Sunday, December 27, 2015

Informal Education: When You have been Duped


The secretary in the Quiet Office is attending nursing school.  She asked me some questions.  She expressed concern over becoming a nurse, mainly because nurses are not nice to other nurses.

"I have to work here for five years after I earn my nursing degree; otherwise, I have to repay the tuition," she lamented.

"What do you mean?  This hospital pays your tuition?" I asked to clarify.

"Yes, they pay for any degree related to your job or healthcare," she explained.

***

Now I'm pissed.  Several people told me before I started working here that one of the great benefits was paid tuition and that you could go all the way to doctorate in nursing, or even pick up an MBA or any degree related to health care administration.  Great.  It was one of the reasons I accepted this job.

As soon as I started, I asked Human Resources.  The guy laughed and said, "Yeah, right.  No more.  Tuition is astronomical and the hospital had to cut corners somewhere, so the tuition assistance program was one of the first things to go."

I asked the union.  The rep said, "Yeah, this hospital won't pay for college tuition anymore.  But there are three scholarships for $1000 awarded every year to the dependent of a union member who is graduating high school and attending a two or four year program."

"That doesn't apply to my situation," I said.

"We can't help everyone," she replied.

So why was I lied to about tuition assistance?  And what can I do about this now?  If the hospital will pay to further my education, I'll go as far as I can.  But I really don't want to commit myself to work in this place for any period of time.

Why is it okay to lie to me?

Gifts with Strings

My immediate supervisor did not give me anything for Christmas.

I'm not saying this to be selfish.  It's proof that something is wrong.

We exchanged gifts last year.  I don't recall what she gave me.  Maybe gloves.  I gave her a bottle of wine.

I gave her a present this year.  "Oh, thank you," she said.  Flat.  No interest.  Like I was handing her a pen to write with.

She is not even pretending to be decent.

I would like to think that she has other things going on in her life that are causing her to be miserable.  The problem is that she is projecting all of this negativity onto me.  My position at the hospital is precarious.  She could push me over the edge into unemployment.  The shift supervisors are just waiting for her to declare me unnecessary.


Admission Ticket to Nowhere

My time in the quiet office ended.

I was summoned to the shift supervisor's office.

"You didn't admit anybody!" she accused.

"The census is full," I countered.

"Your job was to admit people and you did not," she continued, unfazed by my defense.

"Admit people where?  There is no where to admit them to," I continued.  Useless.

She told me to go work on one of the wards.  The same ward where the nurse works who accused me of spying on her, which got me banned from stepping foot on the wards.

I said, "That is not a good idea."

"Why not?" she snapped.  "You are a nurse, so you can work as one instead of sitting in an office all day, doing nothing."

"You assigned me to work in that office.  You also told me that I am not allowed on the wards," I said.

"Well, now I am telling you that you are allowed to go on the ward to work," she countered.

I left her office and found a doctor in the hallway.  He wrote me an "Excuse from Work" note.  I returned to the supervisor's office, handed her the note, and left the building.

I have never done this before.  I don't know what fallout there will be.

I think this is part of a big set-up.  I don't know where it is going, but the goal is to get rid of me.


Finding the Correct Person to Blame

After finishing each day in the Quiet Office, I returned to my normal work area to retrieve my jacket.

Each time, my supervisor in that office was still working.

"Bye," I would wave to her, as if nothing was wrong.

"It's 'bye' for you.  I am still working.  Someone has to do YOUR work when you are not here," she snarked.

I kept going.

It was with her blessing that I was floated out of this office.  "I don't need you.  I've worked fine all these years without you," was my supervisor's response to the "request" to float me.

I would also like to note that I checked on her several times throughout the day.  She was never in her office.  Please note that when I am working in this office, she never leaves me unattended.


Board Certification Goal

While thinking in the quiet office, I remembered that there is such a thing as board certification in psychiatric nursing.  I think I have to take a certain amount of continuing education courses (online), then sit for a test, then file for certification.  It is doable.

My coworkers and supervisors would hate me more for it.  But if I'm going to stay in this field, not necessarily by choice, board certification seems like a natural step.

At this hospital, only one other nurse is board certified in psych that I am aware of.  He has a little sticker on his name badge.

Professional Treatment

The strangest thing happened.

For two days, I was floated into an office that does intake.  From what I could ascertain, this office coordinates the patients who are admitted through the emergency department and need to transition to a longer-term arrangement.

The shift supervisor told me that it's my job and always has been.

I remember other nurses covering this particular office.  I also remember that they get paid extra for it, though I don't know how much.

I tried the union rep.  "Why would you get paid extra for doing YOUR JOB?" she replied.  Well, when you phrase it that way, I wouldn't get paid extra.

The office was amazing.  Windows to see outside.  A secretary who was polite and did work and actually stayed in the office for her entire shift.  No supervisor called me and stopped in throughout the day to question me about what work I've done, what work I have left to do, and asked me to justify my existence.  A few people did stop in.  They knocked first and asked to be excused for interrupting me.

It was almost as if I were working in a different hospital.  It was as if I were a healthcare professional.

I bumped into the person who keeps track of the nurses' time.  (By hand- no computer.)  She said, "Oh, nobody told me you were working in that department.  I'll put your slip in to payroll right away so you get the differential."  I didn't mention that my own union rep was not in favor of my receiving this differential.

I felt myself relaxing.  In the back of my mind, I knew that this would not last.  But I found myself dreaming about a different job.  Are there places like this office, where people do not bother you all day, accusing you of doing nothing, or committing a malicious act against them, or dumping more and more work on you?

When I finished my shift, I felt as if I had not worked.  It makes such a difference when the phone is not ringing off the hook with a line of people hovering around you throwing more work at you.  I was able to sit down and look at each referral, make notes, and then discuss each person calmly with insight.


Friday, December 25, 2015

Union Meeting

Union Meeting.

Lazy, clueless night nurse showed up.  She dominated the meeting with the same question, "Why must I do something called COBRA when I retire from here?"

The answer is:  When you don't work here, you don't get health insurance here.  You are not 65 years old, so you don't qualify for health insurance through Medicare.  For 18 months, you can purchase the health plan as permitted by a federal law popularly called COBRA.

I was thrilled to hear that she was retiring.  But her non-stop questioning about lack of health insurance makes me think that she didn't plan this well, which is no surprise, and that she may ultimately decide not to "retire" because she will be without health insurance.

She had two other amusing stories to tell.

1-  She pulled out baby booties from a large bag and showed off her craftsmanship.  I cooed over them and then said, "But why did you bring them here?  They can get food and stuff on them.  Next time leave them at home and just show us a picture on your phone."

She clarified, "I knit them here."

"I don't understand," I continued, while the union members listened uncomfortably.  "I thought you work here overnight.  When do you find time to knit?"

"Oh, there is plenty of time.  Too much time.  There is nothing to do, so I use the time to knit stuff for my grandbabies."

I looked at the union president.  Her face was a mixture of anger and panic.  For years we battled that night shift doesn't do what they are supposed to do.  Now night shift has no meds to give, no weekly reports, no treatments, no checking on anything.  It's all dumped on other people.

2-  This night nurse reported that the cold temperatures in the building overnight must be addressed.  "I now have to sleep in a sleeping bag!" she added to emphasize the importance of her assertion.

"In your house?" I questioned.

"No, here at night.  It's just so cold.  How can I sleep?  So I bring in a sleeping bag.  I leave it upstairs, otherwise, I would show you."

"What do you mean, to sleep here?" I went on.

"You know, when I'm tired of knitting and reading, I sleep, but it's cold, so I slide into a sleeping bag first," she explained, with the union president glaring at both of us.  "It's a fall risk, really.  If I suddenly have to stand up and walk, I could forget that I'm in a sleeping bag and I might fall down.  Then this place would have to pay my bills.  So it's really better if they just turn up the heat."

***

The union people were displeased with both of us.  I think I made my point.  They dumped the work of night shift on me all those years and here is one of the culprits, convinced that her job duties are doing nothing and sleeping.


Merry Christmas

Merry Christmas.

The supervisor said I could have off.

I didn't point out that I am already scheduled to be off.  I didn't want to be accused of arguing.  Again.

I don't understand why people are on a quest to throw more and more work at me while others are permitted to sit around and don't even have to pretend that they are doing work.

Interference

The theme at the hospital lately is throwing work at me that I've never done before and claiming that it has been my job all along.

When a patient stays on the psych ward, they must be medically stable.  For example, no tubes such as intravenous lines, feeding tubes, catheters.  If they need psychiatric care and medical care, they need to be on a medical floor.

When a patient on the psych ward needs medical interventions, they transfer to a more appropriate setting, either short or long-term.

A patient was sent out for fainting.  Diagnosis was some kind of systemic infection.  He stayed on a medical floor for a week.  One morning, I got a call from the case manager from the medical floor that the patient could return to psych.

Somehow this is now my job to coordinate such transfers.  My supervisor emphasized that this has always been my job.

So the case manager faxed some preliminary paperwork to my office area after we discussed that I cannot access the electronic medical record that exists in the rest of the world.  I quickly noted that the patient had an active order for intravenous (IV) antibiotics.  "No IVs on the psych ward," I advised the case manager.

The case manager knows this, but she tried to pretend that maintaining the IV on the psych ward was fine because the patient would still be in a medical setting.  After several phonecalls back and forth, with my supervisor listening outside the door, the case manager said that the doctor would discontinue the IV and order oral antibiotics so the transfer could happen.

"Okay, fax those orders," I told the case manager.  If it's not in writing, there is no proof.

This was still morning.  Before I left for lunch, I left a voicemail message for the case manager to fax the orders and I would call her when I returned from lunch.

After lunch, nothing.  I called the case manager several times to try to protect my butt, leaving messages that I was still waiting for additional information in the fax.  My supervisor hung on every word.

About an hour before my shift ended, I called the psych ward that would be receiving the patient and told the nurse that I was having difficulty securing information and that the transfer may not be able to happen today.  I continued to try to reach the case manager without success.

Just as I was about to leave for the day, the case manager called, irate.  "Your fax machine broke, so I sent over a hundred pages to the ward where the patient normally stays.  What do you mean you didn't get any of it?"

"Why didn't you return my phonecalls that clearly indicated, since this morning, that I didn't get any additional paperwork?" I asked the case manager.

"Because of HIPAA," the case manager explained.  "I called you to tell you that the doctor discontinued the IV, but your supervisor answered.  She told me that you are not allowed to receive information about patients because of HIPAA, so I can't talk to you.  She also said to fax records directly to the patient's floor because you are not allowed to handle them."

I called the nurse on the ward.  "Oh yes, it's all here," the nurse confirmed.

"Why didn't you tell me this when I called you and said that I had not received any information?" I asked of her.

"Because your supervisor called here and told me that I can't discuss patients with you because of HIPAA.  She told me that I can't tell you that the patient's records are here," the nurse said.

At this point my supervisor appeared.  "Why hasn't the transfer been set up?  We will be in trouble if we didn't fill an empty bed."

I asked her if she told people to stop conferring with me about the patient.

"Well, yes.  HIPAA is the law.  I have to protect patients according to the law," she said.

"Protect them from what?  You told me to set up this transfer and then went behind my back and told people to ignore me.  Then you pretended to not know why I couldn't complete this task?"

"I follow the law," she answered, as if she was making sense and was justified under some higher good.

I fired off an email to a bunch of people explaining that that transfer was not arranged because the case manager and ward nurse became under the impression that I was not authorized to facilitate the transfer as instructed by my supervisor.

Nobody answered my email.  I don't know if my supervisor was able to block my outgoing emails.

Thursday, December 24, 2015

Pillow Fight

Not to belabor the personal items issue, but I remembered another strange occurrence.

After my bag had moved from my office space to a storage room, my immediate supervisor told me that I couldn't leave my bag out on the counter.  I had purposely put the bag in a corner on a tower of boxes, out of the way of all the other crap in the room.

So I moved the bag into a cabinet.  The crap in the cabinets included patient records from the 1990s, copies of those records in case something happened to the original records that reside next to the copies; catalogs from the 1980s; boxes of supplies that are no longer manufactured; random screws and metal parts, and so forth.

Even at this early time I knew to not offer to throw anything out.

The next day, I went to put my bag in a cabinet in the storage room.  When I opened the door of a cabinet, out popped two pillows.  Pillows were stuffed into every cabinet and drawer, filling any space not filled by other random crap.

My supervisor arrived to work and went about her day as if nothing was amiss.  Finally I mentioned to her that overnight someone must have received a shipment of new pillows and decided to store them in our area.

"Oh?" she cooed.

"There's a lot of pillows in that storage room," I continued.

She became serious.  "I know about that.  I am the one who put them in there."

"Oh.  Okay," I said.  There was really no point in asking why.

"We need pillows for the patients, so I had to get some," she said.

"But you told me that I can't give out pillows because someone might use a pillow to sleep," I pointed out.

"See?  This is what I was talking about.  You argue with everybody," she snarked.

"I was just trying to clarify the circumstances under which I can give someone a pillow, now that we have more," I said.  I was really trying to clarify for myself what was going on.

"If you think that you want to give a pillow to someone, you ask me first.  You are not supposed to just go and do something like give out a pillow on your own without asking," she admonished, like I was a small child and not a professional nurse capable of figuring out when a patient might need a pillow.


Marital Problems at Work

Dina's husband asked me out.  Again.  In the parking lot.  I hope nobody was watching.  The allies of his first wive and second wive will come after me.

"Can I have your phone number?" he asked.

"For what?" I asked back.

"To call you.  I'd love to hang out again and just talk, like old times," he answered.

"That never happened," I responded.

"Well, I feel like it did," he smiled.

"Well, that's what we call a 'delusion' in the mental health field," I answered, getting annoyed.

He didn't grasp the concept.

"Listen," he tried keeping me, "Things got bad between us because of my wife.  But we broke up months ago.  That is over.  So the two of us can be together now."

"There is no us," I answered firmly.  "I'm not interested in hearing about your wife or marriage or divorce."

"But it's over between us!" he pleaded.

I hopped in my car and left.

Dina went ballistic on me several times at work, on the floor, in front of patients and other staff, ordering me to stay away from her husband.  I had no intention of being with her husband.  If both of them could have dropped off the planet, that would have been fine by me.  She acted like a jealous, low class, insecure jerk on a street corner, except that she was at work, in a hospital.  I felt so powerless and wronged and I will never risk giving either of them an edge over me again.

What Dina realized was that her husband's wandering eye wanted me.  She couldn't order him around, so she tried to prevent him from having an affair by blocking me.  Well, their marriage fell apart anyway.  I've only been here a few years.  In that time he got divorced from Wife One, officially dated then married Wife Two, and is now divorcing her.

Let's just be glad they didn't make any babies together.


Calculated Gifting

Last year, I was caught off guard by Christmas gifts from people in the office.

I had not received any gifts in past years while working on the wards.

This year, I planned ahead.  I bought fuzzy socks on sale.  In bulk.  Wrapped them nicely, with bows, ribbons, and gift tags.  Lots of spares to hand out to people I purposely push out of my mind.

I have been giving them out, gushing with warm Christmas spirit, not caring if they don't celebrate Christmas or some other holiday or anything.  "Merry Christmas to you and your family!  This is just a little something to let you know that I appreciate your teamwork and care for our patients all year long."

Most recipients are shocked.

I think that an important part of this strategy is to give my gifts out early to ensure that people will have time to get a gift for me.  It's not done out of greediness.  It's to promote the aura and appearance that there is some kind of mutually respective work relationship going on.

The results are paying off this week in the form of gifts for me.  Mostly alcohol.  I'll take it.  I'd rather that they start acting like professional, rational, well-mannered individuals, but this will never happen.  This part I learned already.

Erasing a Presence

"Your stuff is all over the place!" my immediate supervisor is always complaining to me.

I have been taking her word for it, making sure that I don't remove my scrub jacket and place it over the chair I'm sitting in.  I hide my water bottle at my side because she said that I'm not allowed to have a drink at my desk.  "If you want to drink water or coffee, that is fine on your break in the breakroom.  But you can't have any food or drink in the office," she has told me many times.  I disagree with this.  It's an office, not a patient care area.  Maybe if she hydrated herself she would be in better physical shape.  Maybe even better psychosocial shape.

I hide my jacket, bag, and car keys in a remote closet because she used to knock them over and trip on them every day.  No matter where my bag was, she managed to find it, collide into it, knock it to the floor, spill the contents through the zippered opening, and then proceed to trip and fall as she tried to retrieve the bag and contents.  After this happened multiple days in a row, I was convinced that this was no accident and that the behavior would continue as long as she could find my bag.  For the record, it's a small canvas bag from LL Bean to hold pens, paper, toothbrush stuff, and makeup.  It's not a large, clumsy duffle bag that I leave on the floor.  I would leave the stuff in a desk drawer, but none are allocated to me.

In the office and surrounding area her personal stuff abounds:  outdoor jackets, lab coats, scrub attire, walking sneakers, boots, slippers, pictures of her family, prayer cards, bottles of holy water, rosary beads, prayer books, drawings of Jesus, newspaper articles taped to the walls, a collection of rubber duckies, and so forth.

There is literally no sign of me in that office.

Finally I figured out what she means by "your stuff is all over."  Office supplies.  The hospital does not supply us with pens, markers, paper, and such.  We bring them in from home.  When I worked the floors, I carried my own pens and notebooks at all times or they would be gone.

So when I transferred into this office, I happily added pens to the cup of pens on the desk.  I also would bring in small notepads that I received in the mail from charities.  I was happy that I did not have to carry my house on my back to work each day.  My supplies would be waiting for me every morning at the desk, just where I left them.

I noticed that she never uses these pens or papers that I have brought in.  Sometimes she'll grab a pen and start writing, then suddenly stop, throw the pen, blurting, "Oh my God!  That's not my pen," and grab another one.

She has a box of name-brand tissues on the desk.  One day I had really bad allergies and used the whole box.  The next day I brought in an identical replacement box of tissues.  She also brought in another box.  So now there are two boxes of tissues on the desk.  One time she grabbed a tissue from the box I brought in.  Midway through blowing her nose, she said, "Oh no!  These are your tissues!" and grabbed a tissue from her box to complete the task.  She then took another tissue from her box and put it into my box.  "It's okay for you to use these tissues," I chirped, hoping that my intonation would make everything right.

"No, I have my own," she hissed.

As I write this, I'm remembering what she does with the magazines I bring in for the waiting room.  She puts them in a pile by themselves.  Other people donate magazines, which she combines into an eye-catching spread, while mine sit in a separate pile.  When people mix them, she comes through and segregates the magazines that I contributed.  Sometimes someone will ask why there is a separate pile of magazines.  The supervisor will say, "Oh, those are Enid's."  This is why people seek me out and ask if they can look at my magazines, as if I'm still exerting ownership.

I'm also remembering the wall calendars.  I received them in the mail and don't need so many, so I hung them in the little cubicles.  Every few days, another page was torn out of each calendar, until they disappeared entirely.  I replaced them, only to have the same thing happen again.  It was her I now realize.

I'm so glad that I thought of this now at the end of the year.  I am storing a bunch of calendars for the new year in a cabinet, planning to hang them soon.  I better remove them.  I really had no idea that such things were setting her off.

Ultimately, it's not about my personal stuff/office supplies.  She doesn't want ME there.  When she tells me to remove my personal items from my work area, she means me.  Myself.

This makes working here really difficult.

Saturday, December 19, 2015

How to Choose a Nursing Home for a Loved One

Choosing a nursing home to place a family member or friend can be very difficult.  You are placing a vulnerable person in the hands of strangers.  Will they treat her with kindness?  Will they make sure she is bathed, fed, and clothed?  Will they care for her medical needs, prevent conditions from worsening, and recognize when an emergency attention is needed?

The nursing home industry is a business.  The more that a company spends on attracting quality employees and providing good care, the less profit it makes.  People who run nursing homes are there to increase profits and while containing costs.  The goal is not to provide the best care, but rather to make the most money.

The quick explanation of how you will select a nursing home:
You start with the nursing homes in the geographical area that is most convenient for you to visit your loved one often.  You then visit all of these nursing homes and return several times to the ones you liked to take in the atmosphere and get a feeling for what the facilities are like on a regular basis.  You ask friends and neighbors what their experiences were in these nursing homes.  If you know any healthcare workers from the area, ask them for their experiences with these facilities or in dealing with patients who resided there.

If your neighbor who is a paramedic tells you that a certain nursing home has more fractured hip calls than any other, and the staff never seems to know what is going on, this is a Red Flag.

On your tours, you need to look at the staff- are they running around, frantic, understaffed?  Are they nowhere to be found?  Are they sitting around, talking on their phoens, ignoring patients?  Do not assume that every worker is a nurse.  Most are not.  Nursing homes schedule as few Registered Nurses as possible to save money.

Look at the patients.  Are they clean?  Do they look content, or are they yelling for assistance or attention?  Do they have something to do, or are they crammed into a little room to watch a television?

Look at the environment.  Is it clean?  Welcoming?  Conducive to the flow of people with wheelchairs and walkers?  Remember that a "Secure Unit" for Alzheimer's cannot have all the decorations and colors of other floors for safety and cognitive reasons.  (For example, a pattern on a floor or rug may be mistaken for a pit or splatter of dirt by someone with Alzheimer's, so the floors and walls on these units are usually bare.)

In the United States, most people look online to review official ratings from Medicare.gov, which are based on inspections.  [For clarification, Medicare does not cover long-term nursing home placement.  It covers short-term rehabilitation in a nursing home setting, such as recovery from a stroke, open-heart surgery, or a fractured hip.]

As someone who has worked for years during such inspections, let me clarify the implications of the ratings.

During a survey, the inspectors look in the different areas of the nursing home to see that the physical building and the staff are presenting a "good show."  That is, someone in charge knows what needs to be demonstrated, and a bunch of other people have agreed to participate in the show during the inspection.  Extra staff is standard during an inspection.  Chart reviews can't be faked during the actual inspection, but a facility that is survey-minded will have someone reviewing charts year-round and making corrections before the chart is seen by an inspector.

So a high rating from an official inspection does not automatically translate into great patient care, and a low rating does not indicate poor care.  It means that the company that owns the nursing home had the wherewithal to pull things together in that facility in time for the inspection.

Don't be impressed by the furniture.  Google "nursing home furniture" and you can see that the plastic mauve sofas and coordinating curtains are standard issue.  Be bothered if the furniture is falling apart.  The budget for the appearance of the nursing home is the last thing slashed.  If the place is in disrepair, the budget for patient supplies was slashed long ago.

Ideally, you will decide on a nursing home before placement is needed.  You need time to make your inspections and become comfortable with your decision.  Waiting until your mother fractures her hip or has a stroke is a really bad time to try to evaluate nursing homes.

If your loved one ends up in the hospital from home and needs a discharge to a nursing home, let the healthcare team at the hospital know right away which nursing home you want.  Sometimes the case manager or social worker sends a patient to a nursing home without telling the family about the pending discharge or without letting the family know that you have a choice of nursing homes.


Meeting with the Big Wig

[This post is a little out of order because I forgot to publish it.  I met with the Director of Nursing shortly before she quit to get my job description.  At the time, I didn't know she was quitting.  When I called for the Director to meet with the wound care specialist, the Director was secretly meeting with some important people to plan her departure from the hospital.  This was to remain a secret until her official announcement a few weeks later.  This is why the union rep became so angry and accused me of lying when I said that the Director's secretary said she wasn't in the office.  It was quite a coincidence because I rarely called the Director and she rarely budged from her office.]

***

I had a little meeting with the Director of Nursing.  A union person was present when I arrived- I had not sought one out.  I think that the union is on the side of the hospital and not mine.

The director gave me a description of my "job duties," as she called it.  She printed it off the internet from an article titled, "What do nurses do?"

I sought clarification about my specific tasks and who is my boss.  "People from all over the hospital- different departments, different titles- call daily and order me to do random tasks.  I can't tell anyone to do anything, but it seems that everyone is my boss and every job is my responsibility."

"Well," she sighed, "Your daily duties will differ from that printout as necessity warrants."

I asked why she wrote in an email that I am not permitted to give direct patient care.

The union rep started panting and rolling her eyes.  "We have a HIPAA issue here.  You can't go around the hospital, sticking your nose into patients' charts.  Really, you violate the HIPAA rights of patients when you monitor wounds."

"HIPAA rights?  I work here, and going through charts and following up on the cases of my assigned doctors my main job responsibility.  What about the patient's right to medical treatment?  The right for wounds to heal instead of worsening?"  I was pissed.  She actually thinks that the ward nurses who did not tend to the patient are right, while I am wrong for privacy violations?

The director had lost interest and was playing Candy Crush on her phone.  I stared at her for a moment to see if she had any more interest in me or the worsening wounds, but she didn't look up.

The union rep said, "We settled this issue, that you can work with the doctors assigned to your office, but you CANNOT be on a ward or helping a patient at any other time.  Yet you just had to re-hash the issue, trying to get the medical director to let you violate more patient rights."

"The wound care doctor did all that, not me," I said.  "He spoke to the medical director, not me.  I called into this office to speak with the Director of Nursing, but the secretary said she wasn't here."

"Of course she was here that day!" the union rep blurted, angry.  "When the medical director came to us that same day and told us that you needed to resume wound monitoring, our first thought was, 'Why the hell didn't she come to us first?'  You report to nursing, not medical."

The union rep stared at me.  The Director of Nursing continued fingering her phone.

I got up and left.



Worst Eight Hours Every Day

Thank you everyone for your notes and comments.

The last few weeks have been utterly exhausting and life-draining.  My health issues are acting up, coinciding with work issues acting up.  Ironically, I must continue working to keep the health insurance to treat the conditions that the job is causing.

I have no idea how to get another job.  None.

Plus, there is hardly any sunshine.  The sun comes up after I'm at work and is setting as I leave.  I go to bed when I get home and somehow still have to drag myself out of bed over twelve hours later to schlep back to the Snake Pit.

Many stories to come.

Saturday, December 5, 2015

Karma

Karma.

The Director of Nursing retired.  The day after her last day of work, she landed in the ICU with a stroke.  She's on life support and the prognosis is grim.

People said it was strange that she left when she had amassed a lot of paid time off and could have elected a terminal leave of absence.  She would have been out for months, with full pay, as she used up all of her paid time off until it was depleted, at which time she would be officially retired.

(Newer employees, such as myself, have paid time off in the form of "use it or lose it" at the end of the year.)


Friday, December 4, 2015

Illogical Assertions

When I schedule appointments and procedures, I work within the confines of the psych ward's unique schedule.  This translates into a small window of opportunity from around 9:30 in the morning through noon.  Unfortunately, some doctors and locations do not bend to our timeframe.

A nurse called me, yelling about a patient's 7 am slot for Same Day Stay.  "That's when they do those procedures," I explained.

"We cannot get the patient there so early," the nurse insisted.  "People have to come in, get settled, eat breakfast, then see what has to get done."  She was talking about the staff, not the patient's needs.

"Oh well," I answered.  I'm done.  They are so ego-driven and obsessed with finding offense and insult in every task.

For an appointment scheduled later in the day, an orderly came to me and yelled at me.  This is not the first time she has done this.  The first time, I explained that certain procedures and surgeons are scheduled very early or very late beyond my control.  Her assignment to escort these early or late events is also beyond my control.  Instead of accepting my explanation and realizing that she was complaining to the wrong person, she continued yelling at me and continues to return to me whenever she is assigned an early or late medical escort.

First, she's an orderly.  I'm the nurse.  I don't take orders from her.  Second, her job is on a ward, not in my office.  She is neglecting her duty when she leaves her assigned area to come into mine to berate me.  Third, if she has a problem with her assignment, she needs to address it with the shift supervisor, not me.

I ignored her intrusion, so she told her tale of woe to a lazy bitch in a nearby office.  "That girl won't listen to me" and "Someone should teach her how to do her job" were uttered at high volume.

I saw a frustrated woman.  Her plan of action to remedy a perceived trespass against her was to yell at me.  When her behavior changed nothing, she continued the same, continuing to yell at me when she was assigned an early or late escort.  She's an idiot for not grasping that her method needs modification.  She's also an idiot for thinking that her job is so secure that she can abandon her post, harass a nurse, and protest a simple task.

I don't see this institution surviving much longer.  Someone like her is unemployable elsewhere.