Even more, some are aware that I am in their rooms doing things for their patients while they drink coffee or grab a snack. I was peeved. I guess I just need some advice on how to tactfully say ‘No’?

I often help people and they help me, but I feel like I was being taken advantage of that day. I don’t want to be rude, because I don’t want to piss anyone off. Help?

John

Talk with at least 2 nursing graduates who have been working as nurses for anywhere from 3 months to 3 years. Ask them about their socialization to nursing after graduation. Did either of them experience reality shock? How long did it last? Did they recover from the shock? If so, how?

Feel free to email me. Any info would be great!!!

thank you so much!!

Malia

The thing is, conflict is a part of life. So we all have to learn how to deal with it.  It happens at home, at work, even at our places of worship.

The older I get, the more I have come to realize that conflict doesn’t always end in a negative way.  Sometimes it can strengthen a relationship.  If it’s handled with respectful honesty, it can enlighten both sides and bring change and understanding.

Two years ago I had an opportunity to test this theory with my boss.  He had hired a new MA to help cover his expanding hours.  Unfortunately, she needed more hours than he was offering…so he gave her mine.

Needless to say, I was a little miffed.  Out of the blue I get a call from the supervisor telling me I’d be working with a different doctor on Tuesday afternoons starting the next week.  I cried for days.  I loved the doc I was working with.  I had been with him for over seven years and had known him for eight years before that.  The hurt I felt was overwhelming.

At some point, he found out I was struggling and called me.  I’m sure he was sorry he did about two minutes into the conversation.  I had gotten over my fear of conflict at let him have it.  Not in a mean, yelling sort of way–but in a “let me bear my heart to you through deep guttural sobs” kind of way.  He was speechless.

I got a beautiful floral arrangement the next day with a lovely card saying, “Wishing I’d been more thoughtful”.

I’m not saying I handled this well. But because I was willing to be honest about my feelings and willing to forgive his initial lack of them, we were able to resolve the conflict.  He apologized, I accepted.  He figured out a way to give me my hours back, I swallowed my pride, and went back to work for him.

It involved give and take on both sides.

Throughout the whole ordeal, I realized some things about myself.  I am extremely loyal.  I love feeling like I’m part of a team.  I want to feel like I matter, like I make a difference, like I’m important.  Being made to feel like I was expendable was excruciating to me.

I also realized that I would probably be a terrible business person.  He was making a good financial decision.  It costs him less to have an MA.  In order to get her, he needed to give her more hours.  It was logical for a guy who felt the need to tighten the expenditure belt.  He was not in the wrong, he just left out the part about explaining his situation to me.  If he had, since I’m loyal and a team player, I would have moved on–sad but with understanding.

It’s been two years since then.  I’m still there.  The MA has moved on and hasn’t been replaced.  My doc and I have a very good relationship.  He gets me and I get him.  He still makes me crazy now and then and I occasionally overreact to things.  Our relationship is no worse for the wear.  Maybe it’s even better.

I have lots more stories about conflict with my family, but I think I’ll keep those to myself.  I don’t always handle those with poise and grace either.  I do find that on the homefront, humor goes A LONG WAY in helping to resolve conflict.  If I can make my husband or kids laugh during a heated discussion, I know we’ll be okay.  It’s often the turning point for us.

Do you have any tricks to getting through conflict?  We’d all love to hear them.  I’ll start the list:

1)Respectful honesty

2)Humor

3)Yours????

One year ago as a new nurse graduate, I have experienced some uncomfortable remarks, touching and things of that nature that has caused a lot of concern from an emergency room doctor. Since i did not respond to the remarks and did not give this person more to go on, I have experienced some hardships when working directly under this doctor.

He does things like place excessive orders, in a fashion that makes my life more difficult (ordering meds 5-10 mins apart meaning that i make multiple trips to the med room instead of just one or two). He has a bad attitude towards me and seems to do things to make me upset. i haven’t said anything to anyone thus far (being a new nurse and fearing that it could mean the end of my job or making my life miserable there) but i can’t stand by and let this happen.

What should I do?

Their relationship was close, and rightly so.

At work, the emotional bond between this man and this woman grew.  Before long, it appeared closer than the bond each had with their respective spouses.  Then it happened.

One wanted to take the relationship to the next level, a physical level-but the other did not.

The nurse who refused the relationship divulged everything to the spouse at home. The guilt was enormous, and animosity between the two at work grew.  Soon management entered the picture.

Even though nothing had occurred at work that would have been perceived as inappropriate, management asked the nurse who refused the overture to move on from their position.  All the while the other nurse involved kept their position.

How is this right?

If both had engaged in something physical at work, obviously they would have both been fired.   But their work was never a factor. Why was one nurse-who seems to have made the right choice-forced out while the other was allowed to remain?

Ethically, what do you think should have been done in this case?  Has your unit faced a similar scenario? How did your management respond? How did you respond?

I walked into work one day and one of our little patients went into respiratory arrest right as I finished getting report on her.  We spent the next 12 hours saving the life of this poor little girl.

The patient had been born with problems (though all these years later I have no idea what they were) and was blind and deaf.  In fact, she was non-responsive.  She had been in the hospital since birth.  Her mother was already pregnant with child number four and hadn’t been to see her in several months.  It was her father who had been faithful in holding vigil and wanted everything possible done for her.

It wasn’t the intensity of the day that sent me running.  It wasn’t the profound sadness either.  It was the fact that we put this 6-month-old through hell for the entire shift.  Sure we kept her alive, but I felt no pride in that.  I was so conflicted during the entire shift.  I worked my tail off to keep this child alive while praying the entire time she would die and wake up in heaven.

She finally died, but not for another two weeks.  Not until we had spent a few hundred thousand more dollars and put that child through every imaginable horror.

It was ethics that finally made me resign.  It seemed wrong that all I truly wanted for this child was release from this life though I worked heroically to keep her in it.  I finally decided a good PICU nurse should only think about life, so I moved to Colorado and started a career in Family Practice.

I would handle such internal conflict differently now.  Maturity of self and career gives one perspective only time allows for.  The truth is, much of life is filled with ethical dilemmas, but we, as medical professionals, seem to face them on a routine basis.

Have you had some situations like mine?  How did you handle them?  Do any of them still haunt you?

I came across the story of another nurse who faces a similar conflict.  You can find it at http://well.blogs.nytimes.com/2009/03/18/a-nurses-distress-over-a-dying-patient/?hp

It’s so helpful to all of us when we see ourselves in other people’s stories.  It makes us feel like we’re not alone, wrong, or just plain crazy.  Take a few minutes and share your story with us.

Those were painful words to hear from a colleague after she learned that I was using my nursing degree in a new way.

For the past year, I’ve been working in Nursing Informatics at the hospital where I am employed.  It embraces where nursing is headed in the 21^st century.

I’m excited about the direction of my career-even if it isn’t where I slated it to go when I was in nursing school.

That’s why the encounter with my former colleague on the floor I once worked was so difficult.  As I shared how I was enjoying my job and that I would return to school to pursue a master’s degree in either nursing education or administration, I never expected such an acerbic response.

“What a waste!”

Now, in a way, it was a compliment because she considered me to be an astute nurse, back during my time on the unit.  But it was also sad, because even though I am advancing myself, I feel as though I have let her down in some way. That I’ve abandoned “true nursing” by not being there anymore and directly caring for the patients.

But, the truth of nursing is this: In the years to come, it will become a much harder profession, due largely to the aging of the population and the retirement of many skilled nurses. That makes it all the more imperative for nurses to advance ourselves.

What would be a true waste would be never to advance at all.

After that encounter, I was reminded that while you can’t forget your nursing roots, it’s important to follow your heart, advance professionally, and encourage other nurses to embrace their calling-even if it isn’t a traditional nursing role.

The day didn’t start out great—-and soon got worse.

That day I asked the hospital cleaning crew to mop up some fresh vomit. “We don’t clean up body fluids,” she replied. I tried to borrow her mop to clean it up myself.

“You’re not allowed to use my equipment. You’re not trained. It’s company rules!” So I went to the cleaning cupboard to get some equipment to clean the mess myself. But it was locked and the cleaner wouldn’t open it for me. I ended up using a towel to clean up the vomit.

Then a patient slipped from his chair, and I found him sitting on the floor… asleep. I tried to find a nurse to help me sit him up, but couldn’t find one in the immediate area. I asked the cleaner to help me sit him up.

“We’re not trained to do that. It’s against company policy.”

My anger swelled. “I don’t give a damn what your company policy is. Show some bloody compassion and get over here and help me.” My appeal worked, as we helped the patient up off the floor.

Where were the other nurses? I wondered.

When I think of this type of sagging medical care in hospitals, I think back to Mr. Smith. His breakfast tray was always left out of reach. I’d come over from my side of the ward (I didn’t have the time, but I did when I could) just to feed him. Every day he got weaker, more dehydrated. The infection spread throughout his lungs. He just stopped breathing one day. If he wasn’t left in bed or in a chair all the time, maybe he wouldn’t have died. If there were enough physical bodies to just get him going, I’m sure he would have made it.

Managers and government people are always trying to find ways to improve hospitals. They set goals, devise plans, install new systems, but they never work.

Frankly, I think we just need more bodies to do the basic work of a nurse–which is simply to care.

Is anyone out there listening? Do you agree? I’m not the brightest or the most knowledgeable. I just want a chance to be heard. And I think I can make a difference. I think you—a new nurse—can make a difference, too.

“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.