Friday, February 3, 2012

Help

Okay. I'm really, really trying to figure out if I'm crazy or not. I've been polling my coworkers and I'm getting split results. Occasionally, when staffing is really sufficient and rad (one thing I will say for my management, we're no longer trying to run a 45 bed ER with 6 staff nurses, which is always nice) we get a float nurse. Like, someone whose only job is to help everyone else and make sure their shit is in order. I never actually get assigned this task (they give the rooms to the ones they know can take some punishment) but I occasionally fill this role when they assign me to the resus rooms and I don't have any dying patients.
Anyway. It's not fucking rocket science. We page ambulances overhead when they go to rooms, the trackers clearly show who needs treatments and meds now that we do computer charting, and the lab label machine prints out big red stickers for the patient that need LABS drawn. So when I have nothing to do, I look for this stuff, and I go do it, because it's my job, and that's what I'm being paid to do, as opposed to sitting at the computer paying my phone bill. I'm the float nurse. You know, float around and do shit. Find stuff to do.
So the other day I'm getting the standard ER ass kicking- ambulances waiting outside my room as the patient I just discharged walks out and housekeeping wipes the stretcher off type of day. I've been doing this long enough that I can do it all myself. It's just a lot of work. We have two, count 'em, two nurses floating. What are they doing? Shopping online for a friend's baby shower. Obviously.
Whatever. Again, I've got my head above water. I'd just really like to chart and pee and eat a snack, but oh well. That's the way the ER goes. Finally, at one point, I have to flatten myself out a like a roach to get past one of them who is obliviously standing in front of the med area talking about cruise ship food with my charge nurse who is also sitting on her ass when she notices the pile of shit I'm balancing on top of the EKG machine. Ten minutes later when I sit down to chart, the mentalist over here uses her astute powers of observation and makes a comment that I looked busy and if I needed something I could have asked for her help. Really?
Nope. I just gotta sit down and chart all the shit I've been doing for the past 2 hours, it's whatevs. Then she wants to know why I didn't ask her for help. I tell her what I genuinely believe. Really. If an ambulance is coming into my room, I honestly don't have time to figure out where you are and ask you to come help me. Because I have an ambulance. By the time I find you and wait for you to finish your conversation about which airline is your favorite to ask for your assistance, I might as well have just done all the shit myself. So that's what I do. You have ears. If you hear "ambulance to room 2" being announced overhead and you don't have the sense to go in there to help when your entire job tonight is to help, then you probably aren't much good to me anyway. But thanks. I said it in a much less harsh manner than this, yet she and the charge were both looking at me like I'd sprouted a second head.
So what is your stance on this, internets? Am I being butthurt and expecting my coworkers to be all powerful mind readers? Or is a little initiative too much to ask? I really don't know anymore.

26 comments:

  1. You're definitely not crazy- they should be 'rounding' seeing who needs help. Next time shout it from the rooftops, make 'em come running!

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  2. Agree with TinyRN, I love the comment. And fuck them looking askance; they're the lazy asses who need to take a pay cut or an unpaid leave for a couple weeks. I too am a worker and if there's shit to do I will find a way to do it; you and I would make a Super Team. I don't extend that thought but once a decade or so; consider yourself complimented and held up. Initiative sorts the worker from the un-worker, makes easy work of the process... as you know.

    Next time i get sick will you be my nurse ?~! I like your style.

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  3. you are right. you are doing your job. they are not doing theirs. that being said, you being right isn't making your job any easier. i think you were also TOTALLY right to call them out on it. i consider this you giving them the opportunity to get their shit together and contribute next time around. if it's at all possible, i'd remind them of this conversation at the beginning of the next shift you work together. my mom and i recently had this discussion about her work-- hourly employees are paid to work EVERY HOUR-- so every hour they are at work, they should be DOING SOMETHING PRODUCTIVE. it's amazing how many people become "adults" and haven't learned this.

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  4. Since they're clearly oblivious to their surroundings -- not surprising, it's not like you can expect them to know what "work" looks like -- I guess you're going to have to snap at them in the moment.

    A nice sharp "Could you have this conversation another time?" ought to do for starters. And if they ask what you need, tell them that it's their job to figure it out, not to wait for a coworker to give them orders.

    Basically, I think your expectations are realistic in general, but not with these people in particular, because they suck.

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  5. You got guts girl, thats for sure. Nurses as a whole tend to be passive aggressive on this type of shit. We talk to each other about what a shit that float nurse is instead of confronting our co worker. I admire you for doing it. It should be done more often.

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  6. I totally agree with girlvet. You go, girl!

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  7. You're not crazy for doing your job well and expecting others to do theirs well also. And I agree with girlvet- passive aggressive never gets anywhere, so good on you for making your opinion known. At least no one can blame you for secret bitchiness.

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  8. I am not a nurse, but I think you are totally not being butt hurt! If there were more people like you in EVERY profession, the world would be a much better place! Let it go and know that you are an awesome nurse! Even if others never see it, you know you are living up to the high standards you set for yourself!! :)

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  9. I think if a float is sitting on her ass and an ambulance shows up, she should go over and see the ambulance and at least see if help is needed. As a general rule, for run-of-the-mill ambulances, it's always nice having a couple people in the room, at least for the first couple minutes to get all the clothes off, get vitals, and hook them to the monitor while person #2 gets report and starts doing an assessment or lines/labs or whatever.

    My problem is usually the techs sitting on their asses and only getting up if we somehow like spelunk down into the hole they're hiding in and tell them to come help. By that happens, the patient is already dead with rigor mortis setting in. Yes, if you're hiding in a non-patient-care area and we don't see you for 30 minutes, I'm thinking you're busy or on break because, I guess, I can't think in your way of thinking where it's just cool to hide until someone finds you. In short, if you have nothing to do and your job is to help others, walk around and ask if anyone needs help, etc.

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  10. Welcome to the "new" world of nursing. Not only is it nearly impossible to get people to act as a team, they actually don't expect to help, but always expect help when their ass is hanging out to dry. I'm fortunate enough to be able to retire soon. Don't know how much more of this I can take. Just makes me want t o buy a gun for myself rather than call an ambulance, if you know what I mean.

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  11. SO happy to read this post. Had a similar situation myself today. I said something to the effect of, "I assume that if you are here to work, you will be WORKING, we are all adults and I don't have time to micromanage everyone." You would've thought I cursed the Pope or something. My motto has always been, "Lead, Follow, or get the F--k outta the way." I guess most people just don't have the balls to cut to the chase. All these passive-aggressive people can kiss my ass. I think if you are the float and you can't find something productive to do, you are: 1. lazy 2. stupid 3. a pain in the ass 4. all of the above.

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  12. Everyone has down time but if you are shopping online you should at least be pulling your head out of your butt every few minutes to take a walk around and make sure everyone else is more than treading water. And with 2 floats. Is it that hard for them to decide between themselves that if an ambulance shows up they can take turns not being lazy and helping.

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  13. What does Nurse A do if she has a problem with Nurse B?

    Wait for it. . . . .

    She tells Nurse C, duh!

    Now I have never been in a unit that used float nurses as float. They always got pt assignments like the regular nurses if we had one. That being said I expect my fellow nurses to ask for help if they need it. I run around like a chicken with my head cut off, get my shit done and then chill out. If you are running around like a chicken with her head cut off too, I do not know if you have your shit together (like me) or if you are drowning (remember we all have assignments in my unit). So asking for help is always good.

    -CandiNP

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  14. It is certainly nice if the person there to help out actually asks if people need help. That said - on my unit charge nurse doesn't take patients but is expected to help out other nurses. When I'm charge, I do go around asking nurses if they need help when I have time. But nurses are also expected to ask me. In other words, if I have 6 other nurses on the floor, 5 of them may be keeping me busy with their requests (plus the fact that I'm answering phones, leaping up when bed alarms go off, and answering call lights and helping patients to the commode or getting them stuff without even bothering the patient's nurse if I can do it myself), so I may never get to asking the 6th RN if they need anything. I hate it when people wait until the end of shift to complain about how busy they were or that they didn't get lunch. ASK for help if you need it (and if I'm too busy as charge, I will help find you another nurse who has time). (Don't get me started on the nurses who run around busy and complaining, but when I offer to help - even specifically saying hey, I don't care, I'll drop an ng tube for you or start a foley, clean poop, whatever - can't seem to come up with anything they want me to do).

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  15. As is often the case with a marriage, you can be right, or you can be happy with the help you get, but not both.
    So yes, your right, they should ask. It's their job.
    But don't punish yourself by being right and not get help.

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  16. I do what you do. I think if you can't figure out that the time to offer help is when the ambulance comes, not during my ten free minutes to chart, then I probably don't want your help. That said, sometimes you need the help and in that case you need to know how to ask. I go for specific tasks, ie., can you draw these three tubes from the lady in that bed, here are the stickers. Something that I can verify was done right and that would be hard to do wrong. Sometimes if I ask a couple times then they get the hang of how to help me. But I'd rather do it myself for sure.

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  17. I work med/surg, and we have a charge and sometimes a second charge. The good charges are constantly asking if we need help when they aren't already busy helping someone. But if I am busy and it is potentially affecting pt care, it is my responsibility to ask them for help. We have vocera, but I used to just call out to our uc to ask charge for help. I know it's not easy for everyone to accept help; my BFF @work can never bring herself to ask for help. I think she is similar to you in that if she sees someone sitting on their ass while they can see her running around, then she isn't going to ask them for help.

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  18. I have to say this as someone in any field, it sucks to ask for help. It's easier when someone comes by and asks if you need any help.

    Having to stick your head out the door and request assistance nicely, never knowing whether you're going to get a eager beaver who is happy to do anything for you or a grumbling ass who will say how you can't take care of your own work behind your back once they're done begrudgingly helping you, it's risky. And sometimes its easier just to do stuff yourself. Personally I love to do it when I see my coworker messing around on eBay. I call it "delegating" and I hope she will return to favor if she catches me slacking off as well.

    You make the choice to ask for help or not, you can't blame someone else for not helping. That's just the way it goes!

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  19. I totally agree with what you said...I worked in the ER for years and it's damn frustrating to be knee deep and look across the nurses desk and see people sitting there watching you when it's OBVIOUS you need help.

    However, the other coin of this issue is the nurses who need help every single day because they are inefficient, slow, stupid or whatever and you find yourself on a daily basis getting your own crap done and having to do theirs too. No, I don't believe that's you but I work with several who are like this. So yes, I occasionally will sit on my ass and watch them spin their wheels because I don't get paid both of our salaries. Usually, I give in (especially when the docs are looking at me silently begging me to fix things) and trudge over to do something in 5 minutes that they've been "working on all day". Such is the world of Case Management... we don't save lives like the ER, we save the hospital money by moving people out and if you are inefficient and suck at the job, Management turns a blind eye because you've been planted in an office for 20 years and no one wants to offend you by suggesting maybe it's time to pick up your own slack.

    So I strongly agree with you, work as a team...but if you're dragging the team down, go teach or something.

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  20. Good floats, like good clerks, are worth their weight in gold. If the fit is hitting the shan, neither should be cheek-to-chair. They should be up and about, rounding for something to do.

    I'm all for explaining my expectations of my coworkers. Far too many people are unaware for whatever reason. And often, letting them know actually does make a difference.

    You are spot on.

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  21. @Anon- I will actually totally agree with you. We have the ones that take a ton of smoke breaks and then cry about how slammed they are or just the ones that are the chronic whiners with a regular patient load, too. That's when I go revitalize my own patients and make sure they all have fresh warm blankets.

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  22. Frustrating! No one likes to be the only one doing work. Hopefully your team starts coming together and working more cohesively.

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  23. Major props. That's something that has come across my thoughts but I never had the guts to say because I'm a new nurse as well. Some of the nurses I work with have been in the field longer than I've been alive. So when I need help boosting patients in bed, getting lines and labs, etc, I feel like I should just do it myself because I know it'll get done and done fast. If you're crazy, I am too.

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  24. Nope. You gotta let the lazy dumbasses know that you know that they're lazy dumbasses and to stay the fuck outta your way if they're not gonna help.

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  25. If you have someone who actually takes initiative, it is a rare find. This is a personality trait, it can not be taught. Believe me, I have tried over and over again. This happens in every ER that I've ever worked in. The "slackeys" ,as I call them, just act like they are so enthralled in whatever they are doing (you know, shopping on the internet, talking about the night before when they were out drinking or slutting around) until you completely finish everything for your patients. Then as I finally get a minute to chart and have the audacity to ask them to move from the computer that they are on and exit out all the online shopping sites, they ask "Can I help you?". That's when I say "No, I got it." Then I get perceived as being a bitch. Fuck their lazy asses. There's no changing that behavior.

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  26. 75 to 80% of all nurses are overpaid, overweight, underskilled individuals. Fact. There are a few good ones.

    Nurses also need more validation and ego stroking than any group I have ever encountered.

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