My first few days, as a new RN - page 5
Here I am, it has been 6 days, since I have been off of orienation, I am disgusted. I took boards yesterday, keeping fingers crossed, but actually I'm a little worried about having the RN title,... Read More
Sep 17, '06Many facilities hire new grads right into the ICUS - you do an internship instead of just an orientation though. (Which in my mind is a bit better)
In addition - some med surg units are better staffed than others. I worked float in one place where the tele floor was very well staffed and had a great manager, but the ortho floor was just a short staffed, under managed wreck.
Also - many companies own more than one facility - just because you have signed an agreement to work for a company in exchange for tuition and such, doesnt necassarily mean that you don't have options. There are other departments, other units, other facilities and often other locations.
Despite being completely overwhelmed at times, 12 hour days of missing lunch, and working in places I knew I'd never work again - I still wouldn't trade nursing for any other career. I still love the people I have met, the things I have been honored and priveleged to be present for and the human-ness of it all when I have not been working in a hell-hole such as the one you describe.
Standing up for yourself, sticking together with your co-workers, and going to management - or further - may be what you have to do to advocate not only for yourselves but for the patients in your care. Sometimes, that means changing jobs and telling managers and corporate types why.
At the end of the day - nurses just want to know that they have provided excellent care for patients and that they had the supplies, assistance and time to do so.
Sep 17, '06Quote from JoeyDogJoeydog-I have to say a contributing factor to the shortage would have to be at thelevel. I will soon be applying to a program that accepts once a year. Along with myself, about 500-600 other people will be praying they get one of the 40 spots. Many people wait 2-3 years to get into the program. This is not an anomolie (sp) and it is certianly not an elite school, this is a community college. If you read through the student nurses forum this problem exists across the country.
I am not proposing any solutions for this b/c I do not have any that have not already been discussed. However I truely beleive that the small number of students being accepted into (in the US) influences the shortage immensely. Take care.
This is why I was willing to move to Missouri! I am from Washington state, moved two years ago because of the slots vs. applicants numbers were not too favorable. I was ready to apply to EVERY community college in Thurston, Pierce, and King county, AND to PLU, even though I'd have to eat my kid's leftovers to do so. Here, they do not require the loads of volunteer, nurse shadowing, 4.0, or statistics for ADN. This year was the first time they had a waiting list, and being used to Washington, I took my dosage and calculation test as soon as I could. Had I waited an extra day, I wouldn't have gotten in.
Part of the problem is that hospitals only have so much room for students. I have to say too, that the programs up there sound (according to my friend) like they could really care less if you pass or not (this would be at two ) and have heard of horror stories about the instructors making it extremely difficult, not caring or being helpful. I don't know how much so, it is subjective information, but here, it is not a big deal (still difficult, but instructors do care if you do poorly or wash out, and they are very positive and encouraging). Man I'm so glad to be here and be in the program I'm in. I'm loving it, and I can even deal with the couch dates of piles of index cards.
Sep 20, '06i have to admit that I took one of the lowest paying jobs in nursing in my area because of the promises that were made to me. Step -down icu, 3 patients. I also am a new grad, but thus far all promises have been kept. I would rather make 3 dollars less than my class mates and work somewhere that I feel respected by my supervisors. I hope you can find a similar balance.
Sep 21, '06Quote from ElishevaI have been a nurse for 25 years. 5 of them as an LPN...an RN for almost 20 years...Most of the nurses that I now work with here in Georgia all meet in California. Yes... the west coast has a southern accent. 2 years ago on my second shift at a private hospital, there was no house supervisor. Nurses were going to have to have 13 patients a piece unless they had a super...I agreed as I've been there and done that, time and again in my long history...Women/Men... get a clue...I work now in a 44 bed ED level one trauma center in California. Most of the nurses I work with are from my home state of Georgia...Gettin' it now??? We have 4 pts in the ED. or 2 in the ICU or 3 in the transitional care unit. Pay attention. What do you not understand about the word... NO??? We work for an agency that affords us to fly there, pay for extended housing, rent a car for however long you'd like to stay and work. WE COME HOME WITH TWICE THE $$$ and NO BS...even after paying the above...juls02: I so agree with you. Changes in nursing will only come when nurses step up and STOP accepting large patient loads, etc. Sound great in theory, but how do we do it?
We are not unionized in the South, and I don't know how I feel about unions/nursing. But I do know that something has to change. Hospital administrators aren't going to wake up one morning and suddenly feel remorseful for the patients and our plight.
I've been out of the loop for a while. Where's the ANA? Why isn't someone screaming for better care for patients and nurses?Last edit by UnchainedFever on Sep 21, '06
Sep 21, '06Fever has a good perspective on nurseing alternatives. Travel nursing is not for everyone but does look damn good on a resume when you find that dream job and want to settle down.
It seems that the OP is a conscientious observer who is getting swamped by the powers that be and I would refuse new admissions based on the acuity of my current assignment, in part being new to the unit, new grad and no preceptor support. Here in California we have wonderful ratios in place, doesn't mean I will get a CNA or LVN to work with, often I am primary. Being registry I tend to get the cast offs, or the frequent fliers no one else wants. It's a busy day for me and depending on the shift, usually wrack up some OT to complete my charting.
I spend a lot of time at the bedside with the patient and family and document every aspect of teaching or conversation, including the care I have time to provide. Wasn't like that in the old days. I often had 11 patients on a med/surg/tele floor. I didn't feel like I was able to make a difference to them at all, just treading water till some help got there.
Good luck new grad, you have a wonderful heart, you can take care of me or a family member anytime!
Sep 21, '06Quote from JJJJJJ6Amen. Shouldn't it be against the law to give a nurse 9 patients? Thats like asking for medical errors and a lawsuit.Quit While U Still Can.
Sep 21, '06I have a good answer to why California is a better state to work in--don't hey have a really powerful nurses' union? Just a thought. To me, the idea of a good union for nurses is all about fighting for the best patient care, which means the best working conditions for nurses. I am not too concerned about the pay, relatively speaking, ours is pretty good.
Sep 21, '06I have just come off of orientation and already I am considering going back to school to purue a new career. They have started team nursing on my unit, in which there is a team leader who is supposed to hang all IV meds and fluids, discharge and admit all patients for a team of 16 patients. In addition they are also expected to transcribe all new orders, scan them to pharmacy, write down all pt. labs and call doctors if any are out of range. The whole team consists of 3 nurses, the team leader, and 2 nurses, or a nurse and an LPN. This means that each nurse is getting 8 patients. If the team leader were able to actually do everything like hang the IV meds and all admits and discharges this system would work wonderfully, but often there are two admits at once and possibly many discharges at the same time. In addition the team leader needs to be trusted to inform the other two nurses of any abnormal labs. What is happening is that the team leader is doing things here and there which help, but it boils down to each nursing taking atleast 8 patients and looking up labs and speaking with doctors (we were told 16 would be the max but as you guessed they did not stick to what they said and sometimes we are getting 18 or 19 patients to a group, giving each nurse 8-9 patients. It's crazy. I have been getting out of work so late! This truly is back breaking work! I feel that if I continue to work in nursing I will be aged beyond my years from mental and physical stress.
Sep 21, '06Hi,
Welcome to nursing. In the Bahamas this is a normal thing for the staff. Be encourage and just talk it over with your manager for something to be done.
Keep the faith.
Sep 22, '06Starry,
I graduate in May, 2007 and I am scared to death. I don't know what the rules and regulations are in North Carolina (where I live). I know how little we really know when we graduate and I am scared to death that I will harm or kill a patient because of that lack of experience.
I know you feel really trapped because of the payback clause on your loans. I thought even from the beginning that allowing them to pay for my education would amount to me becoming their slave. Your story really confirms that suspision.
All I can say is that I will say a prayer for you & hope that things will get better. Nursing is a calling and I pray that you won't get burned so badly that you leave the profession. Best wishes.
Sep 22, '06That is definitely not safe and everybody has the same suggestions. Take these issues to management and don't stop going up the chain until you are heard. Until we demand better and safer care for our patients we will always have this problem and will always be an obstacle to why nursing is often viewed as a "job" and not a profession
Sep 23, '06This is a very scarry, but real scenario for nurses. I am sad and distressed that many are experiencing the same thing. As nurses we need to do something and it has to be more than just complaining. I would be very careful to 'assume' that CA has figured it out. As the saying goes, "be careful what you wish for". In my units, if the we had the same staffing ratio as CA, the nurses would have more patients than they do now, without a nursing assistant on their team!
My suggestion is that you arm yourself with real facts, ideas, literature to support your concerns..and provide your manager/administration with a "solution". Many nurses have complaints but don't have the foggiest idea how to fix the problem. So they walk around frustrated, upset, etc and become disfunctional. And this demeanor translate to the patients.
I suggest you read the information on the American Nurses Association web site. Go to www.nursingworld.org. In the "core initiative" section read the information related to safe staffing, etc. This information will give you a basis of knowledge to begin to determine what is best for your setting. Meet with your manager, supervisor or nursing director. Begin the discussion about what is best for your patients. When you focus on the patient, patient outcomes, patient satisfaction, etc there are not too many that can argue. BUT you must be prepared. Educate yourself and others.
Do you have shared governance in your organization? If you are not aware of what this is and what it entails you can read about that topic too. Complete a search on the web page I mentioned earlier.
If you feel like this is too big of a task for you then, talk to other nurses, find support for your ideas. Most importantly, become informed to become effective.
Good luck and keep caring!