Monday, May 11, 2009

Think you have what it takes to be a nurse? Let's find out!

I've come up with a list of things a person ought to have if they're going to be a nurse. They're not the qualities you'll find in your average Introduction To Nursing Practice course, no--these are real-life skills and personality traits that'll actually help you keep your sanity and your job.

1. A nurse must have the ability to call bullshit without making a Federal case out of it or getting into an argument.

This is a skill that's developed over time. Once, many moons ago, a resident berated me in the presence of a patient. Unfortunately for the resident, he not only flipped his lid, in a "you're going to kill this patient!!" sort of way, but he also was dead wrong. 

What I would do now is take said resident out of the room and tell him once, firmly, that a) he's not to talk that way in front of a patient; b) he's not to talk that way to me again, ever; and c) he read the tubing wrong and was mistaken. Instead, what I did then was try to be a Good Nurse.

I didn't do it over the patient's head, but I tried to somehow make up for the resident's mistake by double-checking everything and then gently approaching him about his mistake. That trick never works with people who are willing to accuse you of incompetence in front of a patient. Calling bullshit immediately, calmly, and without room for argument would've been a much better decision.

2. A nurse must have an unlimited tolerance for management's good ideas.

Which, let's face it, are rarely good ideas. Take, for instance, our TEAM initiative, which I've not talked about much lately. I haven't talked about it much because, frankly, it was a flaming failure and a giant clusterfuck, and pretty much has sunk below the surface.

Anyway. TEAM is an acronym that stood for "Together Everyone Assmunches Management". Or something like that. I don't recall. The purpose of the TEAM initiative was to recognize Stellar Team Players in the Hospital System, especially as it related to Customer Service. 

What actually happened was this: certain players solicited positive comments and notes and surveys (filled out in-house while the patient was still there) and so got good CS reviews regardless of their actual level of skill or competence. Other players made pacts with employees on their own and other floors to fill out surveys and send nice notes to Management whenever one of their bunch did something even vaguely out of the ordinary ("She didn't spit on me when I was lying in the ditch! What a doll!"). 

Management, being intelligent, took only a year and a half to notice that the same people who kept getting really, really crappy performance reviews were the ones who got stellar TEAM scores...and that the same people kept winning the TEAM Player awards over and over. So TEAM quietly went under after Management's attempt to clean it up failed.

3. A nurse must have a tin ear and no sense of smell.

This is becoming much more important as the focus on Customer Service increases. In an attempt to make hospitals less hospital-like, Muzak is now piped in to most patient care areas, all lobbies, and three-quarters of the cafeterias in hospitals across the country. If you think competing television shows at electronics stores are bad, try competing Muzak in the lobby/cafeteria area/outside patio at Sunnydale General. That stuff gets stuck in your right temporal lobe and replays until you want to take a DeWalt to your own head.

Also, in an attempt to make hospitals less hospital-like, a number of places, Sunnydale included, are laying carpet in the hallways and rooms of the acute-care floors. Now, I don't know about you, but my first instinct when it comes to places that people are likely to poop, bleed, barf, and pee unexpectedly is not to carpet it. Cover it with plastic, maybe, or tile, but not carpet. Besides the smell factor, the carpet will hold all the nasty bacteria that you can drop on it, and breed more--and make it nearly impossible to disinfect an isolation room. 

Which means that we're now getting designated isolation rooms. See number two above.

4. A nurse must be unafraid of bladder rupture, megacolon, or severe dehydration.

Let's face it, people: as the economy continues its slow slide into chaos, even nursing will start being a non-growth career. As such, hospital managements will work out ways to get even more work out of fewer people. Some of my colleagues at other hospitals already have designated times for bathroom breaks and little tags on their IDs that allow them to be tracked (just in case they cheat and go pee early, I guess). Pretty soon, just having a big bladder won't be enough. You'll have to court infection and rupture with a devil-may-care attitude and a smile, all while attending to the Customer Service needs of your Guests.

5. A nurse must have a cast-iron stomach.

As the focus on budget increases and costs rise, what's one of the first things to go (besides staffing, supplies, and support)? Food. And not food service for patients--which is a good thing, as you kind of need to eat when you're recovering from surgery. Instead, food service for employees gets more expensive and less reliable. I recently paid seven dollars for a salad that was brown in spots and rotten in others. When I took it back to the cafeteria, I was told that I couldn't get a refund; instead, I could take my pick of other salads on the salad line. 

I'm brown-bagging it from here on out.

So: Can you do it? Can you be a nurse? Do you have the skills, the balls, the brains, and the patience? Or would you rather go into accounting, or waste management, or hooking, or--worst of all--be a hospital manager?


Kim said...

I think the only one I'm worried about in my potential future nursing career is #4. I have the bladder of a hyped up Yorkshire Terrier puppy. Guess I better ask about that in interviews...

Unknown said...

Aaaahhh... refreshing to have someone discuss the REAL things to prepare for in becoming a nurse. I'm a year away from that wonderous day, and am SO looking forward to dealing with the above mentioned shit for all eternity! Thanks for the heads up, always love your blog!

One Nurse said...

amazing and accurate post! This must be overall issues inside the hospitals. Because I to have had many of these same experiences. Residents who think they know it all (AND DON'T!). Improving rooms to make them "pretty" or "hotel-like" but so not practical for nursing care within the hospital. And the whole idea of "team" nursing?? Great concept if they would hire enough staff to actually do it right. And the cost of hospital food, even with an employee discount is outrageous!!! Not to mention that the food is totally not worth the price!!!

woolywoman said...

One word: Union. Here in CA I can never, by law, have more than five adult patients. Has brought the seasoned nurses back to the bedside in droves. But, organize as much as you want, vicks vapo rub will always be the nurse's ( and nurse's noses) best friend.

girl_in_greenwood said...

I guess that's one reason to be grateful that I work at Big County Hospital that is chronically underfunded due to the high ratio of uninsured, indigent patients - no Muzak, no carpet, no customer service emphasis. We put broken people back together and we discharge them when they're ready to go. The end.

We do have patient surveys, but they're primarily about health and safety things like "did your nurse check your nameband every day?" and "how was the noise level in your room?", not "was the food delicious in every way?" or "did the nurse bend over backward to fulfill your every request for filtered spring water and vegan sandwiches?"

Grammy said...

I like the idea of vicks vapor rub wish i'd thought of it. I always used peppermint, kept them in every pocket that I ever wore into work. The only thing is that the smell of peppermint activated my pea size, yorkshire terrier activated bladder and that led to "hold-on a minute, just hold that position - I'll be right back.....didn't work so well in the ER. My best advice - keep a full change of clothes in your locker, right down to the socks and shoes. Unless of course you enjoy announcing to the world that you've got human waste on your scrubs (yours or whomever's) then going and sorting through hospital scrubs that were made to fit a stick, a really skinny, and a really really TALL stick. AND having to go through the OCD lady that guards the hospital scrubs, WITH HER LIFE.
Just a thought....

Deanna Bland Hiott PhD, MSN, RN said...

Great post, so true... :)

Anonymous said...

I'm a student, and boy I hate manglement. TEAM: Together Everyone Achieves Mediocrity.

I swear if I have to be "talked to" one more time for being "assertive" (but they say "arrogant") and confident (they say "a show off") I'm going to scream.

Tonjia said...

HA! you have hit the nail on the head sistah!

I am an ER nurse (going on my 14th year in the ER) and I swear just about the time I think I have seen everything, some stupid person comes along and surprises me!

And for the record... I can turn off my sense of smell :-)

Anonymous said...

I do not like this post. Go become a teacher, bitter nurse

Registered Nutcase said...

"I do not like this post. Go become a teacher, bitter nurse"

This is me calling "bullshit" to the resident that posted this line of crap.

Get real!, She can't become a teacher, she tells you how it really is, and doesn't sugar coat any thing.

For what it is worth, I love this blog!

geena said...

Including this post in tomorrow's Change of Shift. Because if you won't submit your golden prose, I will simply take it from you :-)

Kim said...

1. Are you sure we don't work in the same hospital?

2. I'm with Geena - you need to be in Change of Shift every time! : )

Michaelle said...

I always love seeing what "special" things other department employees do: He jumped someone's car in the parking lot! Yeah for him!! She helped someone find the gift shop!! Yeah for her!! What a frickin' crock of feces.

jessye said...

you know your blog couldn't be further from the truth, honestly. I have been an aide for the last 11 years and now I've been thinking about taking that next step into nursing as an LPN. I work @ a community hospital and the LPNs do the same as the aides, but make more money doing it. I have noticed in my short time @ the hospital, that some of the RN's that I work with, are lazy and expect the aides to do their jobs. this is not acceptable by any means. What i'm asking is, why did they become RN's if they're not going to do their own job? just a comment about the resident, I think it is in their nature to be paranoid as well it is any health care employee. One minor mistake could turn into one big fuck-up, w/the he said she said bullshit. Most of the time the truth seems to be obsolete?