What kind of nurse are you?

rnicare · Jan 21, 2009

This is very disheartening when one hears such a negative comment especially when the patients are giving you positive comments. As others have mentioned, depending on the institution, the managers have to find something that needs improvement. I don't agree that it should be that way but it is real. I think many of us have been in that same situation. Part of nursing is explaining to the patient what you are doing and explaining their condition to them. Is the manager around observing what you are doing or just relying on hearsay? Ask your manager to point out when you are taking too long with a patient and ask the manager for advice on how you can shorten your time with the patient without cutting out the quality of the care of answering the patient's questions and putting the patient at ease.

Keep up the good work.:)

APRN., DNP, RN, APRN, NP · Jan 21, 2009

I work in a busy ED. Most of the time the patients who come in are scared because they are having CP, have broken something, afraid they're having a stroke, etc...I introduce myself, explain what I'm doing. I talk to them and explain things while I am starting the IV, pushing meds, etc...I don't like just sit and talk to them. I am always thanked for being kind and for explaining things. I've never had patients complain that they have to wait too long for pain meds, etc...waiting on the doctor or on test results yes.
I had my yearly evaluation last week and my manager had written down that I am not as productive as the other nurses. He said I talk to the patients too much. Isn't that a part of nursing? I'm not chit-chatting, I'm explaining things and I don't doddle. I didn't know how to reply but I didn't sign the evaluation because I said I had to think about it.

I think you should be given a big pat on the back for showing a good example therapeutic use of self. Unfortunately, your manager seems to imply that your emergency department is all about the "treat em and street em" mentality.

Perhaps you could use a couple of examples of patient teaching that you've incorporated into your conversations with specific patients that show your ability to multi-task and get that "widget" out the door (since your manager is all about "productivity").

Best of luck to you.

loricatus · Jan 21, 2009

Don't feel bed what was said to you. I have had that same speech said to me. I usually reply with something like-"So, do you have any complaints over my clinical skills or over the patient satisfaction scores I produce?"

Just ask the NM to cite some specifics of your lack of productivity; and, for a demonstration on how to correct your deficit. Will bet ya that you get the same dumbstruck face I have gotten when asking that.

SweetRevelation · Jan 21, 2009

I've kinda had the same thing happen to me, although not on an evaluation. I was told that even though I'm a good nurse and that the families and patients give me high praises, they (the admins) feel I'm not managing my time wisely enough when I don't get out until way past clock out time. I happen to manage my time very well I think because it's something I'm not only persistent about, but something I have to do with as many patients as I have at one time (35 in a shift). Spending that extra bit of time communicating with your patients makes me feel secure that I'm taking the best care I can of them in the time I have and also comforts the patient, which is also what nursing is about. It's not just about the meds and labs and paperwork -- they're people and they need us. I never regret spending extra time with patients or families. If I can help them in any way, no matter how big or small, then I walk away a better person and they feel better, also.

If and when I do get such a thing said to me on an eval, I'm sure gonna let 'em know what I think.

BroadwayRN, ASN, RN · Jan 21, 2009

Thanks Everyone. I did ask for specifics and was told we were not going to go into it. We have this rewards system where your co-workers can give you a filled out slip that says what a good job you did, what it was, etc. Once you've saved some of these you can trade them for merchandise out of a catalog. He mentioned that I've not received a single one of these slips. I told him that the patients heartfelt thanks and hugs meant more to me than those dumb slips. I got 6 cards out of my locker that had been sent to me at the hospital from appreciative patients over the past year. He was kinda stunned. I told him these are all the rewards that I need. He said well the other nurses get their patients in and out quicker. I said I don't see how. They have to wait for the doctor or PA to discharge the patient, it's not up to us when the patient leaves and I take the same amount of patients that they do. Perhaps they feel inadequate next to me because they know they are not giving everything that they should to these patients who are scared and need compassion and education. I am not going to change the nurse I am.

eriksoln, BSN, RN · Jan 21, 2009

Did you know your managers are *required* to find room for improvement in your eval? True story. If that's all s/he's got to say about you in the negative, I'd say you're pretty awesome.
I mean, that's culture today. If you can do it well, maybe you can do it well a little faster?
I got an eval once, it said I'm great at life and all, but I could learn to be more of a self-starter. When i asked my boss to elaborate, she shrugged and said "You're doing everything, the only thing I could think was to have you do everything sooner." (let it also be known I really, really like my boss :wink2:)

I was going to say this too. No matter how in love they are with you, they have to point out something that could be better.

My personal measuring stick for my performance stopped being my annual eval. after my first year. I look at pt. complaints, pt's general attitude towards me, safety (falls, med errors) and my ability to manage the care (extra hospital days due to missed orders or other errors, not catching things before they become a problem like changes in condition or details that slow down recovery). If I'm not doing these things perfectly, changes need to be made. If I am, I am content and dont take the manager too seriously.

True story: Once worked with a charge nurse (they were called "resource" nurses cause they werent exactly charge nurses......didnt take pt. loads or do assignments.......IDK what their role was to be honest) who told those "I used to walk to work in ten feet of snow while everyone else was dying of heat stroke cause it was 210 degrees outside" stories. Loved pointing out how she managed case loads twice the size we did and how she still managed to "pay attention to details". Well, a nurse feel in the parking lot one day and fractured her ankle, couldnt work and there was no replacement in sight. This "resource" nurse had to take a pt. load. She had 8 patients, a full load, like everyone else. Two hours into the shift, a resource nurse from the other unit had to go and take care of 6 of the 8 patients for her. She couldnt do it. The nurses taking over for her said, even with only having 2 patients for most of the shift, she missed EVERYTHING. Labs that should have been called in to the doctor not addressed, new orders signed off but not put into action, the list goes on and on.

I guess my point is, dont let the ramblings of a manager bring you down. Always remember, a lot of them are just hot air.

Keepstanding, ASN, RN · Jan 21, 2009

just keep doing what you are doing. in my opinion you are a "nurses nurse". you do your job, while you are making the patient feel comfortable. i applaud you :yeah:

praiser :heartbeat

patrick1rn, MSN, RN, NP · Jan 21, 2009

You work in a ER.

Maybe your boss is right,

Maybe you do talk too much

Have you considered that ?

You do admit to it

So, what is the other side of the story ?

Or is your boss just making this up ?

Keepstanding, ASN, RN · Jan 21, 2009

how nasty can you get ??? hmm. :confused:

prasier :heartbeat

you work in a er.
maybe your boss is right,
maybe you do talk too much
have you considered that ?
you do admit to it
so, what is the other side of the story ?
or is your boss just making this up ?

gentlegiver, ASN, LPN, RN · Jan 21, 2009

I had a patient once (LOL w/anxiety) who was convinced she was going to die due to the fact that she couldn't breath. I found out about this when her CNA came to me in a panic. I brought her a breathing treatment, and then sat by her side for 10 minutes just talking to her. I asked about her family, her occupation before retirement, cooking, baking, pets, anything to take her mind off her breathing. She responded very well to this, forgetting she couldn't breath and relaxing. As we left the room the CNA asked how I did that. CNA said she never saw pt respond so quickly. I explained that anxiety attacks can be stopped if you can get the pt to think of anything else, and how to do it. The CNA passed that information along to other CNA's and they now have a happier, less anxious pt. Sometimes you really do have to talk to pts, I wish management would realize that fact.

praying_mantis · Jan 21, 2009

You work in a ER.
Maybe your boss is right,
Maybe you do talk too much
Have you considered that ?
You do admit to it
So, what is the other side of the story ?
Or is your boss just making this up ?

You must work in management patrick1rn!

2008pn · Jan 21, 2009

I really won't know until I pass my Nclez in the spring, pray for me!