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Discussion

Things would be so much better if only...

1 ...we had more staff.

It would be great if I could add another RN to every shift. Of course this would mean adding 4 FTEs, and increasing the staffing budget by about 15%, and since reimbursement keeps decreasing, that money needs to come from somewhere. Is there anyone who wants to give up 15% of their pay to hire more staff? And if you look at data from NDNQI, CMS, and Solucient, you will see that the best staffed hospitals do not always have the best outcomes. I am not talking about serious staffing issues that some people deal with on a daily basis. In my opinion, forcing an RN to care for seven or eight patients while sharing an aide with another RN is dangerous and unethical, but RNs on my unit have four to five patients and still complain. And they do seem to find time for their cigarette breaks

2 ...management wasn't always nagging us about so much.

I'm sorry you don't like to be reminded about CHF education, pneumonia immunizations, patient satisfaction, care plans, handwashing, and all of the other things I remind you about every day. But all of these are related to reimbursement. This is how the hospital gets paid, and how you get paid. See number 1.

3...we had better equipment when we need it.

I just bought six new vital signs machines less than a year ago to replace our old ones. Two of them are now in Biomed being repaired because the cords are broken from being unplugged by the cords instead of the plugs. One has a broken face plate and cannot be fixed. I cannot find one of our glucometers, two of our portable phones, and I just found two walkers in one patient's room. If you put things away and are more careful with equipment, it will be available when you need it. All of these items are paid for out of the unit's budget. If I am spending less on equipment, there is more left for salaries. See number 1.

4...the manager would get rid of the lazy, stupid, old, mean, incompetent (or add any other identifier you choose) nurses

Since most of these people do not engage in these behaviors when I am around, it is difficult for me to address these issues. I need to depend on documentation from staff to provide evidence to take to human resources. Most staff will come to me and complain about these coworkers, but few are willing to provide written documentation. So I can talk to the offenders about their behaviors, but without supporting documentation,I cannot take formal corrective action. And in some cases, it is more appropriate for you to talk to the other nurse as a peer rather coming to me for every little issue. And guess what, maybe if you talk to the other person, you may find out you are part of the problem.

Oh, I feel so much better since I got all of that off of my chest. It's been a particularly trying week. I am also on high dose steroids for an asthma exacerbation, so I am feeling especially witchy.

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    Just here to listen...hope it helps. You make some excellent points!

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    Don't get me wrong. We have a fantastic unit, and great staff. They are truly patient centered and work very hard to provide the best care. I am proud of them, and do my best to support them and see things from their perspective. We all have the same goal: excellent care for our patients. But once in a while, they need to understand management's perspective as well.

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    I love your rant. I've had a good week, but I heard a lot of the same things.

    Apparently at our hospital, all of the Hospital Acquired illness will go away if we just purchase a lot of fancy new products- rather than actually you know, WASHING hands, and following the guidelines from the CDC.

    Feel better.

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    Well I have the feeling these are problems found in a lot of good units. Like mine for example :) My own manager (who is currently managing TWO high acuity units) could have written than post. I am sure for the most part your staff is very grateful to have a competent person at the helm. Hang in there.

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    You know what I hate? It is hard to praise a good manager (as an employee of said manager) without it seeming both to the manager and to fellow employees as if there is some serious kissing up going on. I have a feeling managers get nothing badgered from both sides and very little praise.

    The reminders above are timely. Perspective is valuable. I'll be grabbing the plug instead of the cord for the foreseeable future. So there. :)

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    You know what I hate? It is hard to praise a good manager (as an employee of said manager) without it seeming both to the manager and to fellow employees as if there is some serious kissing up going on. I have a feeling managers get nothing badgered from both sides and very little praise.

    The reminders above are timely. Perspective is valuable. I'll be grabbing the plug instead of the cord for the foreseeable future. So there. :)

    Prior to my job transfer my old manager was doing a good job with us rowdy ER nurses. I wrote her an anonymous card and stuck it under her door. I told her how much I appreciated all of the different things she had done to help the department, and I was specific. She still has no idea where the card came from, but I see it on her bulletin board every time I go to visit. We all need encouragement from time to time!

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    yesterday i sent out an email to all my school nurse and quite a few of them said thank you for "being a good boss" It really does feel good torecognize each other. i sent them out just as a reminder that they matter and i ended up feeling great about it; not just for doing a positive shout out, but because i received so many in return so unexpectedly!!!!!

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    4...the manager would get rid of the lazy, stupid, old, mean, incompetent (or add any other identifier you choose) nurses

    Since most of these people do not engage in these behaviors when I am around, it is difficult for me to address these issues. I need to depend on documentation from staff to provide evidence to take to human resources. Most staff will come to me and complain about these coworkers, but few are willing to provide written documentation. So I can talk to the offenders about their behavior

    That pretty much applies to every job everywhere....

    Last time I put a complaint in writting for management, I'm the one that got in trouble.

    A while back we had a "lunch theif".... I saw the one gal taking food out of the break room fridge that was in someone elses lunch bag, so I left a note for the manager lady...

    When they confronted the theif, all she said was "no I didn't" and then the next thing I know I'm being accused of being the theif AND trying to pin it on her.

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    ahh...no good deed goes unpunished!:bow:

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    I'll add: to patients (and their families). 1) Use patience. You are many and we are few, work with us. 2) stop diagnosing yourself on the internet. It's highly doubtful your nosebleed is a sign of terminal illness. 3) tell us about all the homeopathic, OTC supplements you take. "All Natural" doesn't mean it won't screw with prescription meds.

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