Thursday, July 12, 2012

Good Lord, it is hot. And humid.

I've just done all my cooking for the week, except for assembling salads, which are best assembled at the fifty-ninth minute of the eleventh hour. Protip for those of you too hot to eat real food: cut up a shitload of vegetables all at once and put them into little containers. Assemble your nommable salad before work out of the little containers. Seriously, this is the best thing I ever learned from Serious Salad Eaters.

We got a doohickey to fill out this week from our Big Boss, about how our Lesser Bosses are doing. Instead of boring you with the boxes I checked, I figured I would put down the letter I wrote in my head while assessing my bosses for a dozen things which do not matter to anybody but management:

Dear Big Boss,

You want my opinion on my other two bosses. You even sent me a survey form to fill out at a third-party website, with the assurance that my replies will be completely anonymous and confidential and not be prejudicial to my continued employment with Sunnydale General.

Instead of filling out yet another useless survey (because, really, whether or not I'm being given positive feedback on how I'm doing my job is not a major issue around here), and because I know as well as you do that surveys are neither anonymous nor non-prejudicial, I've decided to tell you what I really want in a boss.

For starters, I'd like fewer of you. I have four at last count: Small Boss, Bigger Boss, you, and your Horizontally-Equal On The Org Chart Colleague. Of those people, I see Small Boss the most, with Bigger Boss coming in a very, very distant second. I've seen you exactly four times in the last two years, and your Horizontal Equal not at all. The way I figure it, it's ridiculous for me to submit memos about how I plan to hang educational posters in the family room for Horizontal Equal's approval, since she's never, to my knowledge, seen the family room I'm talking about. Maybe we could take her out of our org chart's hierarchy? While we're at it, could you either show up regularly or just stay away?

Because, really, your visits here contribute nothing to the smooth running or the "culture" (whatever that is) of the CCU. You've shown up once to bitch about the placement of warning signs, once to introduce me to somebody I'll never see again, once to warn me about a VIP showing up, and once because, I dunno, somebody in Manglement complained that you weren't showing up enough. Honestly, your visits take time away from my patients and fuck up my train of thought. If I had the chance to get used to you, or didn't see you at all, things would be much, much better.

While we're on the subject of bosses, it sure would be nice if my Bigger Boss had an inkling of what happens in a critical-care unit or on a stroke unit. See, he has about six months of CCU experience, and that was years and years ago. Our old boss, whom you chased off, used to lead codes. Our current boss stands around looking impotent and gets in the way. Maybe he could be retrained to work in a critical-care setting, then work a shift or two a month to keep his skills up. That way, we could at least use him as a charge nurse when there are four nurses, all of whom are tripled, and not enough support staff to make a dent in our patient loads.

It would also kick ass if Bigger Boss and Small Boss made sure that people who work in my NCCU actually have the certifications you claim to require for employment here. So far, I'm the only person who works here who has all of them. We've been open three years (in August), and that seems like plenty of time for folks to do the online NIH course and the other required stuff. It'd be awfully nice if I could give report to another nurse and not have them go jaw-sagging blank when I say something like "hemiparesis" or "gaze preference" or "NIH score of 16."

Finally, if you're really dedicated to a complete reworking of the Culture of the Institution, hire some more damn people. If need be, hire unqualified people with a modicum of brains; I'll happily train them. Just get me some bodies up in here, so I'm not forced to work day in and day out with nurses who are floated here from the CVICU. It's not fair to them, and it's not fair to our patients. They can spot a-fib from a mile away, but they're not used to doing neuro assessments and don't understand our BP parameters. Have mercy on the nurses who are more comfortable with a Swan-Ganz than a ventriculostomy, and Get Me Some Damn Staff.

Oh, wait: that wasn't my final point. My final point is this: if you're going to hold me responsible for stuff, and yell at me when it doesn't get done, or pass things off to me, and expect me to work extra and train new people, the title of "Mangler" would be peachy fucking keen. I have to admit that it's not the title I'm after so much as the pay grade. In any event, since we're speaking of Bosses, you're making me a FIFTH layer of boss-ness between the people I work with and the real world, and I'd like to be compesnated for it.

Much love and many happy capybara kisses,
The one who makes sure the plumbing gets fixed,

Jo

16 comments:

Comrade Physioprof said...

Too many fucken bosses!

clairesmum said...

ok, thanks for my word - capybara -sounds MUCH nicer than 'big ugly rat'. Ever heard the quote which I think is attributed to Mae West 'what the world needs is more love and less paperwork!'? Now with computers and the internet the ways to create, gather, rearrange, and analyze data are multiplying faster than dust bunnies under the bed - but that is NOT to be mistaken for actual work accomplished! You know that, you're the one who makes sure the plumbing (for the patients and in the patients) gets fixed! thanks for the good work you do, Jo.

Allison said...

Amen.

crow$r00str3st said...

Come roost with the Corvid. 4:1 floors with a back up cc nurse of their own for rat codes, 2:1 at the most and everyone Everyone! Is certified. The high was 83 today.

Lynda Halliger-Otvos said...

Brava, my hero of the truth-speakers, will they ever understand from the perspective of the trenches...

Rosanna said...

This quotation (directly Below) from John Rich, 17th century English adventurer and spy, is just "so you," Jo............ (i.e., as "The One Who Makes Sure The Plumbing Gets Fixed")!!:


"If everybody contemplates the infinite instead of fixing the drains, many of us will die of cholera."


NOT............ (of course, haha!!)............ that your Wannabe-Sainted Bosses would *e.v.e.r.* fool and futz around, though, with NCCU's Infinite............ more than they do with NCCU's Drains!!

jimbo26 said...

I thought bosses were only to 1) stay in their office , 2) stand around looking pretty . ( they don't actually know anything ) .

terri c said...

Love This. Love love love.

Scrub Ninja said...

It'd be awfully nice if I could give report to another nurse and not have them go jaw-sagging blank when I say something like "hemiparesis" or "gaze preference" or "NIH score of 16."

What, seriously? I learned that stuff in nursing school, in basic pathophys. If you've got RNs who don't understand it then there is a serious competency gap somewhere.

Anonymous said...

Perfect!

RehabRN said...

Agree with Scrub Ninja...but I work with SCI patients who have ASIA scores and some of the nurses don't know (and won't look up) what the characteristics of that score really means.

But they have plenty of time for shopping and Facebook!

suzanne smith said...

EXACTLY!!!!! Can you send that to my work too?

Anonymous said...

I think that while you have good points to make, they are overshadowed by the sarcasm in your letter. Funny for me to read, but I would think not very effective if your real motive is change.

Melissa Maddox said...

Actions and thoughts are 2 different things. I agree with Jo, would I project the sarcasm at work? No, but a blog is a great place the vent them. I think your blog is right on and is what many "seasoned" critical care nurses feel.

Jane said...

I'm not a nurse but I take my hat off to all those of you who are. It was my goal in life to be a nurse but getting kicked out of the house at 18 got in the way of that. All you girls and guys rock. Give them hell Jo. Love the blog.

Trisha Lynn said...

Just found your blog while searching for something specific (if you must know, I was looking for information on my own measurements, which are a bit similar to yours), and I have to say that after having worked as an ad hoc human resources generalist for a 200-bed nursing home when my background is being an executive assistant, I have total and full respect for any and all nurses who know their stuff, and you seem to be one of them. I have no idea why administrators don't bow down to you guys more often because head nurses, charge nurses, etc., you guys are the real front line workers and need and deserve more respect and more money than they are currently paying you.

Keep fighting the good fight, and I hope that if/when you are finally able to write an exit letter, you are able to write one sort of like this one.

Cheers!
Trisha