[burndout]

TO PEACHPIE...KUDOS TO YOU!!!! YOU HIT IT ON THE NOSE..IT'S ALL ABOUT ACUITY..WHEN WILL "THEY" REALIZE THAT??? NOT UNTIL THERE ARE ZERO EXPERIENCED NURSES LEFT ... WE'VE ALL LEFT BECAUSE WE ARE UNABLE TO PROVIDE THE STANDARD OF CARE WE BELIEVE IN PROVIDING...JUST CAN'T DELIVER SUBSTANDARD CARE..WE GET BURNED OUT AND LEAVE WHAT WE LOVE..NOT BECAUSE WE WANT TO, WE ARE FORCED TO..IF WE WANT TO KEEP OUR SANITY..SAD...VERY,VERY SAD...

[burndout]

TO FOSSILRN..I Definately Feel For You..been Doing It Myself For Yrs..found I Had To Start Getting A "little Selfish" And Taking Off A Little Extra Time Every Month..just Add A Vacation Day To A Litt;e Stretch (if You Do 12 Hrs) And Make It A Week..i Know Those Days, And What They've Done To Me..make Some Time For You..and Don't Feel Bad Avout It..i Don't ..tho I Used To..now I Even Go Away For A Few Days Alone..no Husb Or Family, And It's Probably Saved My Mind And Career..i Read Your Note And My Heart Just Goes Out To You...hang In There..

[janfrn]

Originally Posted by 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.

OMG, do we work in the same unit????? In our case, the junior recruits seem to be more miss than hit. And God forbid they should be assigned to care for a chronic patient, or someone who has cognitive impairments. It's so far beneath their skills and talent as to be just a waste of their time, don't you know. As the parent of someone who's got chronic health issues, physical handicaps and is cognitively impaired, I resent the Hell out of that. Today is a perfect example. We have a very large (~95 kg, 1.8 m tall) 13 year old girl who is now a T6-7 quad, from an MVC followed by a large right hemisphere bleed, who has been in the unit for more than a month. She was trached last week and has several pressure related injuries from when we were unable to reposition her due to cardiovascular instability. She's been considered fair game for junior staff for a while now and last night she was assigned to one of our too-good-to-be-true newish grads who said that she didn't bathe her because she was having a restless night. Hello, she's awake anyway! So this afternoon, four of us gave her a head-to-toe scrubbing, and discovered that she'd probably not been bathed in a week, maybe more. She still had two sutures on her chest from a subclavian CVC that was pulled several days ago, and a chest tube site dressing that looked putrid. In fact, I think it was the same dressing I put on her two weeks ago. EEEWWWW. This is basic nursing folks; I know it's beneath the prima donnas, but what did they think nursing was about?

[janfrn]

Oh, before I forget, about our manager... She actually told one of our very senior, very skilled and experienced nurses during her evaluation that she'd rather "have ten new grads than you"!

[PeachPie]

Originally Posted by 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

Amen. The obesity epidemic is one that is affecting us. When I worked LTC, we'd have to lug around people who were obese from zero physical activity, yet the nursing home still gave them ham swimming in gravy, buttery grits, bacon, tater tots, hamburgers, etc. These people at least weren't at fault because they didn't have the physical or mental capacity to control their weight. However, how the heck do you get to be 400 pounds, and what responsibility are you going to take?

[RN34TX]

Originally Posted by janfrn

Oh, before I forget, about our manager... She actually told one of our very senior, very skilled and experienced nurses during her evaluation that she'd rather "have ten new grads than you"!

That's not all that uncommon to come from an ICU manager.
I've worked in an ICU where the manager didn't want anyone still working there after 2 or so years of experience.
She herself had less than 5 years of ICU experience and resented anyone with any more expertise than she had on any given subject.
So she slowly drove the old ones away as a new manager upon discovering how much easier new grads are to manage and intimidate.

As a whole (not everyone) new grads are cheaper labor and easier to push around and intimidate.

It's far easier to convince them that if they don't take on an unsafe assignment for example, or float to a unit that they are unfamiliar with and not competent to be working in, that they will get into trouble and/or reported to the BNE.

It's also easier to make them feel that they should be somehow greatful for any job offer thrown at them and not to expect too much.

However, it doesn't take an average new grad long to figure out the real score. Hence, after a year or two, the new grad is no longer so easy to intimidate.

So you push them out and get in a fresh batch that doesn't know any different.

[Retired R.N.]

Originally Posted by PeachPie

Amen. The obesity epidemic is one that is affecting us. When I worked LTC, we'd have to lug around people who were obese from zero physical activity, yet the nursing home still gave them ham swimming in gravy, buttery grits, bacon, tater tots, hamburgers, etc. These people at least weren't at fault because they didn't have the physical or mental capacity to control their weight. However, how the heck do you get to be 400 pounds, and what responsibility are you going to take?

What are you going to suggest to a patient with severe asthma who is taking huge doses of prednisone that has caused him to have two artificial hips due to necrotic osteoarthritis? The prednisone increases his appetite to the point where he is hungry all the time, and he is gaining weight on a 900 calorie diet.

[mary4mary]

I was a CCU nurse, I left because of ethical reasons. Living wills were not being honored, people were being kept alive on ventilator aon ivs like dopamine. One night we coded 4 people, we used all our meds in the crash cart

[PeachPie]

Originally Posted by Retired R.N.

What are you going to suggest to a patient with severe asthma who is taking huge doses of prednisone that has caused him to have two artificial hips due to necrotic osteoarthritis? The prednisone increases his appetite to the point where he is hungry all the time, and he is gaining weight on a 900 calorie diet.

That would be something out of the patient's control, much like actual thyroid problems. Please tell me you've never been peeved at hurting your back after trying to move a bedridden, morbidly obese patient whose family keeps trying to sneak in buckets of KFC, adn that there is only one lift in the ward that keeps breaking down, is always missing, or always has drained battereies because people keep forgetting to plug it in. I am disgusted at the rise in morbid obesity, and the need for facilities to buy more equipment for these people.

[SmilingBluEyes]

I am disgusted that despite the trend toward increased morbid obesity in our populations, of all ages, we don't have more safety equipments and laws in place to protect nurses and other caregivers from dire and career-ending injuries in the FIRST PLACE!