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  #41  
Old 9 April 2019, 15:39
Devildoc Devildoc is offline
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Originally Posted by CAVmedic View Post
That pretty much sums it up where I work too.
That's a 'management' problem, not a 'nursing' problem. Schedule needs to be staffed, people need to be accountable, and not everyone gets Saturdays and Christmas off.
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  #42  
Old 10 April 2019, 01:16
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KimberChick KimberChick is offline
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Originally Posted by Devildoc View Post
That's a 'management' problem, not a 'nursing' problem. Schedule needs to be staffed, people need to be accountable, and not everyone gets Saturdays and Christmas off.
I started at a hospital as a patient transport a little over 3 weeks ago. Some of the nurses are absolutely deplorable. No people skills whatsoever. I have stood in front of a nurse on more than one occassion waiting for her dumb ass to stop looking at Facebook so I can find out whether or not the patient is ready to be moved.
I spend a lot of time in the ER. I know when the nurses who work and do a good job are off. It is blantantly obvious.
There is an entire floor of nurses that refuse to move patients, despite the fact that there are far more of them than there are of us (transporters). They have gotten so lazy and overpriviledged now it make me ill.
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  #43  
Old 11 April 2019, 23:44
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Originally Posted by KimberChick View Post
I started at a hospital as a patient transport a little over 3 weeks ago. Some of the nurses are absolutely deplorable. No people skills whatsoever. I have stood in front of a nurse on more than one occassion waiting for her dumb ass to stop looking at Facebook so I can find out whether or not the patient is ready to be moved.
I spend a lot of time in the ER. I know when the nurses who work and do a good job are off. It is blantantly obvious.
There is an entire floor of nurses that refuse to move patients, despite the fact that there are far more of them than there are of us (transporters). They have gotten so lazy and overpriviledged now it make me ill.
That’s in every profession, since the beginning of time.
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  #44  
Old 12 April 2019, 07:57
Devildoc Devildoc is offline
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Originally Posted by KimberChick View Post
I started at a hospital as a patient transport a little over 3 weeks ago. Some of the nurses are absolutely deplorable. No people skills whatsoever. I have stood in front of a nurse on more than one occassion waiting for her dumb ass to stop looking at Facebook so I can find out whether or not the patient is ready to be moved.
I spend a lot of time in the ER. I know when the nurses who work and do a good job are off. It is blantantly obvious.
There is an entire floor of nurses that refuse to move patients, despite the fact that there are far more of them than there are of us (transporters). They have gotten so lazy and overpriviledged now it make me ill.
You're absolutely right, that is unfortunate that that happens and it happens more often then it should. Again, a management problem.

Organizational culture is usually set from the top down with continuity and leadership and management. That's not just in the medical field, that's everywhere. So that hospital that you were in, I bet it has a crappy president or CEO. Ultimately that person is who allows that culture to flourish.
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  #45  
Old 12 April 2019, 08:13
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EchoFiveMike EchoFiveMike is offline
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I read this whole thread and I find myself asking, what's wrong with the usual solution to lack of quality workers/no one wants to work weekends/night/etc? Open the fucking wallets.

US society has become completely entitled to cheap labor and this is the result of turning everything into a commodity.

And no, don't even bother with the nonsense argument that "they're paid damned well." YOUR opinion (or mine for that matter) on what they're paid is completely irrelevant to the market forces which should be driving their pay ever upward in response to demand, and finite supply. There's just too many unhealthy people, seems to be the real problem.

Because some pogue at United Healthcare makes more $ by shorting wages to nurses(or whoever) is not a valid reason, nor does it have anything to do with "market forces." It's exercise of power in a cartel system. S/F....Ken M
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  #46  
Old 12 April 2019, 12:36
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I enjoyed perusing these posts. While I have not worked as an EMT or SAR or Ski Patroller for many years now, my niece and her husband just move to Longmont, Co a few years back where she is the charge nurse at the ER in the new hospital there. She is still young, thirtyish, and I pray she can maintain her skills and humor as long as some of you have.
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  #47  
Old 12 April 2019, 21:04
Jakers Jakers is offline
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Originally Posted by EchoFiveMike View Post
I read this whole thread and I find myself asking, what's wrong with the usual solution to lack of quality workers/no one wants to work weekends/night/etc? Open the fucking wallets.

US society has become completely entitled to cheap labor and this is the result of turning everything into a commodity.

And no, don't even bother with the nonsense argument that "they're paid damned well." YOUR opinion (or mine for that matter) on what they're paid is completely irrelevant to the market forces which should be driving their pay ever upward in response to demand, and finite supply. There's just too many unhealthy people, seems to be the real problem.

Because some pogue at United Healthcare makes more $ by shorting wages to nurses(or whoever) is not a valid reason, nor does it have anything to do with "market forces." It's exercise of power in a cartel system. S/F....Ken M
Actually, in many hospital systems employees (mainly nurses) are paid a night differential for working nights.

The wallets have been opened in many cases.

There are multiple problems in healthcare ranging from social to financial to misunderstanding of duty to managerial, but discounting the social/misunderstanding of duty does major harm to finding any solution.
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  #48  
Old 13 April 2019, 04:54
justamedic justamedic is offline
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I like E5M’s take the best.
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  #49  
Old 13 April 2019, 20:55
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^They get a bonus and an additional $7 an hour for picking up certain shifts where I work. Sound pretty good to me.
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  #50  
Old 13 April 2019, 22:35
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I've been in medicine in one way or another for over 20 years. It has changed, and the changes reflect our self absorbed and impatient society. People want instant gratification and zero defect, but you can't have both... electronic medical records tend to be a huge time suck for clinicians, and suck for patient care, though they are superb for billing... nursing has been dumbed down due to the insane state of medical malpractice litigation in this country. Don't get me wrong, I have TREMENDOUS respect for nurses, ESPECIALLY ER nurses, but it seems that nurses are less and less able to use judgement and more and more beholden to protocols and practice limitations, which is bad for patients.

And the acceptance of violence against healthcare workers in the ED has to stop. Hospital administrations need to take action against patients and/or family members who attack healthcare workers, and need to stop punishing those who defend themselves.

Burnout is real, and is going to have long term consequences on the medical profession that we aren't really going to understand for another ten or fifteen years. Hopefully it won't be too late by then...
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  #51  
Old 14 April 2019, 12:08
Devildoc Devildoc is offline
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while the money is very important, it's certainly not the only factor. When I started in the emergency department there had been a change over in management and a turnover rate of 50% with nursing. We had combat pay, for certain shifts that was double time plus 15%. I made serious bank in those days.

Although money will draw an employee, employees usually leave because of culture or leadership issues. At least that's the way it is in nursing.

Where I work now, it's an administrative job so I don't have the shift differential or overtime, but I love my bosses, I get all the time off I want, and they're very supportive. So, I have no real desire to leave (but since I'm getting my master's degree in 3 weeks, I will because I need to get a different job).

The unicorn is to find the clinical environment, with the culture and leadership, and with the money. Those places do exist, but those are the exception and not the rule. Most units are just okay.

What is interesting is that patient outcomes have been correlated to nursing satisfaction, that the more supported a nurse feels in their unit and the more they like their job, the better the patient outcome. This has been recognized by accreditation agencies and by insurers, so these things get measured now and have to be reported. Managers are under the gun to improve satisfaction scores. That said, there is a long, long way to go.
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  #52  
Old 16 April 2019, 10:32
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litepath litepath is offline
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Devildoc it's not only nursing.

Pay does attract, but job satisfaction/morale will keep the nurse. There is always some other place that will pay better. A lot of nurses don't want to move, or travel, so they're stuck in podunk-whathaveyou, GA.

Opening the wallet is a portion of it though. It's the easiest way to fix a situation NOW. Many facilities give lip service to that idea. $7? Hahaa. You go do that work and then come back and tell me how that was compensation enough. Take Kimberchicks assessment. You're nursing, trying to do your job and then trying to get everyone else off their ass to do their job; Every. Fucking. Shift. Ever wonder why Docs seem to be in a bad mood? Try dealing with lazy nurses giving lazy/shitty info as often as every minute all day. Why more Docs don't quit or jump out a window is lost on me.

Protocols are what protect nursing licenses (amongst other things). Just wanted to throw that out there so it is understood for what it is (general reader).

The Unicorn Devildoc was talking about has been explored somewhat in Atul Gwande's book, Complications (back in the late 90's?). Good read, highly recommended.
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  #53  
Old 17 April 2019, 08:56
Devildoc Devildoc is offline
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Devildoc it's not only nursing.

Pay does attract, but job satisfaction/morale will keep the nurse. There is always some other place that will pay better. A lot of nurses don't want to move, or travel, so they're stuck in podunk-whathaveyou, GA.

Opening the wallet is a portion of it though. It's the easiest way to fix a situation NOW. Many facilities give lip service to that idea. $7? Hahaa. You go do that work and then come back and tell me how that was compensation enough. Take Kimberchicks assessment. You're nursing, trying to do your job and then trying to get everyone else off their ass to do their job; Every. Fucking. Shift. Ever wonder why Docs seem to be in a bad mood? Try dealing with lazy nurses giving lazy/shitty info as often as every minute all day. Why more Docs don't quit or jump out a window is lost on me.

Protocols are what protect nursing licenses (amongst other things). Just wanted to throw that out there so it is understood for what it is (general reader).

The Unicorn Devildoc was talking about has been explored somewhat in Atul Gwande's book, Complications (back in the late 90's?). Good read, highly recommended.
When I was manager of the surgery-trauma ICU (worst job ever, and I had some shitty jobs in my life), because we couldn't influence pay, we tried other things: preferential PTO, job-sharing, etc. Some worked, some didn't, but overall unit culture scores went up because staff felt like leadership was paying attention to their needs.

Everyone likes money so the more the better. Until you can get rid of the shit-bags though and make it a better environment, sometimes money is all you got. Retention is the bane of every manager's existence; while good attrition is healthy, bad attrition is not. Even good attrition can be detrimental, we see that in the ICU's where RNs get their one or two years of experience before jetting off to CRNA or NP school.
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  #54  
Old 17 April 2019, 10:46
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You're right in all that.

I know I sound like a complainer (and am).
Truth is, team effort is vital to the workings of the avg. ICU (all I have experience in). We need Respiratory, X-ray, Lab, Pharmacy, Hemo, MRI/CT, et al to do their job and stop questioning every last order trying to find a way not to accomplish the task at hand. Never mind the laZy nurses.

I've always said I'd rather work short of staff with great folks than fully staffed with shitbags. Both are more work but the short staffing at least leaves you with a sense of accomplishment at the end of the day.

It's culture! And culture is created and maintained by good leadership.
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  #55  
Old 17 April 2019, 11:56
Devildoc Devildoc is offline
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You're right in all that.

I know I sound like a complainer (and am).
Truth is, team effort is vital to the workings of the avg. ICU (all I have experience in). We need Respiratory, X-ray, Lab, Pharmacy, Hemo, MRI/CT, et al to do their job and stop questioning every last order trying to find a way not to accomplish the task at hand. Never mind the laZy nurses.

I've always said I'd rather work short of staff with great folks than fully staffed with shitbags. Both are more work but the short staffing at least leaves you with a sense of accomplishment at the end of the day.

It's culture! And culture is created and maintained by good leadership.
Heard, brother. I complain about it, too. Shitty and lazy nurses who know how to work HR to their benefit is one reason I left the manager position.

I laughed at your comment bolded/italicized above: I always said that the amount of time trying to get out of doing a job is about five times longer than if you just did the damn job.
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  #56  
Old 26 April 2019, 10:13
schibbs schibbs is offline
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A conversation we had yesterday with my oldest sister was rather sad. My niece, who was a charge nurse (ER) at a new hospital in Longmont, Co, called my sister the other night. My niece has had a rough couple of years in her ER. Her fellow nurse and friend's husband , a PM and former Seal with the FD, killed himself last year. Another nurse (male) recently tried to OD in the ER on pills, he was on some sort of alcohol treatment. Another member of the nursing staff is under scrutiny for stealing meds. My niece is beside herself trying to staff the ER with competent , healthy individuals!
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  #57  
Old 15 May 2019, 04:34
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https://www.wlfi.com/content/news/Pu...509939561.html

Good too see Purdue striving to meet the need.
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  #58  
Old 15 May 2019, 07:28
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So. . .My wife just started an orientation to her new facility.

Day 2 the majority failed to read their schedule and were late to the days first planned meeting. My Wife and two fellow nurses showed.

The therapist, an admin person, 3 nurses and all the med techs failed to show at the appropriate time.

Strong ethic.
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  #59  
Old 15 May 2019, 07:32
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My daughter got a paid externship for the summer in the ortho ward of one of the local hospitals. She's between years 1-2 of her RN program. So far she's killing it.

Typical good attitude from her about it. She has to have both hips replaced, so she opines that at least she'll know how the ortho ward runs once she's a patient. All the steroids from her bone marrow transplant fried her femur heads.
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  #60  
Old 15 May 2019, 08:30
Devildoc Devildoc is offline
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https://www.wlfi.com/content/news/Pu...509939561.html

Good too see Purdue striving to meet the need.
Other programs are doing similar things, but adding that many students is YUGE. Nursing schools are constrained by accreditation agencies regarding faculty-student ratios, and a lot of places skirt by hiring CIs (clinical instructors), nurses with whom students can be paired but who are on the payroll of hospitals so nursing schools don't have to pay bennies, just an hourly.

Nursing schools are getting very creative in trying to meet demand.
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