Why Nurses Book Off Work

mentalhealthRN · Dec 9, 2010

When I worked as a hospital nurse, I "booked off" work all the time, only I called it "calling out sick". I've maintained jobs (this was back in the 90's) when I only made it to work about 1/2 the time. I could give a hundred or more reasons I didn't want to be there. Bottom line was when I was going into work I felt like I was going into hell. Some days I just couldn't force myself anymore. I didn't care if I ended up jobless and homeless, I didn't care about burning bridges, I didn't care about getting a bad reference. Anything was better than working as a hospital bedside nurse. Since I left hospital bedside nursing for good in 1999, I don't think I've ever called out sick.

Just curious, after reading your post, where you left the bedside to go to. Where have you found that you are so much happier? --I personally just wanna know the secret as I have not had great experiences at the bedside either! lol

llg, PhD, RN · Dec 9, 2010

I know this is the "wishy-washy" answer people don't want to hear, but ... we need to find some middle ground here. While nursing credentials should be acknowledged when appropriate, the over-use of them can be ridiculous. While we should be proud of our professional accomplishments and credentials, there are people who are hypersensitive about it who should lighten up a little.

I generally strive for reasonableness. I work in a culture that is informal, where most people go by their first names regardless of their "rank" within the system. That includes administrators and many of the physicians. Both conversations and e-mails tend to use first names only. However, on some items that are more formal in nature, credentials are used. Our common practice is to address items informally and sign them informally ... then have a "signature" attached at the bottom of the page that lists our credentials and contact information.

When I send hard copy letters to people outside the hospital ... If I know the person personally, I will write the inside address using their credentials, then make my salutation informal. At the bottom, I sign the letter informally, but include my credentials in the typed name and contact information underneath my hand-written signature. It shows friendliness but also respect. I've illustrated that system below.

On things like the minutes of meetings, we don't use credentials because it would get too cumbersome, though some people (usually those who have just recently earned new credentials) want us to add them in situations like that.

I find that the ones who get most bent out of shape about such issues are usually either the ones with some professional insecurity or have credentials that they have earned only recently that they want to show off.

llg

First Name, Middle Initial, Last Name, PhD, RN-BC

Contact information

SE_BSN_RN, BSN · Dec 9, 2010

Do I call in? Yes. Alot? No. Maybe 5 times in the last 5 years, and usually because one of my kids is sick. I sometimes go to work sick. Why? Because my facility doesn't and has never had enough staff to cover my shift. AND because I *HATE* working short staffed. In a staff meeting, one of the department heads said "If you think you can make it through the day, come in to work....think about how you feel when someone calls in sick...." The CNA's are already worked to the bone. Then they call in because they are tired of the crap....and I don't blame them. But.....that's another thread.....If I am so sick that I can't get OOB, then I call in. That's why I have sick time, and when I need it, I use it. If a nurse manager has to work in my place, even better. Then they'll have some empathy next time, when they see what REALLY happens on the floor.

Do I care if they call me nurse, or address me as LPN? No. My first name is just fine. All I ask is you treat me how you would treat others, regardless of my credentials.

Truth66 · Dec 9, 2010

I welcome the wide range of responses to this post. I would like to mention a few things though.

A) Nascar Nurse mentioned "I would think if this is the most "disrespectful" thing your boss does to you then you have a pretty great job." I wish that was true. Unfortunately I could write the proverbial book with the countless examples of disrespect, abusive conduct, etc. that my co-workers and I have experienced. This whole issue of respect does tie in to the bottom line of an organization. A few years ago we had a nurse manager who for the most part showed respect towards the staff. With that nurse manager we only had incidents of overtime during Outbreaks and the odd time during the summer months. With the nurse managers that we've had recently and currently, overtime has shot through the roof. One nurse for example made over $20,000.00 in overtime alone in one year. The reason for the overtime was that nurses were calling in sick like crazy because they were fed up with being treated like garbage. Therefore, if some of these health care organizations are looking at controlling their budgets and reducing costs, that's one place they can look. How are their staff treated?

B) llg raised some good points like "I find that the ones who get most bent out of shape about such issues are usually either the ones with some professional insecurity or have credentials that they have earned only recently that they want to show off." Yet, I would suggest that my posts, including the one that I attached are read more carefully. The part that is disrespectful is that a person can write a letter or a memo to someone and include their professional credentials, yet they will not acknowledge the credentials of the person they are writing the letter or memo to. I've had several memos and letters sent to me by various managers over the years who didn't state their credentials, or mine. That's fine by me because I to like a casual work environment. However, I firmly believe that if anyone is to state their credentials, they show mutual respect by acknowledging the credentials of the individual they are addressing (if those credentials are known).

C) I hope people are not just focussing on the issue of Professional Credentials. As indicated in the Canadian Study, the bigger issue is the lack of respect that nurses are getting. Allow me to put this another way:

1) How can an employer or nurse managers expect the best possible work performance from their staff, if they are not respecting their staff?

2) How can patients/residents or even family members expect the best possible level of care, if they are not willing to show respect to those who are providing the care?

I'm sure others here could provide many other examples.

The issue of credentials is but a tiny tip of a huge iceberg with regards to the ongoing level of disrespect of nurses. Respect goes along way.

oramar · Dec 9, 2010

When I worked as a hospital nurse, I "booked off" work all the time, only I called it "calling out sick". I've maintained jobs (this was back in the 90's) when I only made it to work about 1/2 the time. I could give a hundred or more reasons I didn't want to be there. Bottom line was when I was going into work I felt like I was going into hell. Some days I just couldn't force myself anymore. I didn't care if I ended up jobless and homeless, I didn't care about burning bridges, I didn't care about getting a bad reference. Anything was better than working as a hospital bedside nurse. Since I left hospital bedside nursing for good in 1999, I don't think I've ever called out sick.

Been there, done that.

Nascar nurse, ASN, RN · Dec 10, 2010

It's not that. The idea is that you feel that your titles are more important, or why would you not include mine?
claiming that it was just a half witted decision, like signing rn for a check is insulting. First, I've almost made that mistake, but caught myself. Second, shouldn't you have enough respect for me to not simply say "it just runs out of my pen that way, really" Shouldn't I deserve a little more thought than you give to a casual task?

Ok, I've tried very hard to think about my response before just typing away..don't want to let it just flow out of my computer and be insulting (this is meant as a joke, by the way).

1. Maybe part of the problem is I am still in an "old fashion" enviornment. Everything we do is with pen and ink, therefore maybe I am actually hand writing my signature on a legal document hundreds of more times in a week than some of you who electronically login to a computer & that is your signature. Would love to know how many milliions of times I have hand written "Nascar Nurse RN" in the past 25 years. Yep, it really does just flow out of the pen that way. Not meant to be insulting to anyone, just engrained in my brain!

2. Titles don't impress me one little bit. I really don't care what goes behind my name, your name, the bosses name, etc. I've met many a really stupid nurse with more initials than can fit on the paper but can't do the job they are hired to do. Have also met many a brilliant LPN's that are lucky that some will even consider them a real nurse.

3. Where I am from, the nurses leave me notes by my first name only (no title)...and I have two that sign them "Love ya Boss". Trust me, I show staff plenty of respect. It has been well earned by working right along next to them when times are tough.

Sorry OP, hijacking thread but had to put my $0.02 in because I felt I had been misunderstood.

Truth66 · Dec 10, 2010

3. Where I am from, the nurses leave me notes by my first name only (no title)...and I have two that sign them "Love ya Boss". Trust me, I show staff plenty of respect. It has been well earned by working right along next to them when times are tough.
Sorry OP, hijacking thread but had to put my $0.02 in because I felt I had been misunderstood.

No appologies needed. I'm pleased to see that you show your staff plenty of respect. The nurse manager that I described before who did show respect for her staff, I would also call her a "coach" and a "cheerleader". She did an exellent job at coaching me and cheering me on with regards to taking extra courses when we were in the middle of doing training programs on violence prevention. Just as she retired I was in the middle of enrolling in a series of full length courses to get my full certificate in Forensic Studies. After 1 1/2 years I finally graduated with that certificate. Had she not been the type of manager that she was I would never had gone down that road. I hope that the level of respect that you show your staff is just as good, if not better.

Woodenpug, BSN · Dec 10, 2010

Naw, not off thread. The point is that a memo to an md would include his title, I seriously doubt you would forget. I agree titles are not very important. The respect shown in including some peoples titles and not others is on topic.

guinans · Dec 13, 2010

Just curious, after reading your post, where you left the bedside to go to. Where have you found that you are so much happier? --I personally just wanna know the secret as I have not had great experiences at the bedside either! lol

Sorry it took me so long to get back to you. My first forray out of bedside nursing was as a clinical practice nurse at a major teaching hospital. I floated around the different practices - endocrine, GI, General Med, Heme/Onc for awhile as a temp until I finally found a home in cardiology. I just loved it - alot of phone triage, monitoring lab results, coumadin managment. I learned so much I felt like I' did a fellowship in cardiology. But it was not a happy ending here. The docs were fighting between themselves over who we staff belonged to, and I had to go. I temped again at another big teaching hospital, and landed a full time job as a research nurse coordinator. Also just loved it. I left here to raise a family and started doing home care nursing when the kids were young. I find home care a lot more tolerable than hospital nursing, though I wouldn't be doing it if it weren't for my kids. I've also just started with a new company doing medical record review, chart audits, HEDIS and the like. I really like this sort of work.