Concerned Fiancee of a Nurse

[thcobbs]

Hi everyone. (sorry, this will probably be long) Firstly, I'm not a nurse, but my lovely fiancee is one. She works the night weekend shift and I'm getting concerned about the level of work they are throwing at her. I'll try to condense this as much as possible, but feel free to ask questions. I'm coming here because I don't want any retribution onto her. Also, if you're in Mississippi, I'd really like to hear your responses.

Working at a hospital in Mississippi(that's as detailed as I'll get on that), my finacee has had a constant degredation in working conditions over the past two years we've been together. This all started as nurses starting leaving her shift.

First, they would have on average 4-5 nurses on staff at night over the weekend. This allowed plenty of leeway for easy and difficult nights. Then about a year ago, they averaged a maximum of 4 nurses per night shift. At this time my fiancee and I began to expect our lovely little girl. So as you can imagine, the 12 hour shifts were very trying on her.

Now about 10 months ago, they had another nurse quit, it comes out that all the nurses are having problems with the nurse manager and get fed up. Now the really great thing is that their manager was on the floor for 6 months before being promoted to a managerial role. Now, my fiancee had to take time off because the baby decided to tap dance on her siatic(sp?) nerve. When she came back, she was limited to 8 hours at a time.

Now after our baby was born, she is on an 8-12-12 schedule since she had to have emergency c-section due to HELP(advance toximia? ) syndrome. So, she's still on recovery. Now it's starting to get interesting at work.

They now have, on average, a maximum of 3 nurses for the night shift. Each nurse has, on average, 5-8 patients a night. The nurse manager has made it clear that she doesn't plan to hire any more nurses for the night shift. Also, and this REALLY galls me, I've come to find out that they have an expected Labor Cost for the floor. And the nurse manager gets a percentage of the money saved coming in below that line. So, I see a major conflict of intrest right there. To make matters worse, they did hire a new nurse, who actually does a decent job, when she's there. It's come to their attention that the new nurse is the best friend of the daughter of thier manager.... And in the 4 months the girl has worked there, she's had more time off than my finacee has in 2 years.

Now, one of the other nurses and my fiancee trade out Charge Nurse duties. And take care of patients at the same time. The worst I've heard was my finacee being the Charge Nurse and having 7 patients. I believe recently, they gave her nine patients. And now, not all their patients are oncology related. One was in drug detox and the other was supposed to be int the psych ward.

We've come to the decision that at the end of her contract, she will be looking elsewhere. She LOVES the work that she does. She feels that she is doing real good in the world. And I hope she will find another job as an oncology nurse nearby. Now, I know I've been sporifice on details, but here's the question to all of this that I have.

Are these normal conditions for oncology nurses? Is she getting the short end of the stick? And lastly, are the actions of the nurse manager(who does have an RN license) legal and in line with nursing ethics?

You can probably guess my answers to the questions, but I want to hear from other nurses.

[Hellllllo Nurse, BSN, RN]

Those sound like normal conditions for many nurses everywhere, and in all areas of nursing..

That's why so many nurses are leaving nursing, causing a pseudo nursing shortage.

[renerian, BSN, RN]

Sounds just like where I used to work. Good floor but very hard.

renerian

[ptadvocate81]

Unfortunately these do sound like "norms" for staffing. I'm very blessed to work in a hospital that does value their employees in some aspects. We are well staffed, and a charge nurse would certainly NEVER take more than 3-4 patients unless something tragic had occurred. I hope that your fiancee finds better working conditions elsewhere, and a little piece of advice- if they are offering large sign-on bonuses for her to sign a contract- TURN TAIL AND RUN!!! There is a REASON that they are willing to pay you $10,000 or more for "only" two years! I will not sign a contract, that way when things get bad, I am free to go my own way. Something to think about.... Best of luck to you all.

[nursing04]

Hello. I feel very bad for you and your fiancee. Your concern is legitamit and this is not the way her nursing career should be. I work on a very busy oncology floor which a lot of times seems like a critical care/hospice unit. We have pts with trachs (arificial airway in the neck), feeding tubes, pts with severe sepsis etc... which we have to manage. But, I am a charge nurse on night shift and I do have one to two less pts then everyone else. This correlates to 4-6 pts each. It is just unsafe to only have three nurses on a floor unless it is a very small unit- like 15 beds. If someone is coding there is no one there to immediately help. And, believe me I've seen it. It never fails that when we are short staffed or at change of shift a patient is found in a life-threatening situation.Each manager does have nursing budgets and they need to figure out how to stay within that and still run "safely". I have never heard of a manager getting a comission off the money saved. And, no I also don't think this "friend" should get preferential treatment. These are both conflicts of interest.

I don't know what the laws are in your state or the status of the shortage there but she should definitely look into a place where the ratios are fair. When interviewing I highly recommend her touring the floor she's considerring and talk the RN's there. I hope things get better for you both. Best of luck and happy holidays!!

[rn/writer, RN]

I suggest that your fiance look at different facilities and different specialty areas. There are options that are much less physically and/or emotionally draining and stressful.

I don't know if she could work a different shift or if that would cause childcare issues, but days offers clinic nursing, dialysis, and other opportunities nights doesn't have. Occupational nursing has most of its openings on days but there can be second or third shift possibilities in a large company that works round the clock. PMs is another idea. Many urgent care centers (doc-in-a-box) have second shift hours.

If she needs to stay on nights, have her consider other units or other hospitals. If there's a children's hospital anywhere near, peds staffing is usually a little better than for adults. With a strong med-surg background, she might be able to go into a specialty unit like neuro or cardiac ICU, the HOT unit, or PICU.

She might want to give L&D or postpartum a look. Postpartum is definitely the less stressful of the two, but both are interesting.

Psych is another area worth considering.

Some of the positions I mentioned would probably involve a pay cut. But, as a young mother, she might find the trade-off a better deal in the long run.

You're right about there being a conflict of interest when the NM gets to keep part of the money she should have spent on better staffing. Poor management is one of the biggest factors in the current nursing shortage. It ISN'T that there is a shortage of nurses. It's that there is a shortage of nurses who are willing to put up with abuse.

You fiance is very fortunate to have you looking out for her best interests. I wish you and your young family well. Let us know what happens.

[MTBanRN]

This sounds normal but there are other options to the shortage.

[Nesher, BSN, RN]

That doesn't sound "normal" to me! My advice MOVE! I work on a very busy oncology floor doing stem cell transplants - our night shift have 3-4 pts each - days 2-3 pts., with an aide to help if you have 3. Granted these are the sickest folks in the hospital, but I just want you to know that what you are describing doesn't occur everywhere. By the way our charge nurses don't take pt's either....

[shining armani]

I can certainly understand your concern, especially with a new baby. I have moved around the hospital until I found exactly what I was looking for. I moved from Oncology to Medical Day unit to chemo day treatment to anticoagulation and now I do cancer research. I don't expext you to know what all of those are, but you can see the diversity. I have only been an RN for 5 years. This industry changes so fast and just ask your fiancee...it changes in a shift. Encourage her to MOVE around the hospital or to find a new one until she loves to wake up in the morning (or night) and go to work. All the best for '06

[kathjo]

What a shame nursing takes so long to change. People over the years have put nurses down for going out on strike, but the fact of the matter is, that if we didn't, conditions would never change. I remember working in 1973 in a major hospital in San Francisco on the 3-11 shift on a GYN floor. Everyone called in sick, and it was just me & the nurse's aid. I had to take care of 30 patients and only had 1 nurses aid to help me with vitals. I quit about 1 month later & transferred to dialysis, where it was better staffed. I knew if I had stayed there, it would be a safety hazard in a matter of time. I mean, we're human. We can only do so much, and if we by chance make a mistake, our license is at risk. Once that's gone, you won't have a choice. Things have improved over the years, but it's taking a long time, and things are still not perfect. Tell your fiancee to get out of there as soon as she can. There are many other places who will appreciate her.

[AvondaleGrad]

What you are describing is exacting the same conditions I worked under. I have been an Oncology nurse for seven years. In my first few years of nursing I hated the conditions so much that I tried to find another career by going back to school. I ended up staying in nursing. I guess after a while you learn to adapt to the stress associated with nursing. The key to surviving it is having a healthy and full life outside of it.

In the last few years, I was the charge nurse on shift with 5 to 8 patients with 2 other RNs. Before that I worked the night shift with 17 patients and another RN with 16 patients a student nurse to help out. All the patients were Oncolgy patients.

Nursing burnout in Oncology is very high. Taking time out of the area is sometimes the best thing to do. Another area of nursing might give her the break she needs plus be invaluable to her career as a whole.

[SFCardiacRN]

Crappy manager, crappy job, move on. There IS better work out there.