I was reading nurscees's thread and some of the comments about nurse-patient ratios and I started remembering:
Back in 1991, I started my nursing career at Thomason Hospital in El Paso, Tx on the pediatrics floor. We also had adult orthopedic patients overflow on this floor. My shift was 7p-7A. This was a 45 bed floor and we routinely took 15 patients each. We were always full. On a good night, we had four nurses which means that 3 of us had "only" 11 patients while one of us had 12 patients. Those were considered "good" nights and they were rare. There was absolutely no IV team and we had to draw our own admission labs as well as blood cultures on the adults for some reason. We were also responsible for signing off our own charts. Naturally, I had anywhere from 10-12 hours overtime every paycheck because I had to stay late to finish charting, etc. Nurses who couldn't get it all done were excoriated. (guess which category I was in?) One of my coworkers who was actually one of the sweetest, nicest nurses I have ever known told me that they used to provide care to ventilated patients on the floor back in her first days in nursing.
When I moved back to GA, I switched to med-surg. On 3-11 shift, we had 12 patients each but there was an IV team who did everything including giving prn and routine meds. The charge nurse signed off all the orders and made all the phone calls to the docs. I thought I was working at a resort. But in a short period of time, this became harder and harder. The IV team began to be phased out. Staffing ratios were decreased but the patients began to be harder to take care of. We started to provide care that used to be done exclusively in the units.
When I finally left a couple of years ago, we were down to 1:5 ratio on day shift but I was working harder than ever. Patients were sicker, family and doctors were more demanding, and the hospital actually employed nurses whose only job was to walk around and making sure we were spouting our "scripts" and evaluate our customer service abilities. Our nurse manager routinely made comments about how she couldn't understand why we couldn't get our work done when we were taking care of fewer patients. This observation was meant to induce shame and guilt in us nurses. It didn't work on me.
What were your first days in nursing like? Do you remember those days with nostalgic fondness or a relief that its over? Are things better for you or worse?
