Thursday, May 29, 2014

Failing the Test for Organization

I finally took competency tests at my prospective per diem job at a large hospital.  I am not pleased and I am not taking them again unless I am on the clock and getting paid.  I cannot believe that a hospital operates this way.  (Though I say that about my current place.)

I left message after message to schedule my appointment.  Finally the woman who hired me called me back- when I was at work with the Head of Psychiatry and could not answer her call.  She left a rambling message that a lot of time has passed and I have not come in to complete the three tests and, "Oh, I see here that I wrote that I needed to return your calls.  I guess I didn't return them until now.  Ok.  So if you could call me back and schedule these tests, that would be great."

I poked around their phone system and finally got a clerk-like person, Stephanie.  She asked when I wanted to come in.  "This Friday, 8 a.m.," I told her.

She replied, "Ok.  This Friday at 8 o'clock.  And why are you coming in?"

"To take the required nurse competency tests before I start my employment," I answered, trying to keep cool.  I had explained that at the beginning.

I drove through massive traffic to arrive at 7:45 on Friday.  Nobody knew what I was talking about.  Stephanie starts at 9 a.m., I was told  At 9:30 a.m., Stephanie appeared, which I only know because I heard someone calling out to her- not because she sought me out in the waiting area.

Stephanie's response:  "Yeah, um, I'm not sure why you wanted to come in today."

Me:  "To take the pre-employment RN competency tests," I explained as coolly as I could.

Stephanie:  "That is why it was not clear.  We don't give those on Fridays, so I didn't know why you wanted to come in on a Friday to take the test when we don't give the test on Fridays."

There goes half my day off for nothing.

"Can I come in next Wednesday?" I asked.

"Sure," said Stephanie.

I sought confirmation, "You administer the tests on Wednesdays?"

"Yes," Stephanie said, looking bewildered.

On Wednesday, I appeared and had a similar run-around.  Nobody knew what I was talking about.  Finally Stephanie appeared and shuttled me to a computer.  She got the program up and running and left me unattended in the room.  I answered multiple-choice questions about medications I had never heard of and some that fell out of use years ago.  80% is passing.  I scored 76%

I returned to the desk and told the new face that I was ready for the next test.  She didn't understand.  I asked for Stephanie.  She said that Stephanie had left for the day.

I left too.  I figured I'd try again.  They probably wouldn't remember that I already took the test and failed.  I showed up and met a different batch of confused people.  After much hesitation and several phone calls, they brought me to a computer and started up the same test I already failed.

I had learned from my prior attempt.  Smart phone by my side, I looked up the unfamiliar medications and reference ranges for blood values.  I realized how I answered many of the questions incorrectly the first time around, and was feeling very confident about passing this time.  My score:  78%  It could not be possible.

I would like to mention that the location of my testing was the front office of a very busy building.  Visitors did not understand that I did not work there.  They kept barging in on me, asking for stuff.  One woman even yelled at me that I was just sitting there, "Playing a game on the computer," while she needed help.

I returned to the desk and asked to start the next test.  This new face asked me which one.  I said it would be a psych test.  She typed and clicked the mouse and read and read.  Finally she declared, "There is no psych test."

"Psychiatric," I clarified.

Again more typing and clicking.  "No, I don't see that test, either," she answered.  She asked if I wanted to take any other test.

"Yes, the two tests that I need in order to work here," I answered.

"Did they say where you would be working?" she asked.

"Behavioral Health," I replied.

"Let me see if they have a test for that," she answered, and typed and clicked some more.  "No," she declared.  "Maybe you have to take a medication test?"

"I already took one," I answered.

"Here is one called Mental Medications," she said.  "Maybe that is the one you need?"

"Yes," I responded.  How does she not know that behavioral health, psych, and mental are all interchangeable?

Let's not get too excited.  She pulled up the next test and I sat down to see Maternal-Newborn.  "Wait," I said.  "This is not Mental.  It is Maternal."

"Same thing," she responded.

"No, it is not.  I need the mental health tests."

"I'm pretty sure you need this one," she answered.  She went from not knowing anything to knowing which test I needed in just a few minutes.  Now I was getting mad.

I whizzed through the test, knowing very little.  Click, click, click.  I did not bother to consult my phone.  A man came through (remember how open this is) and introduced himself as the union rep.  He saw the test and welcomed me to Labor and Delivery.  I said I was hired for the psych department.  He asked why I was taking the maternal-newborn test.  "I don't know," I answered.  He said that no new hire has passed any of these tests so far.

That made me feel better.  I decided that I would take three tests, as instructed, and hope that they are so disorganized that I can start working in spite of my scores.  My score on the maternal test, which were mostly guesses:  74%  Just a hair worse than the medication test, where I looked-up the answers.

The next new face at the desk hesitated quite a bit, then called up another test for me on alcohol and drug withdrawal.  Again, not an area I am familiar with.  Clicked my guesses as quickly as possible.  My score:  78%  How could I achieve the same score with almost random clicking as I did with researched answers?

When done, I appeared at the desk to announce my completion and my expectation that I would be orienting soon.  The woman asked, "Why are you taking these tests?"

I answered, "They are required in order to work here as a nurse," I answered.

She replied, "That is so cute!  You want to be an RN!  I think you also have to go to school, though."

I looked at her and then just walked away.

I am still going to write about the disorganization of my current hospital, but this place might be far worse.  Wow.

Friday, May 23, 2014

Fish be gone

The orderly who microwaves fish every morning for breakfast has been on vacation.  (Which he then eats with his hands and then touches everything before washing his hands.)  It is so nice to not have that odor smacking me every morning by 8.

People, please do not microwave fish.  Thank you.

Don't some offices have rules against this?

Sunday, May 4, 2014

Your Opinion Counts

An administrative person appeared behind the desk of the ward while I was on the main floor.  She asked about a violent patient (the one involved in the supposed patient abuse).  For years, he has been on special observation:  a staff member is always with him, though not within five feet because of his violence tendencies.

This administrative person asked me, "Do you think he still needs a staff member with him?"

My answer:  "Yes."

She smiled and said, "He has someone with him to prevent him from hitting people, yet he still hits people."  She stood there, still smiling, but cocking her head to the side.

My response:  "He attacks fewer people because he is being watched."

She persisted:  "Shouldn't he not be able to attack people if he is being watched?"  She smiled really big, as if she was waiting for me to finally agree with her.

My response:  "The staff are not human shields.  They do not throw themselves in between the patient and his intended victim.  They verbally redirect the patient away from trouble, but if the situation escalates, the staff member calls for help in breaking up the fight."

She was no longer smiling.  She laid out her position:  "I think he no longer needs to be watched continuously.  I am asking you for your opinion."

My response:  "I gave my opinion.  He needs to be watched and my nursing notes reflect that position and will continue to do so, even if the order to watch him is discontinued."

Her response:  "Well, we are discontinuing his special observation.  Your opinion counts.  That is why I am asking you."

My response:  "I gave my opinion and you overrode it."

The patient was on the main floor with me, but across the room, with a male attendant watching him.  No other staff members were present.  "Let's take him off observation right now," I suggested to the administrative person.  "I will send the male attendant away and stay over here.  You go and sit with the patient, in your skirt and high heels.  When he grabs you, I will call for help."

She flounced off, not coming onto the floor.  And the special observation was not discontinued.

Fired! (Not me)

Someone was fired!  And it wasn't me!

How does someone get fired?  I did not think it was possible at this hospital.  In the back of my mind I figured I would be the first person ever fired, and it would not be because of something I did wrong.  It would be for some made-up nonsense.

An attendant got fired.  She was not on my good list, but she did not rank on the highest tier of my enemies.  She may have been my enemy, but she was also an enemy of my enemies, if that makes sense.  She was part of the swing population.

Rumors swirled, but I went after the source.  We spoke on the phone.  She said that they had her on camera stealing from a patient and hitting another patient.  I told her that she knew where the cameras were and I asked her why she did this in front of the cameras.  (Not why she did this- it's her normal behavior.  Just why she was brazen enough to do it while being recorded.)  She said that she entered a patient's room to clean it (which is a ridiculous assertion- she never cleaned anything) and exited the room, which placed her in view of a camera, with garbage to be thrown out, but had to immediately go to another patient, so she stuck the garbage into her pocket to throw it out later.  In case this sounds strange, we don't throw anything out in the patient's room because the patient will retrieve it from the garbage.  I think that the accusation of stealing was defensible.

As for the second accusation, hitting the patient, it is not what you are thinking.  The involved patient is very violent and is not only constantly trying to hit other people, he also constantly grabs parts of female's bodies.  I myself have swatted him away and have seen other staff members and patients do the same to get him off them.  It's a natural human reaction to strike back when someone goes to hit you or grabs your breast.  He's a big, strong guy with no problem inflicting injury on others.  If this attendant really struck him on purpose to injure him, she would have been beaten into unconsciousness or death by him until other people could have pulled him off her.  That never happened.  My notes on this patient always include his hitting, punching, kicking, and grabbing of staff and patients.

This firing for hitting a patient places me and everyone else (well, the unfavored children) in jeopardy.  If she can be fired for hitting the patient, then I can be fired for witnessing it and not reporting it.  They may not get me on a commission of an act, but they can get me on an omission.