Sunday, September 27, 2020

Public Health Nursing love has fizzled out

 I've been a Public Health Nurse for 7 years. Time has flown by and with it things have changed to make me disillusioned with this nursing role. 

In the time that I've been a PHN I've become a Public Health Expanded Role Nurse. I now work alone and see all patients in the clinic including Family Planning, STD, Immunizations,  Child Health, Tuberculosis, Breast and Cervical Cancer and now Covid-19.  I have my own office and exam room and during a short stint I was nurse manager over my clinic. 

The nurse manager who hired me retired a year after I began. We got a replacement who was a real nut job. She was fired. Our billing manager died during the work day the same year before that NM was fired. I took the NM job and then stepped down because of staff drama and lack of direction and support from the district office. I wanted to keep that job badly, but I was set up to fail. I was told that I would have support, but that didn't happen. When I stepped down they didn't really seem to care all that much. 

We got another NM and she stepped down and went part time. She stuck around for a while but eventually left PH. 

Our temp NM after her stuck around for a few months and then SHE left too. Apparently the travel was an issue for her and I could tell she just didn't like working in our clinic. 

And then when we got another NM she stayed 18 months and left too. 

This clinic is a freaking mess. There is no direction. No accountability for anything. I've been the primary nurse since 2017 and it's been chaos the entire time.  Our district off is constantly telling us that we need to see more patients, that they can't justify hiring anyone else to help in the clinic so all the patients are being seen by me. Don't get me wrong, the patients aren't the problem. I love the people I see. I've made long lasting relationships with a large majority of my patients over the last 7 years. I've seen many come and go and I've seen children in middle school graduate from high school during my time in this clinic. 

The patient population isn't the issue. The management, or lack there of, is the issue. My bosses are all over the place. People have quit left and right in all departments. Or they have switched positions because of stress in their own areas of practice. 

Money is mishandled. State funds are allotted to decorate rather than hire staff to increase patient loads in the clinic and then they complain that we aren't seeing enough people. Well, that's backward as crap because how is one nurse supposed to see more than one patient at a time? There is no doctor in the clinic. There is no one to fall back on. If I want a day off the patients are rescheduled for when I return. There is no REAL break in this clinic. None of the nursing work gets done until I return and then it's chaos as I try to play catch up and follow up with calls, paperwork and patients on the current schedule. 

This is the most disorganized place I've ever worked. I didn't enjoy working in the hospital, but at least in the hospital when I left work continued to happen until I returned the next night. I didn't walk back into a 12 hour shift with the stuff I left undone STILL undone. People worked. Stuff got done and it felt like I was contributing to a fully functioning work space rather than a clinic where time stops when I take a vacation and is a hot fucking mess when I return because nothing got done while I was away. 

There is no room for advancement in this clinic. I've been a PHN 2 for ages and that isn't going to change. If it does they'll have to pay me more and apparently we don't have the funds. Yet they had the funds to buys desks, chairs, paint, roofing, furniture, etc for the clinic. And when I complain about not being able to do everything that is required I am told that the same amount of patients that were seen last year were seen this year too. 

Well, the patients last year were also seen by ME too. I've been the only nurse seeing every patient that walks into the building and when I ask for another nurse who WILL ACTUALLY SEE A PATIENT every once in a while I get looked at like I've lost my damn mind. 

If you're hiring a nurse manager please hire someone who actually wants to do the nursing side too. They can't expect to double book patients and have only one nurse do all the patient care and follow ups while the NM sits in their office and does a days worth of monthly reports all month, who takes off every day for adjusted work time because she came in early to post shit on facebook about the clinic or sit in her office and decorate her walls and then gets to take off work an hour early to sit at home and continue to 'work' to get more AWT off. They want us to see more patients then why were they allowing the nurse manager to take vacations every other month and leave the clinic early nearly every day?

It's not fair. 

And now the first person who has applied for this management position will probably get the job. THE FIRST person. They don't even care if they are qualified. If they applied apparently that means they get the job. WTF. What the actual fuck? 

And I swear if they hire another associate degree nurse who can't do shit because she's not a BSN (and you need a BSN to do public health and be NM) I will pull my fucking hair out and scream. And then that nurse ended up leaving anyway so I trained her for no reason at all. WHAT is the fucking point of any of this? 

It's never going to get better. I loved this job when I started it, but that's when there were people in the clinic who actually worked. Yes, eventually the nurse I was complaining about did start seeing patients but she left in 2017 so I was by myself. Now they are hiring to fill positions and to say that they have someone in the position. Who cares if they are qualified. Our district doesn't or they wouldn't hire someone without management experience nor nursing experience. The last NM had ONE year of nursing experience. The woman couldn't even drawn blood. I watched her stick someone with a needle, take the needle out and then stick them with the same needle. She didn't know that was wrong and when I told her that was wrong she ignored me...

Fuck this job. I'm considering going back to the hospital. I read through my posts from my job at the hospital and in comparison to this, that job was fucking stressful, this shit show is just as bad. Yes, it's M-F 8-5 and that was 3 12 hour shifts, but at least I was doing nursing work and not management too. 

I didn't go to school to attend fucking meetings and present shit to clinic officials. I didn't go to school to read billing reports and complete inventory reports. I went to school to be a nurse. 

Bitchy patients follow you everywhere. They are here too, they just aren't sick. They just keep making the same mistake over and over (STD related) and expect different results. Or they just don't care about getting and STD or getting pregnant. I'm tired of doing this. This population is dull now. I'm not making a difference in public health. I'm just being shit on by management and told to do more with less. 

At least in the hospital I only had to see patients 3 days a week rather than every freaking day. And this two days off on the weekend shit isn't long enough. Especially when you request time off and come back from a vacation only to be more stressed because no work has been done in your absence. 

FUCK THIS. 7 years is enough. I'm ready for a change. 

Wednesday, January 14, 2015

Checking in

I haven't forgotten this blog. I just haven't had anything to complain about. My public health job is simply awesome. I have been working by myself for quite some time. Early on in this job they had me traveling quite a bit for training. I was all over the place. By far driving to the capitol was the worst. I hate heavy traffic. No real issues to dish out. Public health is pretty awesome. Waking up in the morning is still a struggle. I'm not a morning person. I have been a phn for 17 lovely months and I am going strong. Writing this when I should be sleeping. Oh well. Had my 3rd review. Nothing but great things were said. I hope this job stays this way. I don't think I want to work anywhere else. :)

Friday, February 14, 2014

Grateful

God, I am grateful for this job. I have my bad days like anyone else, but thank you so much for opening up this opportunity for me. I love my job, I love my coworkers and I love that I'm happy now.

Please take my grumbling with a grain of salt. Compared to how I felt when I worked at the hospital, I have nothing to really complain about.

I love this position. I love that I can breathe. I love that I can smile.

THANK YOU GOD. THANK YOU SOOOOOOOOOOOOO MUCH!!!

27 to go

I'm slowly completing the requirements to do my job. I wish I could just work. I'm tired of being in training. I learn better by doing, not watching. It feels like a lot of what I'm reading/observing is going into my brain, dancing a bit and then leaving. I retain some of it, but most of it's not clicking. I'm not a visual learner. I'm more tactile.

I'm just frustrated I guess. Today went well. No real complaints. I just wish things were moving a bit faster.


Saturday, January 11, 2014

I need to get this off my chest

My manager had a meeting a while back. It was for the staff to come up with a way for the clerks to alert the nurses of a patient waiting for us in the front of the clinic. The plan was for them to page all the nurse overhead. Which ever nurse wasn't busy would go to the front and take the patient back. It sounded like a great idea at first until I realized that I was the only nurse who ever got up to go see the patient.

Right now it's not that much work because I can't really do an entire case alone. I'm still on training, so another nurse would have to see the patient after I did the initial interview/history, etc. My problem is, wouldn't it be faster and more efficient to for the nurse who would be seeing the patient and treating them to do their history? It takes twice as long for the second nurse to read the questions that I asked, ask the patient everything over again and then decide what to do. At first it was a learning experience because I didn't know how to do the interview. After months of doing the interviews I think I know how to ask a client's history. I try to sit in on the meetings between the other nurse and the patient after the fact, but it doesn't seem to help me at all because I feel like she doesn't know what to ask and she asks me what else to ask. I try to help, but shouldn't she be teaching me and not using me as a way to make her job easier?

I learn by doing. Watching her do everything is like watching paint dry. I don't really retain anything until I'm in there doing it myself.

Back to the point of the over head calling. Why is it that I have to do all the h/v/d, shots, interviews, blood work, etc. I know I'm the new kid on the block, but seriously. Why do I have to do everything when there are two other nurses there doing nothing. The manager is on the phone or is doing paper work all shift. The nurse who I'm supposed to be working with is on the phone talking to her family or in her exam room pretending to look busy. When the clerks call overhead she sits in her room and fiddles around and when I walk by she looks my way and doesn't even attempt to get up.

Why did we have this meeting in the first place when I'm the only nurse who responds to the calls? If I'm the only nurse who is supposed to see the patient just call my room instead. This paging overhead for a nurse is getting on my nerves because it seems like I'm the only nurse in the fucking building who does work or who isn't busy the entire eight hour shift.

One day non of the patients on the schedule came in. We only had flu shots, h/v/d, small stuff like that. No one was busy. It wasn't the end of the month which seems to be the busiest for everyone. The clerks were chatting up front, the other nurses were chatting in their rooms or with other co workers.

When paged over head, the other two nurses are suddenly 'busy' again. Busy doing what? There was nothing to do!!! Help out. Do a shot. I can give a flu shot in my sleep. Why am I the only one responding to pages?  URGHHH!!!

I like my job. I really do. My coworkers are amazing. I just wish things were a team effort and I wasn't worked to death because I was new. I know I have a lot to learn, but that doesn't mean they should get to be lazy the entire week because I'm there to pick up the slack.

-deep breath-

I don't know why this bothers me so much, but it does. I just feel like I'm being used and being taken advantage of.

Also, the little back and forth bickering between the staff gets on my nerves too. I'm the youngest person who works there, but I'm the only person who doesn't gossip about someone behind their backs. Are we all in elementary school again?

I heard the nurses arguing with one another one day. The manager was yelling at the other nurse. I just sat in my room and stayed quiet.

I feel like I walked into a train wreck of a business.

Thursday, November 28, 2013

Happy but nervous

I'm so glad that I made the transition to Public Health. I can't begin to explain the difference in the way I feel when I get up in the morning and go to work. I don't dread it. I actually love my job. The people I take care of, the people I work with. They are all amazing. I don't know why I just didn't start in PH. Med surg was horrible, but I did learn a lot. It has made my transition into this setting so much easier.

Now to the bad. I have to do a sort of preceptorship doing breast and pelvic exams. I don't know why that makes me so nervous, but new things tend to make me want to throw up. My heart races and I feel sick to my stomach. I hate being observed, but I guess if I get this over with I can work alone. It probably won't be that bad. I'm sure it won't. I'll probably love the experience. I'll have to wait and see.

I'm currently trying to enjoy thanksgiving with the family. I have a few more days off to relax before returning to work. Guess I'll get back to that. 

Thursday, August 22, 2013

So...um...

I don't miss med surg AT ALL.

That's about it.