Nursing - throwing everyone else under the bus?

[Truthspeaker]

I've been around and I know. They do it to doctors, they do it to pharmacists and they even do it to the girl bringing the patient food trays to the floor.

If the doctor isn't on the floor yesterday for a patient problem that came up 5 minutes ago, you better believe that RN is typing up a narrative how you were made aware and did nothing about it. It doesn't matter if the RN already has orders to treat the problem, they still like to document it first then give a lengthy handoff to the other nurses. It ain't just docs being tossed under the bus...

If you are a pharmacist and you take too long to send that stool softener upstairs, your dispensing issues will be documented in that patient medical record. They may even send a nasty email to the Med Safety officer who is probably an RN.

Entry level positions aren't safe either. If you are bringing the patient a food tray and it is 30 minutes late because the patient wanted double eggs, double bacon and a slice of pie despite their cardiac diet, there will be a Safety Event filled out about how the RN had to give the meds late since they were recommended to be taken with food.

Is there any end in sight?

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[Osteoth]

I've been around and I know. They do it to doctors, they do it to pharmacists and they even do it to the girl bringing the patient food trays to the floor.

If the doctor isn't on the floor yesterday for a patient problem that came up 5 minutes ago, you better believe that RN is typing up a narrative how you were made aware and did nothing about it. It doesn't matter if the RN already has orders to treat the problem, they still like to document it first then give a lengthy handoff to the other nurses. It ain't just docs being tossed under the bus...

If you are a pharmacist and you take too long to send that stool softener upstairs, your dispensing issues will be documented in that patient medical record. They may even send a nasty email to the Med Safety officer who is probably an RN.

Entry level positions aren't safe either. If you are bringing the patient a food tray and it is 30 minutes late because the patient wanted double eggs, double bacon and a slice of pie despite their cardiac diet, there will be a Safety Event filled out about how the RN had to give the meds late since they were recommended to be taken with food.

Is there any end in sight?

Nope. Nurses run the hospital. Befriend them or they'll eat you alive.

 

[flightnurse2MD]

Nope. Nurses run the hospital. Befriend them or they'll eat you alive.

Nurses are overworked and underappreciated. The extra scanning of meds before administration, finding another RN to witness insulin admin, nursing care plan documentation, etc...the documentation they are responsible for is getting worse and ridiculous. As a nurse myself, I sympathize with their plight. Doesn't excuse the behavior but it does explain it.

 

[ljkeeper]

Agree with flightnurse as I am a nurse myself but that kind of charting is a little overboard. The floor I work in doesn't seem to have problems like this, the rapport between the fellows, attendings, and nurses where I am must be quite a bit better. With that being said seems like truthspeaker is being a little dramatic.

 

[mistafab]

Dude stop tripping - they just some nurses doing their thing.

 

[kb1900]

Dude stop tripping - they just some nurses doing their thing.

If he’s being factual, it sounds pretty toxic.

Healthcare shouldn’t be about just shifting liability around the hospital lmao

 

[Psai]

If he’s being factual, it sounds pretty toxic.

Healthcare shouldn’t be about just shifting liability around the hospital lmao

Have you ever set foot in a hospital? 90% of the work is shifting liability around

 

[Mad Jack]

I've been around and I know. They do it to doctors, they do it to pharmacists and they even do it to the girl bringing the patient food trays to the floor.

If the doctor isn't on the floor yesterday for a patient problem that came up 5 minutes ago, you better believe that RN is typing up a narrative how you were made aware and did nothing about it. It doesn't matter if the RN already has orders to treat the problem, they still like to document it first then give a lengthy handoff to the other nurses. It ain't just docs being tossed under the bus...

If you are a pharmacist and you take too long to send that stool softener upstairs, your dispensing issues will be documented in that patient medical record. They may even send a nasty email to the Med Safety officer who is probably an RN.

Entry level positions aren't safe either. If you are bringing the patient a food tray and it is 30 minutes late because the patient wanted double eggs, double bacon and a slice of pie despite their cardiac diet, there will be a Safety Event filled out about how the RN had to give the meds late since they were recommended to be taken with food.

Is there any end in sight?

Sounds like you work with terrible nurses. Work at someplace better.

 

[Mad Jack]

If he’s being factual, it sounds pretty toxic.

Healthcare shouldn’t be about just shifting liability around the hospital lmao

When you get your medical license, let me know. I know a guy in medmal that would be very interested

 

[Mad Jack]

Better than the nurses where I do my rotations lol.

If something cray cray happens like 5ml zero foley output in 8 hours, they'll page a resident and not even wait. The moment they put the phone down, they'll immediately walk away and chart "resident paged about nursing concerns on foley output. Resident did not return page."

It's pretty hilarious. None of the core students ever match back here and the DME is wonder why they have a 0% retention rate of core students. Even the Board of Directors is pissed about the hospital's exposure to lawsuits over these practices. But unions..

Nursing unions are the worst. I don't get why any physician would work in a union facility post-residency.

 

[Matthew9Thirtyfive]

Nursing unions are the worst. I don't get why any physician would work in a union facility post-residency.

Even where there isn't a union, sometimes there is a de facto, albeit weaker one. When managers won't fire nurses because they are friends, you might as well have a union.

 

[Mad Jack]

Even where there isn't a union, sometimes there is a de facto, albeit weaker one. When managers won't fire nurses because they are friends, you might as well have a union.

Usually you can go over the immediate manager though. And often, the most problematic nurses are loathed by all.

 

[Matthew9Thirtyfive]

Usually you can go over the immediate manager though. And often, the most problematic nurses are loathed by all.

Not in my experience. Two different hospitals, there were nurses who did less than the bare minimum, made mistakes, etc. But they were friends with the OR manager, so they were on easy street. A great nurse who always told it like it was and wasn't afraid to tell the manager when something was FUBAR told a surgeon to get bent when he cursed her out, and she got fired the next day. Nurses will even throw each other under the bus if it's convenient.

 

[mimelim]

Not in my experience. Two different hospitals, there were people who did less than the bare minimum, made mistakes, etc. But they were friends with the *insert boss role*, so they were on easy street. A great person who always told it like it was and wasn't afraid to tell the manager when something was FUBAR told a surgeon to get bent when he cursed her out, and she got fired the next day. People will even throw each other under the bus if it's convenient.

Fixed your post for you. Insert any profession, gender, race, whatever you want. People are selfish. It should not come as a surprise that nurses (made up of people) function the same.

 

[Matthew9Thirtyfive]

Fixed your post for you. Insert any profession, gender, race, whatever you want. People are selfish. It should not come as a surprise that nurses (made up of people) function the same.

You didn't actually, since I was specifically speaking about very specific people who are nurses in a thread about nurses. That other people exist who are dinguses does not change the fact that some nurses are crappy, nor does that change the fact that some are great.

 

[mehc012]

I legitimately don't understand the 'underappreciated' descriptor of nursing. Seriously. My entire life, I've always seen advertisements on TV about how great nurses are, people talk about their nurses when they discuss prior healthcare visits (they only mention the docs if something was bad, usually), TV shows set in medical places always make a point to highlight that nurses are the ones who really run things, etc. Nurses have a massive PR machine working for them, and part of the message being spread so widely is the whole 'unappreciated' bit. Now, don't get me wrong, they're definitely overworked (as are many fields) and they are definitely crucial to patient care and also generally the face of the healthcare team to patients, but...I just don't see them as the 'unappreciated' players in the healthcare game.

 

[WingedOx]

What's up with all these types of threads lately?

 

[Osteoth]

Nurses are overworked and underappreciated. The extra scanning of meds before administration, finding another RN to witness insulin admin, nursing care plan documentation, etc...the documentation they are responsible for is getting worse and ridiculous. As a nurse myself, I sympathize with their plight. Doesn't excuse the behavior but it does explain it.

I feel like everyone thinks they're over-worked and under-appreciated in healthcare. Just the nature of the beast in a field where you are often times doings things to people for their own good that they might not like at the time.

 

[flightnurse2MD]

I feel like everyone thinks they're over-worked and under-appreciated in healthcare. Just the nature of the beast in a field where you are often times doings things to people for their own good that they might not like at the time.

Just like when I was kid and hated getting spanked. Now, I’m willing to pay for it...

 

[Roxas]

Just like when I was kid and hated getting spanked. Now, I’m willing to pay for it...

 

[psychMDhopefully]

Nurses are overworked and underappreciated. The extra scanning of meds before administration, finding another RN to witness insulin admin, nursing care plan documentation, etc...the documentation they are responsible for is getting worse and ridiculous. As a nurse myself, I sympathize with their plight. Doesn't excuse the behavior but it does explain it.

80k for a 2-4 year degree should be appreciation enough.

 

[psychMDhopefully]

I legitimately don't understand the 'underappreciated' descriptor of nursing. Seriously. My entire life, I've always seen advertisements on TV about how great nurses are, people talk about their nurses when they discuss prior healthcare visits (they only mention the docs if something was bad, usually), TV shows set in medical places always make a point to highlight that nurses are the ones who really run things, etc. Nurses have a massive PR machine working for them, and part of the message being spread so widely is the whole 'unappreciated' bit. Now, don't get me wrong, they're definitely overworked (as are many fields) and they are definitely crucial to patient care and also generally the face of the healthcare team to patients, but...I just don't see them as the 'unappreciated' players in the healthcare game.

Underappreciated means they don't get the money or glory that physicians get. They could, it would just require going to med school, residency and sitting for standardized test that are absolutely f'ing ridiculous.

 

[jw3600]

Nursing unions are the worst. I don't get why any physician would work in a union facility post-residency.

Post residency? **** that. I'm not going to a hospital with union nurses FOR residency.

 

[Perrotfish]

80k for a 2-4 year degree should be appreciation enough.

By this standard oil roughnecks and offshore oil platform workers also have amazing jobs.

Nursing, or at least floor nursing, is a legitimately difficult job. The hours are irregular, the work is physically taxing and frequently disgusting, the patients are always demanding and sometimes threatening, the bosses are numerous and frequently have conflicting demands, and finally nurses are in a position where they feel personally responsible for medical care which they may completely disagree with.

Basically nursing is residency, except that it's only 40 hours per week, you are exposed to more disgusting bodily fluids, and it never ends. If I was a resident forever, even at 40hours per week, I would feel underappreciated at 80K per year.

One other FYI: the average salary for a floor nurse is closer to 50K/year

 

[Delfia]

I'm a New Graduate nurse in the Emergency Department and I genuinely had no idea that documenting when I paged the doctor was a bad thing. I've always been told to document everything that I do, and that includes when other members of the interdisciplinary team are at bedside, when you have communication with other team members, when you've paged someone, etc.

I also found it useful to document who and when I paged so that I can look back and know if I've contacted everyone that I need to and when I did it. I would hate to pester or page someone at too short of intervals, but if I need to communicate something critical I won't feel comfortable not following up for extended periods of time. It can be difficult to navigate communicating pertinent information in a timely manner and doing what is best for the patient, while also recognizing and being sensitive to the fact that the doctor is incredibly busy themselves. When I document that I paged the doctor, it allows me to look at exact times and figure out just how important it is for me to get ahold of them. Is a followup warranted, or can it wait?

I never saw it as a bad thing, so I'm really glad that I stumbled across this website and post. I guess from now on I will write it on a piece of paper in my pocket or something. I wish people would be more open about hospital etiquette, or at least kindly let me know if I'm doing something that makes another team member look bad. I can't speak for everyone, but I think that many people just want to keep organized, not throw anyone under the bus. It would never be my intent to do that.

 

[mehc012]

I'm a New Graduate nurse in the Emergency Department and I genuinely had no idea that documenting when I paged the doctor was a bad thing. I've always been told to document everything that I do, and that includes when other members of the interdisciplinary team are at bedside, when you have communication with other team members, when you've paged someone, etc.

I also found it useful to document who and when I paged so that I can look back and know if I've contacted everyone that I need to and when I did it. I would hate to pester or page someone at too short of intervals, but if I need to communicate something critical I won't feel comfortable not following up for extended periods of time. It can be difficult to navigate communicating pertinent information in a timely manner and doing what is best for the patient, while also recognizing and being sensitive to the fact that the doctor is incredibly busy themselves. When I document that I paged the doctor, it allows me to look at exact times and figure out just how important it is for me to get ahold of them. Is a followup warranted, or can it wait?

I never saw it as a bad thing, so I'm really glad that I stumbled across this website and post. I guess from now on I will write it on a piece of paper in my pocket or something. I wish people would be more open about hospital etiquette, or at least kindly let me know if I'm doing something that makes another team member look bad. I can't speak for everyone, but I think that many people just want to keep organized, not throw anyone under the bus. It would never be my intent to do that.

There's a difference between documenting a page, and documenting them as being poorly responsive before a reasonable interval has passed for them to respond.

 

[Delfia]

There's a difference between documenting a page, and documenting them as being poorly responsive before a reasonable interval has passed for them to respond.

That makes sense, thank you for clarifying. I don't specifically document that I haven't heard back, I just put in the same blank note each time I page "Paged Dr at x5555 regarding xyz. Will follow up and continue to monitor pt" or something like that.

Its just my intent to make the communication as smooth as possible, and make life as easy as I can for everyone. It can just be so hard to know if I'm doing the right thing or not, especially since I'm new. Thanks.

 

[The Knife & Gun Club]

Just an interesting thought ...

I once worked with an attending who'd bring coffee and bagels for the nurses every week.

Her take was that its such a meaningful yet small statement that it was 200% with it. When you're on a team, it's better to have your teammates (aka nurses) appreciate you as she said.

Keep your friends close keep your enemies (or MVPs depending on the shift) closer I guess.

 

[NickNaylor]

A good nurse is worth their weight in gold. As previously mentioned, however, nurses are people, and people are found all over various spectra: kind vs. dingus, caring vs. checked out, intelligent vs. idiotic, and on and on. You will likely run into many horrible nurses - people that have no interest in patient care, won't do anything approaching being proactive, and are generally idiotic. By the way, you can find the same thing among physicians. You will also come across the rare nurse who is an incredible asset: intelligent, kind, provides meaningful input to the care team, and can perform their assessments well. The latter is a true asset.

Unfortunately, many people overestimate their abilities, underestimate the importance of interpersonal relationships in the work environment, and are incapable of working on a team. But this is not a problem limited to nurses. This is a problem with people in general.

The other thing to remember is that as a medical student, you're easy bait. Things get a little different (kind of) as a resident. There are also a lot of cultural forces at play, both within hospitals and even within departments. The nurses on our inpatient psychiatric unit, for example, are generally outstanding, while the nurses in the ED in the same hospital are, generally speaking, harpies.

Welcome to the world.

 

[jw3600]

By this standard oil roughnecks and offshore oil platform workers also have amazing jobs.

Nursing, or at least floor nursing, is a legitimately difficult job. The hours are irregular, the work is physically taxing and frequently disgusting, the patients are always demanding and sometimes threatening, the bosses are numerous and frequently have conflicting demands, and finally nurses are in a position where they feel personally responsible for medical care which they may completely disagree with.

Basically nursing is residency, except that it's only 40 hours per week, you are exposed to more disgusting bodily fluids, and it never ends. If I was a resident forever, even at 40hours per week, I would feel underappreciated at 80K per year.

One other FYI: the average salary for a floor nurse is closer to 50K/year

I've worked in hospitals where 25 y/o brand new RN's with a bull**** bachelors and 2 year nursing degree work 3 12's in the ED STARTING at $35/hr (with upward room for night differential). It's really not the impoverishment you're making it out to be.

Medics on the other hand....christ they get screwed.

 

[KnuxNole]

Just an interesting thought ...

I once worked with an attending who'd bring coffee and bagels for the nurses every week.

Her take was that its such a meaningful yet small statement that it was 200% with it. When you're on a team, it's better to have your teammates (aka nurses) appreciate you as she said.

Keep your friends close keep your enemies (or MVPs depending on the shift) closer I guess.

I usually do this too when I work weekends, usually donuts. Or offer to buy lunch for the group.

 

[flightnurse2MD]

80k for a 2-4 year degree should be appreciation enough.

Try $95K... Before I started medical school, I worked a ton of overtime to save and pay off bills. Made almost $120K before becoming a MS-I.

 

[sliceofbread136]

Honestly the most annoying part is having to take the time to fully spell my name for them 1 billion times

 

[psychMDhopefully]

Try $95K... Before I started medical school, I worked a ton of overtime to save and pay off bills. Made almost $120K before becoming a MS-I.

Of course I honestly think nurses are overpaid, the only reason they are paid so much is because doctors are paid so much. I think teaching is a job that is just as stressful and requires a comparably amount of education, the wages between nurses and teachers should be similar.

 

[WingedOx]

Of course I honestly think nurses are overpaid, the only reason they are paid so much is because doctors are paid so much. I think teaching is a job that is just as stressful and requires a comparably amount of education, the wages between nurses and teachers should be similar.

Underappreciated means they don't get the money or glory that physicians get. They could, it would just require going to med school, residency and sitting for standardized test that are absolutely f'ing ridiculous.

You remind me of the resident I had to deal with during my chief year who couldn't figure out why the rest of the staff in the hospital were constantly passive-aggressively f-cking with him.

 

[jw3600]

Try $95K... Before I started medical school, I worked a ton of overtime to save and pay off bills. Made almost $120K before becoming a MS-I.

Probably on the higher side but still not unheard of. A lot of the more obnoxious nurses would inappropriately ask the wanna be PA girls why the hell they are going to PA school to make 120-150k when they could make nearly that with overtime and night differentials.

 

[Lunatik]

Look at me.... I'm the doctor now

LOL. That cracked me up. Captain Phillips was a good movie.

 

[AREYOUSEROUS?]

Nurses are overworked and underappreciated. The extra scanning of meds before administration, finding another RN to witness insulin admin, nursing care plan documentation, etc...the documentation they are responsible for is getting worse and ridiculous. As a nurse myself, I sympathize with their plight. Doesn't excuse the behavior but it does explain it.

Being a nurse myself I agree with this post, but I will have to say most of the silly mistakes and issues like the OP presented have come from newer nurses who freak out on every little detail.

 

[flightnurse2MD]

Probably on the higher side but still not unheard of. A lot of the more obnoxious nurses would inappropriately ask the wanna be PA girls why the hell they are going to PA school to make 120-150k when they could make nearly that with overtime and night differentials.

In nursing, there are PRN positions where you can make more an hour in lieu of benefits. In Phoenix, my base hourly rate was $45.00- add another $8 working nights and another $5 working weekends. It adds up when you work 5-6 shifts per week. One paycheck, I paid over $3700 in taxes...

 

[mehc012]

Yeah that's great money, but if those are 12 hr shifts I don't envy you. I've been there and done that. Also, I would say that nursing and the profession I was in tends to be a younger persons game. I say that because in order to make the $ you are sacrificing sleep, health benefits, and potentially location, all of which become substantially more important to me as I grow older. It was a significant part of why I'm in med school now. I could see the writing on the wall.

I love 12hr shifts, as long as I'm up and active much of the time. Cannot stand 9-5 jobs, I'd rather have a variable schedule than get up at the same time every day. That always messes with my sleep.

 

[anbuitachi]

Yeah that's great money, but if those are 12 hr shifts I don't envy you. I've been there and done that. Also, I would say that nursing and the profession I was in tends to be a younger persons game. I say that because in order to make the $ you are sacrificing sleep, health benefits, and potentially location, all of which become substantially more important to me as I grow older. It was a significant part of why I'm in med school now. I could see the writing on the wall.

You know this is the MD part of the forum.. Why do you not envy 12 hr shifts? I sympathize with nurses. I think their job is harder than the average american job (just my opinion). But I dont know how much sympathy they get from doctors who work 1.5-2x as long, and have many times more responsibility in terms of patient outcome, and lawsuits that may come with it. In the end, we need a ton of nurses, and the barrier to becoming the nurse is no where as high as that to become a MD, meaning you will get a lot of weak nurses, mixed in with the good ones. I have worked with far too many nurses who put their own emotions above patients' well being that it's getting scary. The union only makes this worse. At least give the hospital the ability to fire the bad ones..

 

[PlasticGirl17]

Fixed your post for you. Insert any profession, gender, race, whatever you want. People are selfish. It should not come as a surprise that nurses (made up of people) function the same.

I noticed you did not change “surgeon”....interesting, no?

 

[Bacchus]

A good nurse is worth their weight in gold. As previously mentioned, however, nurses are people, and people are found all over various spectra: kind vs. dingus, caring vs. checked out, intelligent vs. idiotic, and on and on. You will likely run into many horrible nurses - people that have no interest in patient care, won't do anything approaching being proactive, and are generally idiotic. By the way, you can find the same thing among physicians. You will also come across the rare nurse who is an incredible asset: intelligent, kind, provides meaningful input to the care team, and can perform their assessments well. The latter is a true asset.

Unfortunately, many people overestimate their abilities, underestimate the importance of interpersonal relationships in the work environment, and are incapable of working on a team. But this is not a problem limited to nurses. This is a problem with people in general.

The other thing to remember is that as a medical student, you're easy bait. Things get a little different (kind of) as a resident. There are also a lot of cultural forces at play, both within hospitals and even within departments. The nurses on our inpatient psychiatric unit, for example, are generally outstanding, while the nurses in the ED in the same hospital are, generally speaking, harpies.

Welcome to the world.

Not to derail, were you SDN dormant for a while?

 

[Bacchus]

I usually do this too when I work weekends, usually donuts. Or offer to buy lunch for the group.

While I understand while people do this, I considered buying lunch for our office a few times but with usually 6-7 physicians any given day, their 1-on-1 nurses, front staff and additional nursing staff, the financials get out of hand very quickly

 

[mimelim]

I noticed you did not change “surgeon”....interesting, no?

Reading comprehension for the win

 

[anbuitachi]

12 hr shifts are great and I used to work them all the time in my hospital job. I was only saying I don't envy working 6 of them per week. I don't intend to work that much just to break the 100k mark for the rest of my life.

I mean if you get taxed 3700 on a paycheck. Assuming a 35% tax rate and 26 paychecks (1 every 2 weeks), that comes out to 274k. (if 30% total tax it comes to 321k) Even if 12 hr shifts, thats 60-72 hours per week. That is a LOT of money... you go in with minimal debt compared to MD, and come out about the same.. with a lot less liability. And this seems to be RN, not NP

In residency we had a couple of NP quit, and they opened up their shifts to residents to cover while they hire new NP/PA . Their initial pay to the residents was 120$ per hour. Residents fought for it. After realizing they dont need to be paying poor residents that much they lowered it to 60$ per hr

 

[anbuitachi]

Lol this is completely laughable. An RN making 274k per year? What are you smoking? That poster that said they paid $3700 in taxes from one paycheck......not sure how that works when they stated that they were making in the $55/hr range. @flightnurse2MD can you help us out here?

I'm saying he/she paid that much one very pay check, that's how much would have made. The PA on my surgery rotation told us he works 80 hrs a week and makes 330k a year.

 

[mehc012]

Lol this is completely laughable. An RN making 274k per year? What are you smoking? That poster that said they paid $3700 in taxes from one paycheck......not sure how that works when they stated that they were making in the $55/hr range. @flightnurse2MD can you help us out here?

May have been a particularly good pay period with lots of extra shifts during the holidays, etc...wouldn't make that amount EVERY paycheck, but it would definitely pay off the Christmas credit cards!

 

[anbuitachi]

Yeah that's a PA bro. I'm done here, no floor nurse makes 300k and I'm not going to argue about it

Yea and im talking about salary based on 3700 tax. The PA is just an example of how non MD professions can make as much , sometimes more than MDs. Not saying the poster made 270k that year, I'm just saying you can, if did get taxed 3700 per paycheck, it just depends on how much you are willing to work. I dont understand how that is so hard to comprehend to you

 

[PlasticGirl17]

Reading comprehension for the win

Good one. Let me spell out my point - although the fact that you did not change surgeon to a generic “person” was probably unintentional, it reflects my experience of nurses getting the benefit of being just individual people with flaws, are whereas doctors with flaws are reflective of the entire profession. And I think it’s BS.