ICU BURN OUT - page 2

Hi all, I would like to know what different hospitals are doing for the RN's to keep them motivated to stay in the nursing profession. I am a unit manager of an ICU and I have alot of RN's... Read More

  1. by   Phantom2U
    I am surprixed you are going to a LTC and getting better pay and benies!!! That really says alot about your old facility, in regards to how much value they place on you.
    I personally have toyed with the Idea of going into the unit (I have Med/surg and tele experience in my background.) However, after reading these posts I'm not sure.
  2. by   John_G
    Hello all! Im new to the icu (2 months) and prior to that worked the floor for 4 years. For those of you whining about the 3:1 ratio go back to the floor and you'll soon have wistful memories of your 3 pts. I realize that 3 ICU patients can keep you busy, but working the floor, the patients are less critical and thus pile them up on ya as if they were self care patients. I'm new to the unit and memories of the floor are close at hand. I find that the nurses in the unit here who do the most complaining are the ones who have been away from the floors for years. The person who suggested rotating to different areas of nursing had a great idea!

  3. by   imaRN
    Ok... John_G Has anyone told you about the "honeymoon phase" in ICU? 2 months is Not Quite long enough to make that judgement.
    And a bit of advice: Don't let your co-workers hear what you just said......or you might have to eat those words sooner than later. ICU nurses have a quiet, but deadly way of letting people who think it is soooo easy, "drown on their own."
    Hope it is not too late to save yourself!

    We have flexibility, self scheduling, no mandation, overtime with bonus pay but NOTHING makes up for having to work
    SHORT STAFFED!

    As for me I am getting very tired of 3:1 pt. loads. Don't know how much longer I can survive ........imaRN
  4. by   BillieICURN
    [QUOTE]Originally posted by imaRN
    [B]Ok... John_G Has anyone told you about the "honeymoon phase" in ICU? 2 months is Not Quite long enough to make that judgement.
    And a bit of advice: Don't let your co-workers hear what you just said......or you might have to eat those words sooner than later. ICU nurses have a quiet, but deadly way of letting people who think it is soooo easy, "drown on their own."
    Hope it is not too late to save yourself!

    I work in a 20 bed ICU (Medical-Surgical) and our nurse manageer is ADAMENT about keeping it 2:1 and we are still having problems staffing our unit.. You know you have a GREAAAT nurse manager when she closes 2 beds because she does not have the staff to cover it. Therefore, what I have to say about my job is that I love it and love my manager; she certainly wants to maintain the moral of the unit and we all feel that way; if you ever walked in you would immediately feell as if you were walking in on a family and i sware by that statement!!!!
  5. by   Goofball
    Working ICU for a long time, I get burnout episodes and start sniffing around for other jobs.
    Some of the reasons why I don't actually leave:
    $$$$$best money right where I'm at
    Hospital gives 'premium pay' for extra shifts
    Flexible, self-scheduling
    Only have to work 1 weekend a month (12hr RNs)
    No mandatory overtime
    Flexible dress code (as long as you have on
    safe, decent clothing that looks sort of like
    a nurse, and any color safe shoes, it's OK)
    We occasionally do fun outings together socially
  6. by   Stargazer
    I worked ICU for 7 years. For 6.5 of those years I *LOVED* my job. All of my burnout occurred in the last 6 months, because of the following changes:

    *3:1, and even 4:1, staffing ratio
    *Not enough techs
    *mandatory overtime
    *mandatory layoffs despite the fact that we were understaffed
    *New unit manager who fell off the face of the earth from 5 pm to 8 am, but did not authorize us to use agency nurses or incentive pay on eves and nights to fix our severe staffing shortage
    *lack of ancillary support staff, including housekeeping, EKG techs, lab techs. Also virtually did away with IV therapy department.
    *Elimination of "creative scheduling"--we were given the options of working straight 8's or 12-hour 7 - 7's only
    *Hospital stopped providing scrubs

    Basically, the very clear message I got was that administration down to and including my new manager, didn't give a crap about the staff or about providing safe pt care. I left for a much better job and haven't looked back since.
  7. by   Goofball
    I mentioned several little things that help keep me in my job. They are mostly small, but adding them up its a lot. Here are couple more things
    that keeps even us burnt out old jaded nurses from quitting:
    Nurse manager never inimidates, always listens
    she is totally approachable and accepting.
    she often buys us pizzas! Or randomly gives us
    free coffee tickets to Java City.
    she is available at home or by beeper 24hrs a
    day. She jumps in and helps with Charge, or
    takes patient assignments herself until relief
    can be found.
    She backs us up with other departments and admin
    and she's not afraid to do it.
    She lets us change our policies ourselves, and facilitates the committees to do it. For example, our dress code. She refused to enforce the 'all one color/one style scrubs, white shoes only'
    law.
    Having a great boss makes all the diff. in the world.
  8. by   beanbag
    I'm very lucky due to the fact we have 1:1 patient nurse ratio. Having worked on the wards I find ICU less stressful in respect of my basic working day. But in terms of emotional stress, thats a different animal!!! Thankfully I have good family and friends.
  9. by   Goofball
    We are usually so short-staffed that even when we have a pt. who should be a 1:1 it doesn't matter, the nurse still frequently gets two patients (but they try to give an 'easy' pt.with it, like maybe a brain-dead vent pt. paired with the 1:1.
    You might occasionally have a vent pt. with a new MI and new Intracranial bleed with sepsis and in ARDS, could even be a post belly surgery, on every sort of vasoactive and antiarrhythmic drip you can think of, coding every shift and with hordes of familly hanging around asking a million questions. And you still could have another pt. It just depends on the census (always full)and how many ICU or float or agency nurses they can scrounge up.
  10. by   Curlytop
    Originally posted by AnonymousRN
    KSAHR: What's your nurse-pt ratio? If it's routinely 2:1 I find that CCU nurses don't burn out that often. However, the new trend of 3:1 in CCU/ICU, without adequate ancillary help to turn/bathe pts. leads to severe burnout pretty fast. I'm about to leave my staff CCU RN position (departure date June 1) after only 7 months due to burnout and its directly caused by the 3:1 ratio. Management needs to understand how grueling that ratio is. If you don't believe me, try it for one month. Go back to the bedside and try a 3:1 assignment every shift for one month. I guarantee, within that time, you'll cry uncle!
    I can SSSOOOOO relate to your experience with 3:1 ratio. It's so rediculous for this to be expected of us. There is NO possible way for us to take care of 3 patients (the way they deserve to be taken care of). I have 10 years experience as an ICU/CCU nurse and I have thought about quitting many times but I have no other specialty interest. 3:1 ratio didn't become the norm at my hospital until after they got rid of the weekender program and went through a horrible "redesign" which resulted in so many experienced nurses leaving. No one (in administration) seems to be concerned with retention- only recruiting-- even though the number of nurse grads and people going to nursing school is decreasing and decreasing and decreasing................
  11. by   Curlytop
    Originally posted by natosha
    Hello! I have been an rn for a little over six years, and my suggestion to you is to try a different field of nursing. I have done 3 years of med/surg, 3 years in the o.r. and now I work in an icu. I plan on becoming a flight nurse in 1 1/2 yrs, so that will still keep things interesting. As far as having new grads in the icu, go for it! we have a new bunch with us and they are so energetic and willing to learn! Plus, all of their pathophysiology is fresh in their minds! tell your burned out nurses to retire or take a vacation, or, try another area of nursing. I hope that helps! Good Luck!
    I can't help but find this response a bit patronizing! I've been an ICU/CCU nurse for 10 years and I'm not stressed from the work that goes along with being in this area- --just the B.S. of adminstration (3:1 ratio is the norm and not the exception) and the shortage of staff. I love this specialty and I find it quite disheartening when the company, business or whatever a hospitals are thought of these days causes me to not enjoy my job. I've seen many 'new nurses' come and go in a year or less b/c they can't handle it. So I just continue to keep a positive attitude and hope that experienced nurses like me continue in the profession they love.
  12. by   Pati
    I am in currently in Nursing school with 2 yrs to go. I have always had the idea of finding a home in the critical care unit. Am I setting myself up for burn out or worse failure. I have always looked at the challenges of Critical care as something to embrase, but the stories I have read so far just makes me think that I do not know the reality of it all. Should I think twice about being a Critical Care nurse? One thing which I find a little uneasy is the ads I see where hospitals are looking for new grads to staff their ICU. I would never be so foolish to go to ICU fresh out of school, my teachers have ALWAYS advised NEVER to go to any special care unit until I have had at least 2 or more years in Med/Surg, b\c that is the place to gain valuable knowledge and experience.
  13. by   Curlytop
    Originally posted by AnonymousRN
    KSAHR: What's your nurse-pt ratio? If it's routinely 2:1 I find that CCU nurses don't burn out that often. However, the new trend of 3:1 in CCU/ICU, without adequate ancillary help to turn/bathe pts. leads to severe burnout pretty fast. I'm about to leave my staff CCU RN position (departure date June 1) after only 7 months due to burnout and its directly caused by the 3:1 ratio. Management needs to understand how grueling that ratio is. If you don't believe me, try it for one month. Go back to the bedside and try a 3:1 assignment every shift for one month. I guarantee, within that time, you'll cry uncle!
    I agree- 3:1 is rediculous. And to make matters worse, our unit has Patient "techs" instead nursing assistants - "techs" who are glorified transporters and are not trained to do any actual patient
    care (unless you consider stocking linen as patient care!). We also routinely have to share a secretary between 2 of the 4 units which means the phone is always ringing off the hook and we do most of our orders. We must give baths, turn, feed, assist to pt's to chairs, answer phones, officiate dysfunctional family members, etc., etc

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