Feeling Burned Out & Unappreciated!- What else is new?

Nurses General Nursing

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Hey fellow Nurses,

So for the past 10 months I've worked in the ED of a level 1 trauma hospital. To say the very least we are an extremely busy ED. We've had 3 hospitals just in this town close within the last 2 years which of course means MORE PATIENTS. We went from seeing roughly 90K patients in the ED/year to about 110k (as of the last estimate)

I'm relatively new to the ER and I love it, but with only 10 months in I'm already feeling burned out and am looking foward to doing one more year here and them I'm out. Not to mention the nurse turnover rate for this department is high.

It's the sheer volume of patients. It's just too much :crying2: I work 12 hours shift and last night was a horrid shift. At one point I had 11 patients, including an ICU patient and a slew of extensive abdominal pain workups, plus and ETOH patient that was driving me and my other 10 patients crazy.

Then I get a call from the med-surg nurse upstairs asking me why I sent her a patient that was soaking wet with urine and why we nurses in the ED like to send them dirty patients. I just confessed and told her that I was drowning in almost 10 patients, plus an ICU patient, and that the last time I checked that patient he was dry and clean. Not to mention we have no nurses' aides in our ED anymore, they took them away, so between me and the tech (who is swamped with EKG's and Vitals signs to do) I have to stop and help the little old lady's and gents to the bathroom, give pt's bedpans, and change dirty diapers, and linens, and yes somehow try to prevent my psych, ETOH, dementia patient from falling out the stretcher :crying2:

Then I have the doctors from the floors asking me to repeat this lab, place that foley, give this medication. Ugh. This is a 500 bed hospital, and almost all of the time patients in the ER wait anywhere from a few minutes (hardly ever) to hours before they get a bed. Which means that I can hardly get to caring for them properly before a get another 3-4 patients within 60 minutes :mad: from triage.

I asked my charge if I could somehow be skipped over for just a bit from triage, so that I could catch up because I had atleast 1-2 more patients than ever other nurse in the ED last night. Not saying they had it easy, in fact I didn't get any relief because the nurse to my right had 2 ICU patients (plus 9 others) and the one to my left got slammed from triage 3 patients back to back.

I got NO break last night, I wasn't the only one either. I literally worked 12 hours straight with only half an hour break and I barely even got to sit down at all! Right now my head, feet, and back are throbbing.

I love being a nurse, but I find myself getting colder. People just use the ER so recklessly (already the hospital is losing money and closing units) They don't want to wait, been sitting there for 15 minutes, and bark at you for a blanket, pillow, and a dinner tray. Sometimes I feel so used and abused.

I know the doctors work hard too, but some of them barely help you, or see that you're swamped but still want to know when x,y, z is going to be done. One resident told me the attending was upset because a certain pt didn't have their foley in yet???? well HELLO! someone could've told me that it was ordered and I'm sorry that is last on my priority list, I have people vomiting, screaming in pain, etc.. ! The Med-Surg nurse can insert the foley when they go up to the room. Sometimes I wonder where they fit in, in this whole ''team work'' (healthcare TEAM) we're all supposed to be engaged in. Don't get me wrong we have some lovely doctors who will actually start that IV, or give the morphine to a patient doubling over in pain, but the rest of them :confused: and don't even get me started on the surgical or internal medicine residents :uhoh3:

And you can forget management, they think everything can be done! They told us that we need to do hourly rounding in the ER! What?

And this is the least of my worries, I won't even go into other things we are subjected to. No wonder nurses come and go here.

Sometimes I wonder if management sees this? Do they understand how hard we work?

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Specializes in Med/Surg/Tele/SNF-LTC/Supervisory.

Whoa! I could NEVER do that job. That is flippin' NUTS!!! As a med/surg nurse.. I always had respect for my ED nurses b/c I've seen what they deal with.

Wish we could all stop bashing one another and be that TEAM in healthcare.

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Specializes in ICU, Telemetry.

Sorry you had such a rough night; I've been in ICU with 3 patients, and my charge wanting to know if I can handle a 4th because someone's going home sick and the floors can't free up a body, 2 on vents, one on q2h accuchecks, and one in the DTs with a family that's decided to move in and eat us out of house and home. I wanted to run out of the door and keep going. On the floor I've had as high as 12 on a telemetry unit during a flu outbreak, and same thing, I came home and wondered what the heck I'd done to my life.

We've all been there, and it's terrible. Try to get some sleep, and go do something that's fun for you, whatever that may be -- play in the dirt putting in fall flowers, go shopping, go to a museum, go play with the kids or volunteer with the ASPCA. If I don't take a few hours every week when we're slamming to do something "non-nursy" I start getting mean and short tempered.

Look after you, or you won't be able to look after anyone else.

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Management sees it but does not care. It is all about the bottom line.

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Specializes in ER.

First of all, get a new job. I left a job that I really actually liked because the nurse to patient ratio was ridiculous. I had 6 or 7 at a minimum and as many as 11 or 12 at a time. My new job also completely sucks but I don't feel like the world's worst nurse every time I go to work.

Second if all, ena says an er nurse's responsibility is to do stat orders and those placed by er doc. Please stop doing anything but stat and those placed by er md. You can not be all things to all people. Please quote ena to your manager and have her communicate to mds that this is all that er nurses will do as we are focused on through put and not floor orders.

Third, my new job is at a teaching hospital and I sympathize with you. The residents seem to go way outside the limits and I have personally observed them to offer their buddies from admitting services my services for any number of things including second iv accesses. I tell them that I do stat orders and focused on er md orders and they have their own nurses to boss around. (I then laugh maniacally and add "or not" ha ha)

Finally, I watched my friends from my new grad class bounce into icu where the ratio is always 2:1 (while we hold their stinking patients in er!) I suggest you either follow suit or find out through the grapevine who is keeping the ratio at 4:1 or 5:1 every single day in the er. Avoid teaching facilities at all costs. You aren't learning anything from the resi-idiots. Or consider grad school or fantasize about the day when you have five years er experience and can bounce into one of those fancy kaiser clinics and make a ton of money babysitting urgent care patients.

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Yeah ER nurses get such a bad rap, I'm not saying other nurses don't work hard, but we don't get capped, I've came on shift with 14 patients

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Specializes in ER.
Yeah ER nurses get such a bad rap, I'm not saying other nurses don't work hard, but we don't get capped, I've came on shift with 14 patients

Don't ever take report on 14 patients ever again. Ever.

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"funny" this post would be on here when I logged in...I was just thinking about how much I use to love nursing, was so proud of being one, so confident, but changes in healthcare coupled with some tremendous personal losses in the past few years hs left me burnt out from being burnt out. I have changed jobs more times than I'd like to admit over the past 3 years...I've tried to avoid working altogether by cutting way, way back...I am not at a point I have to return to work and am starting a new non-hospital position in a week. I SHOULD be excited...3 days week (every weekend plus one day) in home health, salaried plus mileage...but I'm not. I'm grateful for the job certainly, but really, all I want to do is avoid people. I think about going back into the hospital on a PRN basis so I would have some flexibility, but then I think about all the things you just mentioned and feel overwhelmed just considering it. I have never been anything other than a nurse, only have a nursing degree so I also feel pigeonholed because of that. I've been to the doctor, I know I'm not physically sick, but depressed. I have been told antidepressants would help - help get me motivated again, etc. but I don't know. I think nurses end up burning it at both ends - work and home - more than a LOT of other professions do. Care giving for people at work, care giving for people at home but forgetting about ourselves. I know this post was a little off topic but I feel badly for you and do understand feeling overwhelmed and tired and yet like there is no other choice.

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Specializes in neuro/ortho med surge 4.

That sounds like such a stressful shift. I was getting stressed out reading it. I am a med-surge nurse and I know I could not do what the ED nurses do. You folks get it all down there.

I wonder too on most days what I got myself into. If it makes you feel any better I have probably been able to take a lunch away from patients and the floor 4-5 times in almost 2.5 years.

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Specializes in Certified Med/Surg tele, and other stuff.

And our ED nurses scream if they have five patients each and are screaming to get them to the floor.

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Specializes in Pediatric Endocrinology and Diabetes.

Holy c***! I'm exhausted just by reading your post...

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I suggest transferring to an ICU that has 1:1 and 2:1 ratios. That's what I did and I mentally and physically feel better.

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