Is nursing like this everywhere?

LEM1234 · Jun 24, 2009

I forget what the exact # was, but the mag was normal. The patient was not on tele up to that point...when i got the order for the IV KCl I got an order for tele too...I finally had to get a sitter for the guy because he was in restraints yet kept ending up hanging off the side of the bed and I was afraid he was going to hurt himself...my manager really questioned me about requesting an order for a sitter...but what else was i supposed to do? He was going through DTs and kept ripping off his ostomy bag (and he had mitts on) and poop was EVERYWHERE.

cardiacmadeline, RN · Jun 24, 2009

I forget what the exact # was, but the mag was normal. The patient was not on tele up to that point...when i got the order for the IV KCl I got an order for tele too...I finally had to get a sitter for the guy because he was in restraints yet kept ending up hanging off the side of the bed and I was afraid he was going to hurt himself...my manager really questioned me about requesting an order for a sitter...but what else was i supposed to do? He was going through DTs and kept ripping off his ostomy bag (and he had mitts on) and poop was EVERYWHERE.

You did good. Hang in there. Med surg is certainly a challenge!

kurandagirl · Jun 24, 2009

Hi 'new grad', I have read your experience and its as upsetting as it is reality. Obviously the patient is at high risk of clinical emergency for not being optimised before the nurse left you with a mess to resolve. But I feel for you too, because you sound like you have soaked up some valuable knowledge so far, and have so much potential to excel, yet these dangerous licenced practitioners are capable of stealing your belief that this career choice was a great one. Dont worry, you have chosen an incredibly empowering career, and if you take mental notes with these experiences you will not only deal with the emergencies that pts are exposed to, but also you will learn the art of dealing with these situations in your future paths when you lead a shift, or even manage a unit. You are capable of handling it, and if you grab hold of a mentor and grow some broad shoulders it will get more familiar and easier to manage.

I work in an Australian ICU in Sydney, very busy, sometimes crazy, and as the team leader, it feels like an impossibility to coordinate a safe shift with such a variety in the skill mix. Our unit does not expect its nursing staff to take the postgrad ICU certificate and so the result is that some dont have the skill to be safe unsupervised nurses but are allocated to ventilated critically ill patients. That seems an injustice to the patient, from my angle, but its the reality of things. So instead of being critical (out of sheer frustration at the unnecessary situations pts were exposed to), I began sharing as much knowledge on our nightshifts that i could fit in whilst being the team leader at the same time. It is draining, but the results are so worthwhile. So push through this dilemma, cos you are going to see it frequently, and without getting emotional, identify the problems that can be addressed. These problems are endemic in all units, and they take planning and action, and time, that most managers dont have enough of. Its not realistic to remove staff from units when practice and attitude can be improved. Does your unit have performance appraisals as part of everyones development. Is there a communication book where constructive identification of low standards can be collectively seen as detrimental to the unit? And is there a healthy morale on the unit, and do nurses understand that how they care for people today, will be the way they are cared for in the future. Thats why i encourage you to see the light at the end of the tunnel. And remember that your practice is something you have total control over. Your attitude and application if nurtured to senior level will be worth more than the salary you are paid. The reason for that is because, believing our profession is capable of making a difference takes perseverance. It is such a worthwhile, valuable, satisfying career, and if you can express this in your standard of care well into your limelight years as a nurse, you will be a rare breed.

Those who risk pt safety will eventually understand accountability, but it takes time to sift out the nurse who despite education and support, continues to cause harm or near miss events. We work in a very human occupation, where mistakes can cost people their lives, through no fault of their own.

You'll be alright, dont lose your enthusiasm, then you'll become just like the people you speak of.....easy choice really. Good luck ....

nursecassia · Jun 25, 2009

I hate following crappy people....that being said, I have had some pretty crappy days and unfortunately left a few things for the night shift, definitely not on purpose and try hard not to...It is hard on surgical floors I find, we are always short staffed where I am and we have lots of patients...throw in a couple people going through the DTS or Brian Injured and its a real party some nights...I work in Ortho and Neuro COMBINED on the SAME floor!! I really want to meet whoever came up with that idea in a dark alley one day let me tell you....Or what about the people that start going through post op delerium?? I think everyone has crappy shifts some days no matter where they work, it comes with the territory I guess....All i have to say is I really appreciate the good days, and the people I work with that are amazing that help whenever needed...be kind to those you work with because they are the ones that will get you through the day :) but those that are crappy to follow consistently you need to tell them!! I recently had several talks with a 76 year old they hired on the floor, that was hard talking to someone as old as my granny and telling her I think she is incredibly unsafe....I also had to talk to management about it it was so bad at times..lets just say med errors was the least of the problems.. ( for the record im all for people working till whatever age as long as they can do the job).