This is why I am an anxious wreck...

Nurses General Nursing

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Going to work always makes me anxious. You know, when you can't sleep, eat, or enjoy life. When your brain is consumed by what will happen and how you will handle it all.Granted, some days go well, and it actually feels like I enjoy my job; there are far too many days like a few days ago. Maybe this is nothing and I just need to find a new line of work, or maybe it is just nursing. I work ortho. Started the evening with 4 patients; gave 3 to the LPN on my team in anticipation of landing 3 surgical. Easy start, no doubt.Turns out, all 3 patients returned from PACU within one hour; the last 2 within 5 minutes of each other. The floor was getting other surgicals as well, and I was the only core RN on the floor, so the help on the floor was minimal. Paged the nursing supervisor to ask for some help. That page was not answered until 2 hours later; im quite sure the HUC made repeated attempts. Not throwing the sup under the bus; I know the entire hospital was chaos.One PACU nurse reported that one of the patients came out of anesthesia quite lethargic and received 20 of morphine, but his resps were 12-16 and he was improving. Needless to say, when the patient got to the floor, his resps were 8-10, and was barely responsive.Long story short, he got narcan twice and had rapid response called when his sats hit the 60s after receiving narcan once, while on 6 liters. I can manage this patient, but not with 2 other fresh surgicals, plus another fresh surgical from day shift and 3 other patients in my team to be responsible for.I am not throwing my coworkers under the bus, but honestly I called for help in all the right places and got almost nothing. The level of responsibility I had was too much. It was a very vulnerable situation and my team and I were left out to dry; but ultimately everything was on my shoulders.I guess this is nursing, and I guess we all have days like this. My question is, how the heck does being placed in these situations allow anyone to enjoy work? Avoid anxiety? I am in the process of dealing with all of these issues in terms of reporting and filing unsafe staffing. I just feel like this is a bad deal, and am curious to know if I am over reacting or if this is just nursing as we know it.

I too got a little anxious reading this as well. I have been a nurse for almost 2 years now. I have finally learned to take a deep breath, and as long as all my patients are safe, I don't care what else gets done. Again, I say, as long as I know they are safe, a non urgent med can be late, charting can be late (I usually get this done early in shift anyway) and anything else can go to the next shift.

we can NEVER tell pacu or er to wait at our facility, in fact there are policies in place forbiding this once the patient has been assigned a room and approved by a doctor to go to the floor. you can argue for higher level of care but the pt will be on their way to you by then.

A wait of 15 to 30 minutes isn't a long time, it's not unheard of and most will do it if you ask - once you have a working relationship with the other units. Granted, it takes time to get that kind of relationship but it can be done. Furthermore, that kind of relationship is necessary and worth working toward IMHO. It also goes both ways. I was ER and ICU so I'm not advocating for med-surg specifically but advocating for safe patient care - which I had a reputation for.

I don't mean to be argumentative but I would read that policy again - and also your floor policies. Many times we are so busy the actual policies that regulate our behavior are the last thing we are able to become familiar with. Policies have a way of being transmitted through conversations and not verified by the very people they effect.

It wouldn't be such a big deal if in fact the supervisor was there to help, staffing was adequate and the nursing mix was right but accommodations have to be made for the increased acuity and staffing problems.

I'm not saying it's going to be easy or readily accepted, especially by the other units at first. It's an option for optimal patient care. What's the alternative?

This is becoming quite the discussion, isn't it?

I will be having discussions with my supervisor. I am obviously newer to the game and will learn from my experiences. However, I did precisely what I was told to do the last time I was in an overwhelming situation. Asked coworkers for help and called the supervisor. We all know how that went. Now you tell me...if you have done what you have been instructed to do and no help comes...is it me or the system? I can learn to play the game better, but why are we playing a game in the first place? I am mad. It all seems to fall back on me.

You ..and your patients are in an UNMANAGEABLE situation. This facility will try to force you to manage an impossible assignment, then make you question yourself when you do not fulfill these impossible requirements.

This is all about the almighty dollar.

It WILL not change.. get out now.

You ..and your patients are in an UNMANAGEABLE situation. This facility will try to force you to manage an impossible assignment, then make you question yourself when you do not fulfill these impossible requirements.This is all about the almighty dollar.It WILL not change.. get out now.
Unfortunately, I am getting the vibe that you are right. I asked about what I can and cannot do in regard to asking PACU to hold a patient. What I was told is that we cannot do that because patients are charged for the amount of time they spend in PACU. Therefore, it is allegedly frowned upon to practice in such a way. Basically I get the impression that the higher ups are just listening and don't care. They have to listen, but don't have anything to offer other than to say tough luck.So, the next time this happens its me against the world I guess. I will be long gone the next opportunity I get, but I can't count on that happening too soon. Two kids, loans, guess I gotta grin and bear it.
Specializes in Certified Med/Surg tele, and other stuff.

I would like to know why PACU brought up a pt that had just been recently Narc'd? You know once that dose wears off the pt was going to be circling again. I think that was unfair of them to dump like that, knowing that pt was going to have issues. They should have kept the pt until he was completely stable..not sort of stable.

Is this standard practice? We have an 80/20 rule. We know that 20% of the time it's going to hit the fan no matter how hard we try. The 80% should be a decent day with no problems.

My former hospital had me feeling unsafe virtually every day. I tolerated that for years until I burned out. At my current facility, it's more like a 80/20 rule, but borders more on 90/10.

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