I went to work tonight knowing it would probably be a difficult night. An extremely challenging struggle of a night like every night for the past two weeks has been.
For the past three weeks, I’ve been training in the Emergency Department for a job as Secretary. My job as screener was obsoleted and I was immediately placed and interviewed into the secretary job. It was with great enthusiasm and anticipation that I began my training.
I started training on days with the secretary that has worked there for 33 years. She is a stickler for details and doing things properly. She has some problems with how the secretary at night does things but they seemed to have a cordial relationship.
I began my training on a Monday when the regular day secretary did not work so I sat with a nurse who didn’t want to be the temporary secretary and I learned nothing. Same for Tuesday. On Wednesday, the day shift secretary returned for her normal 12-hour shift and I began training.
I took copious albeit confusing notes about what was required and how things were accomplished. I then found one of my old blank journals that had a sturdy cover and decided to turn it into a guidebook for the many myriad tasks expected of the job. Then I began the night shift.
There were problems immediately.
Every time I made an observation about anything I was soundly criticized about how wrong I was. For example, we had a patient who had been brought in as “AMS”, which means altered mental status.
A part of the responsibility for the secretary is to answer every single call into the Emergency Room and answer questions, turn inquiries away from nurses, refer patients to their Primary Care Physician, etc. So on this night, early in my training, this particular patient had left his truck somewhere on property owned by the Corps of Engineers with the doors open. The man who called from the C of E was quite pleasant and concerned about this vehicle, not wanting to have it towed and needing to speak to the owner, our patient.
Of course, I had no idea what to tell this caller. So my trainer told me to take his name and number and we could get the patient to call him back. I had serious doubts about whether this was possible since the patient had left the vehicle in that particular state (doors open) and his status was AMS.
I stated that I wondered if the patient could decide what to do with the truck and I got a lecture about AMS not meaning that the patient was completely out of his mind and that I should simply give the note to his nurse and not worry any longer about it. When his nurse walked close, I gave her the note and a short explanation about the situation.
The nurse said, “Yeah, that ain’t going to happen. He’s completely out of his head.” I knew my trainer had heard this (she was sitting right next to me). Nothing was said, of course. And the night proceeded in this manner. Every time I made a harmless observation about anything at all, I was loudly criticized and told how wrong I was. Frequently, it turned out that I had been correct.
Now, my trainer was a hefty woman, weighing in at at least 300 pounds. She had had knee surgery in the last year and she had trouble “getting around” and walked with a decided limp. She talked loudly and laughed very loudly. It was obvious that she was starved for attention and was determined to be the center of attention for the entire ED. By the time this debacle ended, I was weary and worn and very, very tired of hearing her talk and laugh at the decibel level of a jet engine. It added a particularly high amount of stress to an already stressful time of training.
It occurred to me early that perhaps I was not getting the full measure of instruction that I should have. My intuition told me that she was not intent on making things easy or specific enough to make sense. Rules frequently changed. Requirements for contents of packets of information required for transfer of patients frequently changed. Procedures were explained in a confusing and nebulous way. When I asked questions about specifics, I was criticized and told that “it doesn’t matter”. I knew this couldn’t be true.
Early in my training, the criticism became almost intolerable during a particularly stressful time. Afterward, my trainer apologized – twice, in fact. As the night wore on, she explained to others that the stress had caused her to “bark at Carol” and she seemed to express remorse for it. So I let it pass.
She had a habit during the most stressful times of jiggling her right leg and she hummed quite a bit of the time. Now, I understand about the humming part. I do that, too. My daughter has called me out on it many times and I have no idea I’m doing it. I knew beyond a shadow of doubt that she was stressed to the maximum amount but there was nothing I could do about it except keep my mouth shut and try not to make it any worse.
Human Resources hired another night shift secretary, since one had been fired and the other one, my trainer, was moving to days. Lo and behold when she came to be trained (at the same time as I did), it turned out that she and my trainer had been old friends and worked together in housekeeping at the hospital many years ago. They had played pranks on each other and even discussed these when we trained on the same nights.
Oddly enough, the other trainee seemed as frustrated and confused as I was. She asked the same questions I asked. She expressed confusion about the same issues that I did. These were not met with criticism of course. Things were simply explained in a more specific manner. In fact, the second night that we had the other trainee with us, my trainer outright asked me if there was anything that she had explained to her friend but not explained to me. Honestly, this told me that her subconscious knew that there was inequality in the way the two of us were being trained.
The stress became overwhelming for my trainer again this week and she sat and jiggled and hummed. Needless to say, this raised my stress level also. I tried to breathe properly and ignore it. She went back to the break room time and time again to get a cup of casserole someone had brought. She explained to me that when stressed, she eats. Ummm, yeah, I guessed that.
So we had another night of stressful happenings and the criticism got bad once again. And once again, she explained to whoever she was talking to that it caused her to “bark at Carol”. By this time, I wondered why she didn’t stop doing it if she was aware that she was.
It seemed that when I questioned policy or procedure, it set her off. So I stopped doing that. I simply wrote down as many possible procedures as I could and hoped for the best. The other trainee would join us for a night and things would improve – for a single night.
Most of the nurses and techs in the ED were quite young (under 30) and they would, at times, get surly and cranky. I totally understood why and figured that this was a part of the job (simply putting up with doctors being critical), everyone being acerbic, sarcastic, and even downright rude at times. I totally understood.
What I couldn’t understand was why my trainer would criticize me over and over when she knew that I already did not feel competent at the job. During the first two days of my training with her, I began to have serious doubt about my ability to handle the requirements of the job. Her bullying pushed me over the edge to outright believing that I couldn’t.
As much as I tried to fight the feeling of incompetence, as the rules and requirements constantly changed, I began to lose confidence in myself, which only stressed me more. She even criticized the way I introduced myself during a telephone call to another hospital, our dispatch, or pretty much any other entity. She kept on me about how I was “giving them way too much information” and muddying the waters. She insisted that my communication with those outside the hospital was incorrect.
Tonight was my Waterloo. She announced that she was going to “get Cokes” for us. I handed her a $5 bill from my pocket and said it was my turn (which it was). As I got caught up on stickers, admits, discharges, and other things, she was gone for about 45 minutes and I wondered where in the world she had gone.
Our supervisor was there at the hospital very late (about 10:00 PM, unheard of for her). Upon my trainer’s return, our supervisor immediately came to me and said “Let’s have a talk”.
Now, I know exactly what it means when a supervisor says that phrase. It means something horrible is about to go down. We went to her office and she immediately asked me if I was “happy” with the job. I replied that I wasn’t happy with the stress level. I was a bit confused about what “happy with the job” was supposed to mean. Did I like the job? Was I happy with my performance so far? Was I happy about anything in general? I replied “No”.
But I furthered my reply with my belief that I would become more comfortable with the job directly. She asked what my biggest obstacle was and I told her that there were many medical terms that were used in the job and being that I had no medical background, I was having trouble understanding when a doctor gave me a diagnosis for a patient.
It was very much like being in an interview where you are measuring every word, every gesture, every facial expression for clues as to what the interviewer wants and how to be most honest in your answers but not shoot yourself in the foot. She said, “Well, would you like to go home for the evening?” And I knew immediately where this was going.
I’ve been fired before. Apparently, the contemporary way to “let someone go” is to suggest to them that it’s their idea and be very, very gentle about things. Of course, this manner is every bit as big and terrifying as a Sasquatch in the office with us. I emphatically told her that I wanted to finish my shift. But I broke down and cried because the rest of the “interview” had now been revealed to me.
She said that sometimes people had personality issues with each other. I assumed that she was talking about my trainer and I said, “I believe I have bridged that gap. I have tried. She is stressed.” Supervisor asked me if I would like to finish my training on days.
I remembered the methods and madness of days (where there are many requirements that are drastically different from days as well as things NOT done that we are required to accomplish on nights (such as restock all the supply carts and the medicine room and type the “on call” list)) and I told her that I didn’t want to finish my training on days.
Wrong answer.
At that point, she suggested that I go home and relax and watch TV. Things were starting to slide sideways and I realized that the moment of truth had finally come. She told me that people aren’t always a good fit for the Emergency Department and sometimes the stress was too much. Did I believe that was true for me?
I didn’t argue or stand my ground. I know what happens when you do. You lose anyway. I knew that the result was a foregone conclusion (I figured this out after the fact the last time I was fired. I realized that it wouldn’t have made a scintilla of difference what I answered.) The result would have been the same. And, honestly, I was relieved that I didn’t have to deal with that shitshow of an ED anymore. I simply gave in. And gave up.
What did my trainer tell her about me? Did she refuse to work with me further? Did she tell the truth about things? Did she lie? I’ll never know.
My supervisor said that she would get together with my former supervisor (when I was a screener) and would see if they together could find me another spot within the hospital. I suspect that the “solution” for that will be to find a job there for which I’m not overqualified nor under qualified (impossible) and go ahead and apply for it. Except now, I won’t have preference.
Also, after crunching about the problem all night, I pretty much believe that my trainer had another friend in mind for the other night position and when I was given the job (because my position was being phased out), she decided to make my life a living hell. But nicely, of course. I was set up for failure as only someone with power over me can do.
Oh, yeah. And I was supremely tired of people talking “at” me when asking for something. Tonight, I had paged a doctor for another doctor. When she didn’t call back within, say, eight minutes, the ED doctor walked out of the office and breezed by at full speed. He was walking away from me and I heard him mention the paged doctor’s name but I had no idea what he had said. So I guessed and paged her again.
She called and she wasn’t happy. No problem. However, my doctor had disappeared as soon as he went around the corner. So now I had paged a doctor and the paging doctor had disappeared. So I told the doctor on the phone I would tell him she called. She had been in a room with another patient at the first page and couldn’t call back immediately. So I waited for the mysterious disappearing doctor (who obviously doesn’t understand Doppler effect while passing and emitting sound waves from one ear to the other with his back turned to me) if he wanted me to page her yet again. He did. Finally, I got them on the same line.
Also, I was talking to the Arkansas Trauma Communications Center, who I was directed by my trainer to call for a transfer, being assured by her that I had all the information he would need “at my fingertips”. The dispatcher who answered asked me how the patient had arrived at our ED and I read off the trauma sheet that he had arrived by an air evac company. He immediately wanted to know the unit number.
The second question this dispatcher asked and I couldn’t answer it. So I turned to my trainer and said, “He wants the unit number”. She impatiently said to “Tell him you don’t know”. So he told me I would have to have that information at some point in the process. After I had given him whatever information he needed, I hung up.
Both the day trainer and the night trainer were standing there next to me. I repeated that the ATCC dispatcher would require the unit number before the entire procedure was over. Both of them told me, “Well, he can just call them himself and get that information!” I thought, “Oh, yeah, I’m totally going to get away with that attitude in telling a dispatcher in Little Rock how to do his job.”
I thought, “Now you’re both lying.”
Tears and Catharsis 