Archive

Posts Tagged ‘politics’

Exhaustion.

December 20, 2011 1 comment

I’m done.  Stick a fork in me.  Cooked.  Tired.  Knackered.  Straight up worn out.

Y’know how I know?  Every little bug knocks me down.  I want to sleep but can’t.  I wake up more than I’m asleep it seems.  Even with chemicals.

That said, I’m taking the rest of the year off.  I get on a plane tomorrow and head for Arizona hoping to recuperate and recharge and maybe stem the bleeding that is my will to continue as a nurse.  Burnout is a terrible thing.  So I’m going to enjoy a white Christmas in the White Mountains with my family.

Hope everyone has a wonderful Christmas and a great New Year.  I’ll be seeing you in 2012.  Promise.

 

Tumbleweed Christmas Tree in Chandler, Arizona

Image via Wikipedia

 

What’s Wrong with Health Care?

September 25, 2011 8 comments
A Burger King hamburger sesame seed bun, as se...

Image via Wikipedia

Customer service.

We’ve turned taking care of the sick and injured into fucking Burger King. Everyone wants it “their” way. Sorry folks, life isn’t like that especially in my house. When we turn patients into consumers, they begin to expect to treated like customers and hence have no skin in the game. This leads to unrealistic expectations and our administrative “leaders” play up that we are in the business of providing customer service instead of healing. That then becomes our problems on the floors and our “customers” think that “their” way is the only way.

Yes, I will be disturbing you at midnight to check your vitals and then doing it again at 4am.

Yes, you will have blood drawn, probably several times through the day and night.

No, you can’t have your hydrmorphodemerolepam every hour, even if that’s how you take it at home – which is probably what got you here in the first place.

No, burger and fries are not part of your heart healthy diet to help treat your congestive heart failure.

Yes, lasix makes you pee. And, yes, I will be giving you a dose tonight, as the doctor ordered, every 8 hours so that you can breath and not have a hugely swollen scrotum.

Yes, it would be nice for your family to come in to learn wound care techniques so they can care for you at home.

No, not all of them can stay the night with you in a double room.

No, you can’t go out to smoke, even just for a minute. And I’m definitely not giving you an oxygen tank and wheelchair to do it.

Yes, you are more than welcome to leave AMA because we’re all racist assholes who won’t give you IV narcotics every hour, please just sign this form.

No, you don’t get a cab voucher, discharge prescriptions or fresh clothes if you do leave AMA. Sorry.

Yes, Dr. First-Year Intern, they just left AMA after threatening the entire staff, but you might catch them by the ED if you hurry. I’d bring Security with you though.

I will be polite and respectful, but I will not fawn over ingrates, feed into those with unreasonable expectations or take the crap from the dis-respectful. I refuse to be turned into a cashier clerk at the local fast food joint or a Pez dispenser of Oxycontin. There is difference between customer service and letting the public run wild in our house.

It’s time to take it back.

To set expectations.

To educate our patients.

To let the world know that we are not there to be exploited, abused and disrespected.

It’s a long journey, but it starts with a single step, for nurses and other health-care providers to stand up and say, “NO MORE!” and start to expect our patients to be active and involved, to care about their health, to put some skin in the game and start behaving like responsible adults.

But that will never happen. Sad.

Meetings: Not a Prioirty

August 23, 2011 3 comments

To: Unit Manager

From: Wanderer, overworked charge nurse

Subject: Monday’s Meeting

I guess one of the included functions in the Managerion™ 2000 automated management toolset randomly creates meetings and requires our attendance.  This would explain relative randomness and recurring frequency of such meetings and their lack of cogent concept or agenda.  Having meetings just to have meetings about meetings is pointless and a waste of all of our time.

In the last 4 meetings we have decided absolutely nothing, but keep referring to later meetings to “work out the details”.  Would it be so hard to make a decision?  Yes, you have multiple units that these decisions will affect, but sometimes you need to throw caution to the wind and make a decision – call it an executive mandate.  There is something to that y’know?

This said, I won’t be coming to any more meetings.  I’m not going to spend an hour each way commuting in to work for a meeting that lasts 45-60minutes and decides nothing.  It is not as easy as some might think.  Whether I drive or not it is at least 45 minutes in rush hour traffic and if I use transit it is even longer.  Now if we were going to decide something or the  meeting was going to last 2 hours, things might be different.  Also if I didn’t have to come back to work the night shift at 1900 it might be different as well.  But the last 4 meetings have done nothing of the sort.

I realize that it is part of your annual review to see how many meetings you presided over, ran or otherwise were engaged in, and I know management is in agreement that meeting indices are not quite what they should be for this fiscal quarter, but please, enough already.

So unless the next meeting will actually accomplish something, or is held in a local pub during happy hour, I won’t even be phoning it in.  I am a nurse, I take care of patients.  I am not a paper-pusher, drone, meeting junkie or have any aspirations to management  so just let me do what I’m good at – no more meetings.

Thanks!

Wanderer, overworked charge nurse

First of a Thousand Words

March 31, 2011 Leave a comment

I’m learning that there is only so much that you can write about on a daily/weekly/bi-weekly basis without getting into things like religion, money and politics – all subjects I learned long ago to steer clear from while at work and the dinner table.  Thees are things that I wish I could write intelligently about and eloquently enough to make a valid argument, but I have neither the time or the inclination to deal with the kooks that would stream from under the rocks if I did.  So instead, every time I get the urge to blather on about the inequities of tax policy, over-reach of global multinational, invasion of privacy, the corruption of our government and political process among other things, I will just post a picture.  It works for me.

Nursing Shortage? Not in Some Eyes.

March 23, 2011 30 comments

I know this rant has been making the rounds on Twitter.  It is full of rage, a touch of woe is me and the grim reality of the situation we place so many new grads in.  A quote (shield your eyes if easily offended…)

Czech nursing students.

Image via Wikipedia: They got jobs.

Well, after a year of getting rejected I have finally decided to give nursing the bird. FUCK YOU NURSING FIELD! Too bad the schools and media are still insisting that people go to RN school. Believe me THERE IS NO FUCKING SHORTAGE! New grads are considered garbage. On top of that, the degree serves no purpose in any other setting. BSN is a complete waste of time and money.   …And it is not just the economy. Hospitals turning huge profits stopped new grad programs and hire foreigners.

Wow.  The rest continues on in a rant that she (assuming a she) will never get a job, never put her degree to use and that she wasted 6 years of her life.

First gut reaction:  she’s right.  It sucks to be told there is a ready market of jobs just waiting for new grads.  Read too many job requirements of  “at least 2 years experience” and raged at the screen saying, “How am I supposed to get experience if I can’t get a job?  WTF?!”  I know many, many grads who have cycled through our unit for practicum who have yet to find jobs.  We have nurses on our unit who jumped at the first offer (methadone clinic anyone?) but persevered and got the jobs they wanted.  In fact that was me.  I got lucky.  I can empathize.  The betrayal of it all is painful, kind of like when you realized Santa was not real, or your girlfriend was banging your best friend.

Second reaction:  buh-bye.  Maybe we’re (as a profession) better off not having this person in our ranks.  Nursing is not easy…what happens the first time they get a difficult assignment?  Or have “one of those days”?  Run out?  Quit?  Nothing in this profession is given to you, one has to work for it.  Take for example NurseXY, who landed his dream job in a world-class CVICU.  Seriously, go read his stuff, he worked his ass off for it.  Nothing was easy.  No one ever promised (at least anymore) that a job would be waiting right when you passed NCLEX – and if they did you should make sure they aren’t selling a pile of hooey.  Just because there is a nursing shortage does nothing to guarantee you a job just because you passed the boards.  Anyone who degrades their education to this degree and doesn’t realize that sometimes sacrifice is a needed part of our job has no place being a nurse.

Final reaction:  no seriously, buh-bye.  If you want to work as a nurse enough to devote 6 years and thousand of dollars to do so, giving up isn’t an option.  She never says that she looked out of state for jobs, into different avenues than the traditional hospital based nurse or for other ways to be a nurse.  Our system interviewed over 500 grads for spots in our residency program and they came from all over the Northwest.  They tried to make it work.  There is nothing to say she did this, just a whiny, “why isn’t it given to me!” rant.  We have too many toxic personalities in nursing and truly don’t need anymore.

I know this is harsh.  Maybe this person is a amazing nurse, top notch clinical skills with empathy to boot, is driven far beyond belief and tried EVERY avenue to make things work, but based on what I’m reading, what they posted onto the internet for everyone to read, I doubt it.  And with this rant, I doubt any but the most desperate, worst, idiot recruiter would ever even consider asking for a resume.  I know it sucks, but maybe it’s for the better.

Is Protecting Yourself a Joint Commission Violation? | WhiteCoat’s Call Room

January 8, 2011 2 comments

When are you guys going to learn? When a patient is choking the life out of you, you HAVE to offer them milk and cookies then tell them to go to a secluded room before you try to defend yourself. Those are the rules. If they have their hands around your windpipe and you can’t breathe, then just point emphatically to the secluded area.

via Is Protecting Yourself a Joint Commission Violation? | WhiteCoat’s Call Room.

Yes.  Yes it is.

This is the inherent problem of large regulatory bodies like the Joint Commission:  they do not operate in reality.  They exist in a perfect fantasy land where falls never happen, infections are impossible and ED (and all patients) are well behaved.  They do NOT understand the complex and dangerous reality that is modern health care.  Like managers, they should be required to spend an amount, say a week a year, of time where they are the primary surveyors.  Your primary survey (management) area is ED?  You get to spend a week in the trenches.   The people who are writing the rules NEED to be intimately familiar with the true consequences of their actions.  Handing down edicts from on high isn’t as easy when you know what it means to the actual providers.

Of course that is just a fantasy because like most bureaucrats, they got into this line of work to avoid (or couldn’t hack it) just this sort of thing.  Actual patient contact?  Ewww.

Obviously the Public Still Doesn’t Get It

December 30, 2010 Leave a comment

Trouble is that patients still seem to think that nurses are not real people. I would be angry if nobody cared about my safety from an institutional standpoint, as was the case in my previous post, but that does not apply in my current position. The issue that steams me lately is the apparently novel idea that nurses are not waitresses, punching bags, ignorant children, maids, or housekeepers. I’m tired not only of being punched and kicked, but also of being ordered around (“go get me some water”) and even of, eg, being belched on. Would you burp on someone anywhere else and blow it in her face? No! So why is it OK when it’s a nurse? Where is it written that normal rules of adult engagement are off when one party is a nurse?

via Commentary on “Hospital staff sick of violent drunks” | Not Nurse Ratched.

There must be a magical aura around hospitals where behavior that is unacceptable ANYWHERE else is suddenly acceptable.  Nurses get the brunt of it.  Sorry, getting hit, spit on, yelled at and generally treated like shit is nowhere in my job description.  Really, I’ve looked and read my job description.  Not there, sorry.

Follow

Get every new post delivered to your Inbox.

Join 910 other followers