Nurscee's Freaking Out! - page 4

Help! I've only been a nurse for a month and a half. Last two nights I've worked 12 hours (supposed to be 8) that's not the big deal though. First I had 7 patients alone....won't even go into the... Read More

  1. by   prmenrs
    closed for time out. Everybody relax, now, please.
  2. by   prmenrs
    I have re-opened thread. There are a LOT of good comments on her, let's try to stick to the OP's original question.

    Thanks, everybody.
  3. by   snowfreeze
    I recall writing up incident reports for unsafe patient/nurse ratios, sending them to the Head Intensivist with copies to the nursing supervisors office, and the administrator.
    Each incident report described the patients assigned to the nurse writing the report, the care involved and that best care possible under these circumstances was administered but optimal care was impossible.
    We always kept a copy of these incident reports ourselves and found a lot of response to them. After they quit responding to these reports we had one patient who was confused, climbed out of bed with a balloon pump...pulled the pump out and bled to death before the nurse could even respond from the room at the other end of the unit to which she was assigned. One nurse had two ventilator patients on her assignment but the rooms were not side by side, while administering to one patient who was relatively stable (yes the stable patient needs care too..DUH) the other very fragile one extubated himself and died, unable to resuscitate. Did anyone hear the vent alarm, sure they did, but could not drop what they were doing immediately and respond. The court figured the response time from the alarm sounding to someone at bedside was less than one minute but the patient was so fragile....that wasn't quick enough.
    No facility staffs for "when hell breaks loose" anymore. It costs too much.
  4. by   begalli
    All I can say that as an RN, who works in a hospital that acknowledges that new-grads need a thorough orientation and preceptorship sometimes even beyond the 3 month period that is usually adequate; that nurses do burn out due to the magnitude of care that is required to care for our sicker patients; and that the voices of nurses working on the front lines is important in planning strategies to deliver excellent patient (and employee) care, is that I'm thoroughly disgusted with what goes on out in the wonderful world of hospital nursing.

    I can also say that I'm disgusted from having been the family member of a patient whose inpatient care was HIGHLY impacted by the nurses of this hospital having high nurse to patient ratios (1:12 on one occassion; usually 1:8-9).

    Even with study after study showing the effects of overloading a single RN (both highly experienced and new) with too many patients, both on the nurse's well-being and patient outcome, hospitals STILL don't get it.

    It's all about money. This is frequently made out to be a "which came first - chicken or egg" problem. Hospitals like to say that having more nurses costs them more money when in the long run it would probably cost the hospitals less by having tighter nurse/patient ratios because of better outcomes (shorter stays because of less complication due to the increased attention to detail nurses with less patients can contribute) and more patient satisfaction (less lawsuits due to the patient and the family feeling that they are being informed of the course of disease and treatments).

    It's about the money and who advocates for what, period. Because hospitals have the money to throw into lobbyists who can line the pockets of politicians for their own political benefits, the hospitals win. Nurses don't have that kind of monetary power. That's where the CNA of California comes into play here in the beginning of something VERY BIG in RN/patient ratios.

    There will be a shift in the future. As more and more nurses begin to see that we are NOT voiceless. And our voices will grow with contributions from nurses just like nurscee!
    Last edit by begalli on Feb 14, '05
  5. by   plumrn
    It seems as if the administrators making up these ratios just don't want to listen to what nurses are telling them. They refuse to believe that nurses are telling the truth about the dangers with these high ratios, and choose to believe that we are just trying to make our jobs easier 'so we don't have to work so hard.' Lazy nurses, every one of us!
  6. by   NurseFirst
    Quote from plumrn
    It seems as if the administrators making up these ratios just don't want to listen to what nurses are telling them. They refuse to believe that nurses are telling the truth about the dangers with these high ratios, and choose to believe that we are just trying to make our jobs easier 'so we don't have to work so hard.' Lazy nurses, every one of us!
    It's probably impossible, but maybe we should just refuse to work for any hospital that is for-profit; or for non-profits whose spending could maybe, just maybe, be reigned in a bit? How is it that Kaiser was able to knock $100 off my monthly insurance (private pay, through an HIPAA policy, about 25% off) last year when many people complained, huh?

    Does anyone remember the scandals of some years back when either BC or BS was accused of some sort of hanky-panky, or the exec was, or something like that?

    I'd love to enroll all the CEOs in this country in a "voluntary simplicity" program--ah, but their trophy wives would be sure to object. sigh.


    NurseFirst
  7. by   CHATSDALE
    nurseee..changing your place of employment is something you should take into serious consideration...but...they may think that you are 'experienced' d/t your current job but if you feel like you need more in-depth orientation let them know in writing up front..
    when all is said and done most nurses will tell you it took them about a year in nursing before they really felt comfortable with what they were doing...
    sometimes with new admits, and staff call-ins you will wind up with a marginal safety load but if you routinely take on a load like this they will just assume that it is a doable workload

    weigh your options...put your license and the the years of schooling as the most important thing to keep in mind
  8. by   BETSRN
    Quote from nurscee
    Help! I've only been a nurse for a month and a half.
    Last two nights I've worked 12 hours (supposed to be 8) that's not the big deal though.
    First I had 7 patients alone....won't even go into the hell that was.
    Then tonight I had 6 but 5 were on insulin, and one of them was a every hour 20 units of insulin.
    That isn't to mention the wet to dry dressings, pegs, brain surgery, and other various and sundrie items.
    Not only that but this antiquated hospital still only does handwritten documentation. No computers.
    I dissolved into tears. Don't know if I can do this!
    YES, I DID ask help. But we have nurses who have 9 pts. They have their own share of problems.
    Did you ever feel like you'd freak out????
    Did you ever feel too dumb to do this????
    Tell me I can make it, or not. Got ANY solutions?
    Is my life long dream to be a nurse just a pipe dream?
    HELP!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

    Can we just clarify a few things here? When you say you have only been a nurse a month and a half.........does that mean you ahve been done with orientation for that time or you ahve just been a new grad that long?
  9. by   wikiwicked
    You seem to be doing good for a new nurse managing near that of a more experienced one. Unfortunately, stress does come with the job. Your skills will develop with time and you'll wonder why you ever worried. Stay on your toes - get a few good pair of Nikes and smile. If you still love what you do, keep doing it!
  10. by   vablueyes
    We have the same response from our management..their response was "I'm sorry you feel "stretched" but there isn't anything we can do."....in other words, tough crapola, you are the nurse, pull up your britches and handle it. It is a very unsafe environment for the patients, but they won't care until something awful happens.
    As for Saskrn....I doubt you were able to give precise care to 13 "acute" patients rightout of school. Perhaps my defininition of "acute" is different than yours. Acute is almost 1:1.....Perhaps 1:4 at best...no WAY 1:13.
  11. by   SmilingBluEyes
    Quote from vablueyes
    We have the same response from our management..their response was "I'm sorry you feel "stretched" but there isn't anything we can do."....in other words, tough crapola, you are the nurse, pull up your britches and handle it. It is a very unsafe environment for the patients, but they won't care until something awful happens.
    As for Saskrn....I doubt you were able to give precise care to 13 "acute" patients rightout of school. Perhaps my defininition of "acute" is different than yours. Acute is almost 1:1.....Perhaps 1:4 at best...no WAY 1:13.
    boy is that the truth.
  12. by   melpn
    Well, congrats on being a normal, sensible human being. The job may or may not be too tough for you (the patient load actually sounds pretty reasonable)but it's not appropriate for a new grad. Hospitals, subacute and LTC are famous for giving a lot of lip service to the nice, long orientations but sister, it just doesn't happen in real life unless you demand it. And you should. Don't go in yelling about everything. Let them know you feel you're making progress with (whatever you feel you have a decent grip on), but you do feel a bit over-whelmed with the rest. Let them know you really want to work there and feel you will do an excellent job with the proper orientation. Ask around to other facilites in the area and find out what their orientation programs are like. In my subacute facility, established nurses get 2-3 weeks, new grads get 8 and then we see at that point if the need more help in certain areas. The nursing shortage is no excuse.The potential for making mistakes is higher when your brain is scattered in a million directions. Don't fail to mention this to them as well. Good luck, stand your ground, please know that it isn't always like this. I'd be worried about you if you weren't freaking out. Always remember to take a deep breath, let it out as slowly as possible, repeat x2
  13. by   nurse01
    I ran into a similar situation when I first became a nurse, BUT we had a 6 week orientation with a preceptor right there with us. It takes awhile, probably a good 6 months or a year to get the time management thing down. We always have 8 patients, and when someione is discharged, the bed is immediately filled. Do not get discouraged...it does get better, and one day when you aren't thinking about it, you'll just be doing it. You'll be a great nurse--Hang in there!!




    Quote from nurscee
    Help! I've only been a nurse for a month and a half.
    Last two nights I've worked 12 hours (supposed to be 8) that's not the big deal though.
    First I had 7 patients alone....won't even go into the hell that was.
    Then tonight I had 6 but 5 were on insulin, and one of them was a every hour 20 units of insulin.
    That isn't to mention the wet to dry dressings, pegs, brain surgery, and other various and sundrie items.
    Not only that but this antiquated hospital still only does handwritten documentation. No computers.
    I dissolved into tears. Don't know if I can do this!
    YES, I DID ask help. But we have nurses who have 9 pts. They have their own share of problems.
    Did you ever feel like you'd freak out????
    Did you ever feel too dumb to do this????
    Tell me I can make it, or not. Got ANY solutions?
    Is my life long dream to be a nurse just a pipe dream?
    HELP!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

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