Why RNs cannot say 'That's not my job'

[Dramqueenie1]

I have been a RN for over 3 years. I am not 'seasoned' by any means and I continue to learn new things everyday. However this is my problem. I got into a major debate with a Resp therapist recently that still burns me up. The resp said 'I am sick and tired of being here for 5 years and I still don't get paid as much as RNs do' I replied 'the reason nurses are paid more is because we are responsible for more care than respiratory is' She sneered and asked 'are you saying you do more than I do on any given shift?' I said 'No I am just saying that when a pt is sick, I clean it up. When a pt is bleeding, I make it stop. i have climbed up and fixed TVs because maintenance said 'That's not my job'. I have given a pt a tissue when a resp was in the room because the resp said 'That's not my job'. I had to get on my hands and knees and mop up vomit because housekeeping refused to loan my am mop or clean the mess themselves and they told me 'That's not my job'. I have fixed beds, remotes, telemetry leads, cleaned floors, changed linens, fixed computers, fixed vital machines, charged lift equipment, charted and cared for my pts all in one night. I have never said 'That's not my job'. So why am I upset? I get paid because I do my job so why can't everyone do theirs?

[usalsfyre]

Here is where you dropped your candy. You should have said, Yes and not only do more, but am responsible for more." And walked away.

Right, because you've got 20-30 patients of varrying acuity at any one time.

For a profession that complains about getting disrespected by physicians, I sure see a lot of people willing to look down on other allied health providers.

[anotherone, BSN, RN]

The RT deserved it. Everythign is the nurse's responsibility but he/she better not get paid for it. I am very glad you reacted this way OP. In my facilty nurses are the least respected employees. we get chewed out constantly by managmenet for HOUSEKEEPING ISSUES. when i see the housekeepers( days only none on nights) take BREAK AFTER BREAK AFTER BREAK. Fine i will clean the bathroom and hk can give the meds.

[OCNRN63, RN]

Maybe what the RT said just struck you wrong at the moment, but I don't think your reply was helpful in terms of keeping a good relationship with RT. I also doubt that's why nurses are paid more than RT in your hospital.

RT does a lot of stuff I wouldn't want to have to do. They have a job that is every bit as complex as nursing...it's just different. I would much rather have them on my side than start an inter-disciplinary war.

[OCNRN63, RN]

The RT was expressing frustration at feeling undervalued. I think we all can relate to that. This was an opportunity for the nurse to reach out to the RT and take the conversation in a different direction.

[TC3200]

Historically, NURSES DID IT ALL> ...

I am severely disappointed in the skills and quality of work that I have been witnessing the past few years. More like the Dollar Store versus a nice department store. In my opinion from working in several states over the years it is nation wide. There are way more important things to be discussed than whether or not RT makes less money than RNs.

That's a very interesting observation, re. the quality of the work. I recently left a RN school due to (actually, was kicked out for complaining about) the low caliber of instruction that I was getting there. Dollar store vs. useful, for sure. I'm an adult who came from technology and engineering to RN school. I was a very enthusiastic student when I started, but I became progressively more dissatisfied and angry during my 1 year of schooling. I felt the the education I was getting was spending far too much time dwelling on developmental stages, and nursing theory like Orem, and whatnot, and was lumping a lot of "carp" into the tallied clinical hours. And that the whole shebang was far too fractured, nonsensical, and lightweight in actual patient care training to suit me.

Since it was an ol' fashioned diploma school that touted a boatload of clinical hours, I fully expected to be using those hours hoofing it up and down the halls, learning how to do actual patient care, not spending hours learning how to game the system to pass NCLEX questions, getting 15 minutes of training on the three sim dolls, and having the school tell me "Why don't you have these skills! We've instructed you!"

While listening to the endless hours of lectures drone on, I often found myself wondering just how this was supposed to make me a capable nurse. I think RNs ought to come out of school fully trained. Why do we get an incomplete education and then the hospital still has to train us some more before we're of any real use??

*********

re. "Not my job": Coming from a different industry, I really believe that these hospitals need to set some boundaries for who does what, and then staff appropriately. If there are RNs, LPN, and CNAs on the floor, as well as housekeepers, then there ought not to be much cross-crafting required or expected of anybody. Sure, emergencies crop up and everyone pitches in, but the way the burden is unfairly placed on the RN, it just sets the stage for conflict and squabbles. I actually think that RN is the worst job on the floor, because you must do the RN job, the MD/DO's job, the LPN's job, the CNA's job, the housekeeper's job...

*******

re. housekeeping: I was in RN school for 1 year and we had clinicals at the hospital after the third week. In all that time, I never saw a patient bathroom in that hospital that was not an absolute unsanitary pigsty. Never. I actually made a point of at lest glancing into the bath of any patient room I was in. I saw blood and diarrhea on the floors that was just swiped up with a paper towel and never followed up with a bleach mop. The faucets had a cloudy film on them forever. Dirt and dust were collecting in every corner of rooms and hallways. Bedside commodes stunk up the storage rooms. There were stains on undersides of commode seats. Disgraceful. Yes, sometimes I cleaned when I had no patient care to do.

[Sehille4774]

Is the title a rhetorical question? LOL.

The answer in my mind is summed up as: Nursing! All of the Responsibility! None of the Power!. Well, I feel that way at times anyway.

Quite simply, if a accident or preventable incident occurs that somehow results in a patient getting injured and we were that patient's nurse...then it was OUR job to access of the potential hazard and then either fix it ourselves or create and manage a plan where the proper person(s) IE Housekeeping, Maintenance, ect...takes care of it or else It Becomes the Nurses fault! .....

You can plug in whatever variables you want...but the equation works the same every time.

I know, $hitty right?!

That's why noone (who cares about their license) likes to follow lazy nurses...If I start my shift..and find that you left a bunch of stuff..orders and ect. wrong and I ignore it and do nothing to clean up your mess..then I could be liable if the next nurse comes in and makes a mistake that I should have caught and prevented.

I feel this is pretty much reality. What is not fair is that while we get the blame and are responsible to get housekeeping down to clean the big leak under the sink...we don't necessarily have any real authority over those departments or other employees in general...so We end up taking care of alot of things ourselves.

I try soooo hard not to do more then my fair share just in principle and so as not to create that standard for my fellow nurses to have to deal with.

I tend to reach out to employees in other departments..in the hope that if I show them respect then when it comes time, they will do their fair share of the work too.

[caliotter3]

I have been criticized for putting linen down on flooded floors when I could not find a mop and bucket. I countered back with the fact that I slipped and twisted several muscles when I did not know the floor was flooded. The criticism increased. So, yes, no matter what the circumstances, it is always the nurses' fault.

[OCNRN63, RN]

That's a very interesting observation, re. the quality of the work. I recently left a RN school due to (actually, was kicked out for complaining about) the low caliber of instruction that I was getting there. Dollar store vs. useful, for sure. I'm an adult who came from technology and engineering to RN school. I was a very enthusiastic student when I started, but I became progressively more dissatisfied and angry during my 1 year of schooling. I felt the the education I was getting was spending far too much time dwelling on developmental stages, and nursing theory like Orem, and whatnot, and was lumping a lot of "carp" into the tallied clinical hours. And that the whole shebang was far too fractured, nonsensical, and lightweight in actual patient care training to suit me.

Since it was an ol' fashioned diploma school that touted a boatload of clinical hours, I fully expected to be using those hours hoofing it up and down the halls, learning how to do actual patient care, not spending hours learning how to game the system to pass NCLEX questions, getting 15 minutes of training on the three sim dolls, and having the school tell me "Why don't you have these skills! We've instructed you!"

While listening to the endless hours of lectures drone on, I often found myself wondering just how this was supposed to make me a capable nurse. I think RNs ought to come out of school fully trained. Why do we get an incomplete education and then the hospital still has to train us some more before we're of any real use??

*********

re. "Not my job": Coming from a different industry, I really believe that these hospitals need to set some boundaries for who does what, and then staff appropriately. If there are RNs, LPN, and CNAs on the floor, as well as housekeepers, then there ought not to be much cross-crafting required or expected of anybody. Sure, emergencies crop up and everyone pitches in, but the way the burden is unfairly placed on the RN, it just sets the stage for conflict and squabbles. I actually think that RN is the worst job on the floor, because you must do the RN job, the MD/DO's job, the LPN's job, the CNA's job, the housekeeper's job...

*******

re. housekeeping: I was in RN school for 1 year and we had clinicals at the hospital after the third week. In all that time, I never saw a patient bathroom in that hospital that was not an absolute unsanitary pigsty. Never. I actually made a point of at lest glancing into the bath of any patient room I was in. I saw blood and diarrhea on the floors that was just swiped up with a paper towel and never followed up with a bleach mop. The faucets had a cloudy film on them forever. Dirt and dust were collecting in every corner of rooms and hallways. Bedside commodes stunk up the storage rooms. There were stains on undersides of commode seats. Disgraceful. Yes, sometimes I cleaned when I had no patient care to do.

You need to learn how to walk before you can run. The fact that you had a lot of experience in another field is immaterial. You have no experience in nursing, so it's a real stretch to think you are in a position to judge the quality of your education. I know when I was a student there were times I thought we were going over information that was immaterial. Well, I didn't know what I didn't know. So, if I had to choose sides in your situation, I'd have to side with the school. There are bad schools out there, to be sure, but most likely there are more students who are dissatisfied, low-performing or otherwise problematic.

It's hard for you to say your education was incomplete when you did not complete your education. Once you're a practicing nurse, you can decide to some degree what in your education was useful and what was "bunk." As far as graduating and being able to "hit the ground running," that may have been the norm years ago, but not now. I graduated many years ago from one of those "old fashioned diploma schools," and it was highly regarded for the nurses it turned out. Nevertheless, we needed time to learn how to be nurses, even with all the clinical time we had. Most professions have a period of time after graduation that allows the graduate time to grow into his/her role. I don't see why nursing should be any different.

[netglow, ASN, RN]

But OCN, I am a second career/degreed nurse. I know that lots of valuable time is wasted on "floppy-hat" kind of stuff in nursing edu.

Nursing needs to seriously do an overhaul. As a "girl" I was insulted at how "girly" and dumbed-down nursing text was. I tossed it early on for non-nursing text. CHF is CHF isn't it, after all. Let's cut to the chase in edu., shall we?

[OCNRN63, RN]

But OCN, I am a second career/degreed nurse. I know that lots of valuable time is wasted on "floppy-hat" kind of stuff in nursing edu.

Nursing needs to seriously do an overhaul. As a "girl" I was insulted at how "girly" and dumbed-down nursing text was. I tossed it early on for non-nursing text. CHF is CHF isn't it, after all. Let's cut to the chase in edu., shall we?

The difference between you and the other poster is you were able to look past whatever perceived flaws you found in your nursing program and finish. Could there be improvement in the way nurses are educated? Of course; name me a profession that couldn't improve how it educates its students.

There were a lot of people in my nursing class who had previous degrees. I don't remember all the complaining you hear now about irrelevant content.

[Dramqueenie1]

Thank you to all the posts, both negative and positive. While I never condone disrespect to any other human being in this world I have to explain some back story to this arguement. You see this particular RT is known for complaining that she and the other RTs are overworked and underpaid. I never provoked her into this discussion. I was simply sitting in a nurse's station receiving report. I could not simply get up and walk away. I said what was deserved and warrented in this situation. Yes some RTs work hard, yes they have 30-40 pts, No thier pts are never critically ill and ready to die at the same time. No they never answer call lights, no they never put bedpans under people, they are only in one room for 10-15 minutes anyway. When I said to the RT 'Y didn't you go all the way and be a nurse' she wrinkled up her nose and said 'Ew gross I would never do that stuff'. So yes interdisciplinary politics are important but gosh darn it if us nurses can't vent on this website about others then where can I?

[Perpetual Student]

Often times the buck does stop with nursing, it's just part of the game. A big part of our role is to keep the interdisciplinary team on the same page and make sure the patients' needs are met. That said, it's totally bogus when someone refuses to do something basic for a patient when it won't detract from their accomplishing their other duties, such as handing the patient a tissue as mentioned in the OP. I must work in a strange hospital because I almost never hear "that's not my job" unless it's something like I asked the wrong department for a supply that they don't manage.

No thier pts are never critically ill and ready to die at the same time.

Umm, really? They do all kinds of important things with critically ill patients. Who do you think manages vents, assists with/performs intubation, draws ABGs on patients without art-lines, and any of numerous other important, time-sensitive tasks?

When I said to the RT 'Y didn't you go all the way and be a nurse'

Why didn't you go all the way and be a doctor? Say you had and were an IM doc, why didn't you become a cardiologist? Why didn't you become a cardiovascular surgeon? Why didn't you invent a healing device like they had on Star Trek? Do you see how that line of questioning is insulting and pointless? Nursing and respiratory therapy are two different fields. Both are important and require competent, intelligent people in order to provide decent care to patients. Respiratory therapy isn't all SVNs for stable patients and simple CPAP.