1st night on new shift, new floor

  1. Well I started over on my new floor, new shift last night. Just wanted to ramble and vent a little about how it went...

    The new floor is one I have floated to maybe 5-6 times, enough to know that I liked it better than my old floor. Anyway, was looking forward to going from days to pms.

    Wouldn't you know it, I arrive to work, 1st day on the new floor & they have me down as lead nurse. I'm fine with doing lead (I've done it on my old floor for about 1 year). But gee whiz, can I at least orient to the new floor 1st?!

    I told my new manager, "Hey, I'm sorry, but I'm not comfortable doing lead just yet. I want to at least orient to the floor." This floor is run different, has a different staffing matrix (I didn't even know where the matrix was), and different paperwork.

    There was one regular staff RN there, who was very cool, but never does lead, and one registry RN. Well, we all agreed to work as a team, and nobody would do lead & we'd just "wing it." That part went ok for one night, but I think it's not a good idea in general.

    The acuity of patients was less, than my former *nightmare acuity* renal/med/tele floor, true. The staffing wasn't too bad, considering, with 1 RN to 5 patients and 1 CNA per every 7 patients!!!!! (that's so awesome, as my former floor had one CNA per 12 patients). Of course, no unit secretary, and the "regular" floor RN and registry don't know how to put in orders into the computer. So I get to put in all the new orders, and there were quite a few.

    Overall, I think it will be a much nicer floor. I was working with my new staff, and was doing my best to be friendly, professional, and warm to all, especially as I am "new" to most of them (even though I have been at the hospital since 1999).

    Then, out of the blue...I had my first problem getting along with another staff member. And I usually am very easy going & get along with everyone! Well, it so happened I had a oncology patient w/ bony mets whose I admitted w/ a temp of 38.3. I very nicely asked one of the CNAs to recheck her vitals after 4 hours and she gave me some unexpected attitude!


    I have never been snapped at like she snapped at me! Truthfully I was a bit shocked. I value and respect my coworkers. I never order anyone around. I believe I am very tactful and considerate. I simply asked the CNA to please grab another set of vitals, and she snapped back, "Why don't you do it! If she's so sick, it's your patient!" I told her, "I am very far behind on my medications, and I haven't even begun my paperwork. I am asking you please, if you have time, to do this.If you don't have time, I understand, and I will do it.But I am far behind, and I don't want to stay overtime more than the 30 minutes I know I already am."

    I felt very rattled by her. I have never had CNAs that I work with be so rude. I have been an RN 4 years, and got along with all the CNAs. In the past, if one of my team CNAs was too busy, they might tell me, "I can't right now, or in a few minutes I will."

    She was just sitting at the nurses station when I asked her this favor, so she didn't look too busy to me. Luckily, she did check the vitals & seemed friendly enough after that incident. But I noticed she kept checking my name badge to see my credentials, and was defensive about a few other things. *sigh* She's new to the floor, too. I hope this won't be a common problem for us. I appreciated all that she did for our patients, and I made sure to thank her, too. I depend on CNAs to help me. I have a hard enough time as it is asking for help. I told her early in the shift to please ask me for help, if she needed it too.I hate to "bother" people, but in nursing you have to work as a team.

    Finally, in the home stretch at 9 pm, staffing calls and says they only have 1 LVN scheduled for the noc shift for 14 patients & can any of us work a double! This is an acute care floor in the hospital! It's my 1st day on the new job, I skipped my breaks, and no way am I working a double. Finally, the regular staff RN wheels and deals a day off in return for working over. They have 1 RN and 1 LVN for 14 patients on nocs. Even that just seems too much to me. I know some of you nurses have it worse out there, but that doesn't excuse poor staffing. Some of these patients are really sick! There are a lot of IV meds...it's a killer for the RN.On my other floor, we had 5-6 patients each on nocs. I think for the one RN to cover 7 patients of an LVN is ridiculous! I know it is done in other places, but I felt really angry at management once again.

    I had a long talk with the staff RN who works on this floor. She has been an RN 20+ years. I told her that I am seriously planning to get out of nursing (I'm going back to school in January). And part of me feels very sad about it, but I am so tired of all the BS. I just can't last till retirement in nursing, I know. This 20 + years Rn says she's pretty burned out herself, and we had a few laughs over that! ;-) I told her I am sick of no breaks, overtime, and not enough staff. I am sick of the STRESS. She said she thinks that they'll never be able to safely staff, as RNs are "too expensive." I think that's a bunch of bull.

    I fear it will only get worse before it gets better. But someday I hope we realize that these studies about patient mortality and lack of nurses are based in fact. We NEED safe staffing. And if we want to retain nurses, we need to not work them to the bone.

    Well, I have a few days off, then back to the adventure! Thanks for letting me vent. I really am excited about my new floor & position, despite my gripes.

    Last edit by Genista on Nov 6, '02
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  2. 2 Comments

  3. by   joyrochelle
    well congrats on your new job!

    wow.....I just wanted to say, after reading your "vent", if you can call it that, that you have a great attitude and I think that the unit is lucky to have your even tempered and quality centered care giving! Keep strong and do your best to stand up for yourself in a unit that seems that it would demand your best!
  4. by   sjoe
    "I very nicely asked one of the CNAs to recheck her vitals after 4 hours and she gave me some unexpected attitude."

    Write her up for being uncooperative and insubordinate.


    "I fear it will only get worse before it gets better. But someday I hope we realize that these studies about patient mortality and lack of nurses are based in fact. We NEED safe staffing. And if we want to retain nurses, we need to not work them to the bone. "

    1) It WILL only get worse.
    2) Those other ideas are correct, but management is not going to do anything about it in most cases, and no one else is empowered to.

    Hope your next career is more pleasant.

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