A unit in trouble

[adrennen7]

First I want to give a little background...I changed careers at 37. I was a accountant then moved on to project management. I had a good good, with a good salary and nice perks. It was demanding and stressful at times which motivated me even more. I put 200% into any job I do. I am saying this because I know what it it like to work hard under pressure, multitask and work as part of a team. I decided to change careers because I wanted to put my energies into providing care for those in need. I love nursing, it is demanding, hard and stressful but at the end of the day very rewarding. Here is my issue...

I work in a small med surg unit with 14 beds. I will have one year as a working nurse in a few weeks. Yes I am a newbie. There are 4 RNs and 2 LPNs the staff the 7a tp 7p shift. Me and one other RN started the same day, the other two have worked together for over 25 years. Before I started the unit changed the hours for RNs. The RNs worked 8hr shifts, M-F, no weekends then were forced to work 12s and 1 week end every six weeks. The two RNs that were there are very resentful of this change and complain all the time that it is the "younger" nurses fault. This was the hospitals policy. This unit has had a high turn over, most nurses don't last 6 months before requesting a transfer or actually leave the hospital. The problem is that the 2 RNs and 1 LPN that have been in this unit are not kind to anyone outside their circle. This goes for me, the other new RN and anyone that is pulled to the unit. I was hoping to learn so much from these nurses, they have so much knowledge. I understand that they are not there to teach me but to do their job but I was hoping for more of a team atmosphere. The room assignments are made up by the seniors nurses (as it should be) but it is starting to get out of hand. From 7 to 3 staffing is 2RNs and 1 LPN no aide. At 3 the LPN leaves and we get an aide. If we are full, each RN gets 5 pts til 3 then go up to 7. Okay, not too bad. However when we are not full the assignments are not split accordingly. In the past few weeks are census was down, the assignments pretty much go like this - 7 pts (our max) go to whoever is there and the 2 senoirs get the rest, usually 2 or 3. I figured okay this is my rookie time so they are trying to teach me by fire, I'm okay with that. But this is done even to nurses pulled to the unit. No one is happy when they are pulled to our unit. These nurses very reluctantly will help anyone but they do help each other with call lights, pulling orders etc. Our satisfaction scores are down for the unit. Our nurse manager (who is wonderful) is trying to figure out why. I know why, there is no team spirit. I have tried to hang in there and learn how to work with these women. I am not a kid, I have worked with difficult people before. I have tried to talk to them but to no avail, they say "welcome to nursing". I have not said anything to the nurse manager because I was hoping to work this out and I don't want to sound like a whiner. And I don't want to request a transfer, I like my unit but we are in trouble.

Any ideas...

[OncallRN]

II think you need to tell the NM what the senior nursing are doing,

there is NO WAY 2-3 pt verse 7 pt is fair for any reason they are abusing their role and you adnthe other nurse

if they always got the one less pt, while not nice, it's not a huge deal

Ithinkthe NM need to know what up,

[TigerGalLE, BSN, RN]

Sounds like your NM needs to hire a designated charge nurse....

Also I think you need to stick up for yourself. I know that on my unit if someone had 3 patients and I had 7 then I would most definitely say something. Unless of course there was a reason they only had 3 (acuity wise or something).

Grow some skin girl and stick up for yourself. You can't let yourself get run over like this.

[morte, LPN, LVN]

presuming that unit assignments are kept, pull copies and give to your manager...

[luvRNs, BSN, MSN, RN]

This is lateral violence, and needs to be addressed by your nurse manager. This type of behavior creates an unhealthy work environment and ultimately has a negative impact on patient care. There was a recent link on the AllNurses site to an article in the New York times that adresses this. Good luck, and know that you are not alone!

[jlcole45]

Actually since the unit is so small the NM should be on the floor every day over seeing what is going on. I'm sorry but it appears that you don't have a good manager. I supervise the house on weekends and we have 9 bed icu, and a 24 bed med surg unit and I never have seen them dump on anyone the way you are being dumped. But when I am there I am PRESENT. I am constantly on the floor - answering questions and generally helping everyone out.

We do have one senior nurse who is one of our float nurses who can at times be more critical then helpful to the new nurses. She has gotten counseled for this behavior on her last eval by the unit manager. Though I have to admit if I were the manager I would be harder on her, because when you have a senior nurse who is basically withholding valuable information from the new nurses - she is essentially sabotaging the whole floor. In that case, I'd rather have all new nurse who actually are kind and supportive to each other.

I would suggest looking for another job - as long as those nurses are allowed to behave that way then you will not learn and your patients will suffer as a result. Go find someplace else where you are supported and mentored.

[HRM672]

I agree, your manager should already know what's going on. Surely she is on the floor enough to see how things are running, and at a minimum she reviews the assignment sheets?

[PostOpPrincess, BSN, RN]

Toxic, Toxic, Toxic, individuals.

They need to GO.

[sethmctenn]

Toxic, Toxic, Toxic, individuals.

They need to GO.

or be separated

[rngolfer53]

I have to ask just what is "wonderful" about your nurse manager?

Does she review Pt assignments? If so, why is she allowing the abusive burdening of one nurse while a couple others float thru their shifts?

You can't really require someone to consistently help out beyond their assigned Pts--they'll find excuses when they have the time to help--but at least starting the shift there should be some balancing of work load among nurses.

Seems to me the NM is overlooking part of her job, a very substantial part. Given the high turnover rate you refer to, lots of people must have the same idea.