Advice Needed on dealing with my Charge Nurse PLEASE!

[Italia13 RN]

Hey guys I need some advice. I am a new nurse who started in the ED. I am a couple weeks off orientation. We have permanent charge nurses where I work and it seems to me like every time I work they seem to slam me with patients when the other nurses have bed's available, not just mine. I feel like they have it out for me. I can have 5 rooms and everyone of them be full and some of the nurses are walking around doing nothing with their one patient while I am running around like a chicken with it's head cut off juggling 5.I am fine with handling 5 patients, but not when they are back to back rescues who need everything done to them and I am the only one getting them. I do not know how to handle this situation. I have been told by other nurses that things have been said in the past and management does nothing about it. So do I just take it as a hazing because I am a new young nurse, or stand up for myself and say something to the charge nurse about it, although I know if i say something the situation will prob get worse and I will for sure always get all the ridiculously hard patients. ANY ADVICE would be appreciated!!!!

[racing-mom4, BSN, RN]

I was a new grad in the ICU and my mgr was very upfront that I would be getting the sickest pts, the most demanding pts and the most patients as well as doing teles. I would have 3 pts and get the admit when my partner nurse had 1.

At least I knew it going into it so I did not take it personal. I am glad she did it to me as it taught me to how prioritize and multi task quickly!!!

In my opinion that is what this charge nurse is doing to you. Call it nurse version of tough love I suppose.

Good luck!!! Trust me things will get better and when *blank* hits the fan in the ER you will be ready.

My advice---just do the best you can do, ask for help when you need it, but take it on. They do not teach us enough in school or give us a long enough orientation period....so by taking on the most pts it is kind of thier way of preparing you for what is yet to come.

[RN1982]

Yeah thats how my NM was. She made me take two patients for the first few months off of orientation. I sneaked a single when I could but I really think it helped having two patients during orientation to help me prioritize and organize my shift.

[Magsulfate, BSN, RN]

Definatly ask for help if you feel that patient safety is at risk. Don't ever risk your license for a charge nurse, or ANYONE!! Don't ever risk patient safety because you feel like you need to prove something to someone.

[Dolce, RN]

Definatly ask for help if you feel that patient safety is at risk. Don't ever risk your license for a charge nurse, or ANYONE!! Don't ever risk patient safety because you feel like you need to prove something to someone.

I agree wholeheartedly. There is a lot to be said for learning from experience. This is what makes good nurses great. However, risking patient's lives just so that a nurse can get toughened up is not safe practice. Five patient's is too many for a new grad in the ED. Somebody is going to get hurt and it will be your license on the line. The physician's system recently had an entire overhaul of their work weeks and experienced doctors threw a fit that the new interns wouldn't get enough experience with ONLY 80 hours a week. However, studies had shown that the overtired, overstressed new interns were causing harm to patients. We need to really examine what is best for patients--not just what is a good experience for a new grad. Perhaps you could do some research to find studies on nurse/patient ratios in the ED and patient mortality rates. I wish I could offer more helpful advise, but I just don't know what to tell you except that I think that your hospital has a poor way of orienting new grads.

[tencat]

"Nursing tough love"? More like "Nursing setting up the newbie to fail and putting the patients at risk" to prove some point....I would NOT want to be the unfortunate patient that had to put up with that garbage. That kind of 'hazing' (and that is what it is) is not productive for anyone and downright dangerous for the patients. Not good practice.......sure you'd be ready to handle anything after that, but at what cost to the patients and your license? Playing Russian Roulette with a patient's life is really not acceptable to prove a point about being a 'tough' ER or ICU or Tele nurse.

[Italia13 RN]

So should I speak up and say something?? I just don't want to be "that new nurse" who everyone talks about who can't handle my own assignment and b*tches about things being unfair, especially when I am greener than grass! I jut say to myself that this is only happening because I am a new nurse and they want to make sure I can handle my own even when the sh*t hits the fan but then some days I feel like they just like seeing me run around like crazy and like making me feel and look stupid. I was on orientation for 6 months, but I still don't know EVERYTHING. I just don't know whether I should say something and risk this happening everytime I work or just take it as hazing when the charge nurse has her favorites on and wants me to bust my butt and them.... I HATE BEING NEW!

[morte, LPN, LVN]

perhaps a copy of the article about interns, with "this applies to nurses, too" written across the top, placed on her desk, would do the trick???

i understand you are running a fine line and i wish you luck

[tencat]

Yes, if you complain you will come off as being the whiner etc......that's the reality of it. Are you really one? No. But it could make your work life there pretty unbearable. If it were me, I might complain, see if anything gets better, and if not then look for other places that aren't as toxic, if you have the luxury of changing jobs during this economic melt down. Can you get another job somewhere else? Do you want another job somewhere else? There have to be places that are better environments than this place. If it's a Level I trauma center and you really want to work there, maybe getting experience in a less crazy ED might be helpful to you, then you could come back with more experience under your belt.

Sometimes it helps to stand up for yourself and say 'what are you thinking???? I don't know my behind from a hole in the ground, and you're saddling me with 5 high acuity patients?????' That way you are not whiney, but stating the truth of it, and placing the responsibility on her while acknowledging your lack of experience. I wouldn't worry too much about what the 'others' think......as long as you are doing your job and trying to do it to the best of your ability.....the others can think whatever they want to......just a thought.

[gonzo1, ASN, RN]

It is a shame that your first job is in such a toxic environment. There are a lot of places like this. The good news is most patients aren't particularly sick, from my experience. But if you think you have a sick one you need to speak up and let your charge know that you need help.

I would just keep plugging along as best you can, but when you get that bad one you will have to sacrifice your pride and demand help so your patient doesn't suffer

The other good news is that before long there will be people newer than you and you can befriend them and hellp them and before long you will have lots of people in your corner

I have seen this scenario played out many times.

Good luck and keep on truckin

[sunray12]

yes, if you complain you will come off as being the whiner etc......that's the reality of it. are you really one? no. but it could make your work life there pretty unbearable. if it were me, i might complain, see if anything gets better, and if not then look for other places that aren't as toxic, if you have the luxury of changing jobs during this economic melt down. can you get another job somewhere else? do you want another job somewhere else? there have to be places that are better environments than this place. if it's a level i trauma center and you really want to work there, maybe getting experience in a less crazy ed might be helpful to you, then you could come back with more experience under your belt.

sometimes it helps to stand up for yourself and say 'what are you thinking???? i don't know my behind from a hole in the ground, and you're saddling me with 5 high acuity patients?????' that way you are not whiney, but stating the truth of it, and placing the responsibility on her while acknowledging your lack of experience. i wouldn't worry too much about what the 'others' think......as long as you are doing your job and trying to do it to the best of your ability.....the others can think whatever they want to......just a thought.

well the thing is that op says she completed a 6 month fellowship so hopefully she knows a little something. anyway i think her issue is the patient overload while others on the floor are doing much less. not that she doesn't know her job.

[pink85]

I would start off by asking how they assign patients. Ask if they have a policy on assigning new incoming patients to nurses. If they ask why you want to know I would just tell them you were asking because you noticed that you tend to get a full load of patients while others do not and you were wondering their rationale behind it. Then the conversation can go from there. Also, according to their answer, you will know what their motive is and if it is a place you want to stay employed.