Why do we put up with it? (sorry, longish)

  1. Okay, so I had kind of a rotten shift the other night. One bad shift wouldn't be so awful if it wasn't for the fact that we had nothing but bad shifts for most of December and January. Then we had a couple of nice weeks, and it seems we are back to unmanageable again. Why do we as nurses, in a field with a huge amount of liability (in a very litigious society), allow this to be the norm?

    I was so busy last night (3 - 1130), I did not have time to check my charts until 11pm. Upon doing this, I found 2 med orders that were never taken off. We have been having problems for weeks now with our computer MARs - one time orders that are in our pyxis are not showing up on our to do list on the computer. In the "olden days", I would have had the order transcribed onto a paper MAR by the UC, so I would have seen it. Anyway, this pt had a K+ of 3.0 and was supposed to recieve K-Dur "now" at 1400. He never got it. Then, at 1500, another pt was supposed to get dulcolax suppositories x2 "now". Keep in mind that I am in report until 1530. So I guess that's why I didn't know about the orders till late. I took care of them, but I was pissed. What if that had been something important? Another nurse I work with said that, if it was something important, I would probably have known about it, but maybe not. And the nurse I followed must just not have seen the orders, because she is usally very good.

    The main reason that I was so busy was my little houdini. She was in a posey and bilat wrist restarints, and she screamed bloody murder all night long. She managed to get out of the restraints at least once and hour, and even though the ANM could hear her, and knew that I was drowning, she would not go into that room. I flat out said, "I'm dying here." She said, "so is everyone else." Yeah, that's a good way to deal with the situation. I repeatedly asked for a siiter. I had given this little tiny lady 4 of haldol IM, seroquel, 2 prn doses of zyprexa, and a mg of ativan per PEG. It didn't touch her! But she did wear herself out...she was starting to nod off about 2345 - 15 minutes after I was supposed to be gone.

    Are your hospitals like this? Where you have to take pt loads that you can't handle alone, or you have nobody to help you, or you constantly stay late every day (most of the time I am finished on time, but I have to wait for the next shift to get out of report)? I work for a good hospital. We keep winning all kinds of awards. It's insane. We aren't union, and it all feels very hopeless right now. I'm sure I'll get over it, but I still think that bad shifts should be the exception, not the norm. I didn't get my BSN to be constantly worried that I don't have enough time to provide adequate care to my patients, and be run off my feet and miserable every night. It jsut feels like there is nothing I can do about it! I like my job! I like my pts! I like (most of) my coworkers! I just feel that we are all being abused by the system now, and it doesn't feel like it's going to get any better.

    Aaaaahhhhhhh okay, vent over!
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  2. 24 Comments

  3. by   Roy Fokker
    Sounds like my last three weeks!
  4. by   Anagray
    Yea! my day as you know it. Hang in there!
    Natasha
  5. by   TigerGalLE
    yup sounds like my hospital to. I work days where i usually have 6-7 patients.. .and the acuity is very high.. I had 2 patients yesterday that I was debating sending to the unit... And our night shift is even worse.. We are a 36 bed unit.. almost always full and many times they only have 4 nurses on nights.... We have a call in problem.... I dunno it is quite discouraging.. So you are not alone... And I don't know why we put up with it.. We just do what we gotta do
  6. by   Dixielee
    I can appreciate every word of your rant. I work in ER and it is the same, too much work, too many patients, too few resources, and management who says....deal with it, you knew nursing was going to be tough!

    I hate to say it, but I don't think it will ever get any better. Computers, I have found usually cause more problems than they solve. I am working to pay off bills, looking into alternative work situations.

    I have loved nursing and have done it a long time, but it is killing me. Good luck.
  7. by   GingerSue
    what could we do to make it get better?

    are computers helpful or not (as you mention above that computers cause more problems)?
  8. by   Cmariehart
    I feel for you guys!!!! That's kinda sounds like my shift last night. I work in a LTC and last night was hellish... We have 4 residents that are wonderful on dayshift and when 4 pm hits they go nuts.

    1 of them is extremly abusive and punched me in the face, bite a CNA and then put one of our orderlies in a headlock!!!!! He had 3 doses of seroquel and a dose of ativan!!!!!

    While we're dealing with this saint the other nurse is down the hall with another abusive pt getting her arm twisted and the orderly down there is getting hit with a phone...

    And our supervisor was no where to be found....

    And the sad thing is I'm going back for more tonight.... I must be a sadist or something!!!!!


    Everyone has my sympathy!!!!!! At times like this I wouldn't mind having velcro suits and sticking people to the wall..... I know I'm mean but I think we all wish it once in a while
  9. by   Ruby Vee
    Quote from gingersue
    what could we do to make it get better?

    are computers helpful or not (as you mention above that computers cause more problems)?
    computers usually cause as much work as they save us. but that's a matter for another thread.
  10. by   Dixielee
    Quote from ruby vee
    computers usually cause as much work as they save us. but that's a matter for another thread.
    100% agreement!
  11. by   nurscee
    These are all the reasons I left hospital nursing. I took a major cut in pay, but for me it was worth it.
  12. by   nurse_nan
    This is the way nursing is because it is a predominately female occupation and we 'care giver' moms won't ever stand up for ourselves. God forbid our little patients should be left unattended while we organize and get better conditions for all. And god forbid we should actually stand behind and support those few souls who are gutsy enough to put it on the line and start the process for organization. WE DO IT TO OURSELVES, LADIES!!!!
  13. by   Hoozdo
    I think one of the biggest problems is that the public DOES NOT HAVE A CLUE on how short staffed nurses are and what patient ratios are in place. The normal patient probably thinks we have all the time in the world to schmooze around at the bedside, get me a blanket, get me some ice, ad nauseum.

    I know at my facility, we are not allowed to say we are short staffed. It would probably cause the patient, and the patient's family to have safety concerns......and they should have safety concerns! :angryfire

    The key would be to have staffing ratio laws like CA does....that would be a big help. Hey, and while you are at it, give me a unit clerk ALL THE TIME so I don't have 500 more interruptions by having to answer the phone
  14. by   Rabid Badger
    Quote from miko014
    Okay, so I had kind of a rotten shift the other night. One bad shift wouldn't be so awful if it wasn't for the fact that we had nothing but bad shifts for most of December and January. Then we had a couple of nice weeks, and it seems we are back to unmanageable again. Why do we as nurses, in a field with a huge amount of liability (in a very litigious society), allow this to be the norm?

    I was so busy last night (3 - 1130), I did not have time to check my charts until 11pm. Upon doing this, I found 2 med orders that were never taken off. We have been having problems for weeks now with our computer MARs - one time orders that are in our pyxis are not showing up on our to do list on the computer. In the "olden days", I would have had the order transcribed onto a paper MAR by the UC, so I would have seen it. Anyway, this pt had a K+ of 3.0 and was supposed to recieve K-Dur "now" at 1400. He never got it. Then, at 1500, another pt was supposed to get dulcolax suppositories x2 "now". Keep in mind that I am in report until 1530. So I guess that's why I didn't know about the orders till late. I took care of them, but I was pissed. What if that had been something important? Another nurse I work with said that, if it was something important, I would probably have known about it, but maybe not. And the nurse I followed must just not have seen the orders, because she is usally very good.

    The main reason that I was so busy was my little houdini. She was in a posey and bilat wrist restarints, and she screamed bloody murder all night long. She managed to get out of the restraints at least once and hour, and even though the ANM could hear her, and knew that I was drowning, she would not go into that room. I flat out said, "I'm dying here." She said, "so is everyone else." Yeah, that's a good way to deal with the situation. I repeatedly asked for a siiter. I had given this little tiny lady 4 of haldol IM, seroquel, 2 prn doses of zyprexa, and a mg of ativan per PEG. It didn't touch her! But she did wear herself out...she was starting to nod off about 2345 - 15 minutes after I was supposed to be gone.

    Are your hospitals like this? Where you have to take pt loads that you can't handle alone, or you have nobody to help you, or you constantly stay late every day (most of the time I am finished on time, but I have to wait for the next shift to get out of report)? I work for a good hospital. We keep winning all kinds of awards. It's insane. We aren't union, and it all feels very hopeless right now. I'm sure I'll get over it, but I still think that bad shifts should be the exception, not the norm. I didn't get my BSN to be constantly worried that I don't have enough time to provide adequate care to my patients, and be run off my feet and miserable every night. It jsut feels like there is nothing I can do about it! I like my job! I like my pts! I like (most of) my coworkers! I just feel that we are all being abused by the system now, and it doesn't feel like it's going to get any better.

    Aaaaahhhhhhh okay, vent over!
    I'm union, I think it makes a big difference. That being said, I have exactly those hell shifts too. Our ward is difficult to staff and we get many sick calls. Management seems to work in complete opposition to the staff, in pushing more and more complex patients onto a tighter staff ratio.

    I personally don't put up with it. A few things I do to cope:
    1) incident reports, tons of them
    2) reports to the union
    3) written (recorded) complaints to management
    4) ensuring your unit manager and charge nurse are aware of your unreasonable assignment and that you require help. Ensure that you are making it loud and clear that you feel that the situation is unsafe.
    5) we still work by the old system, transcribing our orders by paper, often ourself, on top of the busy assignment. MAKE A HABIT OF CHECKING YOUR ORDERS EVERY TIME YOU WALK BY THEM, even if they are not flagged. I walk past the charts/med room every few minutes, and I am anal retentive about checking my charts to ensure nothing is missed. My patients are far too sick for an order to go missed for four hours.
    6) Chart chart chart
    7) resign if nothing else works. Nothing speaks louder than your staff leaving in droves.

    Remember, you can't expect others to advocate for you. You must advocate for yourself and advocate on behalf of your patients. It is your responsibility. If that order is missed and something happens to the patient, you are responsible, unless you take documented steps outlining your concerns and measures.

    And if you think you don't have time for documenting this stuff, realize that it MUST BE DONE. Nothing else will save your a$$.
    Last edit by Rabid Badger on Feb 17, '07

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