Written Warning--Insubordination Last night, I was delt a disciplinary admonition for my conduct one night last week on our floor. Rather than utilizing the chain of command, i.e., apprising the CN of the situation, and allowing her to deal with supervision, which if unsuccessful, I should have then proceeded to contact the NM, I asserted my unwillingness to immediately accept an assignment without delay on the grounds of policy. Moreover, when the NS appeared in obvious consternation and disbelief that an assignment was so delayed, I confronted him with the policy, but our conversation quickly devolved into assignation of blame, a refusal on my part to comply and his part to compromise, and various other verbal and non-verbal indications of animosity. It recalls the line from Bartleby the Scrivener, where the argument between Adam and Colt would not have murderously ended had there been more domestic associations in the office; hence another reason for maintaining the 4N Beautification Committee. Be that as it may, I agreed that utilization of a chain of command was more appropriate, but the outcomes are still limited, for resolution will obtain, either in:

• an effective dialogue and compromise, to varying degrees
  
• submission to dictate
• insubordination
• or surreptition by contacting a more superior authority (contacting NM, NVP, etc.)

  ¶ 6:51 PM 0 comments

  SiCKO It may seem trite and full of affect, but seeing this movie for the second time has me realizing that the work that I do was taken up for prosocial purposes, and that the absence of an ostensible contribution to the community is the source of my current discontents on our floor. I've lost sight of the forest for the trees, and even lost sight of the trees for my habitual ways of looking and doing through my shifts. Heretofore, I have been mocked for inquiring into the socio-economic status of my patients; but rather than giving some smug and self-serving answer (while laughing at the absurdity of the situation), like 'it helps me know how to deliver care to this particular person,' I should have been preaching the injustices of the health care system, and the burdens placed on our patients by preposterous and ultimately pecuniary purposes. "See here," I ought to continue, "the frail elderly removed from her home due to insolvency caused by her infirmities; do we not all care for the happiness of our elders, sick, and poor?" It does well to remind ourselves that 'It may seem strange that some of us should ring our bread from the sweat of another man's brow; but judge not that ye be not judged.' From big pharma to every orderly, we should be a conscientious nation--'saving lives, one bedpan at a time.' If there is little preventative medicine in this country, who better to provide that information than the educative nurse? If the nurse is prevented during her work day, then either she has to give more, or the system needs be more resourceful. Our hospital was notoriously in the black last year. Improvements were made, valuable ones, but there are purer purposes, i.e., ones emphasizing material patient benefit, rather than ones improving efficiency, security of information, and thorough documentation. I am almost prompted to return to school for this one, but that may not be my place, since even grassroots efforts may be effective. I simply must beware of the all too common "blatant benevolence and conspicuous consumption." I do not want to be the man by whom these offenses come. So here we have a resumption of greater conscientiousness in my practice.

Christopher.  ¶ 9:15 AM 0 comments