Whiny nursing rant

stressednurse · Dec 17, 2003

Well, where do I start. First I would like to make it clear I do understand where you are coming from and I have had very incompetent managers in the past.

Do something about it if it bothers you this much. The time has come to write it up, as an understaffing issue with patient care being compromized. Patient acuity and staffing numbers attached along with all the other crap that happened that day: ie. unit clerk called off, patient admissions above usual load. Who you contacted about the need for more staff and what time; supervisor, nurse manager, DON etc. All family member and patient complaints must be written up in a manner of "Concerns". If you don't already have a form for this, make one of your own. The time, date and complaint are written, what you did to address this immediately and who this form is sent to. Write the patient and/or family members concerns as they relayed them to you so you can put them in quotes

All of this should be sent to the medical director, social services, DON and administrator. You can send an initial cover letter about attempting to resolve simular issues with more immediate supervisors but as you have received no positive response you feel that this person needs to be informed.

I also understand that not everyone feels comfortable taking this route. If there is someone in the facility who you can confide in, the nursing educator, one specific supervisor, a nurse manager from another unit. Have them assist you in this.

When all else fails get another job, or get another casual position so you have something to fall back on if things get worse instead of improving.

Make a copy of all that you write, if you feel really apprehensive about things being lied about.....Mail a copy to yourself registered mail, you will have a date and don't open it when you recieve it. This will be your defense in the future if needed so leave it sealed.

Now to what I too miss about what my job could be like with adequate staffing....sitting down and chatting with a patient and their significant other about how they intend to deal with the new disability when this patient gets home. Giving a back rub just because I have the time for someone with back pain who has already had enough Darvocet. Doing my weekly skin assessment while I AM GIVING a bath as opposed to the 30 second once over when the NA has him/her nekked in the shower. Good god, let an RN spend 20 minutes with a long term care patient!!!!!!!!!!!!!!!!! We aren't even given that much time to crush the 14 pills they take in one sitting, mix it in pudding, shovel it in their mouth, give a few sips of thickened juice, turn on our heels and start crushing the next dozen pills.

CCU NRS · Dec 17, 2003

Scope of practice for your state and read closely. If it states that any duty you can not safely perform falls outside your scope of prctice just bring a copy of it to you managers and tell them you can not continue to safely care for the number of Pts they are expecting you to care for and under the scope of practice you have to respectfully refuse.

cannoli · Dec 17, 2003

Originally posted by CCU NRS
Scope of practice for your state and read closely. If it states that any duty you can not safely perform falls outside your scope of prctice just bring a copy of it to you managers and tell them you can not continue to safely care for the number of Pts they are expecting you to care for and under the scope of practice you have to respectfully refuse.

Have you actually done that? If so, what happened?

CCU NRS · Dec 17, 2003

but in a recent post these issues were discussed very broadly so I went to read the scope of practice to see if there was any help there. I live in Oklahoma and there are these two rules listed in the scope of practice. Actually refering to 6 and 8

6. Do you personally possess current clinical competence to perform this act safely?

a. If you answer 'No,' the act is NOT within your current scope of practice until competence is achieved.

b. If you answer 'Yes,' continue on.

7. Is the performance of the act wihin the accepted "standard of care" which would be provided in similar circumstances by reasonable and prudent nurses who have similar training and experience?

a. If you answer 'No,' the act is NOT within your scope of practice. Performance of the act may place both nurse and patient at risk.

b. If you answer 'Yes,' continue on.

8. Are you prepared to accept the consequences of your action?

a. If you answer 'No,' the act is NOT within your scope of practice.

b. If you answer 'Yes,' then:

i. Perform the act based upon valid order when necessary, and in accordance with appropriately established policies and procedures.

ii. Assume accountability for provisions of safe care.

SharonH, RN · Dec 17, 2003

Originally posted by Hellllo Nurse
......I'm sick of trying to give good, quality care, and being told that being "faster" and giving the APPEARANCE of good care is more important.

I'm sick of never being noticed for the good I do, only for the occasional mistake. .......... I'm sick of their answer to short staffing- "Just try to manage your time better. I've had 20 other nurses who never had a problem with this."

I think I should just get out of nursing.

Any words of encouragment, comisseration and/or understanding would be greatly appreciated.:stone

This falls under the "commiseration and.or understanding" category. I totally understand especially the part about the appearance of good care versus actually providing good care. No credit whatsoever for giving good care, saving lives etc. but BIG rewards for schmoozing with the "customers" and smiling a lot. Forget to cross a t and you will be hearing about it. And the person usually coming to notify you of your mistkae willl have a huge shyt-eating grin on their face so happy are they to let you know that you are not perfect. Sick of it. So I left the bedside. I totally feel your pain.

cannoli · Dec 17, 2003

Originally posted by CCU NRS
but in a recent post these issues were discussed very broadly so I went to read the scope of practice to see if there was any help there. I live in Oklahoma and there are these two rules listed in the scope of practice. Actually refering to 6 and 8

6. Do you personally possess current clinical competence to perform this act safely?
a. If you answer 'No,' the act is NOT within your current scope of practice until competence is achieved.
b. If you answer 'Yes,' continue on.
7. Is the performance of the act wihin the accepted "standard of care" which would be provided in similar circumstances by reasonable and prudent nurses who have similar training and experience?
a. If you answer 'No,' the act is NOT within your scope of practice. Performance of the act may place both nurse and patient at risk.
b. If you answer 'Yes,' continue on.
8. Are you prepared to accept the consequences of your action?
a. If you answer 'No,' the act is NOT within your scope of practice.
b. If you answer 'Yes,' then:
i. Perform the act based upon valid order when necessary, and in accordance with appropriately established policies and procedures.
ii. Assume accountability for provisions of safe care.

Well, when you try it, let us know what kind of response you get.

cannoli · Dec 17, 2003

Originally posted by Hellllo Nurse
Well, I'm sick of it. I'm sick of disrespectful, mean-tempered, insubordinate techs, I'm sick of trying to give good, quality care, and being told that being "faster" and giving the APPEARANCE of good care is more important.

I'm sick of never being noticed for the good I do, only for the occasional mistake. I'm sick of managers that are scatter-brained and have no interest in improving care, streamlining procedures, eliminating unneeded paperwork/steps. I'm sick of their answer to short staffing- "Just try to manage your time better. I've had 20 other nurses who never had a problem with this."

Ya, and none of them work here any longer. Why is that?

I'm just sick of having to compromise myself, my ethics and my standards in order to have a job in nursing.

I'm sick of all the pretending that goes on in nursing- managers pretend that we are doing things the right way, they pretend we have time to do it. When nurses take short-cuts and do sloppy work in order to save time, managers pretend they don't know it's going on.

I'm tired of the "right" way of doing things being in such conflict with the "real" way of doing things because of lack of staff/time/resources.

I'm tired of feeling pressured to break-away from a pt who wants to talk to me or share their feelings, concerns, or just a friendly word, because I don't have time for them.

I think I should just get out of nursing.

Any words of encouragment, comisseration and/or understanding would be greatly appreciated.:stone

I totally agree. I would get out if I had something else to do.

Hellllo Nurse · Dec 17, 2003

I acknowledge the responses about official procedures, scope of practice and all that. I've been a nurse for 11 years and that stuff won't help. If I thought writing anything up or showing my mgmt documentation re: safe nursing practice, etc. would have a snowball's chance in hell of changing anything, I'd have done it. I've done it at other jobs and the only thing that happens is the nurse is labled a troublemaker.

I am one of only two RNs in my unit. There are not many nursing jobs where I am. If I don't play along like everything is fine, they would just prefer me to leave, I'm sure.

I am talking about the dynamics of nursing and the way things really are. Things are the same everywhere I've ever worked.

I possess the clinical competence. What I don't have is a work culture that gives anything more than lip service to REAL quality pt care.

Mgmt is not understaffing, according to them. They are understaffing if they want the pts to receive proper care. They don't want that, though. They say they do, of course, but their actions prove otherwise.

I have never seen a work situation where the ideals of nursing and what great care should be are allowed into the building.

cannoli and Sharon, I appreciate the understanding and commiseration.

I am just going to try and get out of nursing. I don't know how- I have no idea. But, I have to try. :confused:

mattsmom81 · Dec 17, 2003

So does your management team (IF they have ever done nursing bedside care beyond a short while that is. ).

We keep speaking up carefully, choosing our words and our moments. Is it ever going to be enough?? I don't know. But those of us still here do the best we can. I still need a job and I'm too tired to start over at my age so I stay and try to make the best of it.

There is a 'shortage' because so many in our ranks WILL NOT do the job anymore, for good reason.

Rapheal · Dec 17, 2003

I feel your pain. It is a tough cold nursing world out there. And wouldn't it be nice that when you have pulled some rabbits out of the hat for your patients that someone would notice? Like when you are a thorn in the doc's side because you keep pestering them to address a patient's need (such as low Hgb's, poorly managed Blood sugars, consistant tachycardia, ect, ect ) and instead of any pats on the back you get told that the family members of the patient in room 300 are angry because it is noon and their loved one has not been bathed- so get in there and do it now.

One of my co-workers told me the other day that I was "too good". And I started to think that if I just went with the flow- things would be easier for me. Cuz everytime I check an O2 sat on a patient( just for my personal satisfaction that they are well oxygenated because they have pneumonia) and find out its low I have to intervene. Everytime I pester the doc's to address abnormal lab values- I have to usually run calcium gluconate or run blood or something else that makes my job harder. And for what? To just have more work to do and no appreciation. Is this how you feel sometimes?

But at the end of the day after you have done your job the best way you could- you sleep better knowing that you helped someone- even at the expense of having a day of total hell.

I posted a vent much like yours months ago. I have tried to make changes at my workplace. I have come to peace with my decision to do my best- and keep looking for a better place to work. So far sadly- I have not accepted another job because I have not found better. But when I do- I am jumping ship. I think you must decide whether to be a nurse who cares and risk burning out at your present job- or to go with flow and just provide the "appearance" of good care. And I don't care what anyone says- many nurses have to make this decision. This decision is yours and yours only to make. I hope you find peace with your decision. I also hope you find a better place to work because you seem like a caring nurse.

live4today, RN · Dec 18, 2003

All we really need do is send this website's link to our politicians so they can read for themselves the issues that nurses are confronted with each time they work.

It's not just one nurse speaking out on this and other nursing websites about the staffing abuse, it's many nurses from all over the USA, and even overseas. Here we are working in different towns, cities, states, and other countries........yet presenting the same issues that need addressing. You'd think this would be enough sincerity of the problem to make a difference.

I have to agree with most of what is posted on this thread by everyone.........from poor management to lack of good quality nursing care given to patients.

Lying is not my expertise, nor is pretending. I only know one way of presenting issues I'm disturbed about and that is by telling the truth the way it happened. No one is thankful that the truth is being told, they only want to hear what they want to hear because they don't want to become a party to what is wrong on their unit, or within the hospital as a whole.

Ohhhhhhhh the shame of it all! May God help us all for not having the guts to stand up to those who make our lives as nurses a living hell, and create unsafe nursing conditions for the patients the hospitals claim to care about. :stone