Monday, October 29, 2012

Big, Bigger, Biggest

Remember the nurse who works two full-time jobs?  The one I wrote the recommendation for?  She was horrible to me the other morning.  Let's finally give her a name:  Marie.

It started when I walked through her floor to the nursing office around 7 am.  I have to walk through that particular floor because it is the only access to the office so early in the morning.  [You would think that people should be in the office already with the day shift assignment figured out, but that is not how it works at this place.]  I have to wait in the office for a supervisor to show up, analyze the assignments, and send me to work somewhere.  This is a very confusing task to most of the supervisors, so it takes a while.  Plus, they are late and have to take off their jackets, set down their bags, get coffee first- you get the idea.

As I was walking to the office, Marie started.  "Thank goodness you are here!  Let me give you the report.  Wait!  Where are you going?  I am talking to you.  You are supposed to take report.  Who does she think she is?  An adult is speaking to her, and she just keeps walking, like she is too good to even look at me."

I kept walking to the office without speaking to her.  Why?  I have tried many times in the past to explain to her that I am not showing up to relieve her, but to walk through to the office.  She does not listen to a word I am saying and continues talking about the report, or telling me what tasks she thinks I ought to accomplish during my shift.  Other nurses and staff have intervened on my behalf with no success.  Marie remains hell-bent on giving me report as I walk through the unit.

This particular morning, she recruited an attendant into this false belief that I was supposed to be relieving her and instead I disappeared.  As I continued walking to the office, I heard the attendant shouting, "Now hold on here!  Are you telling me that this little priss thinks she can walk in here, ignore you, and then go hang out in the back like some sort of princess?  I've heard things about her, but now I'm seeing it with my own eyes."

I arrived at the office to find Meemah struggling with the assignment.  She blurted, "I just got here!  I walk in the door, pick up the assignment, and you pounce on me, wanting your assignment, like you are my first priority!"  I had said nothing.

"I'll just be waiting over here," I answered as flatly as possible.  The office was filled with night shift supervisors.  I guess this a sort of victim mentality, but I believe that they will act as "witnesses" to assure administration that I spoke nastily to any day shift supervisor.

Around 7:20 am and after the corridor had filled with more day shift workers looking for an assignment, Meemah emerged with my assignment:  the same ward I passed through to get into the office, where Marie was acting very hurt and angry.

I hoped that some of the regular nurses had come in and relieved her.  Nope.  Marie was sitting there, fuming, with no day nurse on the floor.  "I'm assigned to this floor.  Let's count narcs," I said, trying to sound factual.

"You make me wait twenty minutes for your break?  I have a family.  A FAMILY.  You have nothing.  You come and go and you don't care.  You are a teenager.  At a party.  Like this is a party.  You go here and you laugh and then you go there . . ."

I cut her off.  "Marie, can we count narcotics so I can start the early medications?  The patients are waiting."

I somehow got through the count, in spite of her anger and her inability to count, intermingled with her references to my wild and reckless teenage ways.  [Note to readers:  I am not a teenager.  It's been years since someone has even mistaken me for being in my 20s.]  When she left the medication room to get something, I shut the door so she couldn't get back in.  I started the medication line.  It was useless to try to explain anything to her.

Around 7:40 am two nurses who are regulars on the floor showed up.  Late.  We start at 7:00 am.  Did Marie blast them for being late and holding her up from her FAMILY?  No.  Hugs and kisses, followed by even wilder tales of how I alone was the sole cause of her delay in relief.  Then the long, fake nails tapping on the glass panel of the medication room door.  "Why were you late?" one of them was admonishing me.  I didn't answer.

Now Marie was no longer in a hurry to get home to her family.  She sat outside the medication room door, whining about how I was too "young" and "bratty" to work at a hospital.  Patients heard her.  Staff heard her.  At one point, a male attendant came along and fed into her drama by saying, "Did you know that they are replacing all of the hospital attendants with RNs?  That is not right.  We will not have any money, while these nurses will have even more money!"

That was all that Marie needed to keep her going.  "Did you hear that?  The RNs are getting all of the money, while the attendants, they will starve.  Did you hear that, you teenager?  You have so much money.  You live with your parents.  You have a big, big house.  But that is not good enough for you.  You want more money.  You want a bigger house.  You say, 'Oh, Daddy, give me the money!  I want more money!'  And he give you the money.  [Her accent and grammar were worsening by this time.]  And she say, 'I want all the money.  No money for the other people.  I work all the job and take all the money.'  More money, she want all money.  She no care about other people.  This poor man, he lose his job, and we say to this greedy woman, 'Please, nice lady, please help us.  You give up your job so this man, he can feed his family.'  And you know what she say?  She say, 'No!  I want all the money for me!  None for you!  You starve and I get big, big, big house!  I want mansion!'  She terrible.  She terrible person, firing all the attendants so she gets their job."

This twisted story further morphed into:  I was getting a particular attendant fired.  She told this to anyone she saw.  While sitting outside the medication room while I gave medication to the patients.  The people who had been working on the floor were ignoring her rants, but the people who were passing through paid attention to her and then looked at me in the medication room.  It is not safe to go around telling people that I am causing someone to get fired.  I work with some very bizarre and hateful people who will believe that I got someone fired because I am greedy.  They will not stop and think that this makes no sense.  They will act on it.

Marie finally left at 9 am.  I understand that her behavior is caused by a combination of fatigue, psychosis, and personality disorders, but her antics make my day miserable and she influences other people against me.

What am I to do about her?  Going to a supervisor is never an option.

Friday, October 26, 2012

Life Skills from Nursing: Organization

One of the life skills that I have acquired through nursing is organization.  I would not call myself completely organized and caught up, but I have reached the point where I anticipate potential problems and take the necessary steps to avoid a blow-up.

While working at the nursing home, I had crappy health insurance.  Ironic, isn't it?  I ended up needing surgery (nothing major) and a trip to the emergency room (nothing major).  When you receive services in this fashion, multiple providers bill you.  The insurance company paid a few, but not others.  The insurance company is not online, so I could not access my claims to check for payment or denial.  It's a "self-funded plan," supposedly exempt from state insurance rules because it's not really an insurance company.  As far as I am concerned, if it acts like an insurance company, looks like an insurance company, then it's an insurance company.  I wrote letters every few weeks, but received nothing.  The unpaid claims went into collection and my credit tanked.  Not that I was looking to acquire a mortgage any time soon- people with crushing student loan debt don't qualify to become homeowners.

I kept copies of all of my letters and the bills.  I filed complaints with the department within my state government that receives insurance complaints as well as United States Department of Labor.  It feels great to have all of this information handy when a bill collector calls.  No claims were paid yet, but I am on top of the situation.  All because of my organizational skills gained from my nursing career.

In addition, I took tips from the bill collectors.  They recommended contacting the providers to obtain copies of any correspondence from the insurance company.  This was very helpful in countering the insurance company's claims that their requests for information went unanswered.

Thursday, October 25, 2012

Do as I tell you

One of the attendants from yesterday's fire paper confronted me.

"You were a real bitch yesterday," she told me.  She's older and has worked there too long.  There are patients with more sense.

A younger attendant was nearby.  He is sassy and doesn't invest much emotion into the job.  We get along.  He sees the world from a completely different vantage point.  So I turned to him and asked what I could say.

"I am a bitch.  You're lucky I'm not worse than that every day, because I can be," he offered.

"I like it!" I responded and turned to the surprised female attendant.

"No!" she tried.  "You're a very nice girl.  I don't know what was wrong with you yesterday.  You think that because you have a fancy degree that means you can tell people what to do."

"What was wrong was that you keep pushing me and when I say that I've had enough, that you have overstepped a line, you call me a 'bitch' to try to put me back in my place of serving you."  This felt good to say this, but she was not following.  I continued.  "You can try to cling to your seniority, but younger and younger people will start working here, and they will have degrees whether you like it or not, and in health care, the person with the license and the degree is in charge of the people without licenses and degrees."

She huffed off, mumbling, "I don't know what's gotten into her."

Wednesday, October 24, 2012

Putting out Fires

Several times a week, we have to do a "fire watch."  It is just what it is called.  You watch for fires.  The fire detection system is turned off for servicing.  A form is utilized on every ward with lines for the time and a signature that no fire was found.  Every half hour, concurrent with the face check, someone needs to sign the form.

I know that this makes no sense.  Why aren't we progressive enough to use the built-in fire detection system?  It's not one of those old, scary asylum mansions.  It's a modern building with electricity and internet hookups.

Anyway, an attendant came to me late in the morning with the form completed for the entire day, even though we had five more hours left.  She told me, "Nurse, you have to fix this.  Someone wrote the time as every fifteen minutes.  Isn't it supposed to be every half hour?"

I looked at the form.  I asked, "Why did you sign that there was no fire at 2 pm when it is only 10:30 in the morning?"

She replied, "I'm not asking about that.  I am showing you that someone did it every fifteen minutes and it's supposed to be every thirty minutes."

"You signed it," I replied.

"I signed it, but I didn't write the times.  Someone else wrote the times, and they are wrong.  You have to fix it."  She stood there, staring at me.

"Actually," I proceeded carefully, "You can fix it."  Her eyes widened.  I continued, "You have discovered the errors and have time to get a new form and fill it out correctly."  She stood there, frozen.

Another attendant was nearby, listening, and now felt the need to jump in.  "Hold on!  When we tell you that something is wrong, you fix it.  That is what you always do."

She is correct.  I usually fix everything that everyone else messes up.  I do this out of fear that I will be blamed for the entire mistake.  I am tired of catching everyone's mistakes and then feeling as if the responsibility of fixing them falls on me.  I don't mention the mistakes to anyone.  I just fix them and move on.  But this angers people that I find mistakes.

I looked at both of them.  I spoke as professionally as possible.  "Ladies, I have counseled you on an error and provided you with the necessary guidance to remedy the error.  If you choose to not follow my directions, that is on you, not me."  I walked away.

They managed to find another form and fill it out correctly.

Tuesday, October 23, 2012

Little Person from Above

Another nurse told me that Meemah talks down to me and is outright nasty to me.

I had not asked.  She volunteered the information.

I was happy because I was thinking that maybe I was being too critical of Meemah, that maybe the attitude I was perceiving from Meemah was merely in response to my bad attitude.

I am also unhappy.  Why is Meemah behaving like this towards me?  And how can I protect myself?  She is a supervisor.

Thursday, October 18, 2012

Not enough hours in the day

Remember the nurse who asked me to write a recommendation for her for another job?

She still works at the hospital, at night.  Full-time.

I asked about the other job.

"Oh, I got it!" she squealed.

"So why are you still here?" I asked.  "How are you still here?"

"It's just a day job, I thought you knew that!" she answered.

"So you work there after you finish the night shift here?" I ventured, hoping this woman was not living, functioning as a nurse, on a mere four hours of sleep each evening.

"Sure I do!" she quipped again.  I finish here by 7:30, but I don't have to be at the next job until 8:30.  They finish at 3:30, so I have time to pick up my children.  It's great."

"When do you sleep?" I asked.

"After the kids are in bed, about 9 or 10."  She looked content with that answer.

"But don't you have to get ready to come back to work for the night shift at that time?"  This was not adding up.

"Yes.  Then I come here."  She seemed to be done with the discussion.

On the weekends, I noticed that she works the day shift after the night shift, a total of 16 hours Saturday and Sunday.  She must work about 100 hours a week.  That is too much.  She probably falls asleep at work.  As a former night shift nurse, I hate to say that she sleeps on the job overnight, but I don't see any other explanation for her consciousness.  She is not a go-getter.  She makes many sloppy mistakes, indicative of fatigue or mental inability, likely both in her case.  Unlike my work at the nursing home, night shift at this hospital does not give out medications.  They check the meds for the day and perform the 24 hour chart check.  That's it.  This particular nurse is known for missing med omissions and transcription errors, as if she doesn't check at all.  She probably doesn't check.

So I helped her get an additional job, not a different job.

Wednesday, October 17, 2012

Nursing Humor

You're pretty uppity for someone who doesn't have a job.
For all my patients who complain about the accommodations at the Hotel.  I mean Hospital.

Tuesday, October 16, 2012

Nursing Humor

Silence is Golden.
There should be a pill for that.

We kind of have such pills already.

"What's this pill for?" a patient will ask me.

"Anxiety.  To help you feel calmer," I will explain.

"It doesn't help me," the patient will counter, trying to find a reason to not take medication.

"It helps the rest of us when you take this pill," I will explain further.

Monday, October 15, 2012

Give Me, Give Me, Give Me

For the first time, I "worked with" Meemah, the name I'll give to the new nurse manager.  Notice the quotes- I worked and she got in my way.  I looked for specific things to identify, behaviors she exhibited- not my mere feelings or opinions.  She exhibited these reportable behaviors immediately.

She arrived in the office with her purse and proceeded to push said purse into my chest as she ordered, "Lock this up."  I didn't stop documenting in the chart in front of me, even though the ink from my pen had been jaggedly pushed across the page.

"You don't have a car?" I queried.

She looked confused and annoyed.  "Of course I have a car."  Shook her head.  As if that was the dumbest thing she ever heard.

"So lock you purse in your trunk," I answered, and kept writing.  We are told over and over to not bring purses into work because they will get stolen and there are items dangerous to patients inside every purse.

"No," she continued, "I want you to lock it up in here."  Now she was really annoyed.

"I can't lock up anything.  You never gave me keys."  I had stopped writing and was looking at her.

"This is unbelievable!" she roared and flounced off with her purse.

She returned in a short while without the purse.  She marched with determination back into the office.  "Give me that pen!" she ordered.

I glanced at the desk.  There were no pens lying about.  There never are.  If you put your own pen down, it's gone in a flash.  We aren't allowed to leave pens, pencils, scissors, and other common office supplies within the reach of patients.  I looked at her.  Her outstretched arm was reaching towards my chest, towards the pen in my chest pocket.  "There are no pens," I answered.

"Yes, there is one pen, right there!" she exclaimed, lunging at my chest.

I quickly jumped away from her lurch.  She wasn't seriously treating my pen, firmly clasped to my bosom, as a common pen for her to grab, if only I was not in her way?  Was she?  Yes, she was.

"Give me that pen!" she ordered again, giving only half a move towards my chest this time.

"Do you need to borrow my pen?" I slowly, firmly asked.

"Whatever.  Just give it to me so I can write!" she angrily spit out.

I handed her the pen.  She didn't say thank you.  She didn't say anything.  This was a test.  I knew that much.  A test of how far she could push me.  I felt like I was failing.  How do you tell your boss that her manners are despicable?

Her next order was for the phone number of a particular floor.  There are lists of phone numbers conveniently placed on the wall in front of us, next to the telephones, in this particular office.  "I don't know that floor's phone number off the top of my head," I answered, flatly I hoped.

"You don't have all the numbers memorized?" she retorted, sneeringly, but seriously, not sarcastically, as if this was a necessary skill.

"No, I do not need to memorize phone numbers.  They are all listed on these papers on the wall."  I kept on writing.

She stood there silently, staring at me, until she couldn't be quiet any longer.  "So what is the phone number?" she angrily blurted.

"Whatever number is listed on the wall," I answered, trying not to sound nasty, while thinking to myself that maybe if I were nasty, she would leave me alone.  Or write me up for insubordination.  It's a fine line to walk.

"So you expect me to look on the wall when I want a number?"  She was again staring at me while I continued writing.

"That is where the numbers are kept," I answered as I got up and left the room.  I couldn't take her anymore.  I quickly realized that I could flee to a patient care area.  I theorized that she would not go near patients.  I was right.  I didn't see her the rest of the day.

Now how am I to handle her in the future?

And how do I get my good pen back?

Wednesday, October 3, 2012

Keep Doing What You're Doing

Love this picture.

You are as old as you think.

I have taken care of many elderly people as well as young people stricken with horrible, deadly diseases.  Sometimes you do everything right- exercise, eat well, avoid smoking- and yet you develop cancer or a degenerative disease.  Sometimes the 100+ crowd pontificates about their poor lifestyle choices over the years and wonders how they are still alive while much younger people succumb.

I have no answer.