The Dog Ate My Care Plan…

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

Archive for the ‘Health Care’ Category

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.

Posted in Health Care, Nursing, Pet Peeves and Rants | Tagged: , , , , , , | 7 Comments »

Are You Ready to Save a Life?

Posted by isntshelovlei on March 15, 2011

As health care professionals and students we have all taken a CPR certification course. Every one to two years we have to take a renewal course.

But is it just something you do because you have to—to meet a job or maybe your clinical requirements? When and if the time came, would you be willing (and able) to use what you’ve learned?

Personally, I keep my pocket mask and even my course book in the glove compartment of my car—do you know where yours are? You never know when you might need them and my mind often flickers to the fact that they are there when I pass accident scenes during my comings and goings. Thankfully, I have never had to use that mask though I do remember once having to perform the Heimlich Maneuver on my own infant because some brilliant fool decided to give her a piece of hard candy. I don’t know if it was the years of CPR training or my mother’s instinct, but I acted automatically. Her color changed and she couldn’t get any air in, and couldn’t cough. I flipped her around almost reflexively on my forearm, head down over my thigh, gave her four blows to the back and out came that offending piece of confection. I then proceeded to annihilate the brilliant fool…

I am glad that has been the extent of my calls to duty and that I have not had to perform actual CPR. But have you ever really thought about what you’d do? When people ask on television shows “Is there a doctor in the house?” I always think that there are more than just those that raise their hand. These days people seem to not want to get involved for various reasons—like getting sued or even not being confident in their own skills…

Will you help that person choking while you’re out at a romantic dinner with your partner? What about your neighbor that collapses from cardiac arrest while shoveling snow? What if you found your own child face down in the swimming pool? Anyone can carry a card in their wallet, but when it really matters will you make it count?

I hope that I never have to use what I learn in those CPR courses, but I know that if need be, I’m ready and I will. But the fact of the matter is someone in the United States suffers from a cardiac arrest every two minutes, so you really never know when YOU may be the one called into action. Are you ready to save a life?

Posted in Health Care, Odds and Ends | Tagged: , , , | Leave a Comment »

Do As I Say Not As I Do?

Posted by isntshelovlei on January 6, 2011

According to the CDC, almost thirty-four percent of adults in the U.S. are obese. Surely that figure includes some of our doctors and nurses. In the shift from “sick care” to “health care,” or a more preventative health care model, we should be seeing a lot more patient education. But as a patient, how do you think I am going to look at you when you sit me down for the weight loss speech: chastising my diet/eating habits, telling me I need to increase my physical activity…if your BMI is just as high if not higher than my own? Isn’t that like the pot calling the kettle black?

Then at higher risk for heart attack and stroke we have our smokers, and more than twenty percent of adults in America smoke. If I’m a cardiac patient and you’re doing my discharge teaching and telling me how much I really need to kick the stick yet anyone standing within three feet of you knows that’s not perfume you’re wearing but more like eau de cigarette…I mean really…no wonder so much patient education just goes in one ear and out the other.

I’m not saying that health care professionals need to be perfect—totally abstaining from all smoking, drinking, and drugs (I mean what would I do without my caffeine?), and only eating tree bark and berries, after all, we’re human too, but shouldn’t we be a little healthier—or at least striving to be? What exactly is our responsibility (if any) to our patients here? Are we obligated to set any kind of example? Most of us are willing to inject foreign substances into ourselves all in the name of our “duty” to our patients. It seems to me that losing a few pounds or quitting smoking is a lot less invasive…

When faced with health care decisions patients will oftentimes turn to the health care provider and ask “if it were you, what would YOU do?” That’s because we’re the “professionals,” we’re more familiar with the most up-to-date research, we’re supposed to know what’s best (or at least be able to make an evidenced-based recommendation). Patients tend to look at their HCP as sort of a health role model. But when we don’t seem to be making healthy lifestyle choices ourselves, do we lose our credibility as patient educators?

Maybe a little practicing what we preach is in order…

Posted in Health Care, Nursing | Tagged: , , , , , | 9 Comments »