Showing posts with label ED. Show all posts
Showing posts with label ED. Show all posts

Saturday, May 16, 2015

PressGaney Kiss My Ass! This Isn't the Hilton or Burger King! You Can't Have It Your Way!

The ED isn't Burger King!  You can't have it your way!  This is medicine not fast food.  You can't drive through and special order your care.  And you certainly cannot do it when you are refusing exams or testing!   So I'm sorry management if you get an unhappy customer because they refused an exam by a provider for drip from below.  I'm not sorry that we do not just give meds to people without evidence of illness....  oh wait... you changed your mind and you are now telling me to just give the patient the meds... without an exam, without the urine specimen that you told them they needed.  

Oh wait patient you're pissed off at me and calling me derogatory names and referring to our hospital as the ghetto hospital because you are upset that you didn't have faster service in the ED..  you've been here an hour.  You had a nebulizers and spent most of the time arguing about how the college educated staff doesn't care about you.  Love how you wasted your nebulizer telling me that I'm a racists because I am not the same shade of you and how I didn't provided you with anything..  I just spent 15 minutes listening to you complain and tell me how you are smart and know what you need, yet you can't tell me what you need.  Thank you for wasting my time and the time of my other patients who actually need help.

PressGaney and happy endings have two things in common--- you get jerked around a lot and in the end are you really satisfied or is it just pity service? 




Sunday, April 27, 2014

Good Bye ER It's been real

I've always had a love for the ER.  In my opinion there is nothing like the ER.  It is unpredictable and things can change on a dime.  I loved getting train wrecks and working with providers to stabilize them.  Unfortunately I had to walk away from my ER job the other day.  It wasn't because of the patients.  A bad day in the ER is never in my opinion because of the patients.  A bad day in the ER is because of a broken system.  Perhaps my ideals are just not in line with the world of Emergency Nursing.  Perhaps I had too much faith and hope that ENA would advocate for better conditions for ER patients, and really start promoting leadership amongst the ranks of the staff nurses that would force nursing management to grow a spine.

On to new challenges and a new environment.  Its time to step away from the toxicity and into the unknown.

Sunday, October 13, 2013

Leadership Is A Lost Art In The Wake Of Middle Management

Many, many years ago the career field of nursing had leadership as a core value, but over the years reorganization and redefinition of management has suffocated the concept of leadership.  Gone are the days when you looked to your fellow staff nurses for mentorship.  Today's concept of nursing has ultimately killed the bond that drew us all together and it is weakening our very foundation.

When I look around at work there are very few leaders.  By leaders I don't mean managers.  In my opinion the two words have completely different meanings, although in today's hospitals nursing leadership is comprised of managers which is unfortunately an oxymoron most of the time because nursing managers rarely lead, they follow the hire up administration's agendas.  Perhaps that is why there are floors closed to accepting patients because there "isn't enough staff" which causes emergency department patients to sit waiting for hours for beds.  Lean staffing was a concept of management, certainly not nursing leadership.  What good nurse would ever want to subject patients to the hell of the dreaded hallway bed for hours?  Where is leadership advocating for the patient's safety and wellbeing?

I recently had an experience with three nursing managers.  Two of the managers were assistant nurse managers and the other a supervisor in the ED.  I had a critically ill patient who was bottoming out.  The patient's heart rate dropped to 32.  I had five patients to contend with at the time, and my neighbor, a new graduate just off orientation had five patients of her own.  Having informed the three managers who were sitting at the nurses station of the situation with my patient, and seeing how my neighbor looked a bit like a deer in the headlights, I asked my neighbor to ask one of the three manages to come over and assist me.  When my neighbor returned she informed me that they refused to help.  Wow was I blown away, well not really.  This is how our management is.  They are managers not leaders.

About an hour into pacing this patient and starting dobutamine, yes DOBUTAMINE, on this patient, one of the managers shows up.  She is eating popcorn, and coughing.  She tells me, "I'm choking on my popcorn", I shoot her a look which probably included an eye roll and I inform her that I needed her help an hour ago.

Her response to me is cold.  She lashes out that "I'm here now".  My response to her was "I needed you an hour ago".

During this hour that has transpired I had patients who were in pain, physicians trying to call in orders and other patients who had room assignments that needed report called, but I was tied up with a critically ill patient who was in dire need, yet for that hour my patients' needs, my call for assistance was less important than popcorn.

Just because one holds the title of manager does not make one a leader.  Leadership comes from within, regardless of rank, title or pay status.  Unfortunately true leadership has been left to the waste side, abandoned for some alien concept of leadership.