Hi everyone I am really in the need for some guidance. I feel like my environment at my job is very unhealthy. I have been a nurse for a year and a half now. I work on a unit that is brand new. We all started out together and at first that formed a great deal of unity and comradery. Lately things have been falling to pieces and I blame it all on management. Everyone is complaining yet Noone is doing anything. I work on a sub acute rehab unit. Things were great there are 2 nurses 10 patients each and 1 nurse on weekdays who does admissions and discharges. The problem now lies with the ratio 10:1 is okay if the patients are stable; as they should be on a rehab unit.
But as the floor progressed that has changed. In order to fill beds we are now taking , or at least it seems, anyone. We have codes every other day and the patients are getting heavier and heavier. Confused, combative, incontinent, unable to feed themselves, going into hf, copd, cvas. Last week we had 2 strokes on our unit. It's getting overwhelming and everyone is getting stressed. No1 works as a team anymore. The aides never really did and I always blamed that on management. I was an aide prior foe 5 years and i would never have gotten away wirh theor attitudes or actions. They strole in late every day, ther are no where to be found, u ask them to do something and they do it 2 hours later and have an atitude.
But anyways that's just a bit of a backgroumd. My main issue that truly identified to me how severely poor the "team" was occurred when I had a severe allergic reaction at work where I broke out in hives all over my body and was as red as an apple. All my coworkers got mad and told me it's not a good day for this and u need to stay or at least til 5. 1 nurse continued on saying she had a cold but didn't call in because she knew it was a busy day and she had responsibilities. I ended up staying like that with my boss knowing this whole time until I finished all pf.my workload and documentation. All that was left were the 6 o'clock meds. When I left to to go to er they told me my throat was about to close up any second and they don't know why I didn't go anywhere earlier. No1 said feel better no1 supported me.
Then the next weekend I'm the charge nurse as well as having a section and the patient informs me he wants to kill himself. So I have a meeting and inform the aides that the patient needs to be placed on a 1:1 until I get a psych evaluation and they were in a uproar said it's impossible with all these patients and stormed off. I had to get a supervisor to explain to them and they even gave her an attitude. I then tell my boss all of this the following day I work during the week and she tells me that there is nothing she can do about it. That I should have wrote them up and told her the day of. If she spoke to them now they wou ld just deny it. Her advice to me was to start to write the staff members up. I then told her that this has been an ongoing issue and all the nurses discuss this and I'm surprised no1 had said anything to her.
I said I'm going to you because I don't want to be the bad guy and the ony 1 giving verbal warnings because I will not be respected and if the aides are against you they can totally sabotage your day. She said it's my job to be their boss not their friend. So that ended thay meeting. Now my weekend is screwed because there are usually 3 nurses on but 2 is fine. 1 nurse left about 4 months ago and now the other nurse is on maternity leave. So I am the only 1 scheduled. The boss had gotten coverage for most shift but now I find out that tomorrow no1 was ever scheduled and I am by myself with 20 patients and 2 aides and nobody else. 1 nurse is staying til 11 from the night shift. Otherwise I guess now good luck to me. I am just infuriated and had it. How does my boss go home and not care that no1 was scheduled. Our schedules are done 2 months in advance.
The night shifts are now scrambling to find someone. Again how is that their job. I just don't get it. Is this how it is on all units and is this the typical political bull u have to deal with in a workforce. I am a new nurse and never experienced anything like this. I dono know if I'm over reactiNg or not. I dont know what to do honestly. I am just getting more and more unappy at my job. Help please
Last edit by TheCommuter on May 1, '16
: Reason: re-formatting (paragraphs)
Apr 29, '16
Some issues you list in your post sound fairly common in nursing, but certainly not codes every other day?? Seriously...every other day?? I work in the hospital and we have had way less than 10 codes called in the past several years put together.
As for your coworkers not giving a crap about your allergic reaction, that is how it is sometimes. Especially in a workplace where everyone is stressed to the max.
Apr 30, '16
1 nurse to 10 patients some of which are unstable is not safe. 1 nurse to 20 patients is dangerous. Even sub-acute patients, this is stretching it.
CNA's with attitude is nothing new. And yes, you need to write them up. Because while you are getting lip, the 1:1 SI is hanging themselves from the call bell cord. And you need to be direct. "CNA ABC, you need to be 1:1 with the patient in 365. CNA XYZ, you will spot CNA ABC every hour for 10 minutes so that no one is left sitting for 12 hours". IF then you get lip, then you can give a verbal warning, and state that to refuse delegation is grounds for a write up, then follow through with it. But again, while all this is happening you have an active SI who is not being monitored.
This is a trying to do more with less situation. And is dangerous. So much so that I am not sure I would be in a place to want to stay. If you are union, speak to them. Fill out unsafe staffing reports
I think that when a unit is strictly sub acute that is one thing, but when admissions are being put in empty beds as opposed to the acuity and staffing of a unit, that is something else entirely.
Risk management is also a good reference. Joint commission is not always thrilled at 2 nurses are with 20 mixed acuity patients.
May 1, '16
I don't have any advice, just an empathetic ear. I too work sub-acute rehab, and in my year there, our load has gone from 13 ish patients to 17-18 WITH admits and hospital send outs.
I really shouldn't say this on here, but I will anyway. I'll leave out specific details.
One night I heard nurse to room 123 STAT overhead. I'll never be 100% sure, but I think this quite young relatively healthy patient died of a PE that would have been caught sooner if we weren't so short staffed. If she had only been checked on sooner....but I'm sure no one saw her for hours. I'm convinced the greed of my company killed a patient.
May 1, '16
The issues you have mentioned in your post are some of the very reasons I left the inpatient rehab nursing setting last year. It was a good run while it lasted, but my sanity and health needed to be preserved.
Sep 9, '16
Are you an RN or LPN? If you are an LPN jobs outside of LTC & Rehab are slim to none. If you are an RN, you now have close to 2 years experience & can probably transition to another area of nursing. If you do not have your BSN, start working on getting it. It will help open doors for you.
Look for a different job, especially if you are an RN. My per diem job has similar issues, although nothing to this degree and there's a reason I only work 2 shifts a month there (I was FT once). Biggest problem with rehab is they think they can give higher patient loads... but more and more seem to be acute care patients. Basically med-surg units are tired of them so they send them to rehab, but nothing has changed medically on them. So now we have 10 patients, when the med-surg have 6 of the same type of patients. It is so frustrating and unsafe. If management is the problem, it's hard for that to suddenly change and you need to protect yourself and license first and foremost. Start applying to other units or jobs ASAP.