Finding A Workplace That Does Not Suck Series Concept #2: Morale

Whether you work for a Mom-and-Pop business or a massive corporation, you will encounter and experience the effects of morale.  High morale can be momentum to get you through the down time at work, as well as provide mental anesthesia for the rough times. Little to no morale at a workplace can be stressful, and have one reading the Classified Ads in the break room at lunch time.

As I have mentioned, it can’t be artificially generated.  Corporate meetings and memos will not make it manifest itself in the workplace.  There are a few factors that can have a direct bearing on whether or not it exists.

I think the biggest factor is how realistic the work load is for each employee.  A worker must have the perception that they can get the daily tasks completed. Some slack should be given if the person is training  or is still orienting to the new role, of course.  However, we have all had coworkers who have an easily managed list of tasks that they can never seem to get done – even with generous amounts of sneaky delegation or avoidance of some jobs to others.  Other workers have the incredible ability to easily handling their own workload, then either look for more work to keep busy OR cover for others to avoid seeing anyone (or their department) in trouble.  The lazy workers are enabled, as they are not likely confronted.  Those actually working get frustrated or angered at working harder than they have, to cover the slackers. That is definitely a morale killer.  Add in the potential dynamic of a lazy coworker that everyone, including the manager, knows about but refused to confront – that is even worse for morale.  Morale can also suffer when the workload is impossible, but management either does not care or – worse yet – actively takes steps to take away resources which make the job even harder.  Water cooler talk ends up being gripe sessions. Venting about a tough day becomes complaining.  While one may bond with coworkers over a tough time, it makes it harder to carry around your own stress – as well as the stress of friends during such times.

The last thing that can kill morale is the unfair application of the rules. As we all know, the employee handbook is something that we likely sign-off on upon hire.  However, some may not know that it is a legally binding agreement.  Your employment is a contractual agreement with terms that have to be met by both parties.  For those companies that do not have handbooks or a Human Resource department, the employer is still bound by Federal laws around fair hiring and employment practices.  Unfortunately, working for a company that does not fairly apply rewards or consequences to all of its employees usually means having to leave to escape the problems.  Confronting the problem makes you vulnerable to potentially being singled out and targeted for arbitrary things to write you up.  Even if you legitimately have a grievance – especially one that breaks Federal law; pursuing it makes your relationship with your current employer adversarial.  You may or may not get justice, but going after an employer with litigation essentially ends your job.  Which, for those who are emotionally close to coworkers, means losing your “work family.”   Choosing whether to stay or to go can be very tough. However, my suggestion is that if one does decide to leave an employer; it should be done discretely and thoroughly.  Research to find out the requirements of how much notice to give, along with what the process is around leaving.  Give your two weeks (or whatever) notice on paper. Be polite. Be civil. Say nothing negative or bash your current situation.  Line up references. Move on. When it comes to the new employer, remember the phrase, “I am exploring new opportunities.” This comes in really handy when the new employer asks why you left, esp. if you have been at the rough job for a long time.

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Finding A Workplace That Does Not Suck Series Concept #1: Team building

I was sitting at the nurse station on my unit when my boss walked by after interviewing a potential addition to our quirky team. All of us introduced ourselves and sent good wishes toward their

Source: Work Families: Where Nursing Shines

Finding A Workplace That Does Not Suck Series Concept #1: Team building

This article resonated with me. Actually, it got me thinking.  I would agree that work families are emotionally possible, but they have to be cultivated….and can be shaped by the people that are on the team. People can be outgoing, shy, intellectual, snarky, sarcastic, etc.  Everyone brings something to the workplace table.  As long as there is good communication, the team will grow.  The subsequent trust and commitment will make the workplace enjoyable and meaningful.  That can make a great shift fun, and a difficult shift bearable.

However, the team needs to bond organically. It can’t be forced.  Perhaps stating the obvious, but years in a variety of jobs over the years tells me that it isn’t obvious to some….namely, employers.  Unfortunately, businesses and corporations want all of the benefits of the teamwork – but are not aware of/understand/nor care about creating the environment to support a team. No, it’s not boring meetings. No, it’s not getting low-budget bling (lanyards, water bottles, etc.) with corporate logos on them.  More often than not, bosses paraphrase the empty parental solution to siblings that aren’t getting along:

“I want you all to get along. I don’t care how you do it.”

That ranks up there with “don’t make me come back there” and “I will turn this car around and we will go STRAIGHT home!” These statements remind me of my  childhood memories of sitting in a large, light blue Ford station wagon barreling down a distant highway during the 1970s.  We learn, at an early age, the difference between a real and empty threat.  The surface truce with siblings could be masked in front of the parents, but the resentment over such trivial things as this-is-my-side-of-the-car-and-thats-your-side arguments did not fade as easily.  The same can be true of co-workers. One moment, they can be civil and stand-offish to outwardly hostile.  This is what is known as “drama.” It exists, to some extent, in all workplaces.  At high levels, the drama can be as stifling as someone seriously ripping a fart in the med room.  This spontaneous analogy being obvious.  You don’t want to be there, but you have to be.

The synergistic power of having a great team of people is incredible.  As a nurse (extending to any medical field, I suppose), it is even more important.  We face very intense moments that require us to focus, assess, and act on our training, skill sets, and emotional resources to keep our patients safe and healthy.  Research identifies the negative emotions as impeding our ability to provide safe care. When our managers and coworkers function as resources and support; we can maximize our care.  However, when the work environment leaves you feeling alone and overwhelmed; you don’t have enough emotional resources left to be the best nurse/worker you can be.

The bottom line: Regardless of the source of your motivation to work, if you don’t want to be there; it is likely time to move on and work somewhere else.

For Hospitals, High Quality Care And Success Depend On The Happiness Of Nursing Staff

Nurses are the lifeblood of a hospital; now there’s just a study to prove it.

Source: For Hospitals, High Quality Care And Success Depend On The Happiness Of Nursing Staff

Author note: I would love to see the data that supports this statement in the article:

“Magnet hospitals are also known as exemplary health care systems, recognized by the American Nurses Credentialing Center as a great place for nurses to work.”

I will have to do some research. Please feel free to add sources in the comments.

Top 10 Things That I Love About Nursing

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10) Patient Education –  I have always wanted to be a teacher.  As it turns out, nursing includes quite a bit of that.  The good news is that the audience is only patients and/or their families, instead of 35 bored, distracted teenagers.

9) Patient Advocacy – There is something very empowering about being the voice of a patient, especially one that is not able to speak up for themselves.

8) Teamwork – There is something very synergistic about working with others, especially if there is a good sense of teamwork.  Coworkers go beyond being other people at work.  They become friends (or work family, at times) and everyone looks out for each other.  The support and encouragement from them can give you more energy to get through a rough shift, as well as make an smoother shift seem even better.  It is also empowering to be able to share insight and discuss how to manage new issues as they arise.  Unfortunately, not all employers provide and/or maintain this kind of environment. Sometimes, you have to work to find them.

7) Scrubs – Having spent decades in the corporate world, I can speak from experience that dress clothes and neckties suck.  Scrubs rock.

6) Improved Time Management Skills – The constant practice of assessing the situation, available resources, and knowing how long it takes to complete a task carries over into my personal life.  Juggling family demands, as well as academic and social demands seems easier, if that makes any sense.

5) Confidence – I am far from being an experienced or expert nurse, but I have faced down some fairly emergent situations that do provide some perspective on what it means to be in a crisis.

4) Doing Something Meaningful – Some people look to make a difference in the world. It is not a requirement, but when applicable, can add an extra layer of satisfaction.

3) Respect – Nurses rank as the most respected and most trusted profession.  I chose nursing because of the overwhelming desire to take care of others.  However, it is nice that I am in a profession that is respected.  It can be troubling, and sometimes annoying when new acquaintances (and even strangers) solicit me for my medical opinion.  A cashier at a gas station, one morning, started rambling on about changing medications. I did not know her.  I just wanted to finish my drive home to get some sleep.  I told her to ask her primary care physician.

2) Evidence-based practice – Anything a nurse does is based on evidence-based practice. In other words, nurses study an issue…..do research….test the findings….then use that data to shape our practice.  Not only does science rock, nurses use it to support their work.

1)Plenty of opportunities to learn – There are so many aspects and layers to nursing that the learning process is always on-going.  Our profession requires continuing education credits, but there is always formal training at work (on-line/in-person classes) as well as informal training (getting a patient with an illness/injury that you’ve never seen before).  For those of us who pursue more education, there are always classes toward a bachelors, masters, or even doctorate.

Did I Mention That I Love Being A Nurse?

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It was a rough week at work.  Patient assignments can vary, but sometimes the acuity level of the patients can elude the numbers generated on paper.  At the end of a few 12 hour shifts in a row, I felt like my body and brain were steamrollered. Luckily, I work with a great team. Nursing seriously rocks.

Setting Unrealistic (Medical) Expectations

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Laser Spine Institute Commercial

Being in the medical field, I take care of wide range of patients….including those with joint and spinal problems.  Pain not only can make doing everyday tasks difficult; it can also be difficult to manage.  Sometimes, pain management is finding the right combination of the type of pain medicine, physical therapy, and even other non-invasive procedures.  Surgery can be an option, but it shouldn’t be the first choice.  Doctors are required to present patients with information about what the surgical procedure is, what the possible benefits are, what the risks are, and what to expect afterwards.  There is ALWAYS a risk with surgery.  It can happen for any number of reasons, including allergic reactions or extrapyramidal responses to medicine, comorbidities with the patient, or any complication during the procedure.  Every person is different; therefore, their response to the medicines, treatment, and surgery can be different, as well. Here is where I begin to have a problem with commercials with the Laser Spine Institute.  It presents all of the benefit with none of the risk. Setting expectations really high….unrealistically high, in my opinion.

I found one website that gives patient reviews about the organization. Granted, I am not completely sure of the credibility of the website….or those who present any information about it.  I am not gullible enough to believe that any presence of data on the Internet means it is true. I also found a Bloomberg Business article about lawsuits against Laser Spine Institute, so I would think there may be more credibility with this information. I will leave it up to the reader to check its veracity of its statements.

Speaking of veracity of its statements, I am reminded of a similar “rosy picture” painted by commercials produced by the Cancer Treatment Centers of America.  I have read articles that say that their success rates are heavily influenced by not taking on patient cases that may have more serious, more aggressive forms of cancer (that may not be as likely to survive).  Quoting a Doctor interviewed for an article from Reuters News Service that Iinked to:

Accepting only selected patients and calculating survival outcomes from only some of them “is a huge bias and gives an enormous advantage to CTCA,” said biostatistician Donald Berry of MD Anderson Cancer Center in Houston.

This is more than just a nurse pointing out nonsensical responses to medical crises on Grey’s Anatomy (Don’t get me started!). This is irresponsibility among those whose motives are financially-oriented that patient-driven.

 

 

 

 

Facebook & The Fine Art of Defriending

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The surface of Facebook may be a shiny facade of blunt cards, pets subjected to silly wardrobes, and people going into way too much details about their lives. The reality is that Facebook has also placed an unnatural framework on relationships. This uncomfortability has given us the term “defriending.” f

According to this website,  over 1 billion people actively use Facebook daily. So, if you are reading this; you statistically are likely to have experienced the phenomenon I am about to describe.  According to another website says that we have an average of 350 FB friends.  Chances are, it’s a mish-mosh of current and former coworkers, childhood friend, neighbors, people you may have met at social functions, friends of friends, extended family, ex-boyfriends or girlfriends, and people from various other sources in your life.  The reality of friendship is that reality offers many levels of intimacy. Some are very close friends. Some may have the potential for that, but are still rather new. Some people may share some common interest, but ultimately will never be that close. Some we have very basic interactions with, but are not likely to go beyond that. Some may have been close once, but life paths may have taken you both in two very different directions. As we age, our perspective on life changes. Our political, religious, and social views change over time. On top of that, electronic social interaction do not share the benefit and nuances of physical gestures,  vocal tone/pace/ inflection, facial expression, and delivery to also indicate meaning. What does Facebook offer us? We can either be their friend or not their friend.

We see Facebook friend requests sitting in our profile when we check in on-line.  Some we accept quickly. Others, we wait.  Then, we may accept or delete later.  As our Facebook friend list grows, we may start to reevaluate who is on it; especially if that particular user decides to overstep social, political, or religious boundaries that we don’t feel comfortable with.  We are faced with struggling to choose between taking them out of our news feed, filter them from our wall posts, or defriending.  I have found that defriending someone can really cause people to get upset.  I have defriended people that I don’t feel particularly close with, but their response was to message me to ask why I did it.  I have also had defriended people call my mom to ask why they defriended me.  What people don’t seem to understand is that friending (or defriending) is my choice. I simply want that expected…..and leave my mom out of it.

Facebook has generated this uncomfortable dynamic, but no one seems to talk about it.  Facebook is also responsible for a great deal of useless drama, not to mention that it can get people in trouble for any number of reasons – including causing them to lose their jobs.  I will admit that I am old, but I think that we collectively need to rethink how documented our lives need to be electronically.  One major advantage about acting like an idiot in real life means that one does not have to worry about “going viral” and end up on Good Morning America to defend obnoxious behavior to the masses.

Doomsday Preppers, The History Channel, and when the SHTF

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While digging through YouTube videos to find new music, as well as nurse bullying info; I found a bunch of Doomsday Preppers/When the SHTF stuff.  Apparently, my NURSE BULLYING (her story) post is from The Patriot Nurse. From what I’ve been able to see, she is an experienced nurse who has an established following who watch her post-apocalypse survival tips. They range from the medical to the social aspects of things to consider when the SHTF (which is prep talk for excrement hitting the fan).  I know that Doomsday Prepping is a television show (I’ve seen a few episodes). The theme has also managed to appear in Pinterest, which is a nice change of pace from womens’ hair styles, clothing, and “smokey eye” tips.  Still, I hesistate about embracing the end-of-the-world movement.

As if the prepping movement needed any help with resting the depressing thought on our collective shoulders that the world will eventually end as we know it; the History Channel offers up a great line-up of shows that share the same theme: We’re All Gonna Die!  Featuring the predictions from Nostradamus, or some computer program that has allegedly made its own apocalyptic predictions.  There are also segments on Biblical passages, including the book of Revelations, the rise of the Anti-Christ, and the End of Days.  There seems to be no end to the film footage of terrorist acts, explosions, gun play, and other violent acts to drive their point home. Oh, I am not sure if it’s the History Channel, but there is also a TV show called Life After People. It shows the world in decay after people are no longer around. It will look a great deal like the I am Legend film (Isaac Asimov’s book made into a film, starring Will Smith).

After watching such shows and/or youtube videos, I usually end up having nightmares for an evening or two. Now, what do I do with this?

  • Go full out prepper – Build a shelter, buy generators, meds, weapons, etc.
  • Go partial prepper – Build shelves in my garage, get some stuff
  • Go mini-prepper – Put together a bug-out bag
  • Embrace the chaos when it happens

If the societal infrastructure were to collapse, due to any number of scenarios; my guess is that the freefall we would experience could last months, if not years.  We have no idea what parts of the system would emerge as the new norms.  Money, in any of its forms, would be obsolete. Much of our wealth is stored electronically. If the power grid were to fail, we would lose access to that data. I am guessing the barter system would come back, that is….once the rioting slowed down. Nature abhors a vacuum. Panic, fear, and hate are all temporary states. People would freak out, then likely settle down after a time.

Healthcare priorities would change as the sickly, injured, frail, and weak would ultimately die off as medicine, medical equipment, and supplies would stop being available.  For those newly injured or maimed under the absence of the current health care system would find themselves divided into one of two categories: those we can save and those who are/will be beyond help.  I can’t imagine that playing out well. While we would reap some benefit of having vaccinations, the pathogenic threats would rise – especially if the waste removal system were to fail. The historic blending of waste and water supplies will not bode well for the masses.  The concept of infection control would be harder to follow, for those even aware of how to maintain it.

The demand for certain skill sets will arise. Here is where we will see drastic changes in how we contribute to society. The Haves-&-Have-Nots will change from financial to those who have the ability to work with their hands.  Building, creating, and repairing skills will become valuable. Those in health care will probably have some value in the new world.  Those in education will have a place in the new world, especially when the emphasis changes from rioting to society rebuilding.  Those who lived off the system, who may not have had the benefit of specific training, or even those with general office skills may be at some disadvantage.  Those familiar with hunting will obviously have some advantage, although the wildlife may not be able to keep up with the demand – if the food supplies dwindle too quickly.  Farmers will have some advantage as well. Which points out the next issue, those who don’t have may feel compelled to take from those that do. That’s gonna be ugly. Those in law enforcement may find themselves falling back to protect themselves, like everyone else. The demand for rules may take some time to become valuable again. Education and the need to train the next generation may also take time to gain value again. Books will come back into vogue again.  Knowledge and skill  not be something we can Google.

I can’t help but think that most Doomsday Preppers are thinking that we will be living in a RED DAWN movie existence….or some kind of post-Pinterest experiment.  I think, however, we are probably looking at something a lot messier….like third-world country messy.  Unreliable power, unstable social structure, and the masses fighting to gather their own resources.  It will be ugly. I am not sure that even a bug-out bag will help all that much.

 

 

Embrace The Chaos

Shift report can be a funny thing. Your patient assignment, even if you have had the group before; can go in many directions. You may have a patient whose vital signs are “circling the drain,” or lab results have just come back all wonky.  Altered mental status, sometimes in the form of ‘sundowners’ can make a quiet evening a noisy/busy one.  There have been shift reports where I felt like that last click on the first hill of a rollercoaster. Butterflies in the stomach. You know it’s going to be a wild ride, but you don’t know where it will go. This is where I came up with the phrase, ’embrace the chaos.’  You fight that new nurse urge to go in the opposite direction of the crisis, and step towards it.  You tap into your spiritual center to remain calm, build upon your desire to help people, then tap into your skill sets and knowledge to work towards saving the patient.

However, those evenings that feel like all the little things spin out of control.  You begin to feel like everything is closing in. Perhaps the feeling of being trapped in a strange medical game show.  I think these are the moments that separate new nurses from experienced ones. As the saying goes, “new nurses run/old nurses don’t.’  Experience nurses work smarter, not faster.  I was able clear my mind, take a deep breath, then attempted to use my best critical thinking skills to determine what I needed to focus on first.  I also found out that all of the rituals I had developed to improve my time management skills, including those during med pass paid off.  Reading this, I feel that I am making smaller events seem larger – which is probably the case. However, I think I had a glimpse into even more intense rapid response/codes in the future.

Not that I have had many of these moments, but I have had a couple. A few cases had to do with hypoglycemia. Another case, a patient I had just collected blood labs on, came back with a 7.2 Potassium level. The free charge was very supportive. There is a set protocol, listing everything to do – include contacting the doctor.  The supplies were organized. The checklist was followed. Luckily, everything turned out well. It was scary, but a manageable, learning moment scary.  I was able to ask questions while things unfolded. Since then, I have also seen other nurses go through crises with their patients.  The sense of teamwork and commitment that my peers and I share reinforce the decision that I made to join this team. Nursing rocks.