My unit is going down the tubes...

[whipping girl in 07]

...and pretty soon there will be no experienced nurses left! (It's been a long time since I've posted, although I visit this board pretty regularly, and I've changed my screen name so maybe I won't be recognized.)

I've worked here part-time for a little over 4 years. When I was hired there technically weren't any openings, but the NM was a little short on weekends and I wanted to work weekend option, so he hired me. It was THE intensive care unit to work in at our hospital (MICU, NeuroTraumaICU, and CCU were considered second tier by most of the doctors). Not anymore. We expanded by 5 beds about 3 years ago and things have gone downhill since.

I don't know if when our NM left the interim NM or the ANMs became less selective on who they hired or if they just really didn't have anyone to choose from. But I've watched the quality of the new nurses they've hired continually fall. For every good nurse they've hired in the past 2 years, they've hired 3 or 4 incompetent ones. SICU has always been the breeding ground for CRNA school (and our hospital has one) so there's always been a lot of turnover. People work there for 2 or 3 years and move on to CRNA. But now, nurses who never thought about CRNA school are preparing to go, some nurses have transferred to other floors and units in the hospital, and people I thought would NEVER leave until they retired are moving elsewhere. Morale is the lowest I've seen (and it was pretty low when we went for over a year with no NM and our interim NM grudgingly took the position on top of the unit he was already over).

I've seen two good male RNs fired for trumped up charges of sexual harassment. We've recently had a mass exodus of RNs from nights and now nearly all the experienced people on nights are gone. A lot of the "middle experienced" RNs on days are gone too and we even have some nurses with only a year or two of experience on days now. I'm thankful I was able to move into a day shift position because I'd fear for my license working nights with these kids. You really can't tell them anything...they know it all, they think. It's a wonder no one's died (or maybe they have and I'm just not aware of it). Now it's gotten to the point where I dread coming in the few days I do work because whoever I follow will have left such a mess that it will take the first 3 or 4 hours of the shift to straighten out (and longer if it's a weekday and doctors are making rounds as soon as I get report). And I don't mean a messy room or the care path not being filled out either. I mean orders not taken off, incompatible drips running together, high risk vesicant drugs running to peripheral sites with central lines heplocked, piggybacks running with TPN (as a secondary on the pump with the TPN!!!) and that's just the past couple of days I've worked. And since I don't work very much anymore, I don't see the nurse I've gotten report from again for awhile to even be able to say anything to them. I hate to be the mean old ***** who tattles to the boss but these things just aren't safe and I have to point them out. I dragged the NM in a room a few weeks ago and said "What's wrong with this picture?" He asked who I took report from but I'm beginning to wonder if it will make any difference.

So here's my question...have you been through this? Did you stick it out or did you leave? If you left, what was the straw that broke the camel's back, so to speak? If you stayed, how did you stay sane? I'm so torn right now; I like a lot of the people I work with and I need the extra job (I work full-time at another hospital in town in a non-patient care capacity and I like keeping my skills at the bedside). Most of the hospitals around here don't use agency so if I go that route I'm looking to drive at least 45 minutes to an hour one way to work (or more). I have three kids and I can't afford not to have the extra income but I don't want to lose precious time with them either by driving so much. I already don't see them on days I work a 12 (thankfully only every other week).

Any response would be appreciated!

K

[whipping girl in 07, RN]

Excuse me? I'm a little confused by your response. Are you calling me elitist because I'm experienced?

I precepted LOTS of nurses and nursing students in the 5.5 years I worked in that unit. I was always a resource to anyone who had questions. I never minded sharing my knowledge with people who were willing to learn. But when I worked one day a pay period and I'd walk in the room and find glaring problems and the RN was already gone, what was I supposed to do? Wait till I followed that nurse again 3 months later? We had about 60-70 RNs in our unit when we were fully staffed. I hung in there for as long as I could. I couldn't carry my own load plus 2 or 3 other nurse's loads to boot. I'm not Atlas.

Was it your intention to flame me? Because that's what it feels like.

[P_RN, ADN, RN]

If it's TOXIC it will kill either you or at least kill your spirit. Been there, tried to stay,finally bailed. You did the right thing. Did you move within the facility or outside. Either way you watched out for what was in your best interests.

[FireStarterRN, BSN, RN]

Thanks for the update whipping girl.

[whipping girl in 07, RN]

If it's TOXIC it will kill either you or at least kill your spirit. Been there, tried to stay,finally bailed. You did the right thing. Did you move within the facility or outside. Either way you watched out for what was in your best interests.

I had worked part time at both major hospitals in town. I went full time at the other one away from the bedside about 2 years ago.

[lamazeteacher]

My answer is short and sweet. I would move on. I would find a way somehow to find work somewhere else.

Patients' needs have to figure somewhere here, and they're not being met! Are Incident or med error reports filed in a timely manner? (Like the opposing IV meds given) Are exit interviews for the departing nurses being done by a nurse (not HR) who can figure out what's up? Are there incentives for staying?

It is essential that a nurse consultant come in, who can be objective, interview everyone, to get the reasons (other than inexperience) for this essential unit's threatened demise. Once a commonality is seen, focus for remediating that should be done.

If everyone "flew over the cuckoo's nest", it would be a sad event for nursing, as there is no situation that can't be met, given an administration that wants it to succeed. OOOOps! Is that the problem?

[lamazeteacher]

Whippinggirl, I'm glad things are working out for you- you did the right thing.

I must have missed something.....

[whipping girl in 07, RN]

Patients' needs have to figure somewhere here, and they're not being met! Are Incident or med error reports filed in a timely manner? (Like the opposing IV meds given) Are exit interviews for the departing nurses being done by a nurse (not HR) who can figure out what's up? Are there incentives for staying?

It is essential that a nurse consultant come in, who can be objective, interview everyone, to get the reasons (other than inexperience) for this essential unit's threatened demise. Once a commonality is seen, focus for remediating that should be done.

If everyone "flew over the cuckoo's nest", it would be a sad event for nursing, as there is no situation that can't be met, given an administration that wants it to succeed. OOOOps! Is that the problem?

No exit interview. I called HR and they said they don't do that anymore, it's a waste of time. I filled out incident reports. Not sure anything ever happened with them. Since they were just turned in to the ANM instead of risk management (hospital policy), I have a feeling they ended up in the trash. I talked to management and the nurse educator till I was blue in the face. Things did not change. Every new thing that came down the line was explained with "we don't want to do this but corporate is making us." I don't know how many times different staff members brought up issues in staff meetings or with management, but things never changed.

Eventually I gave up. You can't beat your head against the wall forever without incurring some brain damage.

So I got out. Went full time at my other job at the other hospital that at least ACTS like they care about their employees and patients, not just the bottom line.

I revived my old thread from over a year ago with an update.

[lamazeteacher]

Whippinggirl07:

It sounds like you did everything you could have done, given the management's lack of regard for looking at or correcting problems. At least you had some good years there, and others who were there know there "once was shangri-la".

What is the old thread you revived? Or is this, that?

[Valerie Salva, BSN, RN]

.....When I complain about the responsibility dished out to me I get a pat on the back and told 'we have faith in your ability - you have more sense than most'. It just freaks me out. Just who is running the hospital?

Eeeeeeeeek!

When I was a brand new grad with no experience at all- a hospital where I applied told me thay wanted me to be a float between med-surg, ICU, and ER- with no experience, and no orientation or preceptorship offered to any of the units!

When I told them that this would not be safe, they said "Don't sell yourself short- we have faith in you."

I think mgrs use these types of phrases to try to convince naive new grads that they are really not throwing them to the wolves- and under the bus.

Mgrs who are willing to put new grads in these positions are risking the patients' lives and the nurses' licenses.

Grads- if you find yourself in a similar situation- don't walk- run! To the nearest exit.

[whipping girl in 07, RN]

What is the old thread you revived? Or is this, that?

LOL yes this is the old thread.

I know I did as much as I could do. Maybe if I'd been working more I could have changed more, but I just could not damage my mental health anymore. My husband dreaded the days I worked there because he knew I'd be in such a foul mood when I got home. He'd have the kids in bed and dinner and some beer waiting for me!

It just wasn't worth it anymore.