Everyday I work 9.5 hours. Sometime I don’t even take my lunch but lunch hours but time is deducted from my total hours. Paycheck only shows 40 hours no matter how long I worked.

Does any one has any solution to this problem? I feel like I am being cheated by hardworking.

I am really struggling with how to deal with some of these difficult patients. I just cannot understand the nerve of some people! Just last night, I was discharging a patient and the curtain wasn’t completely closed. The wife of a patient from the room next door peeked in and told me she was going home for the night.

As she began talking and asking for help, I interrupted her and said, “Excuse me, ma’am, but I’m with another patient right now. Please ask one of the other nurses for assistance.”

I have even had patients’ families actually come into other patients’ rooms while there is a code situation- or while I am doing CPR-and repeatedly ask me for pillows, test results, food trays, etc. How do people not understand that we’re in the middle of something?

I have struggled with trying to be polite, but I think in a way that only will encourage this behavior. I just don’t know how to be assertive without getting so upset at patients and their families.

First, I was put in a room with 3^rd-year med students, which was great because I introduced myself and got to chat with them about their program.

Then I waited over an hour for someone to acknowledge me.  (I was escorted to the room, so it was known I was present).  Other nursing students did this same thing through the semester, so it’s not like I was the first one.

Finally, the MD came in. We all stood up, and he introduced himself, shook hands with the med students, and ignored me.  I was very upset by this, so I forced my hand out at him and introduced myself.

Then the MD told some H&P about a patient, mocked them with the door open, called out individually to med students to follow him-and did not provide me directions.  So, I made the best of it and knocked on patients’ doors, introduced myself, and asked if I could observe the visit.  This allowed me time to talk to patients and get information.

Then the docs walked in, did their exams, and left.

I know how to measure a fundus, use a Doppler, and take H&P.  Whoopie!  I was pregnant before, so this was not an educational experience for me.

Also, I was very insulted by the MD’s attitude.  He is supposed to be a professional.  He made it quite clear I was not welcome-even before he met me.  He was also unprepared.  He told every patient he had no idea what labs were drawn, what the results were, or what meds they were taking. I could not imagine this person as my MD!

For the first time since I was in nursing school, I felt out of place, insulted, and even embarrassed to be in the nursing field.  After that clinical visit, I found out that other students were treated this way.  I made a complaint to my instructor and received no feedback.

I am sure not all doctors are like this, but I recommend reading The Intern Blues instead of following some jerk around if you want to know what doctors do.  As for them knowing about what nurses do, they don’t care as long as they don’t have to do it.

“Who triaged this patient?” She called out across the room to anyone who would pay her attention. Everyone ignored her except me. I knew whose file she had and I knew she’d make a fuss, not because there was a problem, but because she loved to pick faults and seemed to relish making people squirm in front of her.

“A name would help, Pru,” I said, “Whose file you got there?”

Pru glanced at the file in her hand. “Mrs. Smith. Did you triage Mrs. Smith?” She said accusingly. “Yeah, I did. What’s the problem?” I asked.

“Could you tell me why she’s in the triage 3 box? She’s at most a four, or maybe even a five. For goodness sake, why? Why? Why?”

“Well, she is 93 years old, Pru. She’s from a rest home, and it was a big deal getting here. They had to get an ambulance to get her here, then have to arrange one to take her back. She’s got a care giver sitting with her as well. I’d thought I’d sneak her in first. It just doesn’t seem right to let a 93-yr-old lady wait for three or four hours,” I explained.

Pru sighed and rolled her eyes, “We do not triage on age,” she said as if this was the end of the argument and placed her file in the triage four box.

“But Pru, it’ll only take ten minutes to get her fixed. All we need is for you to take a look at her and I’ll do the rest. C’mon, Pru, I’m not going to leave a frail old lady sitting there for ages.”

Pru grabbed Mrs. Smith’s file from the drawer. I felt hope. She then put it in the triage five box. She grabbed another triage three file and marched out to the room.

One issue: They feel insulted if I ask them if they did something. Of course I trust them–I’m just checking because SOMETIMES (especially with my post-op patients who need vitals a lot) things get left undone/uncharted. And that reflects on ME.

So I check nicely. One of these PCTs told me that it did not matter how nicely I asked. It was that I asked at all.

Another issue: When a pt needs medicine, they come find me and tell me and I appreciate it. But if a pt needs to be changed and another pt is crashing on me, or I just plain need help changing the pt because they are heavy, they feel insulted. Like I feel such work is beneath me and I expect them to drop what they are doing.

I clean up plenty of poop and feed patients without ever bothering the PCTs. Don’t they WANT to know what is going on?

They say, “Don’t you trust us to make our rounds?

I want to say, ” Well, yeah, but you can’t catch everything on a round.” But I can’t say it because I don’t want to seem like an arrogant new grad.

This hospital has a very high new hire turnover rate, and we already had a new grad on this floor quit after only three or four weeks on orientation. The hospital is always having me meet with people who ask what they can do to keep new graduates. But I really can’t say that you need to ask your PCTs not to say things like “You would never make it in a big city hospital,” or “If you need that much help, you can’t handle your patient load so you should work somewhere else.” Coming from someone who could be my mom, it really hurts.

Not sure: Am I doing the wrong things? Is it that I am young? New? White? (Both these PCTS are African-American.)

My preceptor told me to handle all the patients, and if I needed her, to come ask any questions. I handled it the best way I knew how.

But when I asked her for help once—the only time throughout the day—she blew up at me. In front of one of my patients, she said, “I don’t like the way you asked me for help.” This caused a huge drama, and she called the charge nurse in on it.

She told her my “attitude” was bad. I told her I was sorry she took my question the wrong way, and that I was struggling to manage 8 patients by myself—with no help.

She minimized what I told her and focused on the way I asked her for help. What a drama! I thought a preceptor was supposed to encourage and HELP a new nurse, not throw her to the wolves, especially when she has been there just a few weeks.

I brought this to the manager’s attention and she said that she’s never had a problem before like that. I thought, Sure, that’s why her hospital can’t keep any “new blood”.

I wonder if this happens anywhere else. Is this a common petty practice of many preceptors? Do they hold a grudge because they “have to” precept?

Plain old meanness seems to pervade nursing, and you wonder, Is there anything I can really do about it?

Letting this behavior go on will progressively change nursing for the worse. We’re in a nursing shortage, and if we don’t address this issue, we’re in trouble. Nurses are leaving already. But it doesn’t have to be that way. With effort, the ideal workplace–where everyone gets along and supports each other–is attainable. Here’s how to make it a reality:

Speak Your Truth
When you hear that someone is talking about you behind your back, or someone says something hurtful to you in public, don’t just walk away. Do something about it. But have patience. Ask to speak to them in private and tell them what you heard. Explain that if they have something to say to you, they should just say it. Then the two of you can work it out. Most bad feelings are left unaddressed in the workplace. So take a stand, speak your truth, and fix the problem.

Never Be a Silent Witness
Nurses who are unprofessional talk about people behind their backs or gossip. And while that’s not acceptable, remaining a silent witness isn’t much better. Never stand by saying nothing. Don’t be the ears that listen while one nurse is slamming another nurse or bringing someone else down. Never. Take a personal vow of integrity. Say, “Professionals do not do that.” Or tell the complaining person to go talk to the person directly involved, not you. At the very least, walk away.

Don’t Ignore Non-Verbal Language
It’s pretty typical for a nurse to be passive aggressive, especially since the average age of a nurse is 47 or higher. Remember, the Boomer generation isn’t as open as Generations X and Y. If you ask a nurse how she’s doing and she says, “Fine,” but her vocal inflections or body language say otherwise, ask her what’s really going on. Take the time to show that asking “How are you?” isn’t just a standard greeting—and that you really do care

Compliments Go a Long Way
Few nurses actually take the time to give positive feedback to their nursing coworkers, even though it’s a critical component of creating cohesion on your unit. Complimenting someone isn’t just a warm fuzzy. You can’t compliment someone for something specific unless you actually pay attention to what they did. We need to celebrate our differences, and affirm each other’s strengths. Sure, we have the same educational backgrounds and training, but it’s the particular things we do on the floor that we have to notice: “Wow, you can get a Foley into anyone!” Or, “Gosh, you really deescalated that patient. You’re really good at that.”

Take Time to Listen
Nurses are labeled as “snobs” or “self aggrandizing” if they talk about their own successes at work. That’s why it’s important to encourage other nurses–especially new nurses–by saying, “I want to hear about your work and your day.” By giving nurses permission to talk about their successes, they become confident in their own strengths—and less concerned about others’ perceptions of them. It also helps nurses to find value in each nurse’s contribution to the unit.

Appreciate the Art of Nursing
The profession isn’t just a science. It really is an art. A nurse becomes more than a skillful practitioner when he or she enters a perfect stranger’s room, who is probably in an extremely vulnerable place, and makes that patient feel at ease within five seconds. That’s talent. It’s the art of connecting with another human being. And it’s incredibly important to remember that you are the artist. When you recognize you and your co-nurse aren’t just “handmaidens”—but professionals integrally involved in helping your patients become healthy—you will see the benefit of putting aside the behaviors that undermine your professionalism.

Of course that’s a challenge. Who am I? I think. They’re the doctor. They know best; they are “above” me. But when you are looking out for the needs of your patient and the unit, sometimes you have to say, “No, you can’t do this because….”

For instance, we have two operating rooms, and we try not to run both of them at the same time. If there’s an emergency and we don’t have an operating room, then we’d be jeopardizing our patients’ well-being. At times we have one procedure going on, and a doctor will want to do something like a tubal ligation, and I’ll say, “No, you can’t do that right now, because we’ve got a procedure going on.”

Then the persuasions are rattled off: “Well, it’s almost done.”  “You can quickly clean the OR.” “This won’t take long.”

It’s in these moments, no matter how weak you feel, you have to stand your ground and say, “We really can’t.” Use your logic and make the patient the priority; they’ll respect you for that. Say something like: “We’ve got five laboring women here, and this one’s baby doesn’t look too hot right now. What if the heart rate goes down and we have to do an emergency C-Section, but there’s no room?”

Lots of times, they’ll argue with you. But sometimes they will understand—and you’ll gain the respect of the doctors for being professional and making your patient a priority. And most importantly, your patients will be well cared for.

I’ve had doctors yell at me for not having what they needed in the room. They bawl, “Hey, nurse, why isn’t such-and-such instrument/med ready? Why isn’t it here? I need it now!”

In those moments, I cover my name badge and say, “Do you know my name? If you don’t know my name–if you can’t show me respect by calling me by name–what makes you think I should know what you want in this room?”

Some docs make the assumption that though you’ve never seen or worked with them before, you should, nevertheless, know everything about them. I should have taken Mindreading 101, I suppose.

But because I’m not a clairvoyant, I’ve learned to be courageous and flip their requests back to them: “What do you know about me?” And once I call them on their behavior, they usually back down. They realize that, yes, they are the doctor–but without you, the nurse, they couldn’t do their jobs.

Be more patient with difficult patients.

Be more patient with difficult families.

Be more patient with myself.

Be more assertive with difficult doctors.

Be less difficult to work with.

Be more assertive with anyone who keeps me from giving my patients the best possible care.

Be more accepting of working the crummy shifts.

Be more accepting of being the “new nurse”.

Stop spending more than I have so I don’t have to keep working extra shifts.

Stop thinking about work when I’m not there.

Stop blaming others when things don’t go right.

Be more gracious.

Be more empathetic.

Sleep more. Play more. Exercise more. Smile more.

Remember each day why I decided to become a nurse.