Overwhelming workload!!! - Page 2

I felt the same way before when I first worked as a staff nurse. Coming straight from college gives us this notion that we have to do everything by the book. I mean the idealistic approach. But this is not always the case. It's exactly different on the real world nursing. You'll just be surprised that you see things that isn't supposed to be. I think your hospital is using primary nursing approach. It was so difficult. We have workloads with a maximum of 15 patients but we usually have 12-14 patients. We were so busy that sometimes we have to run so that I can have extra time with the patient. It was hard at first but as time goes by we learned techniques to speed up our tasks. We learned to prioritize, to delegate, to have good assessment techniques. Just like what you said we have to do nursing such as bed bath, change diaper, do vital signs( some times every hour with post-op patients and critical patients), give medications, give NGT feedings. We even have "for ICU" supposedly but since they can't pay for ICU admission they'll have to stay in the wards. Poor us that we have to take care ICU setting in the wards. Most of the time we can't even have our lunch and dinner during our shift. As busy as we are we have to stay 1-2 hours after our duty just to finish our charting. The work is just so stressful mentally as well as physically.

Just like what you said the nursing service doesn't give much attention to the workload. As long the task is done it's ok with them. But later on they switched to function nursing. As the primary nursing is not the best approach in our situation. Due to the high error on medications, not having little time in assessment and we can't attend much to the needs of the patients. They realized that primary nursing is not the best option. Now the situation is better than before. We have functional nursing. The medication nurse gives the meds, the charge nurse carries the doctors orders, then the staff nurse carry out the nursing care. We have workloads of 8-10 patients. Now, can interact with the patients more and have enough time to do assessment, anticipating their needs, and have a good patients satisfaction. I'm just glad we have improve our nursing care. Recently, they assigned me as a head nurse and I'm glad I'm through with staff nurse. My task is now different.

One thing I can say quitting is not the way to do it. Take the task as a challenge. Take time to think every duty time what things you can speed up. You have been working only for 6 months, I know this is just the beginning. I think after 1 year of experience you'll get used to the procedures and you'll have faster ways to do things. I know nurses thrive in difficult situations. We don't quit. My opinion, I suggest you stay and make the most of your hospital experience. I know somewhere along the road you'll have better days. Godbless!

Quote from Daly City RN

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Also here in the U.S. computerized charting has made the workload of RN's that much lighter. I can do my initial patient assessments and then sit down in front of a desktop computer or a C.O.W. (Computer on Wheels) and do my initial computerized charting. It is soooo easy and so quick once you get the hang of it and you'd never want to go back to paper charting ever again! End result is you will have more time to spend with your patients.

Things will not improve for nurses working in the Philippines until they organize and join unions. I know this concept is so far-fetched for nurses in the Philippines. If the Filipino bus and jeepney drivers, many of whom did not even go to college are unionized and in the process have the power to get the attention of the concerned authorities, then why can't college educated RN's get unionized? Philippine-based RN's can rant all they want about heavy workload but without the backing and political power of a union their voices will hardly be heard. For those leaders or potential leaders out there stop and think for a moment. Make this a call for action!

What is happening in Philippine hospitals these days is a reflection of what nursing was in the U.S. 40 or more years ago. I remember horror stories that my former and now retired nurse manager told us when she started working as an RN in the late 1960's here in the U.S. She said that she had up to 35 patients to take care of with the help of just one Orderly (as Certified Nursing Assistants were called back then). She bragged about being able to give all the meds, do the treatments, carry out orders, etc..

She told us that we, the current generation of U.S. nurses are "cry babies". Of course she was half joking, but when I asked her how much documentations she did back then, her answer was very little. She documented only important things that happened to her patients. If she had to do the kind of documentations that we are now required to do she would never have been able to do all the tasks that she claimed that she was able to do. (OK, with the advent of computerized charting, as I have mentioned before has cut down the length of time to do nursing documentations. Therefore comparisons may no longer be relevant) And I bet you, if someone audited their nursing documentations using today's standards, the auditor would discover that those previous generation of nurses violated many rules and regulations. And did anyone report or even discover the medication errors that were committed?

My point is, many of those things are no longer happening here in the U.S., at least in my home state of California where a maximum of 5 patients per 1 nurse are legally allowed in Med-Surg. units. I have been a nurse here in California for 27 years and I believe that nursing practice, while far from being perfect, is so much safer now than what it was when I started my nursing practice. Take for instance, one month after I finished my orientation as a new-grad RN I was made the charge nurse simply because nobody wanted to be the charge nurse. I was so inexperienced back then I was very frightened every time I went to work. Thankfully, those times are gone. Of course nowadays, charge nurses in our hospital have at least 1-2 years of acute care experience, but the vast majority of our charge nurses have been nurses for at least 5 years and a good number of us have been nurses for more than 20 years.

I am sure that there are nurses out there in the Philippines who are assertive and committed enough to begin the talks of organizing a nurses' union. I firmly believe that there are many nurse leaders or potential nurse leaders in the Philippines who are capable and willing to take the challenging job of being union leaders. These future leaders will have that heroic mandate to make nursing in the Philippines advance to the 21st Century and save its member nurses from punishing working conditions, and make nursing in the Philippines as safe as it can be.

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