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Stuck up RN?

Posted

Hey fellow RN's! Im reaching out to you today regarding my mom who has also been an RN since 2001.

Mom worked as an LVN for many years in med surg in a hospital setting and as charge nurse in LTC. She challenged RN boards in 2001 and got hired at a residency im NICU- she was really motivated and inspired to start an RN career however she got terminated and fired and pretty much bullied by her manager and co-workers for a variety of reasons- per mom she said the unit was just too close knit and theyre jus didnt get along with her and did everything to make it hard for til she quit.

Fyi- mom cries and remembers that experienced til this day. It made it sick to her stomach and bones and the bullying they did that she took an LVN 1:1 pediatric job for 6!years after that.

Fast forward: since that new LPN job Ive encouraged my mom to try new RN opportunties luckily she got IN..BUTT shes not lasting too long and always having problems

RN Hospice job: 10mos Charting piled up where she couldnt catch up til the company just asked her to resign voluntarily ( very lengthy charting, specific like ICU style or head to toe etc)

RN Skilled: 7 months: always stayed 2-4 hours post night shift to finish charting and always late on med pass. My moms never does shortcuts or throw meds or not give em.

present job Rehab: so she has 8-9 px but still stays 3-4 hours to finish past clock out. Charting delays and admission paper work

all these jobs involved mgr and co workers branding her and getting irritated with her on the job.

my moms pleasant and intelligent but I dont know whats wrong? Is it still being stuck up from her very first experience unconsciouslly? Or maybe her personality isnt fit?

Here.I.Stand, BSN, RN

Specializes in SICU, trauma, neuro. Has 16 years experience.

I don't know your mom, nor each situation. Those are some pretty significant time management troubles, though. Employers probably don't want to pay for several hours of post-shift charting, but they can't have her working off the clock either.

JustBeachyNurse, RN

Specializes in Complex pediatrics turned LTC/subacute geriatrics. Has 11 years experience.

Mom needs to figure out why she is staying 2-4 hrs post shift. Paid-budget issues. Upaid--liability & labor board issues. Common theme--not "stuck up" or "close knit" but documentation. Is she inefficient? Not using appropriate abbreviations? Double documenting? Overcharting?

If after all this time she continues to require 2-4 hours over time past shift to complete documentation there is a big problem. She needs to consult the nursing educator or documentation specialist or management to observe and audit how she's document to find the issue. Employers don't take kindly to 2-4 hours of overtime to complete what should be completed on shift.

BSNbeDONE, ASN, BSN, LPN, RN

Specializes in Med/Surg, LTACH, LTC, Home Health. Has 35 years experience.

I don't know how to tap dance around the questions I'm about to ask, so I'll be direct with no offense intended. Is your mom overweight? Does she have joint problems? Is she asthmatic or have any kind of heart problems? Is she easily stressed? Is age a factor? Weight in itself may not be an issue unless it's excessive. But combined with one or more physical and/or emotional issues, it can be a problem. I'm no spring chick myself, and just purchased a treadmill 30 minutes ago. But I have no other physical issues to go with my few extra.....ounces.;)

The one nurse I recall who never left work at a reasonable time had very bad joint pain which caused her to move very slowly. Plus, she was getting on up there in years...not adapting well to a constantly-changing environment. Any kind of issue that would contribute to decreased cardiac output can lead to decreased production. Slow motion is a deal breaker in acute care. Multi-tasking on the fly is a must.

One last thing that I presented to an OP on another thread is that perhaps she's still performing on an LPN/LVN level even though she's an RN. Lots of LPNs-LVNs believe the job duties are the same. But there are added duties that were once left to the RN. Now, with her being the RN, it all falls on her.

These are my thoughts (I could be way off the marker, though).

Edited by BSNbeDONE
spelling

Along with the very informative previous information: Maybe at this point, these facility jobs, with so much multi-tasking, are too much for your mom. If she can not, with the help of others, pinpoint and work on her time management skills, she could consider going to extended care home health. She would be working with, and charting for, only one patient in the home. Minimal contact with other caregivers or supervisors. Unfortunately, since most of these cases are at the LPN level, many agencies pay an RN working these cases at the LPN level. This kind of work is still better than not working as a nurse at all. On an overall basis, the decrease in stress and charting responsibilities, could make the difference for your mom.

Pepper The Cat, BSN, RN

Specializes in Gerontology. Has 35 years experience.

Staying 2 to 4 hours is problematic to complete documentation is problematic. Yes, I would be annoyed if the person on the shift before me does not have everything completed when I start. It means info I need to do my care is not available. I may not know what she did do and didn't do causing gaps in care.

I don't care how pleasant someone is, if every time I follow them I have extra work to do, yeah I am going to be annoyed.

Dafabb

Specializes in Med/Surg/. Has 40 years experience.

It sound like a big time management problem yes but it also sounds like she lost her motivation...Did she have this problem before she became an RN and worked in NICU. Was she on time then and finished at shift change. I am going to say something and I hope your feelings will not be hurt. This is no disparage to your MOM. If she coming from Med/Surg to NICU that is probably the biggest jump you can make in a hospital. It is the one thing I would have never done without extensive training. I am and LVN in Texas and keep in mind we did everything any RN up until the 11/12 where they were changing to all RN. There is no where in a hospital I have not worked and done a good job in all except NICU. I even did that but it was called the white room where the babies were fine getting ready to go home. It was not difficult at all. I think out of anywhere in any hospital NICU is the MOST specialty. They have to know and read minds of what is happening and they have to have that special knowledge and sixth sense.. I applaud all of these nurses and Doctors. All of our other patients can tell us what is wrong in some way. I can see where you had trouble there.... Letting this experience set the rest of your career should not have been a life changing experience but a learning one. It sounds like it was the opposite.....Your time management is also learned. It took me about 7 yrs to perfect it.....I love home health. There are no time rules. You are one on one with clients. You can have as many as you want and are available. And you learn to love everyone of them if you have them long enough. You visit and go to the next and so on then go home at your pace. You could do that as an RN. admission assess. etc. This is my 1st love and I wish I was where there were a barage of clients or maybe will do that after I retire:)

Thanks for your response. Her first job as an RN was in the NICU. She was an LVN doing M/S for about 5-6 years.

Her first job as an RN in NICU as she recalls was very traumatic in which she was basically forced to quit. ( manager asking her math questions, ration and proportion, telling her not to touch anything unless being told) fyi: she was not written up, or did any mistake that put her patients on the line.

I see my mom as super detail oriented, its as if every patients in the ICU. Charting in detail. Whats just so bizarre is in these past 2 years of me setting her up with new RN jobs. The same outcome is happening where shes not effective.

I keep telling her to introspect since she worked as an LVN for many years keeping the same job. What baffles me is after that first Job in NICU it vasically destroyed her.

i tell her to focus on the routine and jus make sure her patients are ok.

After her traumatic First RN job in NICU she actually pursued what you suggested. Worked with 1 pediatric patient with c/p etc. I motivated her to try something different because she wanted also to prove that she can be an RN. Sadly that hasnt been effective. Btw mom is healthy, no communication barrier and is beautiful. Lol. At home she is definition of a nurse at how she does things. Shes not on any psych meds lol.

I think her work experience is a little complicated.

1980-2000 = LVN in m/s ( no problem, no delays in work etc)

2001-6mos = traumatized first rn NICU

2001= still did Little rn work in LTC, registry

2001-2005= left nursing took masters as an excuse

2005-2011= worked 1:1 in home care

2011= RN refresher

2012= home health doing ok

2013- present==== not lasting in facility, job hopping cuz of performance. Resigning before getting fired

meanmaryjean, DNP, RN

Specializes in NICU, ICU, PICU, Academia. Has 44 years experience.

1:1 home care seemed to be a good fit. She can do all the 'fluff-and-buff' type details her heart desires and will, in doing so, likely endear herself to her patient and their family.

llg, PhD, RN

Specializes in Nursing Professional Development. Has 44 years experience.

I think it is a mistake to blame the NICU job for everything that happened afterwards. The NICU job was not the cause of her problems -- it was simply the 1st RN she had, and it didn't work out -- just like the rest of her RN jobs have not worked out.

You say she "challenged the RN boards." I assume that means she did not graduate from an RN program. That might be part of the problem. Just because you can pass a test doesn't mean you can function well in the RN role. Your mom never had the education to be an RN -- she never experienced the supervised practice that RN students get. It sounds to me as if she is being overwhelmed by the RN role because she is not prepared for it.

She finished in the Philippines and has her BSN. I honestly think LVN or RN, work is work and it ends up being a routine. We nurses deal with life and its a no joke job. My take on this is that 30-50% of new RNs quit nursing before the first year- she was part of this statistics and did a comeback which is not going so well. Its weird cuz I think she has some type of nursing PTSD- her struggles in her job that pull her are going too far and beyond- like extensive charting, not doing "shortcuts", formal assessments which makes her look like weak one where in fact cannot be 100% true. Its weird. I guess I'll rest my case. Probably hope she can get a clinic job and do fairly well.

roser13, ASN, RN

Specializes in Med/Surg, Ortho, ASC. Has 17 years experience.

I'm still trying to figure out who the "stuck-up RN" is in this picture and how it is possible to blame one RN for what seems to be some dysfunctional behaviors on the part of OP's mom.

I literally have not heard the term "stuck-up" since high school.

My mom is stuck up lol. Im not blaming the nicu nurses or one significant person. im trying to understand whats causing her inablity To succeed in a job and if this can be related to her "traumatic first job as an rn years back.

KatieMI, BSN, MSN, RN

Specializes in ICU, LTACH, Internal Medicine. Has 8 years experience.

Ok. So, we have at least THREE interconnected problems here:

1). Traumatic job experience. It is a common thing, and more serious than most people think of. The loss of self-esteem bullying causes is very difficult (to say the least) to overcome and can destroy one's career as well as personality as a whole. PTSD or not, if a person just cannot overcome that bad experience and still remembers it with bitter tears years after, then specialists' help might be needed. Although I must say that finding counselor familiar with work-related PTSD is very difficult, professional help might be necessary here. It is very telling that the OP's mom prefers to run "before she is fired" - it speaks volumes about the level of fear she's living in. I was there, too, and my heart is bleeding for her.

2). Obvious time management issues (and possibly more problems, like communication). This can be corrected, but only in place which feels it is worthy to invest considerable time and effort in support and, de-facto, re-training of a nurse. Such places exist, but they are few and far between.

3). Problem with "fitting in", possibly added by age, training level, maybe even accent, which all make the OP's mom feeling as an "outsider" everywhere she is employed.

Now, as a person who went through the similar experience including terrible bullying and PTSD, I can honestly say: it is not about job experience, prestige, salary, benefits or anything else; it is about job and people one feels safe and comfortable with. Everything else should be sacrificed to satisfy these two conditions - at least for the time needed to recover, get back on feet and make CV looking better.

So:

I agree that the OP's mom, whatever her nursing degree is, should not challenge herself with things she seems not to be able to do well enough. If she feels fine with home care 1:1, so be it for now. I would be careful with jumping into office work, as it can be fairly fast-paced and no physician will be happy with employee who slows it down. One other possible option might be RN positions in group homes where patients are more or less independent, do not take a whole bunch of meds and live fairly stable lives within their limitations. I have to communicate rather commonly with nurses who work in such places, and I grew up to deeply respect them, for they know their patients inside out and then some more, although most of them totally lack what can be named "acute" clinical skills. But that matters surprisingly little as long as their patients can be kept safe and comfortable.

Secondly, I would suggest counseling and possibly long-term professional help from a counselor or psychologist familiar with work-related stress and work-caused PTSD. Again, it is difficult to find such help, it may be pricey and require distance driving, but the results can be literally priceless. Some places have grass-root support groups for people suffering from work-related PTSD.

OP, your mom is not "stuck up". She has difficulties to find, among staggering multitudes of options, the area of nursing she's comfortable with. It has nothong to do with prestige, "acute" vs. "not acute", being "not a real nurse" and anything else but her deep trauma and possibly other limitations it (and other personal factors) imply; it doesn't make her "bad nurse" or "less than a nurse". She needs time and help to recover; be supportive and let her being "stuck up" instead of living in paralyzing fear of yet another rejection.

meanmaryjean, DNP, RN

Specializes in NICU, ICU, PICU, Academia. Has 44 years experience.

OP: In American slang 'stuck up' means conceited, egotistical or self-centered. Your mother sounds like none of these things.

crazin01

Specializes in tele, ICU, CVICU. Has 12 years experience.

[quote=llg;

You say she "challenged the RN boards." I assume that means she did not graduate from an RN program. That might be part of the problem. Just because you can pass a test doesn't mean you can function well in the RN role. Your mom never had the education to be an RN -- she never experienced the supervised practice that RN students get. It sounds to me as if she is being overwhelmed by the RN role because she is not prepared for it.

I second this. She performed satisfactorily (is that a word???) for 20 years as an LPN. And that is where the majority of her experience lies, in being an LPN. Was she aware of all the differences in scopes of practice for LPN & RN? I realize she's been an RN now for over a decade, but has had this issue, seemingly all along as an RN. And job-hopping further perpetuates the issues, as just when she is becoming more efficient at company A's charting/MAR, P&P, she resigns to prevent termination.

Also, I won't ask your mothers age, but (not trying to stereotype) is she good/adequate with computers and electronic charting, med administration? Not just in nursing, but just in general, a elderly person will not be as technologically advanced as a 23 year old for the most part. (stereotype done!)

She is lucky to have such a caring son. Best wishes to you both as she ID's and hopefully resolves anything contributing to the bumps she's run into as an RN.