Feeling very pressured, please help

[mia37]

I feel like I am in a pretty bad situation and wanted some feed back from my peers.

I have worked as an acute HD nurse for a few years now. I recently moved and took a per diem acute RN job with a major Dialysis company. Even though I am per diem I am on the schedule to work every M-W-F.

Since I started a month and a half ago things have just been a mess but I mostly want to address the issue at the present time.

A need has come up in one of the acute units my FA has just taken over. The nurse who has been running the program is very unorganized, stuff all over the place, pt information not filed in seperate charts but instead on clipboards all mixed together just to name of few of the issues.

So, this FA/NM gets the idea that she wants to start sending me there. We both went to check out the unit on the same day. I was supposed to get oriented but there was only one patient (and we came in mid treatment) and the place was such a disorganized mess that I spent most of the time helping the relief nurse straighten the place up.

My FA finds out a few weeks ago that next week there is no staff to cover this acute room. She insinuates that she will be sending me to cover. In order to work in this unit you need to be certified by the hospital, which I am not, although I have submitted the papper work which they are supposedly working on.

Okay,To the point now, FA told me on Tuesday I will be covering this place next week. I said okay but can I go there one more day while the regular nurse is there because the first time I did not get much of an orientation. She says okay. Today she calls at about 3pm and says A crisis situation has come up and she needs me to go on Friday and there will be no further orientation. I told her I was uncomfortable with this because its been a few weeks since Ive been there and the place was such a disater I am afraid I will walk back into the same mess, not knowing where things are, can't access the computer system (because Im not certified) dont know all the codes for the rooms etc. I tell her that before I go I must speak with the nurse who has been covering this week to ask questions and get an idea of what patients may be in. I also tell her that I need to have a resource person available to me by phone in case I run into issues. She tells me she can't reach that nurse but she will try. I have asked her twice already to give me the nurses phone number and I will call her myself but she keeps saying she does not have it available and she'll get it to me later ( hello, when??).

I am really tempted to just tell her forget it, I quit. I am worried about not being certified by this hospital and still going to work there. What if somethings happens?? Could it affect my liscense? What about the situation in general? Do you think I am being a baby (I mean after all I am an acute HD nurse and we do work alone...although we can always reach a support person by phone).

Please respond soon, THANKS!

[km5v6r, EdD, RN]

Do you think I am being a baby (I mean after all I am an acute HD nurse and we do work alone...although we can always reach a support person by phone).

NO! NO! NO! DO NOT LET THEM DRAG YOU INTO THEIR DISFUNCTION! Been there/Done that. Do not let them convince you that the problem is with you. Or that you are weak or a baby. If the manager could do the job then she should. They do have a problem but you are not the only person who can solve this problem. You are per diem staff. You are not even getting benefits yet are scheduled in? Good Grief why? The joy of per diem is the ability to say yes or no and set your own schedule. Yes, you are an acute nurse and used to working with a very high degree of independence. However, you are not a mind reader.:) You can not access the computer or the patients chart. Sure the doc wrote the orders for the dialysis but how can you verify that things like the bath with the morning lab to ensure it is appropriate? Can you even access the meds? Our acute docs used to write the orders the night before expecting us to call if anything was out of wack the next morning. You don't even know how to find these pt's or call the floor nurse. I am assuming the pt's come to the acute unit but what if you have to go to pt's room? Can you set up a bedside? The unique nature of acutes is that things change and change quickly. You can not manage that change without knowledge. This is not a problem of your creating and is not your responsibility to fix. IMO this FA has a major problem and is willing to sacrafice the new per diem staff member to try and fix it. If something goes wrong then it was the new person who did it. Trust me they won't stand beside you to the hospital or board. The view will be that you accepted the assignment. If you agree and nothing goes wrong then a precedence will be set. The expectation will exist that any time a problem comes up you will fill in. Again, been there/done that. Other then feeding my ego there were no advantages. I didn't get one more penny of pay or recognition. In fact when it came to the point of not being able to physically keep up with the demand I was dinged for not meeting expections any more. I was still doing more hours, more teaching of staff, more call, more coming in extra, and had more responsibilities then the other staff but I was doing less then what I had done in the past therefore I wasn't meeting expectation any longer. I so feel for you and the position they are trying to put you into. You care about the patients and want them to receive care. You know you can provide that care. You have asked for the orientation and are willing to help out. The FA and company have failed to do their part and provide the orientation and information you need. Don't let them shift this on to you.

[Farkinott, RN]

You are just trying to be a safe practitioner. I work for government health and crap like that would not be tolerated! Well.........maybe it would but if you made a stand there are avenues to deal with that kind of pressure and harassment.

Stick to your guns!

Good luck!

Marc