dunno where to start, dunno where to finish! - page 2
I am really feeling it today, it being a gross generalization of terrible feelings one feels when work seems to get the better of them. for the last 2 12 hour nightshifts we were short on the floor,... Read More
Aug 14, '02Wow, Wendy! I've been there more times than I care to remember. My solution, was to start looking around for another job where the stress wasn't so high. Well, I didn't find a "stress-less" nursing job, but I did find a place where my coworkers were more supportive; when something wasn't done, they'd just jump in and do it without the *itching. End results has been a good "team" oriented job and lots of comraderie. There are better situations to be. If your job keeps doing this to you, I'd really start looking around a LOT. Be good to yourself, Wendy. Wish I could give you a big hug!
Aug 14, '02"Hello, DON? I cannot in good faith ACCEPT this assignment of X number of high acuity patients. I cannot take report. We need help to ensure patient safety. No? fine, I'll be going home then as I cannot take report at risk of abandoning my future pts. Unless you can find us some help. Thank you".
Your nursing practice act forbids you and I to take an assignment we cannot safely handle. I personally can see myself in court answering to the question "Well, nurse, then why di you accept this assignment....." It's hard to take a stand. You may lose your job. But I'll bet you can find one real quick...
Aug 14, '02let this be a lesson to us all...when we are old and/or sick......look OUT! truly horrifying. wendy, you have my total support as well as attention. unbelievable.
Aug 14, '02I was working PRN at the local hospital.
Every time I went in, I had eleven patients. (Med/Surg)
We had a job opening for a new clinical leader. Instead of hiring the in-house nurse who wanted the job (the only reason she didn't get it was because she had too many absences - nevermind that she routinely stayed over to work DOUBLE-SHIFTS), they hire a young guy from a psyche hospital WHO HAD NEVER EVEN WORKED MED/SURG BEFORE.....TO BE THE CLINICAL LEADER.
Needless to say, the other nurse went agency and I don't blame her.
He was not only incompetent but idiotic beyond belief.
Thank God I am out of that hell-hole. The last night I worked was a night to be remembered.
His incompetence led to errors and I started charting defensively whenever I worked.
Example: he didn't even know how to make the assignments out, nor did it occur to him to put a confused, wandering patient next to the nurse's station. After we got admissions called up, he would assign them a room willy-nilly, well then the CNAs would bring them up and decide they needed to be near the nurses' station; so they put them in a different room and told him why, etc.
Well their orders had already been faxed to pharmacy, so one night I had a patient who had been shuffled around like that and their IV fluid came up from pharmacy with the original room # on it. I had 11 very sick patients and probably another admission and I hung it based on the room #. Turned out, it was the right room # but the wrong patient because they had changed their room when they brought them up BECAUSE this INEXPERIENCED, incompetent "leader" didn't know jack squat.
Of course, one of the Clinical Leaders on dayshift had hung the wrong bag of fluids on someone and dismissed it, but even though the only extra thing in the IV fluids was vitamins, I wrote it (the incident report) up myself because that's how I was trained: if you make a mistake, DON'T try to hide it! When I wrote up the incident report, I stated that I felt we were understaffed and it would not have happened if we had had enough staff and also, that the IV bag came up with the wrong Room # on it. As proof, I took the label off the bag and affixed it to the incident report.....(somewhere along the line I decided to chart defensively)....need I say that was my last night working there? The Unit Mgr. didn't appreciate my charting and Mr. Incompetent had already gone to her, trying to get me off the unit. She is never on the floor, (I worked thirds) and so she had no idea of what went on and couldn't care less. She called me in to see her - of course Mr. Incompetent was present - she wouldn't listen to a word I said. She mentioned that she didn't like the way I had been charting on my incident reports - about the understaffing.
WELL SORRY LADY I'M NOT WILLING TO LOSE MY NURSING LICENSE TO SAVE YOUR SORRY-A$$ HOSPITAL FROM A LAWSUIT! I AM NOW WORKING THIRDS IN A LTC FACILITY AND AM VERY HAPPY (I just started...) Hope I stay that way!
You can't work med/surg here very long and keep your sanity!
Aug 14, '02Oh yes! Med/surg at my joint-8-10, with up to 12 if we get stuck with a no show. That can include a vent or 2. That's nights. Some mornings you get in the car and cry tears of relief because you made it through and so did your patients. Our bunch does work well together, which is a big +++. AND, if anyone tries to tell us how the assignment OUGHT to go, we say "yeah, yeah, yeah" and then do it our way. No one is gonna stick around to check on us anyway-they might have to STAY!!!
Aug 14, '02Dear Wendy,
I am so sorry you were put in this intolerable situation! Sending you a big hug. :kiss :kiss
Aug 14, '02thanks for all your support, suggestions, hugs, comforting words, pm's etc.
I'm still feeling really bad, which is not like me at all , usually I am able to bounce back to my hapee self quite easily....
I have never questioned being a nurse before, I went into nursing as a fluke and as my education and career have progressed I am convinced that for the first time in my life I am doing what I was put on this earth for....
it brings me great joy, satisfaction and reward to deal with all the patients and do the best job I can to meet their needs.
not being able to do that to the extent I want to has rubbed me the wrong way.
Someone emailed me with the suggestion that I need to buck up and learn really quickly that my seemingly nice demeanor will get me nowhere fast in nursing and that I put my patient at great risk but not continuously calling the MD til she came.
This has made me feel as though I am a huge failure.....
truthfully I had a hunch she wasnt doing well but she exhibited no real clinic signs of this , and having read her attending MD kinda had the same train of thought, for the 8 hrs I had her her vitals were within acceptable ranges , she was alert and oriented, afebrile, nothing that would definitively say to me or anyone else that she was gonna code, it was just a feeling , a gut raw emotional feeling, the day shift RN said she felt the same thing , the patients condition was the same as the dayshift RN left her as when I had her overnight..I cant explain it , I sit here going over things in my mind and everything is just swirling right now , I'm angry at the staffing, I'm angry at management, I'm sad that one of my patients coded, I'm crying because I'm just a combination of being angry upset and so fatigued that I cant make head or tails of any of this.
I sincerely hope that my posting about this situation has not made you wonder to yourselves about my abilities or the fact that I really do love my job and love my patients immensely.
I think I might have come across badly in my first post....
I never thought I would question being a nurse.
Although nursing doesnt define me as a person it is a tremendously big part of my life and who I am....
I'm on holidays for 2 weeks as of Monday but I really dont know if I can handle working this weekend, but our unit is already short this weekend for nights, I dont want to screw my co workers and the patients over because I'm sitting here having my own private pity party.....
I'm going to do some serious thinking over my holidays and try to get things in order
once again your support and kind words have renewed my faith in nurses, nursing and humankind in general
for that I thank you
Aug 15, '02Glad you are getting a vacation. No one thinks you are a bad nurse. Too many paitents and too little time. The majority, if not all, of us have been through this. I too would go home crying sometimes in pure exhaustion just thanking God that we made it through the night without a patient loss. Only by the grace of God many times. Sometimes we would finish report and I would look around at the staff and say "God help us and our patients today". Take your vacation. Think about another job. Administrations all over better wake up. Med-surg floors are too busy and the patients are sick.
Aug 15, '02In my humble opinion, the situation described by Wendy is exactly why there is a nursing shortage and why so many of us leave bedside nursing.
Nothing will ever change if everyone keeps going to work everyday and accepting these situations. This country is currently experiencing what could possibly the worst nursing shortage in history. There is no reason for anyone to accept these working conditions. There is no reason for any patient to accept the substandard care that accompanies working conditions like those described.
If you're unhappy in your current job...leave! If your assignment is unsafe it is your ehtical responsibility as a professional to refuse it.
It's not bad everywhere. This board is full of people who love their jobs, their bosses and their co-workers.
Just get out there and find one of those places or leave bedside nursing or accept the current situation and live with it.
Your life (and your job) is what you make of it.
Aug 15, '02mm hi wendy ... dont kno you ... but feel for the predicament u r in now ..... do use your holidays to relax , unwind and do things you enjoy ... hang out with friends , get away ... wotever!!
ive just returned to work after a three week break and did alot of thinking about my work in that time ... anyway , returning to work ive now asked for part time and for me .. i kno its wot i need to make me feel better in myself and also be of much better use to my pts ... mm and colleagues i suspect ... gee i could get nasty when pissed!! someone only had to look at me the wrong way n i was off !!
im sure youll feel refreshed after your break and see things much more clearly ..... wot i do with my part time will depend ... it will probably still involve nursing ... as im very much a ppl person n helping others n so on ... bla bla ... its wot i do sooo mm maybe in a totally different area or well gee ... who knows !!! i dont even kno yet .....
all i kno is the time has come to do something different ..... some of the time anyway ....im good at wot i do and to do it less would be ideal for everyone concerned i think .... too much time in the one place was enough to drive me nuts!! Anyway , heres to ya ..... wotever you decide ...... oh ... i dont think as a nurse u have too much to lose ... there are heaps of doors that will open if u decide to change .... since when could a nurse be without a job?? that is wot i think anyway .... there are lots of opportunities out there ...
Aug 15, '02Wendy.....
I agree with researchRN--the reason so many nurses leave is due to shift after shift like the one you described, with absolutely no support from management.
I left management because I felt that my skills were best-suited to the bedside (part of my frustration w/mgmt was that I was always a CLINICAL manager--yes, I helped on the floor, took assignments once in awhile, relieved for lunches, started IVs, and was one of the stronger clinical resources). As a result, I am acutely aware of the issues and dilemmas that staff nurses face with ever-increasing clinical loads and much higher acuity. I fought tooth and nail to maintain a 1:6 ratio of RNs to pts, even on nights, due to potential for falls, cleanup and follow-through that days and PMs didn't have time for, since they also had a 1:5 or 6 ratio (I should mention that these were neuro and complex ENT pts.--fresh radical necks/flaps/trachs--nope they never went to SICU for a day like they do in most places).
I, too, had a frightening experience the other day. Our hospital floats ICU to ICU or ICU to tele. Well, I was the lucky one the other day and got pulled to tele. I had the following day shift assignment:
6 patients: 1 vent who could do some self-care.
1 intracranial bleed in afib--total care/suctioning, etc.
1 suicidal psych patient who ruled in for MI and was going for cath. VERY NEEDY, especially post-cath.
1 post-op exploratory lap w/bilat. pneumonia and PSVT who was hypoxic and confused at times.
1 bilat. amputee, renal insufficiency, HTN, DM, +MI, also going for cath and who was demanding and screaming for cigarettes every 5 minutes.
1 elderly admission of a trauma MVA, r/o cardiac contusion, who did not speak English and was having chest pain.
I had never floated to tele before, so not only was it my first time, it was madness! The unit is over 40 beds, and the chaos is UNBELIEVABLE. I couldn't find charts, couldn't find orders, couldn't find patient labels--nothing! Didn't know how to operate their monitors, although that was easy enough to figure out. I ended up leaving at 5 p.m. (shift was over at 3:30) after trying to get some semblance of charting done and giving report until 4:30 p.m. due to all of the confusion about assignments. I ruminated about it during my drive home and had almost no sleep that night because I felt as though I had neglected patients. I called the unit manager the next day and expressd my concerns about patient safety and quality of care, but also pointed out some changes that could be made to make the workflow easier for the staff. He was receptive, and I hope will make the needed changes, not least of which was to decrease the number of patients per nurse to 4 on days. I think one of the reasons he was so receptive is because he is an ER nurse by background and really doesn't understand the workflow on the floor, and he also knows I love patient care and wouldn't yank his chain about what the unit needs. Still, I felt sick after working that shift, knowing that I wasn't able to give the best care I know how to give because of all the other roadblocks.
I know how you feel, and I would advise you to speak (calmly and with some suggestions for improvement) with the unit manager about the situation. I don't know if it will change things, but it might help. Enjoy your vacation!
Aug 15, '02(((((Wendy)))))
I had many a night as well, where you just hope and pray your patients don't die b/c you're pulled so thin. I hated my job...dreaded going to work...had bad dreams about work...
So I got a new job. Now I don't hate my job, and I no longer dread going to work.
Don't question whether nursing is for you. You're a good nurse, you're just in a bad situation.
What's making you stay?
Don't let it burn you out so much that you can never recover.
Aug 15, '02Originally posted by ERNurse752
You're a good nurse, you're just in a bad situation.
i have found that a vacation helps, but doesn't solve anything. if you don't have any plans, i would suggest researching other hospitals in your area. also, don't forget to take a day for just yourself. makes me think back to the thread...the patients are fine but what about us?
Originally posted by furball
Did anyone c/o 4x4 wrappers or IV caps on the floor? Or in the pts bed? Sorry....couldn't resist.....were your pt's left spic and span in the am? huh? huh? huh?