Need some encouragement:Stretched thin

[KMC-RN-BSN-710]

I am a newer nurse and have been employed since August last year. I was hired on as a RN on a 64 bed unit med-surge unit. Med surge is not the field I wanted to go into, but because of the economy I took the job and I am really learning alot. However I need some advice/encouragement. I feel when I am at work I am stretched so thin. I recently moved from 8hour PM's to 12 hour days because I thought I would have more time for my patients and get away from the task oriented nursing. I feel like when I am at work I am merely getting tasks done, I become agitated when family members ask me to talk so many times during the day, and it is not that I do not want to talk and comfort them or answer their questions but when they are calling multiple times per day when I just spoke with them, I do not have the time to go back 20 minutes later. I became a nurse because I truly want to make a difference in the lives of the individuals that I serve. I have complained about not being able to find enough time for patients and it frustrates me, but I feel like co-workers just brush it off they say that is how it is and to not let it get to me. I want my co-workers to like me but it is hard to not complain about things on certain days. Some days I will have a 2 discharges 2 admissions and a transfer all in 1 shift, on top of all my other duties as a nurse. We have a charge nurse but they are not always available to help and I feel when we ask for help they are not as open as I would like them to or they do not have the time. Often I feel overwhelmed and drained and to top it off I have co-workers who tell on other co-workers if they are not able to get all their work done or they forget to do something. I am not talking about something that could hurt a patient but things that I didn't even do like a missed page on a printed mar, that is copied by night shift or not having an antibiotic hung before shift is over because it was not available. I am still new and I feel some of the other nurses eat their young and there are some cliques that are evident. I am not complaining about having a job I am greatful. I just want to know how other nurses deal with the constant stress of nursing, go home and still are able to sleep without worrying about whether you made a mistake. I go home worrying about making a mistake because I am so busy I do not always get the time to be as thorough as I would like and I cannot always double check. I feel sometimes it is unsafe with 6 patients. When we have 5 it is ok, but we are getting the same number of patients on days and pm's as they are getting at night. During the day we have doctors, families, tests, orders, and heavy med passes. I am not saying they are not busy at nights, because I know they are but. How can I stay happy at my job, have energy to go above and beyond and still be safe and get out of work on time. I want to give the best to my patients but lately I have been dreading to go to work. Positive encouragement only please!

Kristen:nurse:

[zofran]

Welcome to day shift! The families can really mess up your day. I agree with the posters who said that it will get easier as you keep going.

Remember, the only thing you can not pass on to the next shift is your charting.....You can only do what you can do.

Try not to stress over it when you leave. I have been working on days for about 6 years and could have written your post too on some days. I recently went to on call....now I tell them when I will be there. I feel 100% better about my job now.

[Up2nogood RN, RN]

Days is a horribly busy shift compared to swing and noc shift. Discharges and admits are time consuming. Time management is a great concept but you will always have those family members who will suck up all your time if you let them. Boundaries and assertiveness are essential with pushy family members and needy pts. There will always be nursing tasks but once you master them it will be second nature and won't feel so "tasky".

I don't know what specialty you're wanting to go into but all floor nursing sounds like it's like this. If you're want to go into something other than bedside nursing you're getting close to your one year mark!

The reality is it won't get better I'm afraid and we can only do our best. It is a 24 hour job and no nurse can always get everything done in their 12 hours.

Canesdukegirl has great advice also and it does make a huge difference to give the pts a timeline and expectations at the beginning of the day.

Pts and their families get needy when they're anxious too. It helps if I look at the situation from their perspective. It allows me to better connect with my pts/families and offer empathy, problem solve, and makes me feel like I made a difference.

I wish you luck in finding what works for you in your nursing career, it is a stressful job and it takes time to learn to handle the mental burdens that go along with it.

[KMC-RN-BSN-710]

Thanks everyone for your responses. It is nice to know I have allies all over the place that understand what it is like in nursing. My husband is a teacher and he understands how busy teaching is, but he does not understand how busy nursing is. I left my position on PM's back in March and Transitioned from 8 hour PM's to 12 hour days. I did so so I could have more time for my patients, as on PM's all I did was admit and discharge and pass meds. I rarely got time to educate,listen and talk to families. I enjoy teaching and I currently am in school for my MSN in nursing education. I would like to expand my career outside of MS and work in some different fields and gain more experience. I like bedside nursing, but eventually I would like to work as a bedside nurse as needed and work in a different field of nursing that more suits me. I enjoy hearing about other peoples stories and I think back to the days when I first started and I would cry when doctors yelled at me. I too left my first day alone on the floor crying after being yelled at a doctor for calling for orders. I am slowly approaching my 1 year mark and with each day I impress myself, but still feel worn out. A part of me feels that Med Surg is not for me but I was a starting point and eventually I will transition into a role that is more suited for me. Thank you for everyones support and advice. I am glad that I have somewhere that I can talk and not be judged or viewed as I am being being negative. Negativism does not drive my statements, I want to be the most efficient nurse I can be but it is hard for me to turn off my emotions and have that thick skin to stand up for what it is I want and to delegate more. I feel like the CNA's become upset if I ask them certain tihngs like what is the accucheck for a person or vital signs, I have been told to go look at the paper. I know they are busy too but it is not always convienent to keep going in rooms when you are trying to pass meds or find another nurse to witness insulin. For 12 hour nurses or any nurses in general. Besides setting down rules. How do you organize your day. We have at least 2-3 big med passes 9,12 and 18 are probably the biggest med passes and then add on insulin during that time. What would make my day easier. We have optivox report so we listen to taped reports. Would it be beneficial to get to work earlier, listen to report, look over information before I start for the day so I can start earlier. Sometimes I feel that even though I am laying out guidelines for patients and family they still will go to the unit secretary and ask them to talk to me mear minutes after I just talked to them and they call me and tell me the family is looking for me. What can I do to make my time at work easier. For instance for nurses what works for you to make your day go easier? How do you prioritize what needs to be done now and what can be passed off?

Thanks