[inthemindofanurse]

What happened to people taking pride in their work? What happened to people wanting to learn? I am so disheartened by today's society I have been noticing people at work cutting corners and just not seeming to care about things. I have heard "that's not my patient" too many times to count. I hear people tell patients "I don't know" quite often. I watched a girl put her deodorant on in the middle of the office, in the middle of rooming patients. Where did TEAMWORK go? I thought when someone didn't know something that was part of their job, they learned. What happened to being/acting professional at work? I had a meeting with my boss and brought to his attention that things weren't being done they way we were trained and it was making the whole office look bad (ex: pt was diagnosed with breast cancer while up north for the season, we have seen her twice since then, and it's still not documented in the chart) <---- this is just an example! The response I got has now got me wondering why I even try? If the boss doesn't care why should I? Why do I stress myself out to do everything to the best of my ability when nobody else around me is? What's the point? I mean, even on here...I tried to get on here and help people and I got people who were just so negative and hateful (Not all of you!, please know that I do acknowledge those who appreciated what I was trying to do) I feel like everybody has got the mindset of just doing enough to get by. Do just enough work to not get fired. Learn just enough about my health that I don't kill myself by mistake. I just want to give up To make it worse, I see/hear patients say how wonderful their nurse is because she was so sweet and chatty and smiley. Yet, that was the same nurse who didn't take the time to document in your chart that you got a flu shot, who was too busy on facebook to send in that prescription you asked for. Then there is me: who is kind and welcoming but more professional, focused, and concerned about making sure all the i's are dotted and the T's crossed. I am so upset at the society I have brought a child into.

[Railcruiser]

I totally get it. And thankfully so do a lot of people that I work with. Lucky for me and my patients

[redwitch]

Sadly, I think there has always existed the group that just skates. My father was in the Army. There were two types of military -- the lifer and the career soldier. One worked to exist, the other worked to excel. There were more lifers than career soldiers. The same is true in all walks of life. It does sadden me to think that medical staff have this attitude. This my life and the lives of people I know and love in their hands.

One thing that makes a difference is the head honcho. If a lifer is in charge, the staff sees it and acts accordingly. If a career individual is on top, the staff knows and is more willing to go the extra mile.

Maybe it is time for you to look for a doctor who cares if the i's are dotted and the t's crossed. You have my sympathies.

[goodtimesintv]

O.P., you're not alone in such frustration. We had parents and grandparents who taught us to have a work ethic we'll keep on exercising till the day we drop dead.

Now you have young people being fed a steady diet that says they all deserve to get the same pay of minimum $15/hour, when everybody knows some aren't even worth $2/hour and their absenteeism laughs at employers.

We see nurses and doctors forced to spend more time feeding a slow, cumbersome and lacking computer record than actually talking with and taking care of the patient. It's this way because that is the goal of those who are greedy for power.

OP, bravo. I totally agree with you. There are still a few people that care, not just in the medical field, but in all business and service related fields. But, for the most part, people just don't give a crap; they do just what they have to do to get by and keep their damn job because their bosses are cut from the same cloth. It's gotten to the point where I've come to expect to be treated that way and am pleasantly surprised when they at least get to the "above" part (too much to expect for them to get to "above and beyond").

I'm 62 and was raised to do what I could to get a job done by doing it right and to respect the people I was doing it for. WTH has happened to society?

[golfing eagles]

Originally Posted by inthemindofanurse

What happened to people taking pride in their work? What happened to people wanting to learn? I am so disheartened by today's society I have been noticing people at work cutting corners and just not seeming to care about things. I have heard "that's not my patient" too many times to count. I hear people tell patients "I don't know" quite often. I watched a girl put her deodorant on in the middle of the office, in the middle of rooming patients. Where did TEAMWORK go? I thought when someone didn't know something that was part of their job, they learned. What happened to being/acting professional at work? I had a meeting with my boss and brought to his attention that things weren't being done they way we were trained and it was making the whole office look bad (ex: pt was diagnosed with breast cancer while up north for the season, we have seen her twice since then, and it's still not documented in the chart) <---- this is just an example! The response I got has now got me wondering why I even try? If the boss doesn't care why should I? Why do I stress myself out to do everything to the best of my ability when nobody else around me is? What's the point? I mean, even on here...I tried to get on here and help people and I got people who were just so negative and hateful (Not all of you!, please know that I do acknowledge those who appreciated what I was trying to do) I feel like everybody has got the mindset of just doing enough to get by. Do just enough work to not get fired. Learn just enough about my health that I don't kill myself by mistake. I just want to give up To make it worse, I see/hear patients say how wonderful their nurse is because she was so sweet and chatty and smiley. Yet, that was the same nurse who didn't take the time to document in your chart that you got a flu shot, who was too busy on facebook to send in that prescription you asked for. Then there is me: who is kind and welcoming but more professional, focused, and concerned about making sure all the i's are dotted and the T's crossed. I am so upset at the society I have brought a child into.

Sadly, you are 100% on the mark and I have seen everything you describe and more. But I'm just going to comment on the two statements that irk me the most:

I hate the phrase "That's not my patient" I trained in "the old days" when you helped out your fellow resident, stayed until all the work was done, even if it ended up being 40 straight hours. There was no such thing as "not my patient". We were all there BECAUSE of the patient, not in spite of him. Even if a nurse was overtaxed, she would help with a patient or immediately get someone who could. Somewhere in the 90's this all changed, as nursing focus shifted from patient care to documentation. It was the exceptional nurse that could do both (I'm glad you could). The problem was that a nurse was more likely to get "in trouble" for not documenting volumes of paper than for taking 30 minutes to answer a call bell---we can thank the regulators for that one. I remember the first time, in 1999, that I heard a young physician state "that's not my patient", He was 25 years old when I sat him down, I have no idea how old he was when I finished lecturing him. In my opinion this was a result of the "shift mentality" that arose in the aftermath of the Libby Zion case that changed the nature of physician training nationwide.
As far as the example you gave goes, it is almost unbelievable. I cannot imagine something like that happening. In the reverse situation, the first line, the VERY FIRST line of that encounter would look something like "Pt returns from winter in Florida with newly diagnosed T1N0M0 ER+PR+ ductal carcinoma of the R breast. A 1 cm suspicious lesion was discovered on routine mammography; she subsequently underwent stereotactic biopsy with positive pathology. Pt elected to undergo lumpectomy with axillary node dissection and completed 6 weeks adjuvant RT, now on arimidex" I just can't see writing anything else---but this didn't happen not once, but twice? And your "boss" didn't think anything of it??? If Karma exists, this is what will happen down the roda---the patient will call concerned that she has a recurrence of her breast cancer, and the physiciam will respond "What breast cancer?"---Good luck with what ensues then.

Originally Posted by goodtimesintv

We see nurses and doctors forced to spend more time feeding a slow, cumbersome and lacking computer record than actually talking with and taking care of the patient. It's this way because that is the goal of those who are greedy for power.

This is just the modern version of writing volumes by hand. We actually have a pediatrician in town who uses a desktop instead of a laptop, so his back was constantly to the patient/mother!! But the reason for all this computer time falls squarely on the government regulators and insurers. We are being used as glorified data gatherers for God knows what reason, and their hunger for this data grows exponentially. Now, they have no idea what the data is or what it means or how it relates to patient care---they are just there to "gather" it. Very efficient, huh? I am so glad I retired a few months before the implementation of ICDM 10---7 digit "codes" for each diagnosis, with thousands of pages of government regulation behind it. So you can expect more computer time and less patient time from your next visit. Not to be political, but consider this---If you can't get the people to want socialized medicine, and you can't get the doctors or Congress to approve, then just regulate the industry until it crumbles leaving no choice. If you don't think that can happen, I have two words to say---"coal industry"

[Taltarzac725]

https://en.wikipedia.org/wiki/Libby_Zion_Law

Just a little information on the Libby Zion Law.

I remember how much some Tort Law Professors at the University of Minnesota Law School disliked the "arrogance" of doctors and some nurses. Documentation is quite important as a defense against lawsuits and the like. I have not really liked the doctors I have seen in the Villages and elsewhere in Florida all that much since moving here in 1996. No Florida doctors seemed to care all that much about the patients. Most seemed deep into their charts, books, etc. than actually looking at the people they are trying to help.

[graciegirl]

Originally Posted by inthemindofanurse

What happened to people taking pride in their work? What happened to people wanting to learn? I am so disheartened by today's society I have been noticing people at work cutting corners and just not seeming to care about things. I have heard "that's not my patient" too many times to count. I hear people tell patients "I don't know" quite often. I watched a girl put her deodorant on in the middle of the office, in the middle of rooming patients. Where did TEAMWORK go? I thought when someone didn't know something that was part of their job, they learned. What happened to being/acting professional at work? I had a meeting with my boss and brought to his attention that things weren't being done they way we were trained and it was making the whole office look bad (ex: pt was diagnosed with breast cancer while up north for the season, we have seen her twice since then, and it's still not documented in the chart) <---- this is just an example! The response I got has now got me wondering why I even try? If the boss doesn't care why should I? Why do I stress myself out to do everything to the best of my ability when nobody else around me is? What's the point? I mean, even on here...I tried to get on here and help people and I got people who were just so negative and hateful (Not all of you!, please know that I do acknowledge those who appreciated what I was trying to do) I feel like everybody has got the mindset of just doing enough to get by. Do just enough work to not get fired. Learn just enough about my health that I don't kill myself by mistake. I just want to give up To make it worse, I see/hear patients say how wonderful their nurse is because she was so sweet and chatty and smiley. Yet, that was the same nurse who didn't take the time to document in your chart that you got a flu shot, who was too busy on facebook to send in that prescription you asked for. Then there is me: who is kind and welcoming but more professional, focused, and concerned about making sure all the i's are dotted and the T's crossed. I am so upset at the society I have brought a child into.

What you are describing is life in general and there is no escaping it. People who are conscientious and people who don't care hold all kinds of jobs all over this planet. Some of them are bosses, some of them are co-workers and some are people we are responsible to oversee.


Most of us have a few decades on you and we could tell you some stories that would curl your hair. There are degrees of responsibility displayed in almost every effort in this world. Some always do what is right and some hardly do enough to get by.


The secret of success in life is to just keep on keeping on. Sometimes, not often, our good example is enough to change others. The only person that you have much power over is yourself. You say that you want to get your degree. You would be mighty surprised how many folks on this forum continued that effort into their forties and fifties and carefully budgeted and sacrificed and worked part time and full time in order to get it done.


Don't give up. You can do it.

[goodtimesintv]

Originally Posted by golfing eagles

Sadly, you are 100% on the mark and I have seen everything you describe and more. But I'm just going to comment on the two statements that irk me the most:

I hate the phrase "That's not my patient" I trained in "the old days" when you helped out your fellow resident, stayed until all the work was done, even if it ended up being 40 straight hours. There was no such thing as "not my patient". We were all there BECAUSE of the patient, not in spite of him. Even if a nurse was overtaxed, she would help with a patient or immediately get someone who could. Somewhere in the 90's this all changed, as nursing focus shifted from patient care to documentation. It was the exceptional nurse that could do both (I'm glad you could). The problem was that a nurse was more likely to get "in trouble" for not documenting volumes of paper than for taking 30 minutes to answer a call bell---we can thank the regulators for that one. I remember the first time, in 1999, that I heard a young physician state "that's not my patient", He was 25 years old when I sat him down, I have no idea how old he was when I finished lecturing him. In my opinion this was a result of the "shift mentality" that arose in the aftermath of the Libby Zion case that changed the nature of physician training nationwide.
As far as the example you gave goes, it is almost unbelievable. I cannot imagine something like that happening. In the reverse situation, the first line, the VERY FIRST line of that encounter would look something like "Pt returns from winter in Florida with newly diagnosed T1N0M0 ER+PR+ ductal carcinoma of the R breast. A 1 cm suspicious lesion was discovered on routine mammography; she subsequently underwent stereotactic biopsy with positive pathology. Pt elected to undergo lumpectomy with axillary node dissection and completed 6 weeks adjuvant RT, now on arimidex" I just can't see writing anything else---but this didn't happen not once, but twice? And your "boss" didn't think anything of it??? If Karma exists, this is what will happen down the roda---the patient will call concerned that she has a recurrence of her breast cancer, and the physiciam will respond "What breast cancer?"---Good luck with what ensues then.

This is just the modern version of writing volumes by hand. We actually have a pediatrician in town who uses a desktop instead of a laptop, so his back was constantly to the patient/mother!! But the reason for all this computer time falls squarely on the government regulators and insurers. We are being used as glorified data gatherers for God knows what reason, and their hunger for this data grows exponentially. Now, they have no idea what the data is or what it means or how it relates to patient care---they are just there to "gather" it. Very efficient, huh? [COLOR="rgb(255, 0, 255)"] I am so glad I retired a few months before the implementation of ICDM 10---7 digit "codes" for each diagnosis, with thousands of pages of government regulation behind it. So you can expect more computer time and less patient time from your next visit.[/COLOR] Not to be political, but consider this---If you can't get the people to want socialized medicine, and you can't get the doctors or Congress to approve, then[COLOR="rgb(255, 0, 255)"] just regulate the industry until it crumbles leaving no choice.[/COLOR] If you don't think that can happen, I have two words to say---"coal industry"

That's right. Wreck it so that people are desperate enough to want anything promised them by the bureaucrats.

From "The 16 Most Absurd ICD-10 Codes" being inflicted upon medical clinicians:

5. Y93.D: V91.07XD: Burn due to water-skis on fire, subsequent encounter​.

How does this happen? Are water skis even flammable?

4. W55.29XA: Other contact with cow, subsequent encounter.

"Other contact with cow." OTHER CONTACT WITH COW? There are codes for "bitten by cow" and "kicked by cow." What else is there?! What, precisely, is the contact with the cow that has necessitated a hospital visit?!

3. W22.02XD: V95.43XS: Spacecraft collision injuring occupant, sequela.

The existence of this type of code does not engender trust in the National Aeronautics and Space Administration. Shouldn't they have more control over their spacecraft than that? Or are they just careening around in the ether, pinging into one another and injuring occupants/astronauts?

2. W61.12XA: Struck by macaw, initial encounter. ......

See the whole story:

The 16 most absurd ICD-10 codes | Healthcare Dive

Do people have ANY idea what is going on with these bureaucrats??????

[golfing eagles]

Originally Posted by Taltarzac725

https://en.wikipedia.org/wiki/Libby_Zion_Law

Just a little information on the Libby Zion Law.

I remember how much some Tort Law Professors at the University of Minnesota Law School disliked the "arrogance" of doctors and some nurses. Documentation is quite important as a defense against lawsuits and the like. I have not really liked the doctors I have seen in the Villages and elsewhere in Florida all that much since moving here in 1996. No Florida doctors seemed to care all that much about the patients. Most seemed deep into their charts, books, etc. than actually looking at the people they are trying to help.

I agree with a lot of that, but I have a slightly different take on it. I was a resident while the whole Libby Zion case started, so obviously it was of interest to all of us. The Wikipedia article has some faults. Just to be clear, I've never heard of meperidine being called "pethidine"---Everyone would know it better as Demerol. And phenelzine is Nardil, a powerful MAO inhibitor. And while the specific serotonin syndrome reaction to receiving both these drug was largely unknown, we ALL knew never to mix ANY drug with a MAO inhibitor without checking on it first. That being said there would still be two problems. First, serotonin syndrome is pretty rare, and now is listed on a whole array of drugs under side effects on your pharmacy handout---please, nobody get frightened and certainly don't stop any medication, this labeling is overkill for the most part---my wife is on 4 meds that all list this (and they haven't killed her off yet). Second, Libby apparently was wildly out of control, her main complaint at the time was abdominal pain, not "the flu", and she did not tell the physicians what medication she was taking. Plus the cocaine story may have been whitewashed a bit as revisionist history goes
As far as the aftermath goes, the NYS Health Dept is NOT physician friendly--they are out there to hunt heads, not help. The commission made the right decision, but the Board of Reagents made the highly unusual move of overturning their ruling. Perhaps this had something to do with Sidney Zion's friendship with Gov. Mario Cuomo??? Add to that the concept that when you look up a**h*le in the dictionary, there is a picture of David Axelrod
I still think the final result has been the onset of the "shift mentality" in young physicians. They were trained to watch the clock, since the hospital faced huge penalties if a resident exceeded the time limitations. This is why more docs seek employment rather than a private practice---they come, punch a clock, leave, and collect a paycheck. None of the work that goes into a successful practice.
As far as "Florida doctors" (a tremendous overgeneralization) being engaged in documents and computers---that is the new reality nationwide. If I were to make a generalization, it would be that, as a group, they tend to order way too many tests and procedures, but obviously that doesn't apply to every physician. I hope you do find one that you like.

[golfing eagles]

Originally Posted by goodtimesintv

Do people have ANY idea what is going on with these bureaucrats??????[/COLOR][/B]

How could they--the bureaucrats don't even know what is going on with themselves.

From your link:

"There are 68,000 billing codes under the new ICD-10 system, as opposed to a paltry 13,000 under the current ICD-9. The expansive diagnostic codes, intended to smooth billing processes and assist in population health and cost reduction across the healthcare delivery system"

So just how does this monstrosity "smooth" billing, "assist in population health" and bring "cost reduction"????? It's just Washingtonspeak for dreaming up crap that will have the opposite effect of the stated goal

[tomwed]

Originally Posted by goodtimesintv

[INDENT]5. Y93.D: V91.07XD: Burn due to water-skis on fire, subsequent encounter​.

4. W55.29XA: Other contact with cow, subsequent encounter.

3. W22.02XD: V95.43XS: Spacecraft collision injuring occupant, sequela.

2. W61.12XA: Struck by macaw, initial encounter. ......

I found a few in The Village section:
W37.32XB: Struck by macaw again, should have known better, treatment denied
W42.79XJ: Tripped over a stripe, who knew?
W90.94XA Pickleball lodged in the tukas, charged net too soon,
W10.32XB Drone propeller tangled up in hair, stupid nosy neighbor
W43.31XC Burned lips blowing up Yamaha golf cart, senior amateur terrorist attempt

[golfing eagles]

Originally Posted by tomwed

I found a few:
W37.32XB: Struck by macaw again, should have known better, treatment denied
W42.79XJ: Tripped over a stripe
W90.94XA Pickleball lodged in the tukas, charged net too soon,
W10.32XB Drone propeller tangled up in hair, stupid nosy neighbor
W43.31XC Burned lips blowing up Yamaha golf cart, amateur terrorist attempt

Uh-oh. Dangerously close to humor in a "serious" thread. I see you got over your "insecurity" rapidly.

[tomwed]

Originally Posted by golfing eagles

Uh-oh. Dangerously close to humor in a "serious" thread. I see you got over your "insecurity" rapidly.

[Like my swing, it comes and goes. I hope that wasn't just close to humor--I worked on that, I'm still laughing.]

[Bonnevie]

"To make it worse, I see/hear patients say how wonderful their nurse is because she was so sweet and chatty and smiley. Yet, that was the same nurse who didn't take the time to document in your chart that you got a flu shot, who was too busy on facebook to send in that prescription you asked for. Then there is me: who is kind and welcoming but more professional, focused, and concerned about making sure all the i's are dotted and the T's crossed. "

This was me at work as well. People often thought I was somewhat abrupt but usually I was absorbed in correcting the mistakes of others who had "kicked the can down the road" and most often made more money than I did.

I'm sorry for you. When I was at your point of frustration I knew I had to get out and luckily could retire. Since then I've been able to come off blood pressure medications. Try quoting the serenity prayer....grant me the peace to accept what I can't control.