The Dog Ate My Care Plan…

Just a mom/wife/nursing student extraordinaire trying to make it in the big bad city…

Archive for July, 2011

Coming to Work Sick: The CYA Culture

Posted by isntshelovlei on July 31, 2011

I see it everyday in the hospital—staff coming to work with cooties because to not come may be career-suicide.  

There are let’s just say…unwritten policies (and punishments)…when it comes to calling out sick—especially in the hospital environment.

First, now you’re on your managers’/charge nurses’ radar (and not in a good way) because it’s an inconveniece—depending on how much notice you’ve given them they now have to scramble to find someone to fill your slot. Then there’s the fear of being given a write-up for an unexcused or unscheduled absence—which could come back to bite you in the arse during your performance reviews. And now that you’re on management’s proverbial sh*t list you now run of the risk being snubbed, given “harder” assignments or a heavier load than others (and being left to flounder), or other forms of horizontal hostility—even possibly being passed over for promotions and perks.  

So now staff just come to work sick. If you’re sick enough according to managements’ standards (which may mean damn near dying) then they’ll have to send you home. And if management sends you home, you’ll avoid a write-up, be seen as a devoted staff member willing to “take one for the team” coming to work come hell or highwater—plus you’ll still get paid for the day/night. So staff now cover their @sses by putting the ball in managements’ court.

But at what cost? Not only are you not at your best (which can be a recipe for disaster in patient care), but it creates the potential for others to get whatever the hell cootie it is that YOU have! And oftentimes, for whatever reason (*hint, hint* staffing), management may not send you home! They may decide (with the plethora of licensed bodies in a hospital qualified to assess you) that you do in fact “look okay” to stay and work. Big. Fat. Fail. Now what?

This call-out taboo is even brainwashed into nursing students. To call out from clinical is to shoot yourself financially in the foot—students are sometimes threatened with having to personally pay the clinical instructor ($50/hr I have heard quoted) to come in on a non-scheduled clinical day to oversee your make up. As if. Or sometimes they’ll give you an ungodly amount of ridiculous busy work to do to make up the hours. And so students just come to clinical sick hoping they can just make it through the eight- (sometimes twelve-) hour shift. We are breeding the next generation of nurses with cover-your-ass-itis.

I was sick a few months ago. And I don’t get sick often, but I really felt like death warmed over. I went to my primary, who gave me a note stating that I needed to stay home (his exact words were “you shouldn’t be in anyone’s ICU like this”). I called the big cheese to let him know (and way before the two hours notice we’re required to give when we call out—I wanted to give him as much notice as possible to find someone else to come in).  I was told that even though I had a doctor’s note it would still be “an incident.” I stayed home anyway.

Would you???

For more insight on the subject, check out Terri Polick’s post, Presenteeism: Why Nurses Don’t Call Out Sick and @TorontoEmerg‘s How Hospitals Punish Nurses for Being Sick.

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Semester Roundup

Posted by isntshelovlei on July 26, 2011

Here I am back at my poor neglected blog with its splattering of unfinished posts. I just haven’t had the time or the energy this semester…

So here’s my summer semester roundup!

This summer I took Public Health Nursing (also known as “Public HELLth” if you follow me on twitter) and the Art of Listening—I know, WTF right? But I needed one last elective that had to be an art (already had credit), language (only offered the same night as Public Health), literature (too much reading/writing), history (same), or music. So Art of Listening it was. And it was offered online which saved me another night of trekking to campus.

I actually thought I might enjoy a slight break from nursing topics. How bad could it be with no meds, no care plans, and no NCLEX practice questions? Bad enough apparently. Besides the fact that the class was all over the place the topic just didn’t hold my interest—I developed some serious ADHD trying to get all my reading and forum posts done by all of the crazy deadlines.

And then there was Public HELLth. O. M. G. To her credit I will say the professor tried to keep it interesting: breaking up the lectures with videos, tossing frisbees with communicable diseases taped on them around the classroom, and other theatrical stunts—it just didn’t work. She did give out candy at the beginning of class which was nice—especially if there were pink Starbursts (my fave). But eventually, I just stopped going if there wasn’t an exam/quiz or if we didn’t have something due that day. I found her lectures distracting and understood things a lot better when I just read and studied on my own. I’m not trying to corrupt anyone else, that’s just what happened to work for me, for this particular semester. On the other hand, the instructor I have this upcoming fall I’ve had before and I wouldn’t dare miss one of her classes—her lectures are like GOLD.

I also managed to squeeze in a second peds clinical rotation this semester (we usually only have one) and worked as an Asthma Educator in a peds clinic. And man was there some educating to do! From parents giving their kids their maintenance inhaler when they should have been using their rescue inhaler (and wondering why it wasn’t working) to the parents who just didn’t see the point of giving the maintenance inhaler every day when their kid wasn’t currently having any difficulty breathing—and so they didn’t (le sigh). No wonder there are so many uncontrolled pediatric asthmatics and asthma is the #1 admitting diagnosis in our local children’s hospital. Sheesh.

But that’s all over. Now I get a month off to rest my fragile mind (and get some sand between my toes) before heading back into the flames for the grand finale. That’s right—final semester coming up! I can hardly contain my excitement. Until then…

Peace, love, and coffee…

~IsntSheLovlei

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