Friday, August 26, 2011

You make the call: Victory for me er no?

Welcome back to you make the call- Where I pose a moral question and you answer it.

This one involves my work. I am a mental health nurse practitioner. I work side by side with psychiatrists and do my best to help the crazy people. It's a good gig. I do love it so.

That being said, I was recently asked to start giving flu shots. Giving shots is what NURSES do. However, I'm more than a nurse, I'm a nurse practitioner. Which means I have a master's degree and a ton of special licenses to prescribe medication. Just like the doctors.

Which got me thinking. Flu shots are normally given by PRIMARY CARE nurses. I don't work in the primary care, I don't treat sinus infections, rashes or bronchitis. I treat depression, anxiety and schizophrenia. I certainly don't treat the flu. Why am I handing out flu shots?

I say this to my boss AFTER I'VE AGREED TO ADMINISTER SHOTS TO MY PATIENTS. I am the kind of nurse that says yes when people ask me to do stuff. I've got to stop that.

Then, I approach the doctors, the mental health doctors. And I ask, "Do you need to start giving shots too? " And they say, "Oh, HELL NO, we're doctors, not nurses!" (ok they didn't say that exactly, but they did say no, they wouldn't be giving shots.)

Here is two (of the three) psychiatrists I work with:

Again, neither one of them are willing to give shots. They say no, they're doctors.

That kind of pissed me off. There is another mental health doctor though, not pictured above, he was willing to pitch in and give the shots. Guess who is my favorite doctor to work along side?

So I say this to my boss. I say, "Why am I required to interrupt my patient care to give these shots? Why am I required to give these shots when the psychiatrists aren't? Also, the primary care nurse practitioners don't give shots, so why am I doing this?" He kind of blinked and then we changed the subject.

Two weeks later . . .my boss says . . . "I talked it over with my boss and we agree, it's not fair to make you to give the shots when we aren't making everyone [I.E. THE PSYCHIATRISTS] to give the shots."

I was kind of shocked. I mean, I was kind of kidding when I kicked up a fuss. I mean, I was willing to give the shots but I did feel kind of slighted. But I didn't really care because there are much bigger things to care about.

So I accidentally won one for equality- but I'm not sure I was suppose to. I mean, this may compromise, in a small way, patient care. A lot of patients never see their primary care providers. They see us though. So that could mean no flu shot for them.

Then again, flu shots are available everywhere, even walgreens. Our patients are adults who drive and speak English. They have the resources to get their own flu shot.


so! you make the call, victory for me er no?

14 Left a message at the beep:

the queen said...

Victory for you. Essentially you made two points: 1) "You are disrespecting me" and 2) "I will forgive that disrespect because I care more about my patients than my pride."

Anonymous said...

I vote with the queen on both points. And, you're absolutely right...they do have access to flu shots via other channels. It's not like you went on an all-out pouting/ranting bender. You saw the slight, you mentioned it. It got dealt wit. Victory for you, I say!

Me, personally? I'm anti-flu shot, butletmetellyouwhy.

I had the flu at the age of 15. It was a terrible, horrible flu! I didn't get the flu again, though I worked in public service for years, until I was 25. We'd lost Brooklyn in July, had another miscarriage in late November and during my follow-up in early December my OB suggested I get a flu shot due to my stress level and all my body had been through. So, I tooka the shot, Mrs.
And, in January, I got the effing flu. In March, I got the effing flu.
Screw a flu shot since then. And, I am happy to report that I didn't get the flu again until last year, at the age of 30, but my system was already compromised due to the incomplete miscarriage/infection. Basically, I am a natural flu-fighting machine. I should be studied and antibodies should be made from my Goddess DNA.

Anonymous said...

*Goddess DNA is my answer to Charlie Sheen's Adonis DNA. :)

K.D. said...

Yes, it's a victory for you. You expressed your point and continued to do your job (and more). They accepted your point and they rectified the situation. Pretty impressive. You are clearly respected and valued. Congratulations!

Mrs. Hall said...

Thank you ladies. I can say, after thinking about it, i think i'm right. I see a lot of patients in the day and with each one that needs it, I'll say,



Bruce Johnson said...

Before I read the other responses, I am going to weigh in here and then go back and see what the others said.

Based on my experience along the same vein, I would say YES, this was the right thing to do. It does not have to do with patient care, or work loads, it has to do with organizational structure.

As I am sure you have read from my blogs, this sort of things happens constantly in my office. Management will canabalize staff to cover a perceived temporary event (the flu season). This leads to the mindset that staff are interchangeable parts that can be plugged in anywhere there is a 'need' for staffing in the future. This is poor management and needs to be controlled (I call in mentoring the morons).

Management has to realize there is a structure to any office process, be it healthcare, or auto assembly, or farming. When you start taking the tractor driver off his John Deere and have him start herding cows on a quad-runner, it will not promote, but deteriorate the office structure.

In this day and age, management isn't usually that bright, they have to be told "no" to keep them on the right track.

Anonymous said...

I suppose that you are on moral high ground, but how long, really, does it take to draw up the shot and give it? Your patient may not go get one otherwise and in the long run you might be saving someone's life.

Additionally it takes away from the picture of you as a team player in the long run.

Mrs. Hall said...

anon- the shot time:

2 minutes to fill out the form, 2 minutes to draw up the shot and give it, 15 minutes of watching to make sure they don't have an allergic reaction (which I'm not trained to help if they do), then, the patient behind them gets delayed and so on

so no, not the best use of my skills. we have nurses for a reason.

Anonymous said...

You went to nursing school first, got your master's and now prescribe drugs but are not qualified to deal with an allergic reaction? Jesus wept.

Mrs. Hall said...

allergic reactions can involve anything from giving the patient bendryl to epi-pens (injections) to starting an iv, so no,

none of that falls under my job talents.

and iffn you keep critizing, man up and leave a name.

otherwise, good luck to you anon!

Anonymous said...

And upon further reflection I now realize why this has irked me so completely. It's elitist (in my eyes whether that was your intent or not). Your position that is. So taking it in the elitist vein here's why you should give shots when the psychiatrist do not give shots. Because they are psychiatrists and you are but a nurse practitioner. They went to medical school and you did not.

Anonymous said...

Cross post. Oh and I always forget the number one rule of blog reading, the blogger never expects anyone to be honest and disagree, they only expect support for the stance they take. Silly me.

Bruce Johnson said...

What a jerk.......

Hey, lets all be anonymous and criticize other people!!!! That way no one can criticize us.

Speaking from the shadows, means you live in the shadows. Have fun on the dark side my friend.

GeologyJoe said...

if you give them an inch they will take a mile. victory for you, maybe not today, but tomorrow for sure.

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