My unit is going down the tubes...

[whipping girl in 07, RN]

...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

[oramar]

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

[twinmomoftwins]

I found that it's hard to change poor morale on a unit, unless someone is willing to be the cheerleader. Since you only work a few days, you're probably not in a position to change it much.

Personally, I jumped ship when things were spiralling downward.

A new unit, with a good manager, happy coworkers with experience- willing to accept a newbie from another unit...it's amazing how that will change your stress level.

[YellowFinchFan]

That sounds like a nightmare - and it's more common than you think. Reading your comments reminded me of where I work - no one seems to last more than 2-3 yrs - and we have very few "experienced" nurses. It's frightening to go to work most days.

I would keep looking and try to find a way out. You will probably have some awful code/scene happen if you stay and risk it. The thing that makes me sad is no one seems to have 'loyalty' anymore - and I know why - the hospitals/administrators don't appreciate the talent and dedicated nurses they have. They don't support us and so most of us reach the breaking point and leave...and the patient's and the coworkers we care about suffer.

[annmariern]

Having the same issues myself. Inexperieced NM just juggling to keep their job; units going to hell. Budget meaning where the NM screwed up there trying to cover by cutting ancilliary staff, on top of new charting reqs that are making my job impossible. Mistakes, not just by newbies, but agency who dont give a damn, core staff just too overwhelmed to catch, I spend my first few hours sorting out the mess. Major errors, glossed over. Every new staff hired is a new grad; most seem not to want to learn, but get to the end of their shift; yapping on cellphones, etc. Offer to help means you get stuck with it, god forbid they should stand there and be taught how to do it, easier to run on to the next task and get off on time, leaving you sorting out the problem. Doubt this is getting better anytime soon. You are not the only one, if it helps. No easy answers, except to hope we don't get sick anytime soon.

[Dempather, RN]

"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."

.. so what happens when the negative result of one of these incidents happens during your shift? Incompatibilities? Cross-contaminations? Yikes. When things break, we want to fix them... but when are they broken beyond repair? This isn't your mess to clean. Find a place where your licence isn't at risk.

[MAISY, RN-ER, BSN, RN]

My guess is your NM is well aware of the situation. Unfortunately, even with due diligence it would be some time before the situation reversed. Some people should never be management, and some should never be allowed to hire. As a fairly new nurse, I don't feel inexperience is a crime....but, you need that experienced support around you. There should be a good mix on the unit...if not, you and your patients aren't safe.

I am currently considering a move due to a similar problem..New grads abound! We are losing nurses at an alarming rate due to morale issues with perceived patient safety and the constant needs of precepting new grads. While I have learned from great nurses, I am in no way prepared to mentor new grads and that is what's happening.

Stay safe and do what is right for you! God help those patients!

Maisy;)

[FireStarterRN, BSN, RN]

That sounds absolutely atrocious. Time to move on.

[jbp0529]

To quote someone in a similar thread:

Run, do not walk, to the nearest exit.

[Nicky30, BSN, RN]

It sounds like we are working at the same place despite the fact we live in different countries.

I am a new grad (if I can still be classified that after 10 months) and I am afraid. 4 nurses with 30 years experience between them left in December because of work conditions. Next year I will likely be classified a senior RN because there aren't any, I am worried that something major is around the corner. I have no other options hospital-wise I need to stay where I am for family reasons and there are no other hospitals in the region that offer the same units.

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!

[luv2luvlife]

Everyone is telling you to move on,and I'm sure the 'good' nurses that left were told the same thing by others. Nurses are advocates for the patients and should also be advocates for each other.

If I were in your position, I would have the nurse going off shift give me report at each patients bedside. Or have her go with you to look at each patient that she had. Just so you can eyeball the IV's ,charts etc with her. And if there is a problem, have the new nurse fix it. Document everything,,,,,these new nurses need more 'training,education'.

Maybe, you can create a new job for yrself,,,,,ongoing preceptor of these new nurses.

I would definitely tell management that the newbies need more training otherwise the hospital is going to wind up in court with an alarming death rate.

Do a nursing care plan for your unit, and see what you can come up with to resolve some of the problems :nurse:make a copy for yrself and then hand it into management.

There is always a way through the darkess,,,,if you can be the light:hrnsmlys:

[cjmjmom]

I feel for you! I do not have any quick answers for you about changing jobs or staying with your current one however I do wonder how you reconcile the safety issues for the patients you care for? I certainly would begin putting your frustrations in writing to management and also would seriously consider reporting the hospital to the board of nursing and the health department. As nurses OUR FIRST PRIORITY IS SAFE PATIENT CARE and if our employer ignores this it is OUR RESPONSIBILITY to make certain someone outside the hospital environment is notified of the unsafe conditions. Our patients deserve nothing less!