1. My boss is a moron.
2. My boss is a fucking moron.
Seriously: You should have more than six months' experience as a working nurse before anybody gives you a managerial job, no matter how brilliant an organizer or genuinely nice a person you are.
Because, if you have some experience on the floor or in the unit or in a clinic, you would not:
1. Double the number of patients in my unit without warning and without giving me any extra resources.
2. Look at me like a calf at a new gate when I suggest that those of us who might be administering chemo (there is no policy as yet) will have to get and maintain competency, and, given that chemo is an entirely different specialty, that this might be a big deal.
I walked in today to find eight patients and two nurses, which doesn't seem like a big deal, until you remember that these patients are in a critical-care setting, we are doing total care on people who are hemiplegic, altered as hell, and tend to have rapid neuro changes, and there weren't even enough monitors for the patients we had. One of them was on a not-centrally-monitored ancient thing somebody dug out of a basement storage room.
This is, as of yesterday at noon, the new policy: fill all the beds imaginable with all the patients we can get, until something breaks. We were damned, damned lucky today that nothing broke. The guy who lingered on the edge of crumping managed not to crump, the woman who has a violent history with us and was actually labelled as a "Do Not Return" (she was admitted by mistake) managed not to punch anyone, and we got through the day.
Then in the middle of the day, Bossman comes to me to chat about the whole deal, and I bring up the "Oh, by the way, you're also going to be giving chemo" thing. He truly did not understand why maintaining competency would be a big deal. "There are protocols and regimens in books this thick," I said, holding my thumb and forefinger about three inches apart. He had no idea. I am not a chemo nurse, and *I* knew that shit, just from being around it.
Now I am going to drink. Maybe not a lot, and maybe not hard liquor, but I am going to drink. With any luck, it'll mellow me out enough that I don't end up staying up late and writing letters to the medical director, the state board of nursing, the state board of morons, and the paper.
Holy. Crapping. MONKEYS.
Dumbasses. wow.
ReplyDeleteHave another on me!
my boss is also an ass hat. I just work in a state with better laws. so sorry. glad nobody died.
ReplyDeleteYowza.
ReplyDeleteJust yowza.
Enjoy your drinks.
Jo,
ReplyDeleteI feel for you. It ain't monkey crappin' time here, but trust me, it's coming.
Crossing fingers, toes, and talking to me favorite sainted sisters in the hood who pray 24/7 for everything (which just happens to be their job).
We sure need it!
I have always known with no doubt that you are Super Woman, but I sincerely wish the Universe would stop providing instances in which you have to prove it.
ReplyDeletePenny's got it in one there.
ReplyDeleteYou need to start speaking up, Jo - this is turning into a whistleblowing situation where people are being endangered and your ability to do your job is being seriously compromised by the understaffing/lack of resources/monitors/etc etc.
Jeez. Wouldn't want to be in your shoes. Hang in there!
That's similar to why I left my first job. It was dangerous, and I mainly felt we were LUCKY nothing went wrong. It's a horrible feeling to know you can't take care of your patients adequately.
ReplyDeleteI left a job a couple of years ago in a rolling ball of flame. Never mind the bridge, I burnt alot leaving that place. I loved the staff, but manglement kept pulling fast ones on me. We were down to one full-time staff nurse (me) and 3 agency nurses. They brought me into the office and started yelling that stuff wasn't getting done. I finally broke. I told them that I quit right now. I went back to my desk, packed up my stuff and hugged everyone that I had worked with for years and walked out the door. I did send a sober letter to all the powers that be with some result. They continue to struggle with staffing issues 3 years later. And it is never their fault, of course.
ReplyDeleteHang in there ducks, somehow you will find a way through, around, or over this mess.
W.O.W.
ReplyDeleteDocument, document, document.
Fill out an incident report for each and every thing.
PITA, but the only way to cover your bum.
Hugs, and cheers ~
Insane. The worst thing is that, when a patient does go down, manglement is going to try to hang a nurse out to fry for it. Sad beyond belief.
ReplyDeleteUm, so why aren't you writing those letters? 4:1 in critical care is dangerously fucking unsafe. And not sure what Texas law says, but I'd bet my left arm that it's also illegal. Hope that violent one gets bounced right quick.
ReplyDeleteBecca, Heidi, et al:
ReplyDeleteWe are all documenting, filing incident reports, and speaking up. I'll leave the latest Jo Speaks Up for another post; it'll move you, change your life, and you'll want to read it again and again.
Also: I did not write letters last night because all that would've come out would've been an unintelligible scream. Now that we're a bit more calm, DAJ and I are working on that very thing.
*sigh* Clinic nursing sounds good. 8-5 M-F, no weekends? Wow.
You know he's thinking "Chemo-shmemo! What's the BFD??" How scary to think he runs the joint...good luck!
ReplyDeleteDAJ is not calm.
ReplyDeleteHeading off to where the crows call tomorrow.
-disms
This lunacy of cost control and fear-based management is shoving patient care into the dumpster and in addition to the nail-biting stress of having to keep unsafe people safe in an unsafe environment there is the moral distress that comes of knowing you cannot deliver the care you were trained and called to do because the environment will not allow you to do so.
ReplyDeletePlease have a drink for me too. This sucks and it is everywhere.
What we need is a FAIL blog, just for health care. Sheesh.
ReplyDeleteThis chemo nurse says Manglement FAIL. Grrrrr....
But no more well thought out than our Manglement's idea to take the overflow 'stable' cardiacs. Ya know, we could be taking cardiac's terminal extubations and hospice, which we all know and love in Oncologyland. Um. Nope. We get the walkie-talkie-on-admission-turn-on-a-dime rhythm issues that oncology never sees. (My poor staff :( )
Terri C is right. It's happening everywhere. And nurses are leaving. In droves. For that 8-5, wherever they can find it.
I used to believe this stuff came around as often as the latest paradigm. But this is dangerous to a degree I haven't seen before. When I was younger, I recall we left the really insane stuff to the young; but they're getting smarter all the time.
I will drink with you anytime!
There is actually strong research to support the need for safe levels of staffing that can provide the basis for evidence based arguments - stuff like lower patient mortality and morbidity because hospitals don't care about arguments around staff burnout. I'll send you the links.
ReplyDeleteHonestly, this is why nurses need to be unionized - you don't get abused this way. Staffing issues should be part of the contract.
Ok, I must have missed something. Is there no oncology dept at Sunnydale? Will you be simply be administering (ie hanging the bad and leaving), or then also monitoring. Cuz that my friend is a whole other ball of wax and a speciality unto itself, not to mention a complex one.
ReplyDeleteAlso, I don't know about TX, but here in NJ, when a unit is open, but doesnt officially open until (insert future date) it means it has not received final approval from the apprropriate state agency, and the hospital would be, well, in trouble if someone were to support it.
An infusion dept would be happy to train you. Besides, how much training could you need? Yours already chemo certified!!! : )