What do you hate most about your job?

Maevish, ASN, RN · May 31, 2016

Lice.

I've never seen that at work before so I'm grateful for that...icky! I'd still rather have that than someone with a trach though lol

xo

lifelearningrn, BSN, RN · May 31, 2016

I've never seen that at work before so I'm grateful for that...icky! I'd still rather have that than someone with a trach though lol
xo

Haha- give me the trach any day (traches never bothered me)! I work as a school nurse, so I see a lot of lice... it wouldn't be so bad if the teachers weren't so phobic about it. I have one that once a lice case is identified, she sends every student who sits near him or her to be checked, then sends that student to me 2-3x a week for rechecks.. if the lice return, the whole process starts again (with all that students friends and table mates!) ug

Libby1987 · May 31, 2016

Thanks, Libby1987!
If I can ask, what are all the ways you've tried for coping/dealing with the stress of balancing the work load of staff with co. productivity expectations?

I have the belief that you can work hard without working miserable. Being tired is not the same as feeling like crap. Some ways I try to create a better work experience:

Attempt to teach how to be efficient, create mental templates for charting.

Educate re regulations to reduce the time to work thru issues.

Create mental muscle memory for the basic foundation and habits of organizing and scheduling patient care.

Encourage repeatedly to ask for help.

Reduce redundant processes.

Explain rationale and usefulness of helpful processes ie routines that help avoid the time sucking frustrating pitfalls.

Advocate for staff to mgmt above and below me to the realities and extent of what our staffs' (staff's?) job entails.

Encourage ataff to help come up with ways that reduce individual stress.

Praise the hard work.

Point out accomplishments.

Explain the financials, the why of things, method to the madness etc.

Teach how to approach people to get the outcome desired, how to avoid getting the opposite outcome.

Teach how to diffuse versus incite and perpetuate.

Promote our company culture and remind everyone as a group or as individuals of the humanity in all of us, including staff, mgmt, providers and patients/caregivers.

Validate group and individuals without perpetuating unintended misgivings, avoid feeding into negative emotions.

noyesno, MSN, APRN, NP · May 31, 2016

1. Labor law violations (never getting a lunch break)

2. No safe lifting/lifting equipment

3. "Leader" rounding that seems to undermine the staff (have had patients call me saying "your manager was here asking all these questions about you trying to catch you doing something wrong")

4. Coworker hostility (people threatening others with write ups and "telling on" one another)

5. Micromanagement by discharge planners, administrators, managers

6. "Secret shoppers" spying on nurses trying to catch them doing something wrong

7. Schedules getting messed up

8. Manager who lies or doesn't follow through with things she said she would

9. Pressure to police the doctors and told to write them up all the time (no thanks, I'd like to have a good working relationship with them)

10. Constant employee turnout, I wonder why, haha

martymoose, BSN, RN · May 31, 2016

I hate that people who are not nurses or were formerly nurses who don't give a fig are the ones dictating ratios and policies and such.

No one tells you THAT in nursing school.

I'm just curious OP, how does " coping skills " or whatever you want to call it solve the fact that most nurses ( not all, some here seem to be lucky) are risking their license, and their sanity by being dictated how to do their job by TPTB who have no idea, or have an idea and DON'T CARE ? As long as they get their bonuses for "saving money" by cutting staff down, nothing will change.

:no:

lifelearningrn, BSN, RN · May 31, 2016

I hate that people who are not nurses or were formerly nurses who don't give a fig are the ones dictating ratios and policies and such.
No one tells you THAT in nursing school.
I'm just curious OP, how does " coping skills " or whatever you want to call it solve the fact that most nurses ( not all, some here seem to be lucky) are risking their license, and their sanity by being dictated how to do their job by TPTB who have no idea, or have an idea and DON'T CARE ? As long as they get their bonuses for "saving money" by cutting staff down, nothing will change.

If any labor group needs unions more than another it's nurses!!

LadyFree28, BSN, LPN, RN · May 31, 2016

I have the belief that you can work hard without working miserable. Being tired is not the same as feeling like crap. Some ways I try to create a better work experience:
Attempt to teach how to be efficient, create mental templates for charting.
Educate re regulations to reduce the time to work thru issues.
Create mental muscle memory for the basic foundation and habits of organizing and scheduling patient care.
Encourage repeatedly to ask for help.
Reduce redundant processes.
Explain rationale and usefulness of helpful processes ie routines that help avoid the time sucking frustrating pitfalls.
Advocate for staff to mgmt above and below me to the realities and extent of what our staffs' (staff's?) job entails.
Encourage ataff to help come up with ways that reduce individual stress.
Praise the hard work.
Point out accomplishments.
Explain the financials, the why of things, method to the madness etc.
Teach how to approach people to get the outcome desired, how to avoid getting the opposite outcome.
Teach how to diffuse versus incite and perpetuate.
Promote our company culture and remind everyone as a group or as individuals of the humanity in all of us, including staff, mgmt, providers and patients/caregivers.
Validate group and individuals without perpetuating unintended misgivings, avoid feeding into negative emotions.

My approach is similar; I have NO qualms educating the public mic what goes on behind the scenes like an infomercial; it's their hospital, and they need to know what we do is for them or what's best for them; most get, some don't.

I was extremely spoiled at my first position Asa ED tech in a small hospital almost 16 years ago; I had management that would go to bat, would work in the trenches, and was good at what she does; she is well respected and authentic, and I love her as a mentor. When I worked in supervisory positions how she treated people had a positive impact on me; when I entered a new specialty and saw how management treat people like crap, I became part of the solution, and things started to change; I hope the management in place is authentic; they remind me of my first boss; unfortunately the other two components are still there that were the previous management's underlings; they are nervous and rightfully so...I think all new management that can meet us where we are is the best way to move forward, and I have some way to be a part of that.

Jensmom7, BSN, RN · Jun 1, 2016

Haha- give me the trach any day (traches never bothered me)! I work as a school nurse, so I see a lot of lice... it wouldn't be so bad if the teachers weren't so phobic about it. I have one that once a lice case is identified, she sends every student who sits near him or her to be checked, then sends that student to me 2-3x a week for rechecks.. if the lice return, the whole process starts again (with all that students friends and table mates!) ug

Have you installed a revolving door??

dec2007 · Jun 1, 2016

Lice.

...and bedbugs and maggots, oh my!

Paulthenurse · Jun 1, 2016

I wish I had spotted this topic earlier in my career. I graduated with a BSN in '80. My internship and first job was in the same regional CCU. Yep, Paper charts. Two things back the early days was when all disciplines started charting in the same "progress notes," rather than physicians on one color paper, nursing on another page & color, and other therapist under their own tab in the chart. "We" thought it was wonderful when all progress notes were merged onto the same page and time-line. Information, events, and thoughts flowed smoothly.

The other piece of charting in critical care areas was a 3-page, trifold sheet (front and back) that included everything in one place. Over the years I have seen a number of versions.... What was great for us nurses, is that once a year the form was taken thru a process where everyone had input into its updating. Most importantly, it flowed as to how the nurses thought and performed their task for that patient: If the B/p was dropping, the new drip was started and titrated. ABGs were performed, the vent changes were made. Rx given, urinary output, cardiac output, etc. It flowed. And at the end of a rollercoaster day, you and the doctor could look back objectively and see if things were truly worse or acutely a bit better.

Now that I do (the higher tech) home health care with wounds, infusions, trachs, and the sort... I find many of these EMR programs are written for the revenue generation. The nurses who gave input into the program were either ignored or were not real-world nurses in the field. The configuration of questions does not follow a clear thought process.

Some of the programs require you to be "live" with a good internet connection. That's hard when sometimes in a home where that part of the county has little/no cell service. One system I worked with, required over 100 clicks/screen touches just for the simplest nursing visit. Typical home health days of 6-8hrs driving and visiting patients, still requires 3-4hrs of charting time later that night.

One beautiful example is when you determine the patient must go to the ER: 911 is called, physician has been notified. You then call your office, where they are able to see your visit, notes, VS, orders, current Rxs, allergies and is then able to e-fax it to the ER-charge nurse, before the patient arrives.

martymoose, BSN, RN · Jun 2, 2016

rude patients. For example"B(word)- get me a spoon". " I am the only patient you need to care about, I dont care if there are other patients here" " wash me now"

Patient's who literally scream at the top of their lungs if their light isn't answered instantaneously. They are also hitting the light 10x an hour.( no lie)

Patients that have no regard for their room mate.

Patients who bite you when you try to help them. ( this was an elderly, but was fully aware of their actions, threatened other staff she would do the same to them)

So, as a result of these situations, management doesn't help, and they actually side with the patient- after all, the customer is always right.

Ruby Vee, BSN · Jun 2, 2016

Hi Spidey's mom,
Thanks! What is it about computer charting that you like the least?

Not Spidey's mom, but I'll take a stab at it:

Redundent charting -- someone starts a study and suddenly we have to chart our anticoagulants on three different forms AND pull the lab results out of the lab's page and chart them with our anticoagulants. So that someone getting paid $15 an hour doesn't have to hung for the information.

Computers with mouses that don't work, monitors that are dysfunctional in some way: too bright, not bright enough, colors reversed, display flipped backwards or upside down, computers that don't turn on. Computers with inaccessible reset buttons (because the first thing IT always asks is if you tried that.).

Charting programs designed so that everyone uses the exact same pages -- and you have to page through pages and pages of junk pertaining to outpatient so you can chart your every 15 minute vitals and balloon pump settings on your ICU patient. Assessment forms that ask for lochia assessments on 70 year old heart surgery patients and don't have the space to chart both the murmur and the click (both new) you heard on said patient.

Computer charts with no room for free texting all of those important assessments you made that aren't in their standardized form.

That's a start.