Have been out of the hospital setting for about 4 yrs. doing other types of nursing. Was recently contacted by someone about coming to work for her in a large, nice facility about an hour from me - it would be PRN, 12 hr shifts. I was talking to someone this a.m. about it and she said hospitals have changed a lot in the past few years and while the basic patient care remains the same the stress is higher, nurses take more than 3-4 patients sometimes 7-8 and the turn over admits/discharges are more because of the concern for reimbursement/payment..she went on basically stating all hospitals are like this now which is why nurses are leaving the profession or are so unhappy. Time w/patients is limited, charting and repetitive charting is high. While I like the thought of flexibility & the hourly rate, if the days are spend THAT stressful and days off spend trying to recover, I'm thinking the M-F 8-5 position I have interviewed for may be the way to go even though I really didn't want a M-F schedule.

Anyone been out of the hospital, gone back and experienced this?

I've been out of the hospital setting for several years too working in specialty pharmacy UM. I have been trying to get back into the hospital system and find it to be very difficult. I was actually told very recently that a new grad knows more than me since I've been out of the hospital for so long. I am an RN-BSN of 13 years.

It is difficult and a new grad knowing more than an RN-BSN w/13 yrs experience? I don't think so:no:

I think it has changed. I've been out of the hospital for about a year, and the last year I was there it was hell. I stay in contact with my work buddies, and they tell me that every week they have some new responsibility that has very little to do with actual patient care.

Everything your friend said is unfortunately true!! My first day off I'm too exhausted to do anything, even fun stuff. My second is getting caught up on housework and laundry and the third grocery shopping, errands, etc. Those 12 hr days are really 13-14 hours at work another hour driving too and from work which makes 14-15 hours I'm away from home. I thought I'd like working 2-3 long days and just being done but I don't because the days I work I hardly see my kids and husband and the days I'm off I'm tired and worrying about when I work again. I didn't think it was possible to gain weight being on my feet constantly for 39-40 hrs a week but I did. I just want a normal life-work balance again! My hospital was one of the better places to work when I started there a year ago but now they are making all these changes and no one is happy. We are all exhausted and stressed. We are only supposed to have no more than 5 patients but we usually have more. Every day I work (except the rare occasion I get lucky) I have a few discharges and admissions and they are so time-consuming! They have to kick patients out before they should go because of all the insurance and Medicaid reimbursements and make pts get tests on an outpatient basis even though they are already in the hospital if it's not for something related to their admission. Then you have the drug seekers that they admit for "pain" of some type just in case there really is something wrong so they don't get sued and when all the tests come back negative they usually get an extra day by crying really hard about how miserable they are and yelling at you to call the dr for more pain med and meanwhile those that could truly use an extra day are threatened with a nursing home if they don't leave. Most of us have to either skip lunch or stay late to get the redundant charting done that is so ridiculous and time-consuming that just makes you want to pull your hair out. Then we keep getting more and more duties that we are supposed to do that make the organization "look good" but do nothing to promote pt care. To top it all off we get lectures about how we need to be "team players" and have a good attitude whenever anyone gets upset about things like being pulled a lot,being put on call when you need the hours, being pressured about working extra, etc. If you are PRN you won't work as much but on the other hand you will be the first to be called off so if you need a regular set pay then you might pass but if you don't and want to see what you are (not) missing then try it. If you've worked the hospital before then you know how hard it can be. It's only gotten worse. All the reasons you probably left are still there and then some!

As a per diem staff nurses, you will be cushioned from the worst of the stress.

Nursing hasn't changed that much in 4 years, but I have noticed a few changes.

Some days I swear I spend more time looking at a computer screen than the patient. Computer charting takes longer. All the scanning and clicking of electronic med records takes longer than just checking the med, giving it and signing your initials on paper.

The computer charting means easier and more frequent audits of your charting.

"Compliance" is the new buzzword I hear a lot, and it has nothing to do with lungs. If your restraints are charted at one minute over the Q2 hour requirement, you are not in compliance, and you will probably hear about it.

Other than that, you will find hospital nursing as you left it.

I think it has changed. I've been out of the hospital for about a year, and the last year I was there it was hell. I stay in contact with my work buddies, and they tell me that every week they have some new responsibility that has very little to do with actual patient care.

Same. I've been out a little over a year and every time I speak with my former co-workers they tell me similar things.

Thanks for the replies...it sounds like it had changed and not for the better...I spoke to someone last night who works at this hospital PRN and said the PRN's get "dumped on" all the time - which is not surprising really but the main theme seems to be the charting, double charting and the time set on when you have to chart and if you are so many minutes/hours behind you get written up - which seems crazy since some patients can be demanding, emergencies happen, discharges, admits so to be enslaved to the computer over the patient care...wow...sounds like the average load is 6-7 patients and evidently there are a lot of call outs because nurses are so stressed..I don't mind busy, don't mind working hard but even PRN I don't know..something is going to have to give - nurses can't keep doing more for less, patient care will and most likely does suffer...I think it may be best to pursue the M-F job.

It's not just nursing, it seems more and more professions expect you to do more with less. The higher ups are only concerned with the bottom line and not about the employees.