Should I leave "the dump unit" or stick it out?

Nurses General Nursing

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Specializes in ER,Neurology, Endocrinology, Pulmonology.

Hello everyone! If you work on the "dump" unit, you can probably relate.

This is my second year on a very busy med-surg unit of a 500+ bed hospital. We have 8 dialysis beds, 4 bed step-down, soft tele. Most of our patients are heavy, they are VERY ill and at any given time I have at least 1 patient who is on the verge of being transferred to ICU. We get patients that noone else wants - like our GI floor will send bleeds to us, pulmonary floor will send unstable patients to us, cardiology will send MIs to us if they don't need nitro or cardizem, plus we get all vascular and all neuro patients, all detox and all psych patients. We get the older folks and many on isolation. We get infected ortho patients (who most of the time have to room in with AAAs and other clean surgeries:uhoh3: ).

Many times we get patients sent to us from the ER with serious problems, because ICU has no beds. Our patient load is 5-6 patients a piece when we are fully staffed.

The issue is that the patients are getting more complex and more sick, the care is suffering - I do not sit down for 2 seconds during my shift - running from rom to room and I still can't turn someone q 2 hrs. My nurses' aids are exausted and they work really hard. My supervisor is brand new at managing a 43 bed unit and my unit is a total disaster. The patients' families are absolutely rediculous - last sunday we had to remove one of them by 2 security officers because she was irate at how terrible the care is on our floor. If I only had to deal with one family per day I could manage, but I have usually at least 2 that are telling me every 2 mintues what a terrible job we are doing. Many doctors do not want to talk to demanding familes about what's happening to the patients and I end up being stuck in the middle of the controvercy. (Yes, I did speak up about this to MDs ;) )

As far as I can tell nothing is going to change. I have talked to my boss about what's been going on ( it has been a year already of this nightmare) - and I made her cry! Can you believe this? I feel bad for her, but I also feel that I can not stand this any more and I am constantly living in fear of losing my lisence because the situation on the floor is unsafe and med errors are constantly made.

Everyone on the unit is miserable and say that they hate their jobs. I've tried to be positive and I try supposrting others, but it is SO hard when everything and everyone around you is a mess.

I work with a Gulf war veteran, who was a medic during the war. He is finishing nursing school in May (he is going into emergency medicine) and he is constantly telling me how great I would be in the ER, how much I could do for my patients and how well managed ER is in our hospital.

I know that ER has their own issues and if I left Med surg I would be losing a good weekend trak position, but I feel like I am not getting anywhere.

I am excellent with assessments and IV therapy skills, I know tele like the back of my hand, I know how to deal with families and like a fast-paced environment, I am not afraid to get down and dirty. Plus, I can use my native langauge to translate as needed. ED/critical care is something I wanted to do for a long time.

I applied to ED and waiting to hear from them.

what do you think? If anyone has experience with ED work or med surg, please give me some pointers.

Thank you!

Natasha

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Specializes in Emergency.

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I am excellent with assessments and IV therapy skills, I know tele like the back of my hand, I know how to deal with families and like a fast-paced environment, I am not afraid to get down and dirty. Plus, I can use my native langauge to translate as needed. ED/critical care is something I wanted to do for a long time.

I applied to ED and waiting to hear from them.

what do you think? If anyone has experience with ED work or med surg, please give me some pointers.

Thank you!

Natasha

I am an ED nurse. I could never be a floor nurse. I used to work OB, but honestly never did the floors. My hat goes off to floor nurses.

I like the fast pace, the quick thinking, and the autonomy we are afforded in the ED. We have our own problems and a chaotic atmosphere, but I wouldn't trade it.

My favorite part is treating and streeting. In our ED, we don't hold patients so the longest they are there depends on the doctor. When they are discharged or admitted, their family goes with them.

After reading the daily grind you are experiencing, I would either transfer to get out!

Good luck!

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Specializes in Flight, ER, Transport, ICU/Critical Care.

What do you get for "sticking it out"?

Sounds like you are in a near DESPERATE situation. It also seems that you have a goal (ER or critical care), some great skills (IV and tele) and 2 (TWO!) YEARS of experience caring for a range of acute patients - and you have DONE YOUR TIME! You are READY for a change. I sense a bit of near desperation in your post!

Maybe you should be PAROLED! ;)

GOOD LUCK in the ED! I think you will do just fine!

Never pass on any OPPORTUNITY to learn - take all the classes, ask questions! I will caution you that the ED does have its own problems, but compared to what you relate - I think you will be so much better off! GO! NOW!

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Specializes in Trauma,ER,CCU/OHU/Nsg Ed/Nsg Research.

I did Tele Med/Surg before I went to the ED, and it was a smooth transition. You're already able to handle the pace- I say go for it. Like someone before me said, what's the pay-off for staying where you are? I personally think I stayed on Med/Surg 6 years too long. Let us know what happens.

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Specializes in ICU, ER.

Go for it! Get out of the dump. If you can handle what you have been doing, you'll be a great ER nurse.

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Specializes in Emergency Room.

Another ER nurse here...as someone who loves her job (most of the time!) there is no reason in the nursing field that you should stay in a position that drains you so much and is so difficult. It is okay to stay in a position that is difficult if you love the pt population and your coworkers and are fulfilled by that job...but it sounds like you've been fulfilled as much as possible. Go for the ER!!!

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Specializes in Palliative Care, NICU/NNP.

Go for it! I think you have a great mix of experience. You're right, floor work is getting harder, more abusive and on and on. I hope the ED comes through for you. Best.

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I've been on the "tele dump floor" - did it for 2 years. Then, relocated and went to work in a trauma center. You will do just fine!!!

You will have the family issues going on, some will be like the things you have dealt with and yet different things. Such as patients rarely understanding the concept of triage - Ya know - Say that two people walk in the doors, one complains of a stubbed toe and the other is the little old man, holding his chest, gulping for air and turning blue. Of course you take the little old guy back first and the patient with the stubbed toe (who was able to walk in mind you) - gives you a tongue lashing that they were there first - yada, yada, yada.....Always fun to be the "triage nurse"....grrrrr

There are pros and cons to working any floor or unit - but you will obviously do fine because you can prioritize and get the job done. If you couldn't - you wouldn't have lasted 2 years on the "dump floor".

I hope you get the position,

Ginger

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Specializes in ICU.

I have a love hate relationship with the dump ward. We sure get "sh*t" on, but at least I'm busy and challenged. You can't beat the learning experience, say except for ER and ICU.

If you're ready to move on, do it. I've been considering going to SICU or PACU myself.

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Specializes in Neuro ICU and Med Surg.

I started out in a neurosurg/tele floor. On MN shift we would have 10-11 patients each. 3 nurses and a CNA for 32 patients. So we would maybe have 10 patients each with maybe 1-2 heparin drips and 4 caridac monitored patients plus others with pain issues due to back and neck pain due to surgery or injury. We had many patients we received from the ER that should have gone to the ICU right away, but when we tried to talk to bed control or the nursing supervisor we would a lot of times have to take them anyway. I got tired of that. Especially after about 1-2 years. I decided I had enough and went to work med surg at another hospital. I realized it wasn't any better there either. Staffing was better but the patients were still very sick to be on a gen med floor. We would have patients on Bipap and Cpap continuously by mask. We had many patients that belonged in the ICU or at least stepdown and there I didn't have the benefit of a caridac monitor. So I decided I had enough of med surg after 5 years. I finally decided to apply to some ICU positions and I took a position at a larger hospital with the same system and I LOVE it. I do second guess myself at times being new to critical care, but I really am glad that I made that choice.

I say like all the others you sound ready to make the trasititon to the ER or ICU. Go for it. You will be glad you did. I stayed in med surg too long.

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Specializes in ER,Neurology, Endocrinology, Pulmonology.

Thank you all so much for yout input! I feel very much inspired. I think I will give it a try for sure.

Love, Natasha

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