Help!!! I Need A Reality Check

13 posts · started Aug 3, 2008

sereneintexas Aug 3, 2008, 6:02 PM
I woke up this morning feeling like I was in the twilight zone, thinking of yesterday's events at work. I have worked at a residential treatment center for 5 years and this is my only experience in psych (except for 10 weeks when I worked in an acute setting). So perhaps someone can tell me if this is the norm for psych nursing. It is not like anything I have encountered in my 24 years of nursing before coming here. We were short 3 nurses on the day shift. This, by the way, is not due to the nursing shortage that we are experiencing in this country. It is due to a shortage of nurses at our facility who actually want to work, a shortage of nurses who are able to get there butts out of bed and get to their assigned shift. It's a shortage of nurses with integrity of any kind. We have about 4 nurses who come in when ever they please and sometimes leave early. They don't call to say they are going to be late or what time they will arrive, they just show up 1-2-3 hours late. Obviously they are not being held accountable or they wouldn't do this continuously. And from time to time one is a no call-no show. Those of us who have old fashioned work ethics shake our heads and wonder "how in the hell can this continue to happen?". Well, I digress...
Yesterday, due to being short, one nurse was assigned 36 patients, another was assigned 32 patients. I was told that I had to accept an assignment of 43 patients (24 were on the unit I originally was assigned to and an additional 19 on another unit). I happen to know that the nurse on unit X had only 6 patients. Now, this nurse does an excellent job getting to work on time and has excellent attendance. Kudos to her! However, I also know that she sits in her nurses station watching DVD's if she is not too busy sitting outside smoking or visiting with other nurses who think they are at the ______ _______ Treatment Center Social Club. Nurse Giddy was originally hired for one of the busier units at our facility but was moved to an easier one when she complained that the work was to hard. She even went as far as to tell me and the supervisor that she came to work at our facility because her boy friend used to work there and told her that it was a good place to work because the nurses didn't do any thing there. The supervisor asking, no ordering me me to be responsible for 43 patients is part of that social group and friends with Nurse Giddy. I told her that this was not acceptable that I be asked to take responsibility for 43 patients while Nurse Giddy sits on her unit with 6 patients, watching her DVD player. The supervisor, who we will call Nurse Soyal, told me that Nurse Giddy had a right to be watching her DVD player. WHAT!!! Then she told me that Nurse Giddy had to stay on her unit and was not allowed to leave. I knew better and I was livid. I don't know who she thought she was talking to but she acted as if she thought I had fallen off the turnip truck just the night before. Then she stated that this was not about Nurse Giddy. I stated "no, it's about me being expected to take responsibility for 43 patients while she sits over there with 6 and watching her DVD player. ( I just couldn't let that dam DVD player go!!!) Now let me say here that for several months before Nurse Soyal was hired I was doing her job so I knew how difficult it was and I really was trying to be accommodating. This by the way was not the first time that she had attempted to do this to me. She told me that I never wanted to help out and ... I reminded her that before she was hired that I was doing her job plus having a unit assigned to me plus at times had to help cover another unit. She asked me if I was refusing the assignment. I told her that I thought Nurse Giddy should be assigned more patients than what she had. Nurse Soyal stated that if I did not accept the assignment that she would write me up. I told her that I would think about it and call her back. Well, the more I thought about it the crazier I got!!! It was 6:30 in the morning and I called the DON, her boss at home, woke her up, and told her what Nurse Soyal had said and that this was not acceptable. Yes, I really did do that! DON Buzer was not a happy camper but kept an even tone with me stating that she would speak to Nurse Soyal. Well, Nurse Soyal and Nurse Giddy ended up passing the AM meds on that other unit and I was asked to respond to any other needs. I accepted that when they agreed to share a little responsibility. So was I totally wrong to refuse such treatment? I just don't know!!!
signed,
Psycho Nurse
AmandaWIRN Aug 3, 2008, 10:30 PM
Sounds like you need to get out of that place- I'd find a new job ASAP- taking on that many patients at once is dangerous for you, them, and your license.....
cougarnurse Aug 4, 2008, 1:04 AM
Ah, just to be curious....WHO needs the reality check? Certainly not you. YOU are on time, etc.; the others obviously are NOT. I don't even have to wonder why you signed Psycho nurse. Heck, I'd be heading down that path myself.

I'd start looking for a new job, too. THEN maybe the higher ups will get a clue.
sereneintexas Aug 4, 2008, 1:41 AM
I know I need to get out. I don't know why I've stayed there as long as I have, except that I am highly disfunctional myself. I quess I'm a little afraid of getting into a similar situation. So what kind of pt/nurse ratio should I expect elsewhere? And what about substance abuse nursing, how many pts can I expect there?
sereneintexas Aug 15, 2008, 2:43 AM
Hey there, well I have been offered another position as a health coach. This is quite different from anything I have done as a nurse but I think I will enjoy it. I'm just a little anxious over having to apply for license in multiple states as I'm required to do for this position. I've explaned the problem on another thread, perhaps one of you can help. See thread on "info on multiply state nursing license" Or maybe you can get there by clicking on this link:
http://www.ultimatenurse.com/forum/f6/info-multiply-state-nursing-license-33211/#post59416
Thanks for your help.
sereneintexas Aug 22, 2008, 3:54 AM
I started this very interesting job on monday. It's at a call center as a health coach. The company is Health Dialog and is owned by a big health care organization in England. They treat the nurses really good. Zero stress and lots of perks. A saying they have there is "this is where used and abused nurses come to heal", refering to the way many nurses are treated by the healthcare industry. They also refer to it as "nurse heaven". Most of the nurses there are older, many even older than me, and that's old.
Here's a link to HD describing what a HC does, but basically our goal is to empower patients to take a greater part in their own health care.

Health Dialog - Health Coaching

other interesting reading: at the top of the same page place mouse over "Background" and get drop down menu then click on "Unwarranted Variation" and "Shared Decision-Making".
SoldierNurse Aug 22, 2008, 6:24 AM
sereneintexas wrote:I started this very interesting job on monday. It's at a call center as a health coach. The company is Health Dialog and is owned by a big health care organization in England. They treat the nurses really good. Zero stress and lots of perks. A saying they have there is "this is where used and abused nurses come to heal", refering to the way many nurses are treated by the healthcare industry. They also refer to it as "nurse heaven". Most of the nurses there are older, many even older than me, and that's old.
Here's a link to HD describing what a HC does, but basically our goal is to empower patients to take a greater part in their own health care.

Health Dialog - Health Coaching

other interesting reading: at the top of the same page place mouse over "Background" and get drop down menu then click on "Unwarranted Variation" and "Shared Decision-Making".
This sounds like you do telephonic nursing? If so, kind of risky, is it not? Seems like your nursing license could be in harm's way under certain conditions.

Anyway, hope it works out for you.
sereneintexas Aug 23, 2008, 12:42 AM
"Seems like your nursing license could be in harm's way under certain conditions."

Good Morning SoldierNurse, I have thought the same thing in the past. I guess a nurse who thinks she/he has all the answers and spouts out anything to someone over the phone it could be very risky. However, with what little I have learned so far, I can see that it is not any more of a risk than being on a hospital floor with one pt on an insulin drip, one with a k+ of 8, one that is very demanding (and is already threatening to sue the hospital) and 3 other pts who you only hope are not going to crash. Nor is it any more risky than having an adolescent psychiatric patient commit suicide, attempt suicide, attempt to kill another patient, or become pregnant, on your shift while the MHA sleeps, watches TV, or talks on his/her cell phone. I'm told that we rarely have a symptom call but are trained to question them extremely thoroughly. We are furnished with the most recent, proven references available. Of course we do give them a disclaimer since we are not able to visualize them and tell them to talk to their physicians about the info we give them. All our calls are recorded for training purposes and quality assurance.
Most of our calls I am told are health questions which require teaching. The ultimate goal is to educate them so that they will have a better understanding of what is going on with their health. Therefore, become a more active participant in their own health care. It's been a while but as nursing students isn't this part of what we were taught to do, instruct our pts? And, yes, we are trained on emergency calls as well. Yes, it's only been a week, but so far I feel very at ease with this position.
SoldierNurse Aug 23, 2008, 5:20 AM
sereneintexas wrote:"Seems like your nursing license could be in harm's way under certain conditions."

Good Morning SoldierNurse, I have thought the same thing in the past. I guess a nurse who thinks she/he has all the answers and spouts out anything to someone over the phone it could be very risky. However, with what little I have learned so far, I can see that it is not any more of a risk than being on a hospital floor with one pt on an insulin drip, one with a k+ of 8, one that is very demanding (and is already threatening to sue the hospital) and 3 other pts who you only hope are not going to crash. Nor is it any more risky than having an adolescent psychiatric patient commit suicide, attempt suicide, attempt to kill another patient, or become pregnant, on your shift while the MHA sleeps, watches TV, or talks on his/her cell phone. I'm told that we rarely have a symptom call but are trained to question them extremely thoroughly. We are furnished with the most recent, proven references available. Of course we do give them a disclaimer since we are not able to visualize them and tell them to talk to their physicians about the info we give them. All our calls are recorded for training purposes and quality assurance.
Most of our calls I am told are health questions which require teaching. The ultimate goal is to educate them so that they will have a better understanding of what is going on with their health. Therefore, become a more active participant in their own health care. It's been a while but as nursing students isn't this part of what we were taught to do, instruct our pts? And, yes, we are trained on emergency calls as well. Yes, it's only been a week, but so far I feel very at ease with this position.
I do appreciate your explanation. Honestly, this all sounds very doable. I can appreciate what your saying about one of our important roles as nurses is patient teaching and to empower our patients. Please, keep us posted regards to your new path in nursing.
sereneintexas Aug 23, 2008, 9:25 AM
Yes, Soldiernurse, I will keep you updated. We still have at least 4 more weeks of orientation, and was told that we could have more if we felt like we needed it. How many jobs give 5 weeks for orientation? Not any I've ever had! There are at least 4 nurses there that I have worked with in the past who have been there several years. I was talking to one yesturday who has been there almost 4 years and he stated that he was enjoying it as much as when he first started. He said that he actually looked forward to coming to work everyday.
To tell you the truth SoldierNurse, if somebody was telling me about this company, and I had not expeirenced it myself, I'd think they were extremely naive, and say, "Yeah, right." while rolling my eyes. But... time will tell. Have a super day!