Monday, October 31, 2016

Rousing the Evil Dragon, Part Two

One day after emails where I clarified that administrative nurse Wilma controls policy, the psych ward had a real emergency.  The person died.

Normally they page me frantically, expecting me to swoop in and magically save the day.  I don't know where this idea came from.

But for this real emergency, I did not hear about it until I was leaving for the day.

Again the director of the hospital was standing outside when I departed.

"We had a death today," he started.

"Oh," I answered simply and without interest, trying to convince him that this had nothing to do with me.

"We could not find certain medications and supplies," he continued.  I said nothing.  "So tell me, if you are doing your job of making sure that we have everything we need in an emergency, why was it that we could not find necessary medications and supplies?"

I was panicking on the inside.  They botched a code and were blaming me.  This is exactly what I feared when this responsibility was forced on me.

"What couldn't you find?" I asked.

The director named some medications and supplies.  There isn't necessarily a connection between the "missing" items and the outcome.

"You didn't find any of those items because we don't have them in psych," I answered.  Maybe I could be vindicated.

The director hesitated.  "Don't you think those are necessary items for an emergency?"

"I'm not sure," I replied.  "I don't have any experience in emergency nursing."

"Then why are you in charge of emergencies?" he was loosing his composure.

"Because Wilma in administration said so," I replied.

"So why didn't you make sure that people have what they need to appropriately respond to an emergency?" he continued.

"I don't have that authority," I explained.  "Wilma revised the policy.  She eliminated a lot of items, so I can't get them."

"Why didn't you tell anybody?" he asked.

"This was no secret and I did tell a lot of people, including you," I said this carefully.  "You were at a meeting about this and you said that you cannot override a nursing policy because you are not a nurse and will instead defer to Wilma's judgment."

"You have the old policies?" he asked.

"Yes, I do.  They are also on the hospital's intranet, so anyone can access them."  I added, "I have all the emails about my objections to this revised policy, as well as Wilma's and your responses that the policy will stand as she rewrote it."

He stared at me.

"And don't bother to delete my email account here at the hospital.  You'll see that I forwarded all those emails to my private email account.  There are multiple electronic and hard copies," I continued.  "I started preparing my defense to this situation as soon as Wilma put it on me a year ago."

"I'll look into this," he said and walked away.

It was risky taking such a hard stance with the director.  But I can lose so much if the hospital blames me for this incident.  Maybe if they think that I have documents that exonerate me and make Wilma look bad, they won't pursue action against me.  I'm sure that the director does not like Wilma.  This does not mean that he'll sacrifice her over me, but I have to look like a fighter and not a doormat because this is serious.

Sunday, October 30, 2016

Rousing the Evil Dragon, Part One

Earlier this year I was appointed responsible for emergencies and anything that anyone thinks could be related to an emergency.  I have no authority; I am just supposed to be the scapegoat.

The main witch who spearheaded this effort is a nurse in administration, "Wilma."  A few weeks ago, Wilma forwarded me a string of emails of people's usual lack of knowledge about handling emergencies and finding supplies and forms.  Wilma asked me to explain how people could find certain forms and policies.  One of her responses to an inquirer: "I have no idea where Nurse Enid put them.  One would think that she would make them easily accessible to everyone, but that is not the case."

I replied, "The forms and policies pertaining to emergency services, which you authored, are on the hospital's intranet where you put them."  I sent the email to Wilma, the inquirers, and hospital administration.

Wilma emailed only me.  "What is your problem?" and "You do not have permission to email administrative personnel."

I forwarded Wilma's email to hospital administration with a copy to her so she could see that I did it.

As I left for the day, the director of the hospital was standing in the front of the building.  "What is going on in those emails?" he asked.

I answered cautiously, "It seems that Wilma has forgotten that she drafted a certain policy."

He said, "It's good for her to be reminded of the truth."

I walked away.  It sounded like he was on my side.

Just in time for a code the next day . . .

Thursday, October 20, 2016

And Peace for All

One of the doctors loves this combination of injections to calm a person down:  diphenhydramine (Benedryl), lorazepam (Ativan), and haloperidol (Haldol).

But he doubles the doses of haloperidol and diphenhydramine as seen in the picture.

One person can throw an entire floor into chaos.  It's nice to work with someone who wants to help everyone relax.  Not all doctors will medicate a person who is out of control, forcing the entire ward to ride out the storm.

Sunday, October 16, 2016

Union of Sheeple

Just in case you didn't think that the union was in cahoots with administration:

Urgent meeting called by the union.

The hospital wants to change our health insurance.  Without hearing anything further, I guessed that the "new" plan will cost the hospital less and the employees more.

The union rep said, "It's a pretty good plan and it will actually cost us less per paycheck than the current one."

"We have a good plan, one of the only good things about working here," I offered.  "How much less does the new plan cost us?"

The union rep flopped around and finally came up with a number:  $20 less per paycheck.

"Doesn't the 'new' plan have an annual one thousand dollar deductible before paying anything, including routine office visits from in-network doctors?" I asked.

"Well, yes," the union rep said.  "But the current plan also has deductibles."

"Not for in-network providers," I replied.  "You only pay a deductible when you go to someone who is not in the plan."

"Well, it's still a savings," the union rep continued.

"No, it is not," I asserted.  "We have 26 paychecks per year.  Multiply that by $20, and you save $520 in premiums.  But then you have to offset that against the new thousand dollar deductible and the higher office copays.  This new plan will cost us more."

The union rep was growing angry.  "All I know is that I cannot afford to have any more money taken out of my paycheck."  The sheeple nodded their heads.  Some glared at me.  "We HAVE to vote yes in this situation," she stated.

She probably made a side deal with administration to get the union to say okay to the new plan.

Her salary is also at least $30,000 more per year than mine as specified in the union contract she helped draft.

Monday, October 10, 2016

How to Undermine Performance

This article about a student's nightmare internship details some of the same attacks that are used at my job.

1-  The supervisor said that she had never seen the intern do any work.  The implication is that the intern does no work.  When the intern pressed the supervisor to explain, she denied any wrongdoing, explaining that she had never seen her work with a client because she never observed her in the private counseling room and had no intentions of doing so.

People do this at my job all the time.  They report, "I did not see So-and-So doing that" to convey that the task was not done.  When confronted, they will justify the answer with "I was not in the room when you did that, so I did not see you."  However, when spreading rumors, not being in the room and not witnessing an act does not disqualify someone from asserting its truthfulness.

The other shade of this technique is to say, "I don't know where So-and-So is," implying that the person is missing from an assigned work station without permission.  When confronted, the instigator will reply, "I know you said you were escorting a patient.  But I was not with you, so how would I know where you were?"  And no, they can't say, "So-and-So left ten minutes ago to escort a patient."  They have to make trouble.

2-  The supervisor accused the intern of not being successful in patient care.  When the intern showed evidence of her effectiveness, the supervisor explained that any success was do to the intern's improper behavior with clients and not because she is a good therapist.

At my job, other employees get upset and angry if they see that I have a positive rapport with patients.  They accuse me of buying cooperation from patients with money, gifts, or flirtation.  They can't accept that treating patients as human beings would positively impact behavior.

Saturday, October 1, 2016

Owning Overtime

In case I had any hopes that the union for nurses could ever be on my side, that is gone.

On Friday afternoon, a supervisor asked me to work the weekend for overtime on the floor.  "Nurse Megan has been out sick all week.  She usually covers this weekend, but I haven't heard from her yet, and I don't want to be short."

I asked, "What if she shows up?  Do I go home without pay?"

"No, I'll just move you somewhere else where it's wild," the supervisor said.  (Not that her guarantee of today would exist tomorrow.)

I came in Saturday and worked the shift without Nurse Megan appearing.  As the shift neared its end, the supervisor told me that Nurse Megan called, upset that her overtime shift was given away, and demanded that she work tomorrow.  "So I don't need you tomorrow," the supervisor commanded.

On Monday, we had a nurses' union meeting.  The people who take $50 out of my paycheck in return for . . . nothing.

Nurse Megan made an appearance and declared, while glaring at me, that her overtime was taken away and she wanted to file a complaint against the supervisor who did it.

There were gasps in the room.  Some people offered pity, others angrily demanded to know the name of the supervisor who did this.

"Megan, I worked Saturday because we didn't know if you were going to show up or not because you had called out sick all week.  The supervisor said she would keep both of us if you came into work, but you didn't.  She then took my overtime away for Sunday because you said you wanted it," I explained to the unsympathetic crowd.

"I was not sick!" Megan snapped, annoyed.

"Oh, that's what the supervisor told me," I explained.  I recalled that she had been out all week.

"I called out sick, but I was not sick.  I had things to do.  I have a life, you know," Megan hissed, rolling her eyes like an annoyed teenager.

"Of course we'll file a complaint for you!" the union rep chimed in.  "We protect the rights of our nurses."

"I'd like to file a complaint, too," I chimed in.  The group turned and stared at me.  "My overtime for Sunday was taken away."

"It wasn't YOUR overtime," Megan yelled.  "You don't own overtime."

"But you do," I said to Megan.

"Yes.  I've been working overtime since before you ever started working here, so it is mine and not yours," Megan quipped.

"Okay, so Megan," the union rep interjected, "We'll file a complaint for you to be paid for the shift that was taken from you at the overtime rate of time and a half, plus ask for double as a penalty for giving the shift away to Nurse Enid."

"You want the hospital sanctioned for giving me overtime?  I'm also a nurse that you represent," I admonished.

"Well, they were wrong," the union rep answered.  "We can't make demands without stating the facts, so we have to give the name of the nurse who took the overtime, and that was you.  There are rules."

"What rule says that you get paid for not working a shift that you are not scheduled to work?"  The union rep didn't answer, so I continued, "There is a rule that says that sick days can only be used for illness, not running errands."

"We are all on the same team here," the union rep said.

"And what is my position?" I asked.  "Odd man out?"

So I left.  But first I went over to the refreshment table and placed a bunch of bagels and cookies in a bag and carried it out.  Breakfast for a week, but still not a recoup of the $50 from this paycheck.