Unsafe working conditions - (Graphic)

[AmyRN1227]

Hi all--

I was in the chat room last nite and talked to a few people and got some pretty good advice but was trying to still process what would be the best thing for me to do. I am a new grad since May of last year. I began working at a hospital in Sept and they just recently began training me for a Team Leader position, since they do team nursing there. Well, it's been a complete disaster. Their turnover is tremendous, they understaff all the time. They only gave me a two week orientation! Most of my friends are getting 6-12 weeks at their hospitals. Well, on my last nite of orientation something happened and I don't know if I could even go back to work there. I was trying to wait until my six mos and transfer to a hospital within the same system. And if I didn't do that, I wanted to give a two week notice to cover my references. People are telling me that nursing jobs are so abundant that it shouldn't be a big deal but I don't want to burn any bridges. Okay, here's what happened in a nutshell---WARNING! It may contain some graphic material but I may not be able to explain it and the depth of it without going into detail. Sorry if I offend anyone. Okay, I work on a med-surg, post surgical unit. We had a lady come from the ER who was in the process of a miscarriage. She was 17 weeks and her US showed that the baby was in her pelvic/lady partsl area. She came to the ER stating that she felt the "baby was coming out". Okay, so I admit this woman - I'm still on orientation supposedly. First of all, she shouldn't have even been on our floor and second, I should have had someone help me through this mess. Well, I get her admitted, she's comfortable, and then the doc shows up. My preceptor or whatever you want to call her, sends me in with the doc and disappears! At this point, the doc is asking for some gloves and lubrication. And before I know it, she's pulling out this fetus. Oh my gosh, I didn't know what to do. The patient was basically in shock. Then the doc says she needs a clamp and sterile scissors which we don't carry on our floor because we are not an OB floor. We had to call the OB floor, and the house supervisor. In the meantime the doc is waiting like 20 mins to cut the cord....then she asks me for a blanket to wrap the baby in. Hands the baby to me!!! I didn't know what to do. And the patient is right there. She tells me to put the baby in the STORAGE ROOM until the mother decides if she wants to hold, have a burial,.....etc. In the meantime, OB comes down, weighs it, takes footprints, and explains all this stuff we need to do, the forms, etc. the grieving materials for the mom....and that we need to take some polaroids of it. I had a new grad nurse with me who was very brave, thank god. Well, then we were told that if the mother decided to "dispose" of the baby that we would have to put it in saline water. So they gave us the things we needed and left. I know that I may have to deal with things such as this in my career but I feel it was totally wrong for me to be left alone. Now I feel like I'm suffering from PTSD or grief or something like that. I am ready to just leave this place but I want a good reference....or at this point I don't know if I care. I was going to call on Monday and tell them I can't work under these conditions any more, that my license is on the line. Someone here mentioned to me to go get a doc's note saying I can't return to work but then others are saying that may look incompetent when I go to the next place. I need some serious advice before Monday when I have to go back to this place. I don't feel safe here. I have only had two weeks of training and they are throwing me to the wolves.....

Please help!

[Charles S. Smith, RN, MS]

It sounds like this one incident has put you over the edge. Were there more incidents with the same magnitude of stress or was this an isolated one? If your stress level has been mounting over time and this is the straw that broke the camel's back, so to speak, maybe you should have a conference with your NM, and/or human resources rep. Are you a union hospital? If so, have your rep with you when you go to conference if possible.

Nursing is highly unpredictable. There are many times we are faced with things we have never encountered. Consider unpredictability as the norm rather than the exception. It does take time to be able to tolerate ambiguity with confidence and you have had precious little time thus far in the trenches, so most every thing you encounter will be a little stressful. If possible, ask for an extension of orientation time. If not possible, look for a facility that will guarantee you IN WRITING an acceptable orientation period based on YOUR needs, not institutional policy.

And best of luck to you

chas

[Cascadians]

At least you are not physically injured!

Our condolences for your trauma.

The situation was very inconsiderate towards you. That type of inconsideration we have seen over and over again nightly in a big University Hospital.

It is a problem when every floor is short-staffed and Admits come in from areas one has no concentrated experience with.

One thing we noticed was that many Doctors seemed to rely on the RNs for the "bedside healing touch" and compassion fount when dealing with tragic patient situations.

It's no fun to get floated hither and yon every shift to a totally new area, either, chock-full of "competency challenges" and nobody around to help or even show where things are.

Unfortunately this seems to be a hospital problem and those RNs who are very energetic with photographic memories, who gain in-depth competency in one area and then tackle functional competency in a jack-of-all-floors approach, and then do Agency and Travel, are the ones who seem to grow the hide to withstand the current mayhem in hospitals.

It seems you might think about writing down your experience, thoughts and reaction, then going in to talk to your supervisor about how you can be assured help when these things happen.

Unfortunately traumatic sights, sounds, smells, and shocking surprises seemed the order of the day where we worked.

[4XNURSE]

Amy,

Relax, Take a deep breath.

Only 2 weeks of training? What were you doing in nursing school? What have you been doing for the last 6 months? Did you not have rotations in school, through OB, OR, ....?

Relax, Take a deep breath. Adapt. Improvise.

I'd go to my supply closet, grab a penrose drain, - You said Post-surgical, right? Get out a suture kit or a suture removal kit. - They all have sterile scissors in them. Take these items to the doc. Tell the doc this is the best you have here. Doc ties the cord with the penrose, cuts the cord, and goes on.

There was a doctor there, you wern't on your own. The ER and house supervisor had assessed the patient and determined that your floor was safe, and that your skills were adaquet to perform the necessary care. Take that as a compliment. The fetus was aparently already deceased. Nothing you could have done for it.

Carry on. You do what you can under the circumstances, and carry on.

Relax, Take a deep breath. have a half of a glass of wine, and a hot bath. Go in Monday and do it all again. If they trust you, maybe YOU should trust yourself. You can do this.

GOOD LUCK!

Relax, Take a deep breath, carry on.

ken

[Mary Dover]

Oh Amy, what a terrible ordeal for you to have to go through. You have been (what I refer to as being) "baptized by fire". Yes, thrown to the wolves, and left to fend for yourself. Use this time you have off over the next couple of days to get yourself 'regrouped' emotionally. You are a NURSE - you can do it. Yes it was very traumatic, and sadly throughout your career, you will likely encounter other traumatizing situations. You will have to decide for yourself if you are going to let "them" make you or break you. It sounds to me like you did the best you could under the circumstances. The fact that you just didn't walk out in the midst of the situation, speaks highly of the courage you must have inside. I hope this doesn't sound patronizing. I don't mean for it to. You have some decisions to make for yourself, and you have to follow your heart. But don't let one very scary scenario make you think you don't have what it takes to face other such critical situations.

Do what you feel will be best for you AND your career. I personally agree with working out a proper notice. One thing I mentally tell myself during tough times is that "I can deal with anything for 12 hours - as long as I know I won't be having to deal with it for a lifetime".

I also personally believe that ANYTHING you go through, good or bad, will serve to build character. It may not seem so at the time if it's something bad, but I guarantee, somewhere in the experience, you will have learned something - about yourself, as well as about others.

Hang it there Amy. My thoughts and prayers are with you.

Mary

[AmyRN1227]

Thank you all for your posts.

The fact of the matter is, I feel like I am going to have a nervous breakdown. My stomach is killing me, I can't get this gruesome image out of my mind, I can't function and take care of my kids, and I feel jittery and shaky.

Yes, the stress has been building up. The turnover is tremendous at this place. They treat the nurses poorly, not even staffing us appropriately. People have made comments that it's not even a real hospital the way things are run. And then to have only two weeks of training to deal with something of this magnitutude ?? Maybe if I had some more experience under my belt I could deal with this in a better way. I didn't appreciate the fact that the nurse who was supposed to be orienting told me "I can't deal with this..." cause she has two young children also and left me alone. That was so wrong!!! And I don't think I deserve it. If this is what nursing is about, I'm sad to say I won't last.

Thanks all for your input.

Amy

[AmyRN1227]

And yes, I had started at this place in Sept. as an "associate nurse" which is what they do for all new grads. It's basically a med passer. They do "team nursing" there. So it's only been two weeks since I've become a team leader. I was still supposed to be on orientation when this happened. And also, I've gone to my manager with how unhappy I am with everything going on. Nothing's been done. People are leaving left and right. I was just waiting for my six months to be up so I can transfer out of the hospital. My six mos will be up on the 17th of this month but I seriously don't know how I can go back into work on Monday. I have no resource people. They are not there to answer questions, or they roll their eyes at me cause they are stressed out with what they have going on. I'm the new "kid on the block" and they are really treating me like it. But I can only take so much. I don't want to get burnt out of nursing this soon and also, isn't my license in jeopardy??? So, is it worth putting on the line for this place so that I can be polite and give them a notice after how they treat their nurses?

Thanks!

[Cascadians]

Amy, sit down now and write a polite, professional Notice stating that the 18th of this month will be your last working day. That way your 6 months will be under your belt.

Also, this will give you the fortitude to make it through the 18th

Then, you will have to take some deep breaths and realize that hospital work is no picnic. There is no shortage of RNs, but rather a big bunch of burned RNs who refuse to work in hospitals. Scary for those having emergencies and needing to be hospitalized; even scarier for the RNs whose licenses are always precariously on the line.

Maybe if all the patients begin protesting something will change?

[fiestynurse]

It sounds like you got dumped on, which happens often with fetal demise patients. The ER dumped on you because they didn't want to deal with it. The Ob dept dumped on you because she was only 17 weeks and they probably refused to take her. The more experienced staff dumped on you and left you hanging.

I would be darn angry! You don't have to put up with this crap!

Your first year out of nursing school is hard enough. Start looking for another position elsewhere that will provide you with more support.

[rncountry]

There is a terrible tendency in nursing to say Buck up and deal with it. Sometimes that is appropriate and sometimes that is not. In this situation it is not.

First of all we are supposed to be doing what is appropriate and best for the patient. Nurses, doctors, hospital. Throughout your career you will find ther will be times that you will need to be a strong patient advocate for your patient in order for that to happen. In this situation it is obvious that what was right for the patient did not happen. I would have hated being in your shoes, but I would have hated being in the patients shoes even more. This was handled so poorly that it leaves my mouth agape.

It is my thought that you have to be able to advocate not only for yourself but for the patient you were taking care of. If this was horrible for you, think how much more so for the patient. By advocating for this patient to the appropriate people, you are in turn advocating for yourself.

Please also speak to someone about how you are feeling, it is most important to take care of yourself. Next, look for another job right away. If this is how this hospital operates normally than I would run away as fast as my legs could carry me. Getting another nursing job right now should not be difficult. It is entirely inappropriate to think that a nurse who is not experienced to handle a situation like this to do so. I have been nursing just short of 11 years, have worked neuro-trauma, now do wound nursing with some pretty grusome wounds and this would have made me freak out. Nursing school prepares you for the bare minimum of what we do. Experience teaches us the most of what we need to do and how to handle certain situations. It is painfully obvious you are not getting the support you need, and because of that you are not going to be able to give the appropriate care to your patients.

You are going to have to be strong enough to advocate loudly for yourself. To go to your manager and whoever else needs to hear this. If you are positive it is not going to do a lick of good then flee from the building. Next write this situation down as unemotionally as you can, do it as professionally as possible. Don't worry about it being graphic, and then send it to your congressman, senator, state and federal and ask them if this is how they would want their wife, daughter, sister etc... treated. Is this how they would want their child cared for. These people must be woke up to what is happening in the healthcare system. If you take the situation and make it something that helps you stand up for yourself, your patient and your profession you may find yourself able to handle it all a bit better. Get angry and use it, you have the right to be and don't let anyone, lest of all the 20 year veteran nurse, convince you otherwise.

[Mary Dover]

Amy - go talk to someone NOW. Not your supervisors or anyone you work with maybe - but someone who can be impartial. Talk more to your MD. With the sx you are describing - medication may be warranted. Get help with what you're feeling in the HERE AND NOW. Not a good time to make a decision about the rest of your career, given the acuity of what you are feeling right now. Please keep us posted.

Mary

[Brownms46]

WOW...rncountry and Mary Dover! I absolutely, and totally agree with everything you posted!

This poor nurse has been traumatized! I mean she is saying she is about to go over the edge! Mary Dover..you're correct...SHE must go and take care of herself....FIRST!

rncountry-"There is a terrible tendency in nursing to say Buck up and deal with it. Sometimes that is appropriate and sometimes that is not. In this situation it is not. " Totally CORRECT!

This is a time...when this woman needs some understanding...but mostly...she needs to find a more supportive setting! It's evident that she hasn't received the kind of precepting, that would have allowed her to set into the position of team leader!

The fact that those more experienced nurses left her to "deal with it"...makes me want to ...just scream! How could so called caring people to do this to another person??? Yeah...maybe they're burnt out, and have had enough too! But to leave her in that situation....was just plain...heartless!

Amy...I know only you can say...when enough is enough! But from what I'm readiing...I think you have already said just that! Time to pick up your pen and pencils, and go play somewhere else!

This past summer I met a new nurse...who was also thrown to the wolves in her first place of employment! Thankfully SHE has a sister who was an experienced nurse...who told her just what I and other are telling you now! SHE was quickly able to find a position, where she given the time to gain her sea legs before being released on her own. When I first met her...she had little or no confident in her abilities. She was wide eyed and scared!

But to make a long story short...I went back to work a shift for an agency, and I worked with her.... 7 months later. She had been transformed into a "real nurse"! She had an air of confident that showed in everything she did. And you know what else had changed?? SHE SMILED almost all the time...NO matter what was going on! SHE also had walked out of her last position...and she is a completely different nurse then the one I met just 7 short months ago! Just 7 months ago..I wouldn't have let her take care of my toe! But the nurse I met on that day...I would let her take care of even my own child!

Now you can stay....and try and "suck it in"...or you can do what is neccessary to take CARE OF YOURSELF! Whatever you do...YOU must make the decision...as YOU are the only one who knows what YOU can and can't handle! Life is short...and I am constantly reminded of that fact on a daily basis. To some two weeks in a drop in the bucket...BUT to others it's a lifetime! Just ask the people who thought they were going to wake up today and didn't...ooh...but you can't...they're gone. I wonder what they were going to do the next two weeks of their lost life???

IMHO