My first few days, as a new RN - page 8

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

  1. by   CherryAmes7
    Quote from nw nurse goin nuts
    This is the gist in a nutshell. A friend emailed me yesterday, "Welcome to the world of capitalist medicine where it is all about greed, greed greed."

    Exactly. Hospital staffing and nurse/patient ratios are, in my opinion, set by the hospital administration with dollars in mind.


    The nursing shortage is NOT driving nurse/patient ratios. The bottom line is. Even if there were "enough" nurses ratios would still suck.

    I'm a licensed R.N. not practicing today strictly because of horrible nurse/patient ratios.
  2. by   bbcewalters
    I would like to give my input as to not scare EVERYONE.......
    I went to school in Atlanta and graduated 1 year ago. While in school I NEVER spoke with a med/surg nurse that had the pt loads that are stated here. M/S ratios at most were 5 to 1 in the day...... ICU 2 to 1 sometimes even 1 to 1....

    Now I am a nurse in Louisville I have worked TCU for one year ratios were 3 to 1 but were changed to 4 to 1 and we thought we had it bad....
    I now work ICU and it is 2 to 1 sometimes 1 to 1.....

    Lesson:
    Cali is not the only state that cares. You need to look for TEACHING hospitals with plenty of resources and research dollars
    IMHO

    Good Luck
  3. by   gauge14iv
    When I said DOCUMENT EVERYTHING - I was referring to who you reported the problems to - who you spoke with and what their response was.
  4. by   jojotoo
    The theory behind nurse/ patient ratios is great, but the practical application doesn't always work out as planned. My hospital is staffing the floors as close to the bone as possible. Each shift staffs for the following shift using the current house census. This means that there is no plan/ leeway for floor admissions. So, if at the beginning of the shift, a nurse already has her maximum ratio - what do you think happens when I try to start sending up my admits from the ER? Yes, we force M/S and Tele to go out of ratio. Because what else am I going to do when there is literally no bed or chair in the ER to put a patient in. And this is terrible - but sometimes I can only get an ICU bed if somebody dies! It is VERY rare that the ER or the floors don't go out of ratio each shift. What's the solution? More nurses -OF COURSE !!! Will we get them? Probably not.
  5. by   whaley
    I work in the UK on a respiratory ward and qualified about 2 months ago, the usual ratio of nurses: patients is 1:15! Being a medical ward it is a bit different to a surgical ward, but I have been on placement on a surgical where the nurses have 12 patients. It is very stressful and I do not get to do the basic nursing that I love and I do not get a chance to have a chat to my patients and see how they are really doing, it is very frustrating. however my days do go very quickly! The US system does seem very different to the UK, but the UK government is saying that we do not need anymore nurses, but really the NHS just can't aford to employ anymore! They have even stopping foreign nurses from applying anymore, but then at least it will mean that there are more nurses in developing countries.

    It is very frustrating that one knows that one can do a good job if only we had the time and more funding. But then again I have worked in Africa and their situation is even worse, even less nurses as they all move to the developed world, and the minimum amount of money, so we can call ouselves lucky in some ways even though it does not feel like it when you get home after a horrific shift.

    I hope that this thread does not put off any budding nurses, nursing is a great job.
    enguin:
  6. by   mchrisrn
    In our hospital you cant refuse an assignment..they say it would be patient abandonment. If you DO refuse, I'm sure you would be fired and as I have worked there for almost 30 years, I would probably never get another job b/c they would not give me a reference, even though i have an excellent record and have always had great reviews. One time I went to my head nurse and complained about a dangerous assignment I had and she responded that "In nursing, Mary, we all have to decide when it's just too much for us". So in conclusion, that was 10 years ago, and I figured I either do it or quit, it's as simple as that. If I quit, I lose a lot of money in pension, I carry the hospitalization for my husband and my college age son. We have lost 4 full time RN's and 3 part time RN's in 1 month, and I've been looking for a job for almost a year now. No one from administration is even addressing the loss of staff or questioning why it's happening. They continue to put "stable?" ventilator patients on our medical telemetry unit and also give us 5-7 other patients. Our head nurse has had NO communication with us about loss of staff. When a new hire comes in, takes about 1-2 months to orient some of them, then they leave in 2-6 months. I've given up trying to change anything. One nurse got called in to her manager b/c a patients family complained that the "nurse looked to busy, you must need more help"...The manager told the nurse that "in the future you are never to LOOK busy even if you are". That nurse took a job in case management where she was also overworked and retired early. Another nurse was called in to her manager and told there was a family complaint that the nurse didn't "dote on her mother' enough. This is the mentality we're dealing with. There ARE NO OTHER NURSES TO call in. I realize ALL professions seem to be like this...they squeeze every last drop out of you and after 30 years, I still cant sleep the night before I work or the night after AND IM ONLY PART TIME! I cant imagine having a family, kids, parents with needs AND working full-time in our facility. Anyway, I dont feel they'll ever change, they just wait for new grads who will stick it out for awhile and leave. ............I wish I had some ideas to change things but nothing I've tried has worked..................................
  7. by   Elisheva
    Quote from mchrisrn
    In our hospital you cant refuse an assignment..they say it would be patient abandonment. If you DO refuse, I'm sure you would be fired and as I have worked there for almost 30 years, I would probably never get another job b/c they would not give me a reference, even though i have an excellent record and have always had great reviews. One time I went to my head nurse and complained about a dangerous assignment I had and she responded that "In nursing, Mary, we all have to decide when it's just too much for us". So in conclusion, that was 10 years ago, and I figured I either do it or quit, it's as simple as that. If I quit, I lose a lot of money in pension, I carry the hospitalization for my husband and my college age son. We have lost 4 full time RN's and 3 part time RN's in 1 month, and I've been looking for a job for almost a year now. No one from administration is even addressing the loss of staff or questioning why it's happening. They continue to put "stable?" ventilator patients on our medical telemetry unit and also give us 5-7 other patients. Our head nurse has had NO communication with us about loss of staff. When a new hire comes in, takes about 1-2 months to orient some of them, then they leave in 2-6 months. I've given up trying to change anything. One nurse got called in to her manager b/c a patients family complained that the "nurse looked to busy, you must need more help"...The manager told the nurse that "in the future you are never to LOOK busy even if you are". That nurse took a job in case management where she was also overworked and retired early. Another nurse was called in to her manager and told there was a family complaint that the nurse didn't "dote on her mother' enough. This is the mentality we're dealing with. There ARE NO OTHER NURSES TO call in. I realize ALL professions seem to be like this...they squeeze every last drop out of you and after 30 years, I still cant sleep the night before I work or the night after AND IM ONLY PART TIME! I cant imagine having a family, kids, parents with needs AND working full-time in our facility. Anyway, I dont feel they'll ever change, they just wait for new grads who will stick it out for awhile and leave. ............I wish I had some ideas to change things but nothing I've tried has worked..................................
    So...how do we change this?

    We all (including me) vent about it, get angry about it, but, in the end we accept it as "just being nursing." I'm guilty of that, too. But, it's kind of like being in a bad marriage and complaining about it every day: you either have to leave or you have to change it.

    I left 10 years ago. I'm going to TRY to come back (and I'll leave just as quickly if I hate it). The only people who can change this situation are the nurses: the hospitals, the administration and even the patients to some degree (most of them get well, go home, and put whatever their hospital experience behind them) have NO incentive to change anything. Our bottom line is that the onus is on us to change this situation.

    How? I wish I knew. The only thing I could even guess would be nurse solidarity and a refusal to accept unacceptable conditions. I think it can be done, but it will take a greater mind than mine to achieve it.
  8. by   dedami
    9 patients in my opinion is too many for a newly graduated nurse. Actually, 9 is too many for most nurses I would think. When I started out,they started me with 4 patients, then went to 5, and then up to 6. 7 only if short staffed.
  9. by   dedami
    9 patients in my opinion is too many for a newly graduated nurse. Actually, 9 is too many for most nurses I would think. When I started out,they started me with 4 patients, then went to 5, and then up to 6. 7 only if short staffed.
  10. by   bradleau
    Have you ever had the CNO tell you that you can lose your licence for "abandonment" of patients? Don't know how that works if you refuse to add more to your work load. Our CNO says to assign a tech to the team so that as team leader and precepter I can spend more time teaching a new grad. HAH! Also to get written up because you did not get the coffee to the patients visitor fast enough.....Nuf said. Oh by the way, I earn $28.79 an hour with a $3.50 hr shift dif. I have been at my position going on 17 yrs here in Nashville,TN. Started nursing in the early 1970's at $1.95 an hour. ( pay then in CCU was $3.00 an hour). My plumber, car mechanic, etc make more than this. And they are not held responsible for someone's life.
  11. by   Simplepleasures
    Well said.Please see General Nursing POLL questions, some good insights could be gained by contributing answers/opinions.
    Last edit by Simplepleasures on Nov 22, '06
  12. by   octopus
    Quote from jenni82104
    to someone on the outside looking in, I do not understand why people take on more work then they can reasonably handle. Do people accept these unsafe assingments because if they don't they will be fired? Is it because if one nurse refuses, then another nurse feels that they have to accept a bigger load, and then everyone hates the one nurse that refused too many patients?
    If you've never worked as a nurse, then you have no idea. We do it, not because we think it's right or safe, but because we care about the patients and can't bring ourselves to say 'no' to caring for somebody if that means they may not receive the care they need.

    We know that we are placing ourselves at risk; we know that our decision to take 9 patients only perpetuates the problem; we know that it's false economy to think that if we take 9 patients it is better than taking 4 and doing a good job. But when we're faced with the reality of the ward situation, we still choose to look out for the patients as much as we can because someone's got to do it.

    Don't judge until you've been in the situation - you might be surprised by what you would do if faced with it yourself.

    One thing you're right about - we do need to stop doing this to ourselves. We need to join together and support each other to force change. Until we do we'll keep giving in when faced with the reality because we just can't help ourselves!
  13. by   Simplepleasures
    A nurse who complains or refuses her assignment is the nurse that finds herself out on the street looking for a job, only to find out that it is no different anywhere else. Isnt it about time that instead of just saying lets band together for mutual protection, we actually do it? Why so many nurses out there still dont trust unions is a mystery to me. Enlighten me please.Please see poll in General Poll section regarding unionization and abused nurses. How about voicing our opinions to someone who may actually know how to affect change?

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