection to my current work situation.

Hang in there and look forward to the next place!

[llg, PhD, RN]

As a fairly new nurse (a little over a year) I would not enjoy working with you on a personal level, but I would love learning from someone like you.

Well said.

The OP is not a "bad person" or "bad nurse" or anything like that ... but apparently she handles problems at work in ways that sometimes make life unpleasant for her coworkers. That inability to cope with the frustrations with grace contributes to the workplace stress of her colleagues.

That's how people (and departments) get reputations for "eating their young" or "being mean," to new people who sometimes make mistakes, etc. They don't intend to hurt people's feelings or to contribute to the negativity on a unit, but they do.

I hope you (and the other new nurses & students who read this thread) can remember this example the next time an experienced nurse seems in a bad mood and is intimidating to be around. That nurse who scares you or who just ruined your day is herself suffering -- and just doesn't know how to handle it well.

[EmmaG, RN]

Must be something in the air this week for us travelers! I've had one of those weeks also. In fact I'm still composing a "vent" post in my head. Usually I can keep my tongue at work, though when I can't I will try my best to get the person in a private place to sound off. (I once grabbed a doc by the front of his shirt and pulled him into the med room to have my say - extreme circumstance). My other method for dealing with this is to call an old nurse friend when things get really bad and tell her about it - along the lines of "You won't believe the ridiculous thing that these people do!" Helps to vent to someone who understands but has NO connection to my current work situation.

Hang in there and look forward to the next place!

As a relatively new traveler (only 2 1/2 years), I wonder about this. What recourse do we have when something happens like what the OP described? Do (most) travel companies have a liason to help work out these issues? I know mine has a clinical liason, but I'm not aware of anyone who assists us when there are other concerns.

[bagladyrn, RN]

As a relatively new traveler (only 2 1/2 years), I wonder about this. What recourse do we have when something happens like what the OP described? Do (most) travel companies have a liason to help work out these issues? I know mine has a clinical liason, but I'm not aware of anyone who assists us when there are other concerns.

Your clinical liason is the one to talk to if any of this is really impacting your ability to give safe patient care. If the situation is just hostile, I do let my recruiter know about it as it occurs. Not saying that they can help with the immediate situation (sometimes you just have to roll with it, count your remaining shifts and think how good the place will look in your rearview mirror). What this will do is give you some credibility with your company if the hospital pull something like this later in your contract. You have documented the treatment and your attempts to rectify it long before they complain about YOU. In extreme cases, if you have documented this and it is truly dangerous, you will have showed good faith to your company before giving notice and getting out of there. I have done this and the company backed me to the extent of keeping me in my apartment and having me in another contract within a week with no financial loss to me. In fact they were the ones you said they saw me as being completely justified in giving notice.