What Hits the Fan

No this isn't about a 300 pound patient with C. diff.

Although I did take care of one last week and my back still hurts from cleaning up the proverbial storm.

This is about the bull, chicken, horse, human, and whatever other creature is throwing it's waste around the unit these days.

Our boss, who is the unit director, recently decided to end the Baylor shifts that we've had since the unit started 3 years ago. The hospital is cutting back on budgets and tightening everything up, but our boss seems to be exempt somehow. She has actually added to the positions that get extra pay- the "leadership" people. And it wasn't necessary to end the Baylor shifts now, but there is some controversy over whether this was a vindictive move by our boss, because she hates the night shift Baylor people, as they have been outspoken against many things she has done.

Baylor shifts are for people who work weekends only. They get paid like a full time (three 12 hour shifts a week) staff person for doing only two 12 hour shifts a week. Then the rest of the staff doesn't have to work many weekends, and everybody is happy. Baylor nurses are usually the most experienced nurses and tend to be older. It's a nice arrangement for them.

Last weekend I was talking with one of the other weekend nurses on the unit, she has about 15 years of nursing experience, and she is one of those losing her Baylor position. She is going to go full-time, which she is dreading. She said how she thinks our boss and our manager have inadequate experience and no clue what it takes to take care of these patients, that the weekday charge nurse is so dumb, that she's seen that charge nurse be not very nice to me, that there is no support on the unit, that it is chaotic and unprofessional, that the weekday unit assistant is horrible and nasty, and basically echoed everything I've been thinking and feeling, plus adding her own take on things.

I'm about done. The only thing keeping me in my job these days is the necessity of a paycheck. Otherwise I could walk away. Three and a half years as an ICU nurse in this place has taken it's toll on me, my health, and my attitude.

I am looking, trying, putting the word out, applying when possible, for another position. I want to leave and I would love to get away from inpatient nursing. Right now the budget is tight, no one is hiring, so much for a nursing shortage.

I have paid for this out of my hide and my wallet. Too stressful to be there full time. Cut back to part-time. Cut into our personal budget. Follow that with anti-depressants, counseling, decreased quality of life, health problems, doctor visits, and lab draws. Any job that requires you to recover unpaid from your actual work time is poorly compensated. Any job that costs you more than the wages you make is reverse compensation. If this continues much longer, I will be in reverse compensation.

My boss is so weak she surrounds herself with weak people, has a thick wall around her of pathetically inadequate so-called leaders. As I've said before, they couldn't lead their way out of a cardboard box. Amazingly, in a time of tightening budgets, she keeps adding these positions so more people become part of the "leaders" and also get extra pay. They don't all have to work as many weekends, holidays or be accountable to the rest of us.

I started as a new nurse without pretense, despite my prior life experiences, with an open mind, wanting to learn. They treated me like dirt and didn't provide support or adequate training, I had to learn everything on my own and by asking a million questions of the more experienced weekend nurses and respiratory therapists, and the occasional kind physician, with pervasive contempt from my co-workers on a daily basis.

Not afraid to be humble and ignorant, I brought only myself and my willingness to learn. I was secure enough to be small. But I must terrify the crap out of these people because they are afraid to help me out, or help me get good at anything, because that might be a threat. I might see their inadequacies and point them out. I might reveal them for the pathetic idiots that they are.

After all, I was the village idiot. I was not good enough to train on anything. The line was drawn above my head. I was denied opportunities like being part of the new outreach program ("you need more experience taking care of patients") and training for codes, RRTs, and traumas. I was kicked out of codes on my own unit. I was given lower acuity assignments than the float pool nurses. I was ridiculed and gossiped about behind my back.

I got my CCRN at 2 years, earlier than any of them, by studying on my own, and I didn't take a review class, because I wasn't offered the opportunity to attend one when everyone else did. Only then did they treat me less like an idiot, but I still didn't get the assignments. I didn't get any mentoring worth a crap because the mentoring program they invented and dragged their feet on never was finished, followed up on, or pursued. There was no accountability to me, the person with the least experience on the unit.

The weekend charge nurse and I figured out our own way of doing things. She made an effort. I had to sign up for weekends just so I could be around some nurses with knowledge, experience, and willingness to let me do things like go on transports or take sick patients.

And up until now only one person has ever apologized to me for how they treated me.

With one charge nurse in particular, I get treated like I'm invisible, like there is a ghost taking care of my patients, I'm not seen or acknowledged, and certainly never thanked for my efforts. No eye contact is made with me in group report. When I walk in the room to help with settling an admit I am not talked to, acknowledged, or thanked. At the end of the shift, often she does not get report from me on my patient. She goes around to everyone else and talks to them. Often she'll run out of time before the night charge nurse comes in. If she comes to me to get report at all, it is the last thing she does.

I am not communicated with, I don't get information shared with me about what's going on in the unit. When I ask, I get this look from her like, "what the hell business is it of yours?". I don't get a fair warning when I'm to get an admit and I can get stuck with an admit because I disagreed with the charge nurse the day before about something. I often get assigned to the far end of the hall and everyone ignores my call light when I need help.

I have been told to my face, by the nasty unit assistant, that my efforts in patient safety are stupid, I am not thanked for keeping us from having patient falls on the unit, even though while I was on that we had the best safety record in that regard of any inpatient unit in the whole hospital. I am not valued or recognized for any of my efforts.

So I have stepped down from my role on the safety committee, and I am about to step down from all the data collection I have been doing for my boss. She can find someone else to do it. I can't support this unit anymore. I don't believe in supporting what they are doing, since they are not giving me (or most of the other staff) any support.

Let's see how many descriptive words and phrases I can use for the business as usual state of the ICU where I work.

nastiness
passive aggression
selective accountability
dehumanizing
unprofessionalism
lack of integrity
lack of follow through
girls' clique
hostility
contempt
soulless
empty
shallow
hollow
lack of empathy
callousness
unsupportive
favoritism
vindictiveness
no commitment to staff development or professional growth (except if you're an ass kisser then you get a position made for you)
lip service to staff concerns, patient care and safety, so-called "healthy workplace"
lack of feedback
lack of appreciation
lack of attention to proper training for new nurses
lack of substance in everything they start and never finish
excuses for lack of educational offerings

My days are numbered in ICU, and I'm not the only one saying that. I hear it from the other Baylor nurses who are also looking for a different job. If they want to run the unit like an adolescent girls' clique, let them, they can have it the way they want it. I'm over it. It's just a matter of time, and I hope I can keep my health and sanity within normal limits until then.