Why does only nursing have to put the patients first?

[wooh, BSN, RN]

Caution, rant ahead:

So the other day I'm in a tiff with radiology because they want me to transport a patient that (per policy and per good nursing judgement) I'm not required to accompany and I can't accomodate them because well, I have other patients that I need to attend to. So they call my charge nurse who tells me that we all have to work together and put the patient first. Well if they really wanted to put the patient first, as in my other less stable patients, then they wouldn't insist on me leaving my other less stable patients to accompany a perfectly stable patient. Heck, there's no reason this couldn't have been done bedside, so if THEY truly wanted to put the patient first, they'd bring themselves on up to my floor and do it at the bedside.

I'm just soooo tired of everytime I stick up for myself, I'm accused of not putting the patient first. But other departments don't fully staff on weekends, because the patient can wait until Monday. We do labs at 4am for the MD's convenience, even though it wakes up the patients. I don't have a medication, pharmacy expects me to run halfway across the hospital for it, because most of them are at lunch. After I've searched all the boxes THEY might have accidently put it in. Heck, housekeeping won't even clean the IV poles. But the other departments, and even our fellow nurses, expect us to drop everything in a split second for the convenience of another department in the name of the patient being first. And if we dare say, "Hey, that other department could do x,y,z instead of me dropping everything, ignoring my other patients, and leaving an hour late, then getting called to the principal's office for my incremental overtime" then we as nurses aren't being team players. But do you see the other departments being team players on the weekend? Nope, they aren't there. Are they being team players at 7pm when we want to go home? Nope, they left on time at 5pm.

If nobody else wants to do it, it's the nurse's job. Not "if nobody else CAN do it." Not "if nobody else is QUALIFIED to do it." Plain, flat out, if nobody else WANTS to do it. And we as nurses are expected to suck it up in the name of the patient first. Because if we don't do it, the patient suffers. How about, "If housekeeping/radiology/respiratory/MD/pharmacy/customerservice/cafeteria/whoever doesn't do it, the patient suffers"???????? Why not lay the guilt trip on someone other than nursing for a change???

[catshowlady]

I don't know, Wooh - I had a crappy weekend at work. It seems like nobody else has to "own" anything but the nurse. Not the other depts, not even other staff on the floor. If the tech doesn't do his/her job, it falls on the nurse. If pharmacy didn't get the meds up in a timely manner, the incident report falls on the nurse anyway. Another dept can't get the MD they have in front of them to place a central line when the pt has dopamine running into a #22 in her knuckle and needs integrillin too, but the #22 is the only access he's got. Why? Because they got called in on the w/e and don't want to be there a minute longer than they have to. Oh, and they brought her up in a bed wet with blood and urine. Meanwhile, I also have a pt in a-fib w/ RVR and a pressure of 78 systolic to manage. And there's only one PT person for a dept on the weekends, and it takes 2-3 big strapping guys to get my one pt OOB, but it's on me to see that her activity orders are followed because there's not enough PT help. Oh, and I am supposed to make sure all my rooms are spotless for some big shindig scheduled for tomorrow. Hello, housekeeping?

Sorry to steal your rant. But I totally feel your pain. I'm in a heck of a mood after this weekend.

[PAERRN20]

Amen!

[Riseupandnurse]

I agree; it's a whole different mindset that nurses are supposed to have. I was very shocked to discover this when I graduated, as I had been an XR tech before, and we expected other disciplines to do their jobs. I could not believe that I was being called on the carpet for not making sure other departments like PT and lab did what they were supposed to do. I'm still of two minds about it. Yes, I accept that the buck has to stop somewhere, but it's often just too much to watch over and be responsible for every darn thing that happens to four or five or six patients or more, everything from their getting a bath that day to the consult actually showing up. I can try to deal with the patients' needs but when they add in customer service for visitors that just sends me over the edge.

[wooh, BSN, RN]

Sorry to steal your rant. But I totally feel your pain. I'm in a heck of a mood after this weekend.

Feel free to steal my rant!:redbeathe We're all in the same crappy boat paddling around. Just that it often feels like the rest of the hospital is on a cruise ship blasting their horn at us.

[Nurse_Hagatha]

I wanted to puke several months ago at a hospital wide customer service rah rah meeting when people from other departments were sharing heart warming stories about how they saved the day because some ratchety nurse wasn't doing his/her job. HELLO PEOPLE! NURSES CAN ONLY BE STRETCHED SO THIN WHEN THEY'RE TRYING TO DO THEIR JOB AND YOURS TOO!!! I am so sick of being blamed for everything that goes wrong with a patient's stay in the hospital.

This morning, a manipulative patient that I had been dealing with the entire night, was screaming at the top of his lungs for his wheelchair. I was sitting at the desk charting so that I could go home. I like to do that after 13 or so hours with no breaks. The security guy comes up to me with a smug look on his face like I am neglecting my patient, and need to get in there right away and take care of him. I wanted to choke Mr. Security Man. I really did. I just looked at him like, "Go back to your little office sanctuary away from the screaming yelling psycho and enjoy another donut and cup of coffee, and then save this scenario in your mind for the next customer service meeting as an example of another lazy nurse not doing her job."

[NurseCard, ADN]

Geez... anymore, it's like EVERY single thread that I read on this board any more, makes me feel SO happy that I'm now working 11p-7a on a child psych unit. My job mostly involves paperwork. I DO catch some heat if Pharmacy screws up the MAR's and I don't catch the screwups and correct them... but for the most part, I only have to worry about my job and my MHA doing her job, and I'm blessed to have good MHA's. =)

Anyway, I'm hearing what you all are saying... definately been there and done that.

[mama_d, BSN, RN]

I've been complaining about this exact same situation for years, I totally feel for you!

The lack of responsibility felt by the other departments is overwhelming at times. Luckily, where I work, the night CT and pharmacy staff are awesome, so it's not as bad as it could be. There are some nights when I literally watch the clock for 2300 so that I know I'm guaranteed to get someone who cares when I call the department. I'm sure that there are people who staff those departments who care during other shifts, but the percentage is much higher on nights.

[wooh, BSN, RN]

The lack of responsibility felt by the other departments is overwhelming at times.

I love when I get told by another dept that if I don't do their bidding that the pt won't get their ...insert whatever here... It's like, "Ummm, well why should I feel worse about that than you?" Of course, the fact is, I actually DO care more about it. I know the patient, want them to get care. I think a lot of staff in ancillary departments often do see the patients as just medical record numbers on a to do list. Not all of them, but enough to make my life difficult!!

There are some nights when I literally watch the clock for 2300 so that I know I'm guaranteed to get someone who cares when I call the department.

It's funny, when I work nights, about 2330 all the meds we'd been waiting on for 4 hours magically appear. Pharmacy works 8 hour shifts. Coincidence?

[ana tomy]

It's called accountability..Every unit has to speak up and streamline what other Disciplines are Supposed to be doing! Call them on it. Of course we care/look after our patients but we can't be the only ones. We all ultimitely have to do our jobs.

[sicushells, RN]

Yes, we all have to do our jobs, but nursing ends up being the ones staying over to write up incident reports or try to email dept managers to TRY to get something done.

I'm expected to email my manager everytime a med is late or missing from pharmacy.

Oh, and I have to call pharmacy and go get the med.

And I have to makes sure the techs are doing their jobs.

And make sure the patient gets water/pain meds/oxygen (you know, the little things)

So... yeah, I resent when management tells me it's my responsibility to make sure all other disciplines are doing what they are supposed to be doing, in a timely fashion.

Oh, and did you hear? According to Joint Commission, before a medical resident starts performing an invasive procedure, WE'RE supposed to check to make sure they're signed off on it.

Yup, that's nursing's job too.

[wonderbee, BSN, RN]

Yeah it is frustrating and maddening. The nurse is ground zero, the coordinator of EVERYTHING. We are the central cog in the wheel. Did it rain today, ah, it's nursing's fault. Thus it will always be.