[inthesky]

I have just finished my 8 week new grad psych nursing orientation. I have been extremely lucky that my preceptor is an incredible nurse and human being. He is really the first mentor I have ever had.. and I've told him that he is stuck with me =P

I actually do enjoy working with psych patients and I am pretty good at it. buttttttt There has been some upheaval in the unit.. changes which are well..hostile to nurses..

Taking admissions is now the priority.. yes.. trumping care of the patients you already have!!! Admissions can come whenever they are ready.. med pass.. shift change..not done with your current admit..while your detoxers are moving towards DTs.. whenever..doesnt (&^(*) matter. And they call the (^()&% manager if you delay an admit even if you have a valid reason!!!!! Everyone is overworked.. irritable and stressed. More mistakes are being made. You can practically taste and feel the negativity!!

I recently had a shift where i worked for 13 hours with no breaks!! 10 patients..and two admits.. and i was still chewed out by the AM nurses for not doing enough!!!!! I came home and cried.

The unit was also really vulnerable.. i had 12 patients.. one patient had no admit paperwork completed from day shift (shift change admit), but slept my whole shift because she was combative and was given a ton of ativan (not on her med records btw). One patient was a regular admit.. ok.. my 12th patient rolled in the door at 6am..before shift change at 7am.. my preceptor's patient rolled in the door perfectly at 7am >_<. So day shift.. inherited my passed out patient without paperwork.. and the 7am admit.. i stayed late to complete my 6am admit.. it was hell..and we would have all been so screwed if a patient had acted out or had a medical emergency. in fact.. think about it.. what if my sleeping admit.. had woken and acted out..when my 6am patient rolled in.. to just be complicated when the 7am rolled in???????????? and when was the last CIWA of my detoxer?????

i like the theory of nursing.. this job sucks.

i feel ABUSED and EXPLOITED! and I feel like I am betraying my patients who trust me that they are safe and that their needs will be met.

is this what nursing is??? as much as I like caring for patients.. I refuse to be overworked to death.. i'm young and have a bachelor's degree. thanks for listening!!!!!

ps.
(a joke that was in my mind)
I rate my day a 2/10. I am having active SI. I am having HI against you with a plan. I have voices in my head telling me to quit.. *$*&&( you! LOL

[RNKittyKat]

Although a new grad, I am new to psych. I pass meds to 13 pts. Nearly half of them cannot come to the med window for behavioral or medical reasons. About 1/4 of them require meticulous skin care with multiple creams and ointments and that same number are insulin dependent diabetics. It's not unusual to see nurses, particularly charge nurses, work double shifts two days in a row. That's 16 or more hours. I can assure you, I have no intention of being one of those nurses.

[Beowoulf]

In my psych ward, we carry a max of 7 pts. If they try to saddle us with more, we ALL immediately fill out a dangerous work conditions form. These forms state that we evaluate the situation to be dangerous and will not be responsible for catastrophes. Our union takes these forms quite seriously. If the union gets one form, the admins. get a phone call. If they get a few of these on the same issue, a meeting is set up to find a solution. Your admins need to know that you WILL NOT be placed in that kind of situation.

From what I read on here, it is my (male) opinion that nurses need a LOT of work on BOUNDARIES. I think the "overwork motif" in nursing has become the standard because the job's essence was formed in femaleness. Females are mothers. And who always gets left "holding the bag?" MOTHERS! And what mother is going to say to it's baby, "No, I am too busy."? Seems to be a kind of "role transference" as though "mother" and "nurse" are the same thing. It is my (male) opinion that they are not.

[aloevera]

Where do you guys work with only 7 or 10 pts.?????? We usually have between 25 and 30....some of them are line of sights, too....Staff is usually 2 RN's (if no one calls out), the med nurse, and 2-3 techs.....
We generally work through breaks and eat a bite of lunch at our desks while we are working.....or do you do all the meds and tech work too??

[inthesky]

thanks for all of your replies! I wonder how patient satisfaction correlates with nursing workload? I know that there is no nursing union in arizona =(.. plus it is a 'right to work' state. It just astounds me how the largest professional workforce has such little power.

it takes me forever to pass meds to just 12 patients.. especially when i am tracking 6 of them down. and 6 of them need multiple PRNs.

After that one shift of hell..i actually had 4 nice shifts =). I guess it was nice and sunny outside and people didnt want to detox =P I agree with the poster talking about nursing as an initially female profession. Doctors have never been known as selfless =P

I had yet another run in with a peer nurse >_<. oh why.. is another nurse trying to 'eat me' {nurses eating their young}. Right now.. im just hoping for another run of good shifts. my last 4 did make up for the crap that was last tuesday.

i sure wish we could fail a 'dangerous environment' form.

thanks!

[RNKittyKat]

There is talk in my state about legislating the nurse patient ratio to 1:6. I think we could provide excellent care with that ratio but I know we would have to lock our doors if that happened or pay whatever fine is imposed. There are just not enough nurses.

[Suesquatch]

Welcome to nursing.

[aloevera]

We are so understaffed, it is pitiful.....nurses are leaving all the time....I don't know if it is the salary or working conditions....We have had 8 nurses leave since Jan....we are working extra shifts, short-staffed, I don't know what is going to happen...It seems to be getting worse....A new co. took over and I would think the first thing they would look into is the staff/pt. ratio....instead, they are improving the cosmetics of the building...go figure...I would want to know we are losing so many good nurse....oh well, I am not in management....

[rotary]

12 patients? Are you kidding? On my psych unit each RN or RPN carries a maximum of 5. Occasionally we will take an extra patient if someone calls in sick and the shift isn't filled, but that's it.

Carrying as many as 12 is a dangerous load, especially when you're in acute care. How many support staff workers do you have available to help should something go wrong?

[Chaoticdreams33]

Hate to say it, but, welcome to nursing.
The working conditions you describe are very dangerous to all of the staff and all of the patients that are there to be kept safe. A patient recently hung himself In a CT hospital. Could lack of adequate staffing have anything to do with this?
It is scary and unsafe, and happens all too often. What will we as nurses do to make changes to keep everyone safe? All I can say is good luck, I'm getting out while I can.
Edited to add: Sorry to be so negative, but I just wanted to be honest.