Saturday, August 18, 2007

The REAL reason why there is a nursing shortage...

Being a nurse is a stone cold trip. If you choose not to "play the game" one can easily end up on the shit end of the stick. And in all fairness, I think that applies to all nurses regardless of color. But if you are reading this and you are a minority nurse, I think you know what I mean. I first noticed it in nursing school. It started with little nuances that are designed to weed out those who they "think" aren't going to make it. Most of the time, my school worked with me and my family situation. But there were those occasions when it became clear to me that they really didn't care about me or my family situation and that I needed to make a choice between being a mother or a nurse. While that is clearly not a choice I decided that I needed to see this thing through because I knew that if I quit nursing school it would be impossible to find a job to pay that private college tuition that was accruing with the federal government. Despite my family problems I had a solid GPA that was a true indication of my talent and drive to be a nurse. Don't misunderstand, nursing is my passion. I didn't get into it for superficial reasons like money or power, I love taking care of people.

I thought it would be different once I became a bonafide registered nurse. Think again. In the workplace, I have noticed that I get special attention that other nurses tend not to get. Even other new nurses. I am a new nurse, but a competent nurse. I noticed that if I ask a question, I get snubbed because perhaps maybe it is a question that people think I should know the answer. But if I don't ask a question and there is a marginal outcome, I am held accountable. I don't have a problem with being accountable at all. If I made a mistake I own it just as well as I own the things about my performance that I am proud of, it is part of my growth as a human being and an example of the splendid person that God created. I love my mistakes and great accomplishments, but damn! Is it a learning opportunity for EVERYONE? It is discussed in the conference room, in the break room, at the nurses station...wherever. And without regard to my feelings or need to have a healthy self esteem as a nurse. Sometimes, before I even have an opportunity to ask for help, I will turn around and there is a room full of nurses, which can be a good thing. At first this was a welcome sight because I knew that someone had my back. That was until I got called into the office about my performance. I talked to the charge nurse and she told me to politely ask people to leave if they come into my room on some bullshit. I can't tell whether or not it is bullshit or sincere help so I am a little cautious, which can be both to my benefit and/or my detriment. I was warned that one day I will call for help and no one will come. If that shit happens, I guarantee that I will not be the only one in trouble.

In my culture, you are to demand respect from others. That's how it is. Watch your mouth when you talk to me, treat me with the same respect that I treat you with. Or else. I do NOT kiss ass. Let me say it again, I DO NOT KISS ASS. I feel like I am just as good as anyone else. I am not going to sit around and gossip to the others about you. I will tell you to your face. The next day, I will still treat you with respect because that's how I am. Not at my job. One day I talked to someone about something that they did that I didn't like and she was so nasty, you would have thought that I had disrespected her. I followed the proper format too! You know the one that goes, "I didn't like it when you _______. It made me feel like_______, and I would appreciate it if in the future you would ________." There is no good way to give a nurse feedback. It is always misconstrued. Maybe I should try a different approach like, "I think you are a great nurse, ______. I respect your expertise and admire your style. But, it really bothered me when you _________. It made me feel like _________. I really want us to have a good working relationship. I would like it better if you ________. I hope you don't take this the wrong way. I truly value your friendship." Hell no, that is kissing ass. And besides, people aren't that nice to me. They will tell me off in front of anybody. The doctors, the patients, other nurses...whomever is present. But if I do it, no matter how I do it, I am defensive and mean. Ah, whatever. Sometimes you have the be the bigger person. But must DiVa always be the bigger person, taking the high road?

And the saddest part of all is that there are two other nurses that belong to my ethnic group, both more senior and more experienced that me. One is very helpful. The other treats me like crap. If the roles were reversed, no one could say shit about either of them in my presence. I would defend them to the end. The more senior of them has done everything possible to help me in my troubles as a new nurse. Without her help, I would not have made it as far as I have. And I understand that there are limits to the help she can give me without compromising her position. People respect her opinion and she is the one thing that keeps our unit afloat. Without her, our floor would be crap and everyone knows it. I can only hope that one day I can be as good a nurse as she. The other, she's in with the clique of nurses who sit upon the throne of nursing goodness and cast stones at those who choose not to participate in their brand of ostracism. I guess she really needs to be a part of their group, being snobby to others. She is so nasty to me that I have stopped speaking first. In my culture, if you see someone first, you are supposed to say "Hello." It's just one of those things my grandma taught me when I was little. There have been times that I have spoken to her and she acted as if I was invisible. I talked to her once and asked her what I ever did to her. She couldn't pinpoint anything. I told her that she wasn't a very nice person. She didn't sound surprised. She was nicer for a couple days and returned to being bitchy. Oh, and then there was that one day she implied that I was a bad mother because I don't allow my son to operate the lawn mower unsupervised. That isn't a very big deal, but it still pissed me off. It is clear that she thinks that she is better than me because she grew up in the suburbs and had the finer things in life. I learned something a long time ago that I take to work with me everyday. The worst possible situation that a person could have could easily happen to you. Never think of yourself as better than someone else just because you have more education, or money or more anything. You never know where you will end up. All that ass kissing that she does must pay off because people don't mess with her like they mess with me. The absolutely LOVE her.

The clique. I have found that if this group of nurses spend all their time pointing out the flaws of other nurses, then no one will notice that they aren't that great begin with. I imagine that they treat me like that because I choose not to hang out with them or attend their parties or say anything negative about other people. I can't trust bitches like that because if they will talk bad about others, they will talk bad about me and I don't play that. I don't tell them my business. They don't need to know nothing about me. In a way, I wish I could have friends at work but a the same time with friends like that, who needs enemies? This sort of behavior is not exclusive to the nurses on my floor. Doctors can be just as bad.

It seems to me that if there is a possibility that a situation that might have an unfavorable outcome, the doctor will find some way to make it a nursing issue. I cannot write prescriptions. I have not reached a level of expertise where I can question a doctor's judgement. Nor can I make any suggestions regarding the plan of care. I can only voice my concerns and document interventions the rest is up to the doctor. Twice in my short career has a doctor tried to shift the blame of a situation that had been going on ALL DAY on me. They need to settle the feud between them and family practice and find a way to work more cooperatively. Otherwise, family practice physicians should not do OB. Period. We are all on the same team. I strongly feel that medicine is a collaborative process. It is not us against them.

Whine, bitch, moan. Oh DiVa, you are the perpetual victim. This is my blog and I can talk about whatever I want but damn, wouldn't it be nice to hear me speak of my glowing experiences as a nurse. Wouldn't it? I am always doom and gloom. I have had a few nice deliveries, but it is always foreshadowed with drama. I am still wondering when I will be treated with the same respect and professional courtesy that I treat others with. I could always quit this job. believe me, I have had offers, but at the same time I feel compelled to stay. Maybe it is because I refuse to let this job beat me. Or that I feel like the patients need at least one nurse that really cares. Call me crazy. I guess I can control the stuff I write about, but in all reality, I don't have anyone to talk to about the stuff I experience as a nurse. No one that would understand anyway. I am sure y'all don't mind. I heard that it is like that everywhere. Can this be true?

DiVa...trying to make the best of a bad situation.

Addendum: I didn't even mention the long hours, low pay, lack of time for family/household responsibilities, huge workload and lack of recognition for service.


Brownsavvy said...

Hi, I've read your blog for a while now. You write EXACTLY what I'm going through. I'm a new grad African American woman who started working in the ER about two months ago. The same things are going on at my job. The cliques, the stares I get from you know who, all the extra attention I get that the other new grads don't get, the nosiness, all the questions. It's almost like I have to work extra hard to prove to them that I deserve the same amount of respect. I work so hard doing my job. It's a very, dare I say, racist environment where I work, but one of the best hospitals in my area. I'm going to stick it out for a year and then maybe leave, but I'm still in orientation now.

Anonymous said...

And here I was about to think that because all patients need care that the nurse playing field was even.

Vixen said...

Wow, both of you sound like you are going through it. I'm an AA nurse as well, but I started back East in Baltimore, and we were the majority. My unit did have cliques, so all I did was form my own clique with any new nurse that came after me. Eventually we all got immersed in the unit life. I think that as a newbie, they do want to test us before they 'trust' us, but I don't let them bother me. I'm here to do my job well, take care of my patients, cover my ass and go home at the end of the day well and paid.

Currently, the new unit I'm working on is kinda strange. IT's so disorganized, chaotic and not enough resource people. They are chronically understaffed. I'm not feeling it at all, I"m thinking of leaving soon.

Nurse Diva Extraordinaire said...


I am so glad to hear that I am not going throught this crap alone. I find that it is all consuming. It is affecting all of my relationships and I am falling into a depression. Something has to give.

I have been out of orientation for a while now and it is still the same. Except now, they want to know why I am so defensive. Why I am always explaining rationales for my nursing interventions. Why I am so defensive when they come rushing into my room. I don't know how else to respond.

I used to think that because all patients need care that the nursing playing field was even. So I tailored my care to be less social and more patient focused.

I spent all of my time in the patient's room, breathing through contractions with them. Catching up on my charting and developing a therapeutic relationship. My co-workers couldn't see what I was doing or watch my response to my tracing.

So they started complaining that I spend too much time in the patient's room. Seriously. My boss said that my peers had a problem with me spending too much time in the room. If they cared about taking care of patients the same way that I did, then the nursing playing field would be even. But they don't.

I agree that they need to establish a certain level of trust when a new nurse is on the floor. I don't blame them, we work in a high litigation field of medicine. Plus we are short staffed and many of the people on our floor have less than 2 years of experience. So essentially, it is the blind leading the blind.

What I need to do is learn how arrive at a place where I don't let them bother me. A place where I go home well and paid with my ass covered and my patients in good care. That is my new goal.