I'm a nurse who is 5 years out now. I've been in tele/med/surg, home care, long term care and cardiopulmonary stepdown...yeah, been looking for my "niche". I started late in nursing and it's a second career for me. I'm 43. 'Nuff background...
I've gone back to tele/med-surg now, at a small, rural, community hospital. During the interview I was told sometimes patio ratios could get as high as 1-7, but that wasn't most of the time. I kind of looked surprised, but I needed the job. My home health gig was over because my grandparents I'd been caring for had to enter a nursing home. There are not many jobs in our rural community, so I had to take what I could find. Finances, ya know.
Six weeks of orientation offered, and I'm in week 4 now. I have had my doubts and reservations all during the process but just tried to stick things out and believe that in time it would be better as I got used to things. I'm not so sure. My preceptor and I have regularly had 7-9 patients to deal with, and so have the other nurses on the floor. Many times they do not have enough techs, or a tech is pulled to another floor and so the nurse has to do primary care. They do usually drop that nurse's patient load to 5-6 when she has to do that job as well as her own, but STILL.
This is a tele floor with no monitor watcher! Most of the nurses cannot read rhythms. They have ICU as backup to watch our monitor. The computer system is confused, since they are trying to go "all electronic" and some doctors resist this, they are still going back and forth between a lot of chart stuff and some computer stuff. Protocols are sketchy-many times no one seems to know who is supposed to do what (who transfers orders when a patient comes back from surgery?), you don't have a charge nurse or unit secretary on the weekends so you do all of their work too (and being new, I'm lucky to understand what the heck the NURSE is supposed to be doing in this place).
Bedside nursing has never been something I enjoyed, but I recognized it as a valuable tool to learn a lot, and it's really the only job op I have right now. Many of my other nursing friends who are still in large hospitals are telling me that seeing my coworkers crying in the breakroom due to the patient load is a sign to me that it's a bad work environment and I should get out.
In two weeks, yes, right as I get out of orientation, we are moving to our new hospital that they just built. Management said they had "high hopes" of our floor becoming more of a stepdown unit once we get settled at the new facility, where we are ACLS certified, titrate meds, and get a monitor watcher. That's great, but they also said they wanted to see us have a max of 6 patients there. That would be more than we should have, in my opinion, if we are doing all those other skills...however, the new schedule came out and it plainly shows our manager is not scheduling to have enough nurses for us to have 6 patients. So, same old same old...they are going to require us to become more highly certified, have higher acuity patients and more duties, and still have 7-9 patients.
I'm not comfortable with this, but I don't know what to do! I hate the idea of having gone through my orientation and then just going and finding another job! I mean, that will look like crap on my resume, and make it harder on the other nurses on the floor because my leaving with cause them to have to train someone else new for 6 weeks. I have been working in different settings since I graduated, trying to find the right place for me...I've never stayed anywhere longer than 1.5 years. If I leave, I'll have to explain in interviews why I went through orientation at a hospital only to seek another job.
Financially I had to take this job, we couldn't wait any longer for me to find something because we were sinking. But I feel I may have made a mistake. Maybe I will just have to tough it out for awhile, but I was really hoping to find someplace where I could put my feet down and STAY so my resume wasn't so jumpy. It seems I'm looking for another setting every year or so.
I don't know...I'm worried about the patient acuity/ratio and potential dangers...