This is why I am an anxious wreck...

  1. 6
    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.
    Lovely_RN, Merlyn, imintrouble, and 3 others like this.
  2. 18 Comments so far...

  3. 0
    Hell, I'd be a nervous wreck, too. I've worked places where I felt safe, and places I didn't. Whether what you describe is "nursing as we know it", I can't answer. But I wouldn't have been in this career as long as I have if I'd had to stay someplace like you're describing. Maybe I've just been lucky.
  4. 2
    I have had shifts just like this. It only helps when staffing is based on acuity. Primary nursing is so much better because of this. If it was primary nursing it would be more difficult to justify one nurse getting 3 fresh post ops but management can cover it up with " there is an lpn to help you. " Nothing will change unless the whole thing is restructured.
    netglow and gaylarn4 like this.
  5. 2
    I've had some nights, lately, when I've felt I had more than I could manage. It seems to me that a shift as bad as you describe as a rare (once every year or two) emergency, or a string like I've been having of bad (but not as bad as that) shifts, might be tolerable. But a place where you pretty regularly feel circumstances are unsafe probably won't be a lot worse off with one less RN.
    netglow and barbyann like this.
  6. 0
    You are not over reacting. No one wants to be labeled as an incompetent nurse etc so these consitions continue. Things improved slightly on my unit when pretty much the whole staff revolted. when it was just one or two complaining things kept getting worse and worse. eventually most of the staff left and those who stayed went to top nursing and medical managment about unsafe staffing etc. If this was a one night fluke vs a constant thing makes a big difference.
  7. 2
    I'll tell you what I would do. You work with the nurse who has the transfer and inform her of WHEN you can take the patient. You're right, you are responsible and if you can't give safe patient care then you can't accept that patient at that time. You are allowed to schedule and prioritize care so that the essential assessments get done in a timely manner for these patients. Sorry that your supervisor didn't answer your page - have you talked to your manager about it? The more you tolerate it, the worse it becomes.

    By the way, you can do this in a spirit of cooperation, "what's best for the patient" kind of attitude. Tact goes a long way especially if this is not the norm in your hospital. Think of it this way: if you had refused the patient at that time, your supervisor might have made an appearance to your unit!

    I'm assuming here that it isn't the norm in your hospital and I ran into that once. When we first started "scheduling" our transfers and admissions, there was a bit of an attitude from other units. Eventually they respected us and it did become the norm in the hospital. It's part of professionalism and perhaps you'll have to be the one to start it in your hospital.
    GrnTea and gaylarn4 like this.
  8. 0
    Cathy, you are right. That is not the norm where I work. I should have not accepted, though I am not sure they wouldn't have sent the patient anyway. Just going by what I have witnessed. Experience is a cruel teacher sometimes. Unique situation, but not unique in that I was left to dry when I needed help. Hence the anxiety.
  9. 2
    Quote from CathyRN06
    I'll tell you what I would do. You work with the nurse who has the transfer and inform her of WHEN you can take the patient. You're right, you are responsible and if you can't give safe patient care then you can't accept that patient at that time. You are allowed to schedule and prioritize care so that the essential assessments get done in a timely manner for these patients. Sorry that your supervisor didn't answer your page - have you talked to your manager about it? The more you tolerate it, the worse it becomes.

    By the way, you can do this in a spirit of cooperation, "what's best for the patient" kind of attitude. Tact goes a long way especially if this is not the norm in your hospital. Think of it this way: if you had refused the patient at that time, your supervisor might have made an appearance to your unit!

    I'm assuming here that it isn't the norm in your hospital and I ran into that once. When we first started "scheduling" our transfers and admissions, there was a bit of an attitude from other units. Eventually they respected us and it did become the norm in the hospital. It's part of professionalism and perhaps you'll have to be the one to start it in your hospital.
    Totally agreed. Do not take all the patients within minutes of eachother. They can hold on while you get each one admitted and settled.

    A little assertiveness with out being b!tchy can go a long way,
    GrnTea and cmsorra like this.
  10. 1
    I can't imagine how you felt but I can certainly understand your anxiety. I was in a situation like that a few times too. I came to the realization that it is MY license on the line and I don't play around with people's lives. If you are not getting the support you need from your workplace, consider your options. I considered mine and went into case management. Now, I'm a manager and work from HOME. Now, I LOVE nursing whereas before I was going to quit and never go back.
    Before I switched jobs, I couldn't sleep, I would cry before my shift, get into fights with my husband because I was so bitter, angry and anxious. It wasn't fair to myself, my kids or anyone else. It was the best decision I ever made. Perhaps a different unit would be good for you.
    nurse2shop4 likes this.
  11. 0
    I can feel the anxiety building up in me when I read this. It is so typical to have days like this on the m.s. floor. I found out a long time ago that as a nurse we have to specialize in some specialty nursing to get true job satisfaction. Trust me it is not over-reacting on your part at all. :heartbeat


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