Tuesday, May 13, 2008

Another turning point in Jo's career....Of Magnet, of autonomy, of managing my license like a business

MyHospital (let's call it 'MH') is working toward Magnet status, and I anticipate this effort will be ultimately fruitless. I have been part of my Nurse Practice Council (NPC) for 18 months before I sent in my resignation on Saturday. I started the ICU's NPC with my co-chair, G. G resigned Monday. Several nurses on the ICU committee are also abandoning it now, too.

I'm not interested in telling you specifics, and MH may find an arbitrary reason to fire me if I do. (Not that I find this bothersome...I'm an RN, for chrissakes. How many RNs among you have gotten flyers/emails/recruiter taps in the past month?) Besides, the specifics of MH aren't interesting.

The point is that I believe MH has parsecs of vacant emptiness between the offices and the bedside. It doesn't appear to matter that some of those offices contain people who have sat for, and successfully passed, the NCLEX. No understanding appears to exist between the two. No honest conversation happens in both directions, it's radio broadcast from one side only.

I needed to get involved. I came from the consulting world. You hire a consultant for your organization to come in and identify the root of your organization's effed-up problems for you. They recommend changes, they help you implement the changes your organization can tolerate and they leave when the problem is resolved or at least tolerable. This suits my mentality. I am not interested in bandaids. I am interested in resetting the bone.

I believe this to be true of most bedside nurses.

It was natural of me to find stupid things on my unit, within the organization at large and try to become part of the solution. I observe the direct correlation between your overtime dollars timed to the implementation of your ludicrously obfuscating computer charting system, for one example. And I say you made a blunder of enormous proportions that can be salvaged with the more than willing cooperation and collaboration from the bedside.

But such observations are unpopular among administrators at MH. I was hauled into the principal's office for that one. (Remember when Linda Blair's head spun off her shoulders? Yeah. Dude, you should have seen it.)

But I can't do this anymore. It's not that I met a brand new managerial howitzer that is pointing directly at me and my partner, G. It's that the meeting was the last shred of proof to me that it's no longer worth the fight.

I'm not even sure if I believe in that Magnet crap, anyway. I only believed in the ability to work to improve things for my patients and my colleagues. I am afforded less and less an opportunity, as the tools of divide to conquer and fear of arbitrary reprisal are pulled out. As my friend, a charge RN (read: quasi-management), makes a sincere attempt to mediate and is told to 'keep her nose out of it'.

Another friend is talking to a recruiter. A third is now picking up shifts at a sister hospital. A fourth has switched to part-time. Etc, etc. The experienced nurses leave my unit, leaving an ICU full of cheaper new grads who don't know defib patches from pacer pads.


So now. If I'm mentally checked out of trying to fix the bureacracy from within, I'm left with what my next set of goals are. I'm the kid of person to grow in the job I've got until I've gotten all that I'm interested in getting from it. Then I find a new place to grow. I'm just started growing in the ICU, and I'm comfortable there. I know everybody; the things I know, I know well. I learn something new every day. I know the docs, work well with the majority. I'm friendly with the pharmacists; when I send a med-gram for drugs I need, I get them (a bit unfairly) fast.

But there are a lot of ICUs in town, and they might be interested in having some more prn nurses.

Considering looking at Jo, RN, as a business. A business needs to have something to offer (which I do), be fiscally sound (and there's certainly several ways I can improve that). And a good one continues to grow, refurbish, repolish, try new tools, new skills.

I love my unit, because I really care about the people there. It's one of the most fun, interesting curious bunch of people I've ever worked with. I'd rather not leave.

But a business can, and maybe should, have more than one client. Maybe I need to consider that, too.

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