If, in your "healthcare job" you never touch anything but paper, or smell anything but coffee, YOU ARE PART OF THE PROBLEM WITH HEALTHCARE TODAY!
If your job description DOESN'T have an annual requirement to be on your knees, geting freaky with Resusci® Annie, YOU ARE PART OF THE PROBLEM WITH HEALTHCARE TODAY!
If your hospital department is closed on Christmas Day, YOU ARE PART OF THE PROBLEM WITH HEALTHCARE TODAY!
If the "alphabet soup" after your name on your employee badge is LONGER than your actual name, YOU ARE PART OF THE PROBLEM WITH HEALTHCARE TODAY!
If you have an assigned parking spot for your 9-5 job, while the 24/7 clinical staff walks from their assigned parking 1/2 mile away, YOU ARE PART OF THE PROBLEM WITH HEALTHCARE TODAY!
If, from your primary work area, you couldn't see an actual patient with binoculars, but earn twice as much as those who do, YOU ARE PART OF THE PROBLEM WITH HEALTHCARE TODAY!
If there is an "RN" after your name, and you NEVER, EVER wear anything but business clothes to work, YOU ARE PART OF THE PROBLEM WITH HEALTHCARE TODAY!
If "every other weekend" is NOT in your job description, YOU ARE PART OF THE PROBLEM WITH HEALTHCARE TODAY!
If you've ever written a memo that had the words "mandatory in-service", "self-education module" and "during employee's spare time" and distributed it via company-wide email, YOU ARE PART OF THE PROBLEM WITH HEALTHCARE TODAY!
If the trunk of your car is full of pens, post-it pads, pen holders (and other trinkets with a brand name drug on them) that you hand out by the thousands so you can bribe your way into spending 5 minutes shmoozing a physician, YOU ARE PART OF THE PROBLEM WITH HEALTHCARE TODAY!
If you have NO IDEA why the blue thermometer tastes better than the red one, YOU ARE PART OF THE PROBLEM WITH HEALTHCARE TODAY!
I just spent a night on a M/S unit. Night shift. Had two patients that were transferred to the assignment I was going to take over right at the end of the 3-11 shift. Both were from ICU. Neither had any business being on a M/S unit......not at all. I know M/S nurses tend to say that too quickly and all, but......no kidding, Joe The Plumber would have known better than to have either of these two patients transferred to a M/S unit.
Both required calls to the rapid response team, one of them twice in fact. The one who required two RRs went back to the ICU at the end of my shift with doctors and everyone else scrambling to get the family on the phone to finally address the code status issue that they had been putting off for the past week.
Now, between the lines, you will see the reality of how this affected my ability to perform as a nurse and hence affected every pt. on my assignment. Between the lines, you will no doubt concede to me that my assignment basically consisted of two ICU patients and six very needy M/S patients (I work on a pulmonary unit, so my peeps are on heavy steroids and breathing treatments, anxiety disorder is the norm).
Let me say that again, TWO ICU level patients, and SIX others. Now, in the ICU, they get to have the two patients I spent 90% of my night with, and then they are done. Not me........I had six other patients to get to outside of that.
Anyone want to know what letter grade I give the quality of care most received that night?
Now, after a night like that, I've learned not to come in here and vent, taking my frustrations out on someone else over some mundane issue (pick any of the many that appear frequently in general chat).
My point is, I hope the "suits" read this and see what the end result of all the rules and policies tends to be, on a daily basis, for most of us still on the front lines.
If we come across as critical, resentful or bitter..............there is a reason, and its not because we are unwise or immature. In a hospital that has functioned for over 50 yrs., and pays millions annually to people.........the "suits".......to make sure things like this don't happen.......a night like I had is inexcusable. Yet, they happen, on a daily basis and continue to go unnoticed because.......the suits are in a meeting discussing how to further cut back staffing and how to nicely phrase the next "You need to remember to check this and that box" email. My patients (first and most important) and I are the only ones who suffered for this hospitals great systematic lapses.........why should they bother to notice I guess.
I don't know what reaction one would expect except when you are part of an administration that has things like this occur under you on a daily basis.
I admit that i have known some of the types of administration people that the OP mentioned. I am a DON and I do not live by those types of rules. Yes, I dress in business casual, BUT, everything I wear is wash&dry. I am out on the floor as needed, I toilet, feed and answer lights... nothing is beneath me as I would not expect my staff to do anything I would not do. I also am in charge of the staffing office, medical records, MDS and such. Staff sho-up in my office with complaints to handle and I get right out there and address them.
All of managment including myself took a 5% pay cut a year ago, no raise since either. The floor nursses got to keep their wages and for those still climbing the scale continue to do so.
I get to work at 5:00AM and am ther at least until 4:00PM. I like being able to see all my shifts and let all the staff know that I am available. Granted I do not normally work weekends but, am on-call 24/7 and have been known to pop in at night or weekends.
The last facilty I was in, I would shampoo carpets, was once on a ladder tearing down a sheetrock ceiling, and when a cook did not show up in the afternoon was in the kitchen cooking a meal for 65 residents.
I took the OP's original message with a grain of salt since i have worked for peopl like that in the past and vowed to never be like that myself. I just laughed at some of the examples listed.
Please, please, please come to work in my facility! I can see where the bitterness against management can come from. It is really lousy to leave [yet another] mandatory meeting, this time the focus was on how poorly staff responds to call lights in a timely manner. The solution? All staff -and this was stressed- from management on down can respond to call lights, if it something a nurse is needed for let the pt know you will find someone to help. IMMEDIATELY upon leaving this meeting, DNS and all nurse managers walked right on by every call light on their way out for a smoke break!
Please, please, please come to work in my facility! I can see where the bitterness against management can come from. It is really lousy to leave [yet another] mandatory meeting, this time the focus was on how poorly staff responds to call lights in a timely manner. The solution? All staff -and this was stressed- from management on down can respond to call lights, if it something a nurse is needed for let the pt know you will find someone to help. IMMEDIATELY upon leaving this meeting, DNS and all nurse managers walked right on by every call light on their way out for a smoke break!
If you can be on CNN and justify telling me that a 1l bag of IV 0.9% Nacl and an iv line is worth $250.00 in the USA but less than $10.00 every where else in the world. YOU ARE PART OF THE PROBLEM.
(Dr Satjay Gupta explained away the high cost of medical equipement and accessories in the USA to patents and development costs. he also stated that hospitals collect less than half of monies owed to them, so make them pay dont kill those who are willing to pay.)
I know that I will take some heat but...........
i can take it.
I couldn't agree more. Can somebody please explain why two tylenol cost me $7.00 in the hospital...and this was 23 years ago when I had my daughter, yet I could buy a whole bottle for less than half that at the drug store?
I've never worked as a nurse. I've never spent any time in hands-on healthcare. I'll never get the chance to, because about a decade ago, my body tried to wreck itself and I wound up with a major spinal cord-related disability.
In stead of direct care, I decided to go into health information management/healthcare administration because I thought it would be a way that I could physically tolerate that would let me help the state of American healthcare in my own small way. I'm making myself learn a lot of skills outside my program so that I can help research what works and what doesn't, so there isn't so much guesswork or so many idiotic unproven steps.
I will never work the floor. On the other hand, I'm here, right now, because I want to learn about the problems real nurses have. I'll do the same thing for other types of direct care professions. When I'm done with school and out in the workplace, I'll talk regularly to anybody and everybody so that I know where the real problems are - what works, what doesn't, what might, and what's laughable.
Except it sounds like I'll be lucky if I don't just end up talking to myself. If life is always going to be paper-pushers versus ministering angels, we're all in trouble. The problems we face in healthcare today are too big, too real, too intertwined, for any one group or subgroup to come up with the perfect soultions. We have to work together, talk to each other, and LISTEN to each other.
Are people (managers, direct care workers, head honchos, whoever) always going to like what I come up with as viable options to change things for the better? No. The changes we need to make in order to make the system as a whole better are inevitably going to impact all of us. I might advocate the feedback paperwork as an important way for the facility or healthcare group or whoever to know what patients and their families like and hate. OTOH, there will never be a time in my life when I'll advocate some sort of a$inine "customer service" bull that makes nurses repeat scripted responses. That's demeaning to bank tellers - it's sure as check insulting to nurses! I'll do my best to combine and cut back paperwork so that we have the important data and aren't making direct care workers spent half their lives repeating the same information on ten different sheets. On the other hand, the paperwork I will need will be vital, which means I'll really need your help in getting it done.
I'll probably never be able to help you treat a patient. But I'll be there behind the scenes, doing my best to keep divergent viewpoints focused on what we all have in common. I'll volunteer to help with what I'm allowed to do. I'll be an open ear whenever you need one. You'll be hacked off at some of the options I advocate, but you'll always know I'll give every viewpoint a fair hearing. We'll both have to give in order for everyone to benefit.
I'm a future administrator. And I'm proud of what - and who - I am.
"I'm a future administrator. And I'm proud of what - and who - I am." quote from post #148 by TDCHIM
Well, I wish you well, but doubt that your administrative and/or research studies will be pertinent to conditions on the floor of units at whatever facility where you will work. It would take many months of shadowing nurses of every level, to thoroughly appreciate the pressures and challenges of our work, its scope; and patients' aspect of the care they see necessary for their recovery.
Most problems in patient care are derived from no and miscommunication between those who are nurses, and those health care workers who have not been in our shoes. You have been a patient with or without knowledge of the role nurses take, tasks performed by them, and what those who like you, think they have all the answers, without any experience.
I remember saying, when I began teaching expectant parents how to give birth, that I sincerely said and felt that not having experienced that myself, gave me "objectivity". WRONG!! After I gave birth nyself, I became a much better childbirth educator because I really knew what I was talking about, from the perspective of an OB nurse and patient.
Students who took my classes after we'd all given birth (when they were anticipating another baby) said the change in my teaching was dramatic. The comparisons I draw from that, are that you can act like an administrator, but you can't really administrate health care facilities accurately, without personal experience doing what health care professionals and non professionals do. On the other hand, objectiviry is required for research; and you may be better suited for proving what we keep saying, so that others can provide work settings that are appropriate, law abiding, and effective.
If you tell those working in health care facilities and outpatient settings that we must take 2, 15 minute breaks and a 30 minute lunch break per 8 hours of work, without providing additional informed staff to spell us during the time we take off the floor, you'll lose credibility that can't be replaced.
Yet that is the labor law, and administration should lose accreditation of their facility, if it isn't followed. That is the crux of nurses' dissatisfaction and burnout in their work. I don't know one nurse, certainly not me, who has ever been able to observe that law, for one day. In OB that might happen if no one is admitted in labor, and you don't get sent to another busier unit, with no experience in that area, or sent home without pay.
The emotional effect of that runs the gamit, from " no one cares about my needs", to "this place isn't credible", theyefore it's an unsafe place for me to be. I'll never forget being told when I was first in the USA, from Canada, that I couldn't complete my work as it would take longer than the time I was given to do it. The duplicity and lack of reality nurses experience when that happens, creates disrespect and a "we" vs "them" adversarial atmosphere that becomes quite derisive. In Canada I hadn't been given assignments that were beyond my ability to complete. Here, no assignment given nurses that I've known, is in touch with reality. That's because demands placed on staff haven't been given by anyone that walked the same walk.
It's too bad that I have to be so blunt, and I certainly respect where you're coming from, but I'd like to save you (and those who you hope to help)the time, energy and frustration, by telling you how it is. That's what's brought us to the current place we are.
>That's because demands placed on staff haven't been given by anyone that walked the
> same walk.
That is because we have come to a point where anything ANYONE else doesn't want to do gets dropped on nursing.
We are now charting peak flows on acute asthma patients pre/post neb tx. because RESPIRATORY is "too busy" to do so.
We now have a full-page form on "multi-dose inhaler use discharge training" I must fill out on everyone that gets an MDI in the ER because it was felt it would "be more efficient to have nursing do it than have an RT come down to the ER each time."
No snarky comment is even needed here. ("res ipsa loquitur")
>That's because demands placed on staff haven't been given by anyone that walked the
> same walk.
That is because we have come to a point where anything ANYONE else doesn't want to do gets dropped on nursing.
We are now charting peak flows on acute asthma patients pre/post neb tx. because RESPIRATORY is "too busy" to do so.
We now have a full-page form on "multi-dose inhaler use discharge training" I must fill out on everyone that gets an MDI in the ER because it was felt it would "be more efficient to have nursing do it than have an RT come down to the ER each time."
No snarky comment is even needed here. ("res ipsa loquitur")
That has become the latest "economy crisis survival tactic" at my hospital. Support staff, everywhere, from dietary to housekeeping, maintenance, transport, security and a lot of "administrative" have seen their hours cut back. Many jobs were completely eliminated. Whatever they can't unload on the people in the dept. that remain, they somehow turn into a nursing responsibility. Just the other week I had an RT person refuse to do trach care because the nurses hadn't gathered her equipment for her and then, after being told to gather her own supplies by her supervisor...........tried to pawn off the documentation of the trach. care onto us.
Nurses must be watchdogs regarding safety issues! When tasks already land on the "overload indicator", any nursing administration type who approves one more responsibility without adding more staff, needs to be told that he/she is responsible for any error made by staff. The Safety Commitee needs to be formally informed of extra work that lands on nursng's doorstep! No one individual needs to sign those written notices, unkess they have an urge to commit professional suicide..... Take a page from administration's protocols, they never sign anything personally, do they?
Contact the National Nurses' United (NNU), and as many of you as possible join it! Support the National Nursing Shortage (hush, you new grads....) Reform and Patient Advocact Act, S1031 which establishes national, minimum RN: patient staffing ratios, whistleblower protection for RNs and a federal RN workforce initiative to promote nur4sing education and mentorships, and HR2381 and S1788 requiring safe patient lifting practices in hospitals.
Get the addition of other disciplines' taskseliminated, as requiring information nurses' don't customarily provide. That can be added to existing legislation before it passes, or be its own measure, whichever is fastest. Develop your own ability to say, "NO!" (while smiling)
You can contact NNU by accessing NationalNursesUnited.org or call 1-800-287-5021. Be proactive!!
360Joules
Shocking! Too bad you didn't get it on camera.
(while smiling)
eriksoln, BSN, RN
2,636 Posts
Hmmm.
I just spent a night on a M/S unit. Night shift. Had two patients that were transferred to the assignment I was going to take over right at the end of the 3-11 shift. Both were from ICU. Neither had any business being on a M/S unit......not at all. I know M/S nurses tend to say that too quickly and all, but......no kidding, Joe The Plumber would have known better than to have either of these two patients transferred to a M/S unit.
Both required calls to the rapid response team, one of them twice in fact. The one who required two RRs went back to the ICU at the end of my shift with doctors and everyone else scrambling to get the family on the phone to finally address the code status issue that they had been putting off for the past week.
Now, between the lines, you will see the reality of how this affected my ability to perform as a nurse and hence affected every pt. on my assignment. Between the lines, you will no doubt concede to me that my assignment basically consisted of two ICU patients and six very needy M/S patients (I work on a pulmonary unit, so my peeps are on heavy steroids and breathing treatments, anxiety disorder is the norm).
Let me say that again, TWO ICU level patients, and SIX others. Now, in the ICU, they get to have the two patients I spent 90% of my night with, and then they are done. Not me........I had six other patients to get to outside of that.
Anyone want to know what letter grade I give the quality of care most received that night?
Now, after a night like that, I've learned not to come in here and vent, taking my frustrations out on someone else over some mundane issue (pick any of the many that appear frequently in general chat).
My point is, I hope the "suits" read this and see what the end result of all the rules and policies tends to be, on a daily basis, for most of us still on the front lines.
If we come across as critical, resentful or bitter..............there is a reason, and its not because we are unwise or immature. In a hospital that has functioned for over 50 yrs., and pays millions annually to people.........the "suits".......to make sure things like this don't happen.......a night like I had is inexcusable. Yet, they happen, on a daily basis and continue to go unnoticed because.......the suits are in a meeting discussing how to further cut back staffing and how to nicely phrase the next "You need to remember to check this and that box" email. My patients (first and most important) and I are the only ones who suffered for this hospitals great systematic lapses.........why should they bother to notice I guess.
I don't know what reaction one would expect except when you are part of an administration that has things like this occur under you on a daily basis.