help! Is my job normal?

Nurses General Nursing

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How bad is my floor? Is it normal?

Hello everyone, this is my first time posting on this forum..Right now I am in desperate need of your opinions. I am currently working on a surgical unit, graduated from an excellent nursing school in a major city and did pretty well throughout school. So this job is my first real nursing job as an RN and I've been there for almost a year now. Things on the unit seem to be very hectic and staffing often seems to be short...Stress levels in general for all the nurses seem to be increasing but I have nothing else to compare this job to as this is my first job. I feel like I am incompetent as I often feel as if I am just getting through the day by keeping my patients safe and fulfilling doctors orders. I sometimes feel out of control (haven't made any big mistakes so far) and I probably look so stressed all day long, I don't get lunch breaks and rarely get to go to the bathroom without feeling like I am putting myself before my patients. I can't tell if this is what nursing is, or if my floor is just crazy.

I just would like to give you what a typical day looks like on my floor (nurse to patient ratio, turnover rates, types of patients, etc.) So here's what my day today consisted of: Started with 5 patients.

patient #1: 75 y/o male s/p hemicolectomy c/b oliguria & ileus.

patient #2: 73 y/o male with malnutrition, lung cancer, tongue cancer & s/p R side pneumonectomy with chest tube & peg tube placement on Q4 gravity tube feeds.

patient #3: 68 y/o female s/p lap chole c/b confusion and uncontrollable pain.

patient #4: 57 y/o male s/p t10-t11 laminectomy for tumor removal c/b SBP in 180/-190s r/t uncontrollable pain even when getting morphine, dilaudid, Oxycodone.

Patient #5: 72 y/o anemic female pre-op for colostomy placement requiring blood transfusion.

Turnover rate: typically discharge 0-2 patients and obtain a patient for each discharge later in the shift.

Apologies for the lengthy post I am just beyond stressed out and miserable with my current situation and I'm just wondering if it's normal to feel like this during your first nursing job or if this is not an acceptable work load. Thank you in advance!

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Sounds pretty normal honestly. Especially on surgical wards, all of your patients can be discharged with all new admits. You need to take time for yourself and you need your breaks. Part of your feeling out of control may be related to the fact you haven't eaten/ sat down. You will get better with time management as you gain more experience. Surgical wards do tend to be fast paced with complications. Do you have care aids who can help? Other nurses? Is everyone this busy? What's a normal patient ratio on your floor?

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It sounds normal, to me. And if five is your limit (even a soft limit), you have it better than a lot of new grads. Hang in there.

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That.... looks pretty normal. I wish it wasn't but..

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Hi! Thanks for the response. The nursing assistant situation is another issue itself. I am in no way ageist, but the 2 full time day shift assistants are both well beyond their retiring age, try to get by doing the bare minimum and do not fulfill many job duties that the part time nursing assistants or student nurse-techs do. They always refer to us as "you young people" and talk to me like I am clueless. I understand that they have been doing this for 30+ years and are tired but it's getting to the point where it's affecting patient quality of care and overworked nurses. I believe I treat everyone who I work with with respect and i hate asking for help as I prefer being independent. But I often get nasty push back when politely asking for help taking a patient for a walk, help with feeding a patient, do a bladder scan, etc. these concerns have been raised to management by multiple staff on the floor but it is very difficult to get fired in the healthcare system I work for. This has caused me to do everything on my own as it improves patient care and is more efficient if i just do it myself.

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Appreciate the responses! I feel better knowing I will feel more comfortable over time. I think I just feel out of control because of the amount of medications I have to give around the clock.. I always feel like I'm barely giving meds on time on some days. Typical patients get approx 25-30 meds in a 12 hr shift. I also work with a lot of younger nurses due to the high nurse turnover rate on the floor as well. There are 3 nurses on the floor that have been there 5+ years and said that it is very busy the past couple of years but I think I am also just anxious as a new grad as well. Nurses are always there to help but often are busy themselves to stop and help others.

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I've been a surgical nurse for a little over two years. THIS sounds completley familar. I also get 5 patients. Sometimes we don't even have CNAs and when we do it's like pulling teeth to get them to help. It gets easier though, more manageable, and you will stress less. We have a great team and management is wonderful. If I am having a very bad day I just tell my co-workers that I HAVE to take a breather because I am about to lose it... they get it and tell me to go. My team is the only reason I can handle it day after day.

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Specializes in Travel, Home Health, Med-Surg.

"Apologies for the lengthy post I am just beyond stressed out and miserable with my current situation and I'm just wondering if it's normal to feel like this during your first nursing job or if this is not an acceptable work load. Thank you in advance!

"

I am sorry you are in such a stressful situation but I am afraid that yes, this is the norm. But it is equally right that this should not be an acceptable work load. Your first year/nursing job is always very hard and especially with all the changes that have made hospitals worse, higher acuity patients, charting etc. It will get a little easier with each passing day as you gain experience. In the mean time, ask questions when needed, this is a must for patient safety, and also nurse well-being (you don't want to go home and worry about what you did or didn't do), and find a healthy way to deal/cope with your stress, find what works for you! Good luck!!

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The ratios at my hospital are slightly better start with 4-5 can discharge 2, pick up 1-2. But honestly, it all depends on your patients... could have 3 and think you won the lottery and be running around like a chicken for those 3 needy/unstable patients.

But I digress. I think it's entirely normal what you're feeling. It will get better. You'll get better at prioritizing and delegating with difficult cnas. Please prioritize breaks though. You'll burn out very fast if you don't. And if that means not calling back 2nd family member for an update right away or fetching someone a coffee, then so be it.

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Specializes in ICU.

About the "older" nursing assistants: I have found the opposite at my facility. It seems the "younger" assistants stay on their cell phone constantly, and are nowhere to be found when you need them. We even found a young one asleep in her car! So, it works both ways. Age isn't the factor; work ethics and how much you care about your patients is.

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Sounds pretty typical. Med-Surg is hard and we work our butts off

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Specializes in Medical-Surgical/Float Pool/Stepdown.

Sounds pretty close to the med-surg trauma floor I "grew" up on...just wait to see how much you will improve and grow within the next year! You will be amazed! Hang in there ;-)!

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