Category Archives: Work

So mad

So back in August, my manager approached me and told me they were restructuring the PRN pay scale and requirements. She told me I was working enough hours to qualify to be either a part-time employee (with benefits), or a PRN Extra (no benefits). Since I’m on my husband’s insurance, I opted for the PRN Extra, which carried a whopping 10% raise, but also required that I work two minor and one major holiday per year.

This was back in August. My manager submitted all this to HR August 29. Remember, SHE approached ME.

Since then, I’ve been asking my manager periodically for updates. I’ve been given many different excuses why I haven’t been given a raise yet: the code is not in the computer, there’s no other PRN Extras so they have to start from scratch, the higher-ups haven’t approved it yet.

So why did THEY ask ME?

Last week, I spoke to the Chief Nursing Officer (the woman who originally hired me). She told me that she was the holdup. She wanted to make sure, since I was the only employee who was going to be a PRN Extra, that the requirements were objective and would apply to anyone who wanted the job, not just me.

Okay, whatever.

She told me I’d have an answer by the end of last week. Nothing.

I wrote her a terse email this morning. She wouldn’t respond via email, except to say she’d try to get in touch with me before her meeting this afternoon. That seemed like a bad sign.

She finally called me as I was about to leave. She said that she and one other admin person had okayed the new status for me, but the raise wouldn’t be effective this paycheck. Even though the last pay period just ended yesterday. She said it would take effect the beginning of next MONTH.

I told her that I would be taking this up with Human Resources, and that I didn’t think it was fair that the raise wouldn’t be retroactive. Thank god I was prepared for them to do this, because if I hadn’t had a scripted response ready, I would have blown up.

I explained my situation to a woman in HR, and she told me she would get back to me after she looked into it. Which she hasn’t.

I have the bad feeling they will talk to me tomorrow while I’m at work. And it won’t be what I want to hear. And I’ll be hurt and mad and upset. And there won’t be anything I can do about it (like walk out) because I will be at work. And I will be furious all day. And I may cry, which I NEVER want to do at work!.

I’m thinking I’ll tell them to forget about the raise and the new position. And forget about me working ANY holidays at all. I’ll just come in and do my job and nothing extra.

I’ve worked there seven years. I’m a very good employee. Even though I’m PRN, I still take charge nurse duties, orient new employees, triage, and do extra work to support my unit. I feel that they should be happy to have me, and want to do what they can to make me happy. I play a valuable role in the department. If they really don’t want me to be a PRN Extra, why did they offer it to me?

They initiated all this. Why don’t they want to make good on their offer? I’ll let you know what happens tomorrow. But if I feel like I’m going to cry, I’m just going to go home. And I may be sick Thursday too.

Nothing worse than hurt feelings.

I had a very bad day at work

I don’t often lose my cool at work. I can handle pretty much anything.

But today, a patient pushed me over the edge. I had three patients. Plus one I took from another nurse who wasn’t feeling well. Then I got an ambulance. That’s five.

That’s too many. And I didn’t have any help with the fifth, except when I begged for someone to get an EKG. There were malfunctioning equipment, nonexistent symptoms, dangerously morbid obesity, made-up medical maladies, simpering, rudeness, and of course, a large mental health component hanging over it all.

What makes people think that because they have something wrong with them (or think they do), they don’t have to use basic manners?

Get me
Do this
I need
I have to have
You need to

Is it so hard to say please? I see clearly all the problems this woman has, and they should elicit pity from me, but they don’t. Because of her lack of common courtesy.

All I know is, I will never be so fat that I have to have someone else wipe my ass or use a rag on a stick. So there.

A really good day at work

I walked into work this morning ready for pretty much anything. But when they told me I was charge nurse, I groaned audibly.

For a whopping $1.50/hour extra, a charge nurse has the whole ED on her shoulders. She is the one who controls the attitude and climate of the unit, balances the patient load, prioritizes and re-prioritizes constantly, and keeps her staff, the doctors and the patients happy. It’s so not worth $1.50/hour.

And while I hate the responsibility, I also relish the challenge: today, I get to do this my way. And while I don’t do anything radically different, I am able to change the expectations of the staff a little. I can raise the bar.

Today turned out to be a great day. It was not very busy, just a steady manageable flow of patients. We had a quick, intelligent, even-keeled ED physician for the majority of the shift. And even when the slowest ED doctor on the roster took over in the afternoon, we were able to keep up the pace.

My team was comprised of nurses who ranged from inexperienced to seasoned, from efficient to slow, from frenetic to calm. We set our priorities early in the day: get the patients back quickly, make sure the triage nurse is always free for the next patient who walks in, and help each other out. With clear expectations, things went so much more smoothly.

There have been shifts during which I have been charge that went to hell in a handbasket, where we all felt happy that we merely survived. Today was not like that. Each nurse was happy at the end of today’s shift. Each of us felt like he/she succeeded in giving exemplary care to his/her patients. We actually had the time to do that for a change. What a treat.

This is the kind of shift that makes me look good. Talk about intermittent positive reinforcement.

Major venting

When I work, I do not sit at a desk all day. I work twelve straight hours, usually with no lunch except what I can choke down standing up betweens tasks. When I do get to sit, it’s briefly to do charting.

I get up to four patients to take care of at a time. Sometimes more, if another nurse is occupied. Any down time I get is spent helping my coworkers. They do the same for me. We work as a team.

When a patient comes in, I get vitals, perform triage, dress wounds, draw blood for labs, do a focused, then complete assessment. I record and reconcile all their medications, I put in orders for tests and procedures. I start IV lines, insert foley catheters, do EKGs, install nasogastric tubes, suction secretions. I apply pressure dressings, clean wounds, perform stroke assessments. I interview patients and their families, provide reassurance and give updates. I calm angry people, try to wake lethargic people, calculate IV drip rates and dosages. Most of this I do before the doctor has even seen the patient. I move quickly to provide comprehensive, exceptional care.

The patients do not come in at a steady, evenly spaced rate. We can get five ambulances within a half hour, along with two chest pains that walk in at the same time. We make sure patients are taken care of immediately, no matter what else is going on. That’s what patients want. When I am triaging one person, another may need medications or procedures. Another may need to be discharged or need a drip started, or be admitted. As soon as one room is emptied, it is usually filled again quickly.

Some patients require more care than others. A simple fracture may require pain med, xray and splinting. An abdominal pain requires a lot of time and work. A chest pain or a stroke must be taken care of very quickly. A psych patient can take a lot of a nurse’s time. A patient may have pain issues or toileting needs that cannot wait.

Today we had only three nurses all day when we should have had five. We had a great doctor and wonderful support staff, but each of the nurses had to perform the duties of 1.66 nurses. The computers were down for over half the shift, and when they came back up, there were many glitches to work out. It could have been much worse, but it wasn’t. We worked hard, we didn’t eat lunch, we didn’t sit much at all. But we gave great care.

So when I came home to a kitchen piled with dirty pans and cups and filthy counters and a sink full of dishes, I was unhappy. I didn’t want microwaved red meat for dinner. All I wanted was not to have to work anymore today. That’s all I wanted.

Well, that and maybe a hug.


I really don’t want to go to work tomorrow.

I just want to stay home with my men, maybe have Dani and Miles and Tommy over, maybe Cait and Koby and Owen, and Ryan. Dani could cut all our hair. I could make a big dinner. We could have Fire Night on the deck with the chiminea and make s’mores. The boys would love it.

But I have to work. I have to put in twelve crazy busy hours and be on top of my game. We are already down two nurses out of five, so I can’t call in. And it will doubly suck because of what day it is.

September 11, 2011. The tenth anniversary.

I wasn’t there, I don’t know anyone who died there. But it affected me deeply. I was pathologically compelled to watch the news channels 24/7 for months afterward. I cried when I watched the first tower fall while I was on the phone with Bill. I thought of getting my kids out of school and bringing them home to me. I became anxious.

How will I feel tomorrow? I don’t know. Since I realized I can’t call in sick, I decided to try to readjust my approach to the day. I’m just going to attempt to carry on as if nothing is different. And actually, nothing is. People will still get sick, seek drugs, break bones, and come in to our ED. And I will still be expected to give them the best care I can.

But I’ll probably have a news channel on a TV in an empty patient room, if there is one. I’ll probably be half-holding my breath all day, waiting for what I hope will not come. I will be anxious. I hope I don’t get snippy or short with people.

And I hope it is steady, not too busy. But busy enough for the day to go by quickly.

I guess if I have to go in to work, I’d like to just get through it and get it behind me. Let’s hope for a peaceful, uneventful day.