Sunday, March 16, 2014

Right back at you

I understand that not everybody likes everyone else.

The part I don't understand is the one-way view that the person has, as if it doesn't occur to her that the other person could dislike her back.

In addition, I don't understand why dislike of a person should serve as an excuse for treating someone badly.

I really don't care if someone doesn't like me.  I think that the only people on the planet who you need to like are friends and romantic partners.  You voluntarily put them in your life.  All other human relations and interactions do not require that you LIKE the other person.  Civility is required in all interactions; liking the other party is irrelevant.

Everything has a price

On my ward, there is no official manager.  Someone held the position, but she was out a lot and has not worked for months.  When she was at work, she couldn't be bothered with anything.  Now she has officially left- retired or quit- so a new manager is needed.  The job has not been advertised.

I thought about going for it.  The manager works as a floor nurse but has extra managerial tasks.  It comes with a pay raise of a few thousand.  I figured it's not worth the aggravation, especially since the staff despises me and nursingmanagement always sides with the other person.

Several doctors and social workers approached me and told me that they hope I become the new manager and that they would put in a good word for me.

Then someone from nursing administration reached out to me:  the Director of Nursing has already decided to deny me the position "because no one likes you."  She said that someone from the outside would be hired to fill the position.

This raises two points:  Employment is based on popularity (and I'm no winner in that arena) and the hospital has zero potential leaders in the pipeline.

A doctor approached me and told me that he had to defend me in a meeting about a problem on my unit because it happened when I was not on duty and the Director of Nursing was blaming me.

Another doctor approached me and said that the Director of Nursing is incompetent and the doctors are trying to get rid of her.

This is all interesting, but I don't see any of this working out in my favor any time soon.  Even if I got the manager position over the objections of the Director of Nursing, she and the other nursing administrators would make each day horrendous to punish me.  The staff on the ward is unmanageable.  They have no intention of ever doing any work or cooperating.

A friend of mine asked how this is not a hostile work environment, as admitted by administration- "No one likes you."  The staff sabotages me in lieu of performing work and administration sides with them every time with the excuse, "They don't like you and this is your fault, so these are the consequences."

Another nurse asked me who was running my ward and if I would get the position.  When I explained the "No one likes me" justification for my denial, she was worried.  She said that administration can't tell me that nobody I work with likes me and can continue to harass me until I win them over.  She said that they need to move me to another ward.

Lamenting Lamination

There is a woman who works at the hospital who is constantly presenting me with laminated crap to hang up because "This is very important" or "It's a Joint Commission requirement."  Problem is, she doesn't spell half the words correctly and the grammar is horrendous.  She should have someone proof-read them before she wastes so much money on laminating these ridiculous mistakes.

How do people get these positions while I have to work my ass off?

And yes, I quickly scan each lamination she hands me and tell her the errors.  She's always surprised.

Walking on Eggshells

I've been working a lot with idiot nurse.  We'll call her Helen.  I think she has Borderline Personality Disorder (BPD).  I was not sure at first, thinking it was a language barrier.  I also expected to see two extremes in her treatment of me:  The "You are the Greatest" as well as "I hate you and will destroy you."  The two versions I see from Helen are "Despondent" and "I Hate You and will destroy you."

Helen is the nurse who invented a reason to yell at and accuse me in front of an audience, supposedly based on a rumor she heard that I bad-mouthed her.  That was extreme and is typical of the fragile stability seen in someone with BPD.

When I returned from lunch the other day, a patient asked me to call her social worker.  I do not do this because every patient asks constantly to call their social worker to ask when they are being discharged.  If you have not been told that you are being discharged, then you are not being discharged any time soon.  This particular patient was supposed to be discharged within the week.  So as to not besiege the social worker with identical phonecalls, I asked Helen if she had already called the social worker for the patient.

Helen lost it.  "You don't know what I do when you are not here!  You act like I do nothing.  That is not true.  You know what your problem is?  Your tone.  I don't want to hear you."

I tried to keep it professional.  "No, I don't know what happened while I was at lunch, so that is why I am asking you if you reached out to the social worker or not, so we don't both call him."

Helen grew angrier.  "I have so much work to do and you act like I don't do any work.  You need to change your tone."

Now I was done.  "I don't care for your tone, either, Helen," I answered back sternly.  "I asked you a simple 'yes' or 'no' question and you started ranting.  I'll just call the social worker myself."

Helen wasn't backing down.  "I already called the social worker.  This is what I am talking about.  I do something and you say it's not good enough and you do it over."

Doesn't she hear herself and lack of sense?

Later the clerk told me that when Helen covers the ward when I am off, she is a mess and usually calls out if she knows in advance that I am off.

I thought to myself:  If she needs me so badly to handle the ward, why does she treat me like garbage?

Then it occurred to me that she was exhibiting another typical BPD trait:  extreme anger over perceived abandonment.  When I go to lunch or am off for the day, she sees this as abandonment.  Most of these tiffs are when I return from lunch.  If she works the ward on my day off, the next time we work together she constantly mentions things that went wrong "because you weren't here."  It's not said as a compliment.  Her tone implies, "You were supposed to be here and played primadonna and did not show up, and so things went wrong because you designed the place to fail without you."  When I was focusing my attention on New Nurse, Helen felt she had been abandoned and went to the supervisor to regain my attention.

Another way of detecting BPD in someone is by noticing your own thoughts and feelings when around this person.  If you feel as if you are walking on eggshells and the person can go off on you at any moment for any little thing, you could be dealing with someone who has BPD.

How to deal with BPD?  Not easy.  Setting firm boundaries is necessary.  When I work with a good nurse, it's more symbiotic with both of us grabbing whatever work pops up, finishing it, and then grabbing the next item without declaring, "That's not my job, it's yours."  When I work with Helen, she constantly calls me to help her with everything from finding a chart to assessing a patient that she is standing next to.  She drags me into every task she does, which is inefficient and obnoxious.  In contrast, if I tell her that I'm inundated, she'll answer, "That's your job, not mine," and continue sitting and swinging her feet.  Her explanation for any undone work is, "I told Enid to do it."  She runs out the door five minutes before the end of the shift, leaving me to give the useless report she wrote to the incoming shift.  The problem with trying to draw boundaries with her is that she complains to the supervisor that I won't help her.  She won't help me, but that is not relevant to the supervisor.  Helen doesn't have to help me because I don't get along with her; I am to start demonstrating my willingness to work well with others by doing Helen's work for her whenever she demands and not putting my own work onto others.

Marked Target

Every day (except Saturday and Sunday), various administrative people saunter through the ward, looking for trouble.

One of the attendants scurried away when a particular administrative person arrived on the ward.  The attendant whispered to me, "I'm staying away from her.  She's the one who got me suspended because I called her a stupid bitch."

This bothered me.  This attendant has called me far worse names and nothing was ever done about it, except lecturing me about my inability to get along with others.  I have complained about things yelled at me that were quite atrocious, yet nothing was done to the speakers.

Some people are protected while others are not.

Wednesday, March 12, 2014

Where is my Coffee?

I was summoned to another ward where a patient was asking for me.  He thinks we run a billion dollar company together.  I wish.  Anyway, he needs a bribe to take his medication every morning.  The bribe is coffee.  This is against the Rules, but patients are people, too, and they like to have control over their environment.  This particular morning, the bribing went awry because no regular staff members were on duty.  The patient refused his medication because the staff would not give him coffee.  By the time I got there, a useless supervisor was on the scene.  She questioned me immediately about the billion dollar company, chastising me, "You should have reported that you have a business relationship with a patient."  She believed the patient's grandiose delusion.  If I am a billionaire, why the hell would I work in this hell-hole for so little money?

The patient heard the supervisor speak my name and began yelling for me to bring his coffee.  "Fine," I told him.  The supervisor objected and proceeded to lecture the patient.

"Coffee is bad for you, don't you know that?  You should not drink coffee."

This only set off the patient more.  He yelled back, "Coffee is bad for me?  How about the other poisons you give me every day?  Depakote has made my hair fall out.  Haldol has made me shake so bad that I have to divide drinks into two half-full cups so I don't spill everywhere.  And you have the nerve to tell me that coffee is bad for me?"

The supervisor walked away, shaking her head, while the patient was still ranting.  She loves to stir conflict, but won't engage patients for long.  She spent the rest of the day trying to corner me into answering her questions:  Did I get him coffee after she left and did I report my business relation to human resources.

Yes, I did get him coffee.  Try quitting coffee cold turkey.  It's mean.

Sunday, March 2, 2014

Reading the Nurse's Note

New nurse brought to my attention a note in a chart written by one of the night nurses.  "This is not how you are really supposed to write a note, right?" she asked.  I looked.

Wow.  An entire page about the nurse's interaction with the patient around 3 am.  "The doors upon which she arrived were shut.  This was done to keep her out, which I explained to her.  She twisted up against the doors, bobbing like a worm, whining like a seagull, to try to get through these doors, which I had already told her were locked and she cannot come through."

The rest of the page could be described as a sermon delivered by the nurse to the patient about accepting what she has been given, being thankful for her gifts as well as her struggles, needing to figure out why she had the struggles and how she could use her faith to find strength to overcome her difficulties.  The note concluded with a hug.

The note had no relevance to anything, except maybe to indicate that the patient did not sleep through the night.  And that this nurse is bonkers.  Nursing notes need to easily convey relevant information.

Yet people criticize my notes.

Writing the Nurse's Note

A nurse chastised me for writing actual words spoken by patients, placed in quotation marks.  I write precious gems such as, "Patient periodically screams, 'Fuck you!' at passerby."  "When nurse explained purpose of the new medication, the patient responded, 'I'm not listening to you.  You are a cock-sucking whore.'  Patient then ran off before medication education was concluded."

The nurse said I should use wording such as "The patient cursed" or "The patient was verbally abusive."  I disagreed.  These are generalizations and conclusions that are not for the nurse writer to make; rather, the reader is to reach the conclusions set up by the writer.

I hate reading "verbally abusive."  That does not tell me what the patient did.  It tells me how the nurse felt, which is not relevant.  With the crowd I work with, it is very easy for them to feel abused by a sidewards glance, lack of enthusiasm to see them in the morning, not dropping everything and giving them your undivided attention.

Saturday, March 1, 2014

Looking good on paper

One of the psychiatrists I work with told me he would help me get a job where he moonlights.  (Yes, all of the doctors have to work second jobs too.)  Ironically, it is where I applied online in December.  He said I need to fill out a paper application.

So I called the hospital and asked them to mail me an application.  Nope.  Applicants must come in.  My online application?  "Just a screen," was the explanation.  "Just a waste of my time in the hopeless job search," I thought.

Over the years, I have noticed that applications for employment must be filled out in person in front of someone.  When I was new to the healthcare industry, working as a secretary, I was one of the people doing the supervision.  I had to take notice if the applicant used a translator or a scribe.  These were Red Flags that the person did not speak English and/or was illiterate in some capacity.  Yet they were hired anyway . . .

You've read my writing.  I am literate in the English language.  Making smart employment decisions- not so skilled.

I hate applying for jobs.  It's a waste of my time and I rarely get a call back- nevermind an offer.  When I fill out the application on site, I have to bring with me any possible piece of information that could be requested on the application, such as references, schools, licenses and numbers, past employers, supervisors, phone numbers, and on and on.  Smart phones help tremendously now, but there is always some piece of information beyond my reach at that moment.

I hoped and wished the entire trip to the hospital that I would not have to fill out the application there.  Yeah!  I was allowed to take it with me, plus one "for a friend," and supposedly I can mail it back.  I see this place as great for per diem work- as long as the advertised high rate is what I actually get.  I think the regular, full-time salary is what I currently get, so I don't see the point of jumping from the pan into the fire.

Division of Labor

I just don't know what to do.

Another bad day.  Well, nobody was hurt, in spite of some stupid antics.  The day started when I had to wait to punch in while Queen Bee in front of me took forever.  I soon discovered why:  she had a stack of cards in her hands and was punching in multiple people.  Had I realized earlier, I would have taken a video.  Probably would not have mattered anyway.

The work kept piling in and piling in.  My partner nurse declared early on, "I'm only here to do meds."  Whenever I asked her to do anything else, her response was, "That's too much for one person."  Exactly!  That is why I, who is only one person, needed her to help out.  She flat out refused.  She told me, "Put in a short-staffing form."  For what?  Been there, done that.  The form does not make a bunch of useful nurses appear instantaneously.  What the form does is anger administration.  Once I got a call back from the investigative agency from the State.  The woman said she's never heard of the hospital.  I gave her other possible wordings of the name, the address, names of officers; she still denied that the hospital existed and asked if this was a joke.

The attendants have become more emboldened after the recent fiasco when I lost to an attendant who complained about the unfair workload (as if I created it) heaped onto him alone (even though others also had assignments and he didn't do the assigned work anyway).  I didn't create the work and I didn't decide how few people of such little quality work on the ward.

The attendants refused most of their assignments as well and told me, "Tell the other nurse to do some work.  If she's not doing anything, then we aren't either."  As the day wore on, several attendants told me, "It's your fault for letting people get away with it."

I told the supervisor throughout the day that the work was too much and nobody was helping.  She reminded me, "We've had this discussion before.  You need to learn to get along with your coworkers."  I tried the angle that my lack of a personal relationship with my coworkers should not be a valid excuse for them refusing to do any work.  The supervisor emphasized that there was "a lack of teamwork" and that I was the cause of this lack.

The patients destroyed the ward.  Broken glass.  (Yes, there are/were glass panels along some doors.)  There was some kind of game where chairs were stacked and the ceiling tiles were punched out.  The flimsy chairs also broke in the limbering towers.  Another game involved throwing objects at the cameras until the lenses shattered.  The attendants watched.  "We aren't allowed to tell the patients what to do," was the explanation.  They can tell the nurse what to do, but not the patients.  I kept tossing all the broken stuff into a back hallway.  The supervisor kept demanding incident reports.  I couldn't keep up with the nursing notes for the charts and the administrative reports of damaged property, so the property reports did not all get written.  It's called prioritizing.  Patient safety is my number one priority, but it seems that the supervisor simultaneously wants my coworkers' elusive happiness and redundant paperwork to be my first priority.

Once home, I tried vodka, klonopin, exercise, chatting with friends- nothing worked.  So I called out for tomorrow.  Queen Bee's husband answered the phone- he was supervisor this evening- so there is a risk that he will deny that I called out.