[abimathew]

beacuse of fear

[pyrolady]

Hi - I'm new to the board but wanted you to know that I just quit management in a hospital. Why? Because no matter how loud certain managers hollered (aka me) nothing was ever done about short staffing. You know, I sometimes don't really believe there's a nursing shortage - I think it's a self imposed (by institutions) staffing shortage. The leaner they run, the more they get as a yearly bonus for keeping cost under control. Our ICU would sometimes run 3:1 with telemetry overrides !!! But of course, if someone "important" was there it was practically 1:1. If you can scarf up the nurse for that kind of staffing for "VIP's" then it's there for everyone....EVERYONE is a VIP to me. I got so tired of having them float off my techs to other parts of the hospital to "fill in" because I had an "extra" nurse on my telemetry unit (5:1 for three nurses and 6:1 for the other - mind you they handled about 6 - 12 discharges and an equal amount of admits per day). We constantly received people who should have been under closer watch (one day we finally got someone transferred after begging and lo and behold he coded one hour after he left the unit!). I'm sick of hospitals making an extra buck from short staffing. I told all of my nurses personally that when you are called and asked to work on your day off, the answer is NO THANKS unless it is really something you feel like doing (and for heaven sake DON'T explain why you can't, it's YOUR DAY OFF). If it is desperate and I call you, I will tell you so and then it is still truely YOUR option. I think that until we, as nurses, stop bailing out the hospitals when they are short ( because they will find the nurses if they have to) then we will see change. For heaven sake - they can't operate without us !!! You should see the panic down in the staffing area when there aren't enough to go around and the ER is full, wings are full, and people are still coming !!! Somehow or another agency just seems to appear then BECAUSE the regular nurses are not bailing them out yet again. We are TOO NICE and TOO consciencious, and TOO caring and MANAGEMENT KNOWS AND TAKES ADVANTAGE OF IT !!! Been there, seen it, DID NOT DO IT, left to take a higher position so my nurses can be treated they way they should be as much as humanly possible. YOU are the backbone, you deserve to be praised (I did constantly) and thanked (yup) each and every day for all that you do, INCLUDING even showing up ! I am taking some of my nurses with me to my new place, because they want to follow me there - Sunday we have a party together - they are my everything.

[chigap]

I have been in ICU for 3 years. Had 2 years of experience on a med floor before ICU and I have done 1 year of ER in the middle of my ICU years. The work is physically demanding and very stressful. Skill mixes are a joke. Many of the experienced nurses are bitter and burnt to a crisp. Newer nurses are counting their days (can you blame them -- the work environment is unhealthy on so many levels). Management is cold and demanding. If you are staff getting time off for education or vacation is a joke. I cope with all of that by working agency or per diem. Currently, I work agency/registry in a large city in California where things are supposedly better since the law regarding ratios was passed. Let me just say that the law is a joke and every hospital I have worked at violates it every shift in one way or another. Nobody cares. I worked an night shift the other night and ICU nurses were covering each other's patients while the other nurse slept (it's ILLEGAL to cover another nurses patients for breaks). So, I had four patients for 2 hours because I covered the nurse on either side of me. This was against my better judgement, but I was not going to fight about it. I'll just never work a night shift there again. One nurse read me the riot act because another nurse woke her up and she thought I had put her up to it. I told her that I was minding my own business and had nothing to do with her being woken up and she just kept ranting. I did not take a break because I did not have anyone I could legally report to. The charge nurse covered nobody's patients and was gone for about 2 hours. How would you like to be a new nurse stepping into that sort of a illegal and nasty culture? Nice!

Let me just say, I was the only nurse there that night that was born in this country. There were about 10 nurses. That is not a slam against those nurses, I have been one of those foreign nurse in a hospital where 90% of the people on the shift are born elsewhere: there is a reason for it! I have worked agency in 3-other hospitals here; one of which I will never work in again. A few years ago, I was staff at one of the large teaching hospitals for a couple of years. They probably would not dare violate any laws, but it was incredibly busy, the staffing tight and you were just another cog in the machine. About half of the moderately experienced younger staff were in grad school and on their way out, about half of the older and very experienced staff were ready to retire, the other half of them were circling like vultures because the manager was nearly retired and the rest were new grads who were out the door ASAP and not going to put up with any crap. Good on them -- a healthy person runs away from fire anbd not into it...

It is very difficult for me to get shifts lately and hospitals will do things like book me in advance and then cancel me at the last minute, so I will have missed out at the chance to be booked at another hospital. A couple of weeks ago, I only worked one shift in the entire week. I applied for a job in April and did not get an interview until July at one hospital. Got that job, but won't be able to start until the end of August HR is a bit slow). Another hospital did a phone interview and said I would be contacted by the Nurse Manager within 48 hours to schedule an interview. Haven't heard from the manager in nearly 2 weeks. Experience tells me she will call long after I have even forgotten that I applied for the position. Bet me!

Anyway, I take care of myself first. I work to live and not the other way around. I do my best to keep friendly and fresh for the sake of my sanity and the patient's safety.

[TopherSRN]

Originally Posted by soliant12

The smart ones go on to advanced practice.

No further replies necessary as this is the correct answer.

[willti1]

I work in a 20 bed MICU-- split into 2 sides-- on any given day there will be 3-4 out of 10 patients over 300 lbs-- it is tiring and honestly I've got an attitude about it... if I can my butt up to the gym at 0430 and make it into 12 hr shift for 4 days in a row then others should at least be able to get some type of exercise in... I'm so sick of these extremely overweight people... it is a burden on us physically and the comorbities that go along with obesity are draining the healthcare system as well... course then most of us work for hospitals who won't even put an on-site workout facility on campus so that at least the employees can try and stay healthy. GRRRR

[jaymz]

dukeRN
I don't totally disagree with most of what you say as our ICU has been destroyed by the FOR PROFIT hospital group that purchased us.
However,
Please remember that you were once a new ICU nurse with less than 1 yr.
And ...... You've obviously not tried to get in to CRNA school, it is by no means EASY
You also are in a CRNA educational hospital, there will always be more
people there trying to get in.
none the less, of the other statements I agree.

[jaymz]

Chigap
Anyone sleeping during their shift should be fired immediately.!!!!!!!!!!!!!!!
and their license suspended.
This is, at the very least, negligence of the worst kind .

[janfrn]

Originally Posted by jaymz

Chigap
Anyone sleeping during their shift should be fired immediately.!!!!!!!!!!!!!!!
and their license suspended.
This is, at the very least, negligence of the worst kind .

I'm in total agreement but my unit'd be in serious trouble if that ever was implemented. The majority of our "permanent" night staff sleep for at least an hour each shift. Our contract allows for breaks to be combined, and our administration looks the other way when the staff lounge is full of people huddled under flannels with the lights off taking naps. Heck, they even bought us some comfy leather couches and fleece coverlets for the lounge to make those naps even better. Some of our staff feel so entitled that they will actually take their naps in a vacant bed in an isolation room... come and wake me up in 90 minutes, I'll be in Room 15. Our management knows this happens but does nothing. It burns me that these people choose to work permanent nights but don't make it their lifestyle. I work one day, one night, three off and you would NEVER catch me sleeping at work. It also makes my blood boil that I can't take a break in the staff lounge on nights because of the sleeping beauties. AND... they all like to be on break when x-ray comes to do the daily CXRs, so whomever is break covering (me!) has to do the x-ray then give sedation so that I can get my own patient's x-ray done. And then it's time for the 0400 bloodwork which is also left for the break-covering nurse. We are an intensive care unit... we are also the hospital's code team. How effective is someone who has just awakened from an hour long nap? Any suggestion that this practice be stopped falls on deaf ears. And they wonder why people don't stay.

[Bubbles_RN]

Well, I have watched the quality of care in the ICU where I work steadily decline over the last 3 years. The primary reason is we got a new manager, who has a personal bias towards staff.

I'm sure her mandate is to get rid of senior (i.e. "expensive") staff, and replace them with junior RN's. The quality of the new RN's is really hit and miss...some are fantastic real "keenrs" and the others come because they want to coast. They hear how ICU nurses only get one or two pts. and they think it's an easy ride. They come to the ICU and sit on thier a** while the rest of us wear holes in the floor running around.

I don't want to leave the ICU, but I'm beyond burnt out. I changed my shifts to weekends only, and that has alleviated some of the problems, because I finally lucked out to a schedule that puts me with the really goos nurses.

[RNsRWe]

Wow. As a new grad, this really gives me something to chew over.