I'm doing a new grad residency program. My home unit is neuro/trauma critical care. My 2nd unit is the general neuro med-surg floor. It seems like the entire hospital uses the med-surg neuro floor to dump difficult patients or behavior issues. Every shift has been a nightmare on this unit. Last shift, I had a pt who had bilateral hip fracture, bilateral leg fractures, bilateral arm fractures, etc. He should have been on an ORTHOPEDIC floor, not neuro. But because he had dementia and was "difficult" (constantly pulling tubes, pulled out his Dobhoff twice...ugh!), they dumped him on us. I am constantly getting patients that do not belong on neuro. They're just behavior problems. It's really making me dread going in for my shifts. I don't like it whatsoever. I can see why they have a hard time keeping staff on this floor. The worst part is that I'm now scheduled there until the end of October. I should have been back on my neuro/trauma critical care unit, but the person ahead of me in the program is still there, so I'm stuck on this awful unit.
I'm trying to find the golden nugget in all this stress. The good thing is that I'm really learning to prioritize. But I never get to take a break until after 0400 (my shift starts at 1900). Last shift, I didn't get to eat until 2 hours before my shift was over. I'm just exhausted and I'm starting to hate neuro. I don't want to feel this way. This was my first week all on my own (after 6 weeks orientation with a preceptor). I feel like I was thrown to the wolves with no help. And they keep trying to give me new admissions when I'm already maxed out on nurse/pt ratio. When I say there's no way I can take on another pt, the charge nurse gets really snippy with me. I'm NEW, I am at my wits end just trying to keep up with my pts. It wouldn't be safe for me to add another pt, especially when a new admission takes between an hour to hour & a half to do the full admission process. Don't they remember what it was like to be a new nurse? If they want me to take on extra patients, don't give me a slate full of total cares & behavior problems. I feel lucky I made it through the week without a patient falling. I have so many that try to get out of bed all night long (high fall risks).
Sorry, need to vent. It's just so frustrating! When I was in critical care, my patients were 100% total care, but the nurse/pt ratio was so much more manageable. I had 3 to 4 pts max. On the med surg floor, we're supposed to only have 4, but I usually end up with 5 or 6. One night, I had 7. It's not right. I'm dreading going in tonight because it's Sunday. The last Sunday I worked, 2 people called in sick and they left us short-staffed instead of calling in extra staff. Both techs were on 1:1, so we had NO extra help. I have no problem jumping in there and doing total care. But I can't roll a 350 pound patient myself to get him/her cleaned up. Like I said, very frustrating!
I don't want to start dreading going in to work. I love being a nurse, but I do not like this unit. I have the sinking feeling I'm going to be stuck on this floor for the foreseeable future.
Any advice for effectively managing a full load of pts with behavioral issues? Obviously, I can't give them all Ativan...LOL