Tuesday, May 28, 2013

Triangle Exposed

A Frequent Flyer came to stay at the hospital for the umpteenth time.  She brought along with her an ax to grind against all the employees she feels have wronged her in the past.  I am on her list, naturally.

She doesn't shut up.  She is manic, angry, and delusional.  Her voice is loud and projects off the barren walls and floors.

Yet she is absolutely correct about something about me.  I was around a corner and not within her view when I first heard her speech about me, so I could at least compose my face.

When I first started working at the hospital, I started a relationship with another employee.  Things were going well from my standpoint.  He cautioned me to not tell anyone at the hospital about our relationship because we would both become targets.  "People around here are weird.  They will try to destroy you if they think you are happy."  He was right about this, but I was uneasy about the secrecy outside of work.  "Someone from work might see us," he cautioned.

Well, I am stupid and gullible.  He had a fiancee and I was some kind of fling for him.  When it ended, I was grateful that nobody at work had known in the first place, or so I thought.

This loud, tireless patient screamed one afternoon that I was having an affair with [insert name here] and that I was so stupid because he had a beautiful girlfriend [insert name here].  She gave dates of when we started and ended and damn- she was spot on.  I was also very surprised that she knew the other woman's name.  That took me a while to find out.

The guy is very careful at work- I don't think anyone else knows his (real) girlfriend's name, so I hope that nobody finds too many truths in this patient's story to take it as gold.

How in the world did this patient pick up on all of this?  And do any of the employees know?

Sunday, May 26, 2013

Umbrellas Only Block the Rain

One of the other nurses finally lost it.  And thank goodness she did.  Because now I know she is an Enemy.

I am never sure if someone is a full-blown enemy.  They do things that hurt me and I think to myself, "They didn't mean to hurt me.  I am not someone's number one concern.  Other people are stronger than I am."  I fear that if I say something or do something in retaliation, then they will come at me even worse.

One of the nurses I work with- we'll call her Princess.  She has a ridiculous name of similar value.  Princess is always late, talks on her cell phone most of her shift, disappears, and then yells at the end of the shift that I wouldn't help her with any of the work.

I keep telling myself that this is her work style and is not aimed personally at me.

On Sunday, the supervisor toured the floor and I kept hearing "umbrella" emanating shrilly from Princess's mouth.  I thought nothing of it, until the supervisor came to me and questioned me about giving an umbrella to a patient.

I told the supervisor I gave a patient an umbrella for his grounds pass and that he turned it in upon his return to the ward.

The supervisor turned to Princess and said, "I don't understand.  I thought you were upset because she wouldn't give the patient an umbrella."

Princess:  "NO!  She can't go around, doing whatever she feels like doing, like she's in charge, like she runs the place."

Supervisor:  "I am not following you, Princess.  What is the problem?"

Princess:  "SHE IS THE PROBLEM!" and pointing at me.  "It is against the policy to give patients an umbrella.  They can kill somebody.  Who does she think she is, going around, handing out umbrellas?"

Princess had herself so worked up, she was actually panting, sobbing, and trying to shout out more words.  The supervisor brought her to an office and shut the door.

Two hours.  They were in there for two hours, mostly with Princess screaming about me.

When the supervisor came out, she said to me, "I don't know how you work with her.  You were correct to give the patient an umbrella for his pass.  I don't know what she's talking about, that it's against the policy.  She hates you.  I am not sure why or what to do about it, so just stay away from her."

Thanks for the guidance and help.

Princess composed herself in the bathroom, grabbed her purse and keys, and was gone for the rest of the shift.  No endorsement of her assignment.  Nothing.  Just gone.

I overheard two of the attendants talking, asking why Princess left.  One said, "You know, because of what that other nurse did to her."

"What?" the attendant asked, ready to hear some juicy gossip.

"You know that patient who went out yesterday?  She lent him an umbrella in case it rained," came the response.

Silence.  "Wait, no, that can't be it."  More silence.  "Well, I'm not sure, but it must have been pretty bad."

Saturday, May 25, 2013

Inappropriate Partners

A coworker said something to me many months ago that really bothered me.

Okay, a lot of coworkers say a lot of things to me that really bother me.

There was a male patient around the age of twenty.  He was hostile, guarded, did't trust anybody.  This was understandable.  His diagnosis was schizophrenia.  At age twenty, he had not fully developed into his diagnosis, so he was not completely delusional and in La-La Land.  Most of my coworkers have no people skills.  They ignore patients or yell at them if the noise is too much.  I try to establish the Therapeutic Relationship.

After a few weeks, the young man let his guard down around me and we could have some conversations about his illness, medications, and plans for discharge.  To many other staff members, he was still openly hostile, especially the nasty ones.

I was talking to this young man on the floor one day when an attendant came by and said to me, "Okay, you can stop flirting now.  We all get your point."

This really surprised me.  My immediate reaction was, "Am I flirting?  Am I attracted to this guy and it is showing?"  No, I wasn't attracted to him.  In spite of his progress, he was still a mess, on the brink of a violent eruption whenever the voices instructed him to kill somebody.

Then I thought:  the attendant is an idiot.  He was making a joke, but it is a potentially damaging joke.  A nurse can't hit on the patients.

Then the third phase of analysis:  My interactions with some patients is viewed as flirting by the staff.  This is unsettling and dangerous.  Honestly, I am not flirting.  I have never felt the mildest attraction to any patient.  The typical patient is grotesque, violent, unbathed, addicted to drugs and/or alcohol, smells to high heavens, and is downright repulsive.  Addressing the lack of self-care is not the first goal of treatment at the hospital.  Establishing trust between nurse and patient is the first step.

I treat the patients like human beings.  Most of the staff does not.

After the flirting comment, I did curtail my exchanges with patients.  I tried to sound and be even more professional, using Mr or Mrs and trying to not smile or laugh.

A few days ago, something similar happened.

I get a pink rash on my neck at this time of year.  It must be caused by some flower or tree in bloom.  I never figured it out.  It itches and swells a little, but the skin does not weep.

A young male patient was getting ready to erupt.  We got him to go to his room to cool off, but he was pacing, pounding his fists, and muttering to himself about "fucking that bastard up."

The attendant who had made the flirting comment months earlier returned from lunch.  I told him a brief run-down of the situation.  He looked at the rash on my neck and said, "He did that to you?"

I thought the attendant was asking if the patient had hit me or tried to strangle me.  Stupid me.  I never see it coming.  "No, this is from seasonal allergies," I said innocently.  Because it was.

"You mean it didn't happen while you two were making out?" the attendant laughed back, in front of other staff and patients.  Some of the staff laughed.

I froze.  I suddenly remembered the flirting comment from months ago.  It was no one-time poor choice of words.  He is seriously harboring this delusion that I have romantic physical relations with the patients.  And he is an attendant, not a patient.  Once the patients are told this idea, they will run with it.

I had to at least try to squash it.

"Mr Smith," I sternly stated, "Your comment is disparaging to me and the patient."  The smile left his face and anger formed.  "The safety of the patients and staff is compromised by the situation on hand, and you come in here joking about me personally."  Now nobody was laughing.  "If you want to tell people vicious lies about me, do it on your own time and not when we are trying to protect ourselves from an attack."

I am not sure how much anybody understood, other than I was upset.  They probably think I became upset because my secret was outed.  I work with such fools.

Friday, May 24, 2013

Computer Be Gone

The hospital has officially abandoned all electronic documentation and reverted back to paper.

The only thing affected was the daily report for administrative purposes.  Everything in the chart was and remains paper.

"Thank goodness," a lot of nurses applauded.  "That computer was too hard.  It took me all day to type the report."

My thoughts:  What year is this?  You know you are unemployable anywhere else?  Can you now claim that it took you the entire shift to write a few lines on a paper for the report to the nursing office?

I still can't believe that only one tiny aspect of the place was computerized and now that is gone.

Thursday, May 23, 2013

In Hindsight

Thank you all for your support and encouragement.  It means a lot.  I don't mean for this to sound like a gripe board, but I am having a really tough time at work and an even tougher time finding a different job.

I cried every day last week.

They are getting ready for some survey.  State, Federal, Credentialing- I don't know.  Everyone has a different opinion on who is coming and when and their opinion is correct.

I have people who have No Medical Knowledge interrupting me, no matter what I am doing, trying to shove a chart in my face, telling me that something is missing.  "I can't help you with that right now," does no good.  The response is along the lines of, "I didn't say you had to do it NOW.  When you are finished with that, then you can get to the chart."  As if I didn't have a thousand other things lined up ahead of fixing a chart.

So I sought advice from a bully nurse, though I didn't put it that way to him.  He helped me see things more clearly.

Big Bully:  You did what you were supposed to do in the chart:  daily notes, weekly summaries, signed off on orders you took off, correct?

Me:  Yes.

Big Bully:  Then anything else is their problem, not yours.  As long as you did what you were supposed to do, they cannot come after you for not fixing somebody else's omission or mistake.

They are coming after me, but he is right.  I cross my T's and dot my I's.  Other nurses are sloppy, cut corners, and get away with it.  That's too bad.  Let it come back to haunt them, not me.

An example:  Administrative person (I have no idea what her job is) directs me:  "Look at all these order sheets.  Most have no allergy written.  You are required to write the allergies on every sheet.  I need for you to go through this chart and write the allergies whenever they are missing."

Me:  "There is no order sheet with my signature that is missing an allergy."

Administrative person:  "I didn't ask you that, and that may be true, but the allergies still have to be written on every order."

Me:  Flipping to a page without an allergy- "Why don't you ask Nurse Smith to write the allergies?  She signed this sheet, and Nurse Jones signed off on the 24 hour check below that."  Then I turned to a page with my signature and pointed out the allergy already written.  "If my name is on a sheet, then the allergy is written."

Administrative person:  "We are not here to blame other people.  We need everyone's help in getting the charts in order."

Me:  "You've had my help from the start.  That is why I always listed allergies on the top of order sheets that I handle.  And now, please excuse me to attend to my patients."

All of a sudden, the hospital wants things done correctly, which happens to be how I've been doing it all along, and I am supposed to carry everyone else?  No way.

Sunday, May 5, 2013

Spilling Over

"He was so rude!  He could not answer a simple question.  He had to be flip and rude."  The supervisor told me this about a hospital attendant who was sent to retrieve a patient.  He talked to the nurse in the clinic and the driver in the same condescending manner he talks to me.  They found it so unacceptable and rude that they both reported him.  And now the supervisor thought I should be impressed.  I was not.

"He talks to me like this all the time.  You never thought that any action was necessary," I coolly replied to the supervisor.

"No!  You never told me he is always rude to you," she tried defending herself.

"Just this morning, I asked him if Mr Smith was out of bed, right in front of you, and he replied, 'You're the nurse.  You're supposed to be smart and know these things and not ask other people.' This is how he responds to questions," I reminded the supervisor.

"I don't really remember his answer," she stumbled.  "I remember you asked him something, but I don't know what he said.  Anyway, just make sure that you're not the one being rude."  Tables turned on me, as usual.

I am glad that others are speaking out, but the supervisor still clings to the idea that I am forcing the staff to behave so badly, even when they are not with me.  Administration excuses their behavior, claiming that I forced them into it.  They don't behave poorly just when I work.  It is spilling out into other shifts, departments, and nurses.

Thursday, May 2, 2013

Choosing our Burdens

In a moment of exasperation and desperation, I finally reported my "partner" nurse for doing nothing.  She was gone most of the day.  She appeared three times during the shift, scolded me for doing work, and then disappeared again.  The final straw was when she appeared at the end of the shift to collect her personal belongings and scolded me for not being done.

I marched into the supervisor's office and handed her a short staffing form for the shift and told her I had already faxed it to the State.  She saw that the number of nurses listed was only one- me.  She squeaked, "There were two of you!"

I snapped back, "I was by myself all day.  She was not here.  You will not see her name or initials on a single document for this shift.  I did everything myself.  I told you several times today that I was underwater and by myself.  We won't even mention how I received no help from the attendants."

The supervisor called the other nurse into the office.  I returned to the patient I was admitting, for free, after the shift had ended.

"Partner" nurse marched into the room, no knock, no "excuse me."

"Some people choose to do all the work, and then complain about it.  If you want to do everything, don't complain about it later."

I said nothing.  I don't engage in employee arguments in front of patients.  That is the most absurd complaint out of her selfish, stupid mouth that I have heard to date.

Wednesday, May 1, 2013

Job Offer?

The nursing home where I interviewed last week called me to come in and fill out papers.  Does this mean that I am hired?

I went in yesterday and filled out consent for background search and signed other papers about dress codes, confidentiality, and the like.  I brought them into the Human Resources office.

"Am I hired?" I inquired.

"Depends on your background search," the lady answered.

I have no record, or should not have, so the background search should come back fine.

"What is the rate?" I inquired.  It's about money.  Let's stop pretending.

"Oh, I don't really know," the lady replied.

That's ridiculous, I thought.  Almost hired, and Human Resources claims to not know how much people get paid.

"I need to factor in the rate of pay as I consider my options," I replied.  Sounds firm, right?

So she told me a rate:  $28 an hour for per diem.

My stomach sank.  Not as severely as when I found at that my high school crush had gotten married.  But there was shock and repulsion and then lots of thoughts about how I was not going to make enough to meet my loan payments.  I have a deficit of a few hundred a month- if I don't eat.  If I eat or have to buy anything such as shampoo or soap, I have a bigger shortfall.

"That's less than I make at my regular full-time job.  Are you sure that's the per diem rate for an RN?"  I tried.


How did she go from not knowing the pay to knowing it was $28?

Remember that this place is in the inner city.  There are people passed out from drugs and alcohol on the sidewalk out front, with groups of surly people sizing me up as I pulled into the parking lot and dashed inside.  The place is locked with security guards checking identification before allowing you in.  Every door, stairwell, elevator- locked, just like the psychiatric hospital.

In general, the rates for working in this environment are higher.  Battle pay.  If I go south or west, the rates drop.  I might as well work in a nice suburb for the same pay.  If I can get hired anywhere else.  That's the problem.  I can't find work anywhere else.

I don't want to offend the woman I work with by not taking the job.

I don't know what to do.  I need the money, but I would hate giving up overtime at my regular job, if they offer it, to work in a hell hole for less money.