Sadly, the overwhelming response to my post "Dark times" from yesterday, on Twitter and the blogosphere, is "same here." This makes me very, very sad. I'm not sure what I expected, but probably more along the lines of "buck up and quit whining; it's not that bad." Evidently, it IS that bad, and it's also not just me. There is something in shared misery and having my perceptions legitimized (I'm not nuts), but it also increases my sense of hopelessness. Those Emergency Blues (one of my favorite nursing bloggers) has written a thought-provoking commentary on the post. Notably (emphasis mine),
I’ve argued on this blog before that there is a spurious belief out there that once a nurse becomes management he is somehow exempt from the professional duties and responsibilities which bind all nurses, and hospital policy or the demands of human resources takes precedence over these obligations. This pretense needs to stop: it’s damaging to the profession and it harms patients. Nurse managers who create an unsafe or hostile working environments are responsible in turn for increased patient mortality and morbidity. The evidence is pretty strong for the link between quality of nursing work-life and patient outcomes. By the nursing standards of practice here in Ontario — like most places — abusive behaviour and harming patients is surely a matter for professional discipline. Do we need to start reporting a manager’s “bureaucratic terrorism” to our respective colleges/state boards of nursing? Maybe it’s time we called them on it. There is clear sense among frontline nurses that we need managerial accountability for poor practice, and evidently hospitals aren’t providing it.
The post goes on to suggest that individual nurses can do nothing but quit, thus voting with our feet. The first part I fear is true; the second part, not so much. I've seen nurses get mad and quit and nobody cares. Departments go insane over the budget, making byzantine schedules designed to eke out savings here and there, while they spend a gazillion dollars per year training new nurses rather than look into staff retention a little bit. It seems almost insanely stupid to me, but it's a fact. In addition, given that nurses are generally cowering in fear over disciplinary action and/or termination as a baseline, it's highly unlikely anyone is going to individually start reporting nurse managers for this behavior. I'm not. I think they are responding to their own set of crazy-making forces. The buck does, however, eventually have to stop somewhere, and where that is I don't know.
What it comes down to is this: the only nurse I have any control over is myself. I am mulling over the resources I do have at my disposal, including the stated availability of counsel for secondary trauma and job-related stress. Which I definitely have and which are now undeniably affecting my life in unacceptable ways. I wonder if I would still be married were I still in my old career. And I'm waiting to see if my new relationship survives this one. Not OK.