Friday, December 15, 2006

In which Jo contemplates the destruction of nursing

I think Nurse Ratched and I work at the same place. I would've thought her last CoS entry was over the top had practically the same thing not happened to me a couple of years ago.

The story is here. Read it first, then come back.

I got assaulted by a patient's nutso family member a couple of years ago. Not punched, thank God, and nobody was waiting for me after work, but I did get grabbed and shaken. The family member wasn't removed from the hospital until after he'd assaulted two other nurses, forged a letter on stolen hospital letterhead giving him permission to sleep in the ICU waiting area, and punched a security guard.

The reason it took so long for him to get booted was that management was afraid of getting the patient's family upset. Customer Service is key, you know, coming before good patient care or even employee safety.

I remember reading once that the profession most likely to suffer on-the-job assault or murder is nursing. I understand why. The emphasis on "customer service" is going to ruin nursing. Seriously. You can get pretty-much-adequate care anywhere for whatever ails you, so the focus now is on making a patient's stay as pleasant as possible. Unfortunately, in the rush to focus on the patient's happiness, things like staff safety are being ignored.

We once got a letter, post-discharge, from a patient suffering from dementia. The letter was six single-spaced, typed pages and ran the gamut from accusations of starvation to physical abuse to white-slave trading (I kid you not; I thought that went out in the 1920's) and kidnapping. Copies ended up on the desk of the medical director, the director of nursing, the president of the hospital system, and every member of the board of directors.

And we got pulled in for a Very Important Meeting on Customer Service. After forty minutes of lectures on how we could've been more sensitive and improved this patient's stay in the facility, I finally asked, "Has it occurred to anyone else that this patient is demented and probably not in touch with reality?"

Instead of giving a long, rambling, incoherent series of complaints about kidnapping and slave trading the attention it deserved (nil to none), we had a Meeting. And we got Lectured by Management about how we had fallen down on the job.

Managers, listen up: There are some people who will never be happy. It is not my job to be abused (twice), have things thrown at me (twice), be threatened with physical harm (once), rape (once), or cussed at (still counting) in order to make them happy.

Your responsibility as a management team is to make sure that nurses have the resources and ability to do their jobs well. This means, first and foremost, that we must be physically safe when we're doing our jobs.

I don't know how to put it more clearly than that.

I worked for years in women's health care, longer than I've worked at this hospital. That environment was ripe for assault and threats, but I only ever got touched by an angry person once. That's because the people who run women's health care clinics and abortion clinics take staff safety and dignity very seriously. If a patient even came close to crossing the line of appropriate behavior, they were booted. Period. No questions, no meetings, no focus on customer service.

The understanding was that I have a duty to provide care, and you have the obligation to be civilized. The management of La Schwank has forgotten that last bit, as have managements all over the hospital map.

We're going to lose nurses over this. Nurses are gonna decide that it's not worth the effort to go in to work, only to be screamed at and grabbed, and they'll go cheerfully off and get a job at an insurance company.

It's pretty damned depressing when working at an abortion clinic in the Red-State, Anti-Choice South is safer than working at a specialty hospital.


Anonymous said...

It's not just depressing, it's bullshit. Yeesh.

Judy said...

You need security officers like my son.

"Yes sir, that nurse can be a bitch sometimes, but if you try to swing at her, my colleagues (all 4 of them) and I will have to put you in restraints."

He almost never has to. He has this really scary smile......

Anonymous said...

wow, came across your blog and reading through the archives.

I live in nz, we have signs up everywhere saying abuse of staff is not tolerated... you will be removed. and the rest.

I really feel for you guys