Need To Vent About Yesterday @ Work

[CareBayer]

I am a fairly new nurse....I just hit the 6 month mark not too long ago. I work on a busy step-down unit. I arrived at work yesterday at 3PM to four monitored patients and a new admission. The new admit was a SBO who was vomiting all over. I tried to place three different sized NG tubes (with the help of another experienced nurse) with no success. I spent 45 minutes with this lady in all trying to get her (and the room) cleaned up. Right after leaving her room, I was given another admission (now I have six patients.) This patient had profuse diarrhea and a potassium level of 7.1. We don't have an nurse-aide after 6PM, so while giving insulin, D10, calcium gluconate, and kayexalate to this patient, I was cleaning up her as well.

My other four patients were busy too....I had families coming up to me in person demanding my immediate attention......so I was trying to do damage control and then run back to clean up the vomiting and pooping patients.

I was a crappy nurse yesterday, my charting was awful, I did not leave work last night until 1AM. It was one of those nights when you are just happy that all of your patients are breathing at the end of the shift.

[Babs0512]

You are not a crappy nurse, you did the best you could with what was handed to you. That is all anyone can do.

I also agree that assignment was too heavy, for any nurse, much less a new nurse. So, don't beat yourself up. You did a good job, as you said, all patients where breathing and stable when you left!!

Someone said "why didn't you contact the nursing supervisor..." regarding the acuity of your assignment.

In the real world, that usually doesn't do any good what so ever - it should help, but usually just gets you the label of troublemaker or lazy - which is absolutely wrong.

You and I are warm bodies to fill a shift. It shouldn't be that way, and in a perfect world, it wouldn't be, but in too many cases that is the way it is.

We have 2 surpervisors that are great and will pitch in if you need a hand, and a 3rd who wouldn't get off her tush unless the building was on fire. And yes, administration is aware of that 3rd supervisor, but she is willing to work nights, and she too, is a warm body.

Do the best you can, try to get the other nurses you work with to work as a team, and don't be afraid to ask for help from your co-workers, because another night, they could end up in a similar situation as yourself.

Good luck dear, and welcome to the club.

God Bless

[Daytonite, BSN, RN]

someone said "why didn't you contact the nursing supervisor..." regarding the acuity of your assignment.

in the real world, that usually doesn't do any good what so ever - it should help, but usually just gets you the label of troublemaker or lazy - which is absolutely wrong.

i was the one who posted that. just because something doesn't help or work isn't a reason to not follow policy and procedures that is absolutely wrong, will get you in trouble, goes against good principles of communication and breaks down lines of communication.

as house supervisors we had control over where the admissions office was placing patients when they were being admitted from the er. it's called bed control. anyone in management or supervision had that authority over the admissions department and their unit in just about every place i was a manager or supervisor. sometimes the manager/supervisors in the house got their heads together and worked these things out fairly. the people in the admissions office are clerks who are often not clinical people and only looking at empty slots on a piece of paper with certain guidelines when it comes to placement of the patients, but a nursing manager or supervisor can override an admission clerk's decision. if managers or supervisors aren't appraised of what is going on or the admissions people don't inform them of the admissions (we were supposed to keep in constant contact with the er and know who was being admitted from the er to the in-house units during the off shifts) plus make their rounds of the in-house units to know what was happening on the nursing units, how can they make an informed decision based on what kinds of problems the staff nurses are having? communication is a two way street and a two-way responsibility. just because one supervisor may be failing in their duties doesn't negate the staff nurses responsibility to report the situation they are in. once a staff nurse reports their situation to the supervisor the ball has been passed. the supervisor has to answer for their failure to act if you don't think they are doing their job. they have someone who evaluates their performance as well as every staff nurse does. write them up or report them if you don't like the way they respond to your problems.

one thing i found was that new grads especially, because they don't have the confidence and self-esteem, can be easily pushed around and manipulated by lazy staff nurses who will dump extra work on them and let them flounder with not a care in the world about them as i suspect might have happened in this case the op described since she said nothing about what her coworkers had to say about her situation. i took my job as a supervisor very seriously and i watched over new grads particularly closely and would have caught this situation before this poor kid got stuck with the second admission. people failed in this situation and it wasn't the op. so, again, i ask where were the co-workers on this? and, where was the manager or supervisor?

[barefootlady, ADN, RN]

Daytonite hit the nail squarely on the head. Read the post well and remember, as a new nurse you will have bad shifts, it is up to you to speak up and request help from fellow staff members, if they cannot or will not assist you, then take it to the next level, but do not expect miracles. Nursing is a difficult job on the best of days, most of us who have been in it a long time realize you got to love it to do it.

Good luck and hope the next shift is a better one for you.

[ArwenEvenstar]

....I had families coming up to me in person demanding my immediate attention......I was a crappy nurse yesterday, my charting was awful, I did not leave work last night until 1AM. It was one of those nights when you are just happy that all of your patients are breathing at the end of the shift.

You were not a crappy nurse. You did the best you could for the circumstances. Your priorities were right on target. This is nursing!

I was a bedside nurse for 14 years. I actually handled it just fine and liked bedside nursing for about 10 years. Then I started to get burned out. By year 14, I was so burned out I was toasty. Should have left sooner...

Something that bothered me the most and contributed to my burnout were FAMILIES actually. I related to your comment "I had families coming up to me in person demanding my immediate attention." Over the years, it seemed like families became increasingly demanding. I'd be dealing with some real crisis situation....someone with symptomatic third degree heart block for example....and then I'd have some family throwing a fit and demanding my immediate attention because mother is constipated. Hmmm....third degree heart block or constipation...which problem should I address first? But families just could not understand.

But hang in there! Shifts like this happen!