Am I burnt out? Or, are my coworkers making me bitter?

[Aloe_sky]

I'm at a new hospital, I love bedside nursing but we are always understaffed, 3 patients in the ICU is the norm which I really hate!! I still don't dread going into work yet, in fact I pick up extra shifts EVERY week. 

I use to be a helpful nurse but I don't offer any help at all at this hospital. I will however always assist in an emergency situation, that's when I get VERY assertive.

Here's the issue, I am the most experienced nurse on the unit and on nights, all of the nurses only have 2 years max experience but talk as if they know EVERYTHING!! They talk down on nurses that just got off orientation, they talk down on newer nurses that don't know how to ex. Set up an EVD. They will smile, laugh and talk bad about the same nurse they go out with and call "bestie", this is every shift, It's annoying and draining. 

I don't talk to majority of them, not even hi. I've worked a handful of hospitals and this is by far the WORST when it comes to lateral violence and bullying. 

My old manager flat out warned me they are all know it alls that think they are better then everyone. She wasn't the manager for long unfortunately, only lasted a few months.

There's no thought process when they are making assignments, literally they rock, paper, scissors who will admit. No taking into account patient acuity. The nurse that gets floated to another unit depends on who they don't like rather then a pull list. 

And is this a new thing to trendelenburg a patient in septic shock?!?!? I walk in the room and see intubated patients in trendelenburg and ask why the patient are in that position?They act as if because their blood pressure is low is the answer. I ask why not titrate the pressor up? I don't get it. I had a patient that became obtunded, Map dropped to 50 and the "resource nurse" on the unit put my patient in trendelenburg when I started the levo and acted like it was the position that raised the blood pressure, he started to brag about it on my unit as if I didn't know what to do! I was so irritated he did that and just elevated the patients HOB up. 

I had a patient with a large stoma from a lary tube that came back from OR where they placed a trach to put him on a vent, A&O x4 on cpap, doing his crossword puzzles and as I was assessing him, the "resource nurse" came in took an obturator and TRIED to shove it into my patients inner cannula because it "looked like it was out".  I was very mad and irritated.

I had a patient that was in Afib with RVR and was hypotensive, now if I need help I will ask for help but I absolutely don't need help with most tasks! I got the crash cart and put it next to my patients room, put the monitor bedside and was placing the pads on the patient to cardiovert when the "resource nurse" came out of nowhere and asked if I was cardioverting the patient, theDr said yes and he just grabbed the machine. Didn't ask if I needed help, just yelled clear after I put the pads on and cardioverted my patient at 200J!! Then told everyone how he had to shock my patient. 

They just think they know everything and over step their boundaries. 

If I can't find a policy on something, I will ask them about it, they will give an opinion when I really don't care about their opinion. I'm asking about a policy and how/where to find it. 

There's an aide on the unit that's just sitting there but it takes 3 nurses to give a bed bath to a patient. They don't know how to utilize the staff or time. Maybe it's their bonding moment and I honestly don't care but they complain the aide "just sits there" or they will complain they are behind when they could have told the nurse to call them only when they are ready to turn the patient or to ask the aide to help instead.

3 ICU patients is a lot of work, most of the day shift nurses noticed that I always get 3 patients out of the rest of the staff (10bed ICU that should have 5 nurses, only runs with 4 so 2 nurses will be tripled). I don't complain, do my work and go home even though I am highly annoyed.

We once were "lucky" to have a nurse stay over to "help out", she quickly gave up her patients to triple me and another nurse. While she sat on the unit with no patients, refused to take patients to MRI or CT because she "didn't feel comfortable" since she's "not familiar with these patients", has the aide go pick up her food from the ED and refused to give baths because she's "not an aide". Nobody had an issue with this but I WAS BEYOND MAD!! I had 3 patients, 2 were q1 neuro checks and 1 had an MRI that I was gone for 2 hours and had to catch up on meds and charting. 

I really don't like doing unnecessary extra work. Nurses don't ask me to get anything for them but they will have other nurses running around the unit all shift. Standing in a patients room that is not in isolation to get them CHG wipes or a towel. When it probably would have taken them less time to get it themselves.

I think it's inconsiderate to have other nurses constantly getting items for them, while they just stand there waiting for things to be handed to them constantly. 

I know I'm not a team player, I feel they need to bring their issues to management and their staffing ratios, my focus is always on my patients and my tasks. I also really don't like the nurses attitudes on my unit.

Maybe I'm burnt out and bitter. 

[CrunchRN, ADN, RN]

I am not an ICU nurse, but everything you say sounds more like a poor work environment and people with less experience and knowledge than they think running the show.

[RNperdiem, RN]

Please start looking for another job ASAP. This job sounds like it has no redeeming features. The longer you stay, the more damage it will do. 

One or two issues you can handle short-term, but inexperience + understaffing+ toxic work culture + ineffective management + lack of support will destroy your mental health. Something terrible is likely to happen on one of your patients due to the poor work conditions, and you will have to live with that. 

Workplaces where people support each other exist, and you deserve better. 

[MaxAttack, BSN, RN]

Why would you possibly stay there? This place sounds super toxic.

[Queen Tiye, RN]

It sounds like this is the culture on this unit and you won't be able to change it unless you are interested in becoming the unit manager and hiring new people. Another option is to leave.

[JBMmom, MSN, NP]

Clearly you have a reason for being at that hospital, otherwise you already would have moved on with that environment. It sounds like you are making the best of the situation by not engaging as much as possible. I would also be livid if people starting intervening on my patients without my request. 

I suppose that Trendelenburg is one way to raise blood pressure, but it's going to be a transient help and with intubated patients you're directly going against VAP prevention guidelines and increasing aspiration risk. Your coworkers are clearly in the "a little knowledge is dangerous" phase. They're likely scared and to cover it up they act over confident and put other people down. 

For whatever it's worth if you can move on it will probably be better for your mental health. But if you have enough reasons to stay, keeping your head down sounds like the best way to go. Good luck. 

[JKL33]

Aloe_sky said:

Maybe I'm burnt out and bitter.

 

In my opinion your mode of functioning is just fine under the circumstances. Thoughts I think will help you:

1. You say you're not a team player. Maybe that doesn't mean what you think it means (or what management wishes you would think it means). Those who are not team players rarely take care of their own portion the way you are doing. After all, if everyone just took good care of their own portion, you'd have a pretty high functioning "team" at baseline! What management wants from conscientious hard workers is for them to take great care of their own portion and to flit about picking up everyone else's slack, too. That's a fantasy. Don't emotionally buy into the idea that you aren't a good team player if you are "only" doing your very best with the portion on your plate.

2. Whether you are burnt out and bitter is a matter of the way you feel about or react to your situation. I'm not criticizing those who feel bitter--I've been there. But, having made it through to the other side I can see that I could have done things differently and felt better much sooner.  It boils down to this: Either decide not to feel bitter (change one's internal dialog about the situation) or make a situational change that will lessen your need to constantly fight against internal bitterness.

Change yourself, or change the situation in which you find yourself.

(Both are often necessary!)

Hang in there ~ ??

 

[Nurse Beth, MSN]

This is an awful situation. They have no regard for evidence-based nursing practice and worse, no intellectual curiosity.

When you work in a unit where the bar is low, you either stay low-level angry all the time or sink to the norm.

Or get out.

[Aloe_sky]

RNperdiem said:

Please start looking for another job ASAP. This job sounds like it has no redeeming features. The longer you stay, the more damage it will do. 

One or two issues you can handle short-term, but inexperience + understaffing+ toxic work culture + ineffective management + lack of support will destroy your mental health. Something terrible is likely to happen on one of your patients due to the poor work conditions, and you will have to live with that. 

Workplaces where people support each other exist, and you deserve better. 

I agree, I also feel bad for the patients. These nurses are new and I may come off stand offish so they don't ask me questions. The sad part is, they wait till day shift comes in to ask questions when I could have answered it. Although they really should know by now to ask the Physician if they are unsure! 

[Aloe_sky]

Queen Tiye said:

It sounds like this is the culture on this unit and you won't be able to change it unless you are interested in becoming the unit manager and hiring new people. Another option is to leave.

You're right, they hired a new "charge nurse" last night was her first night. She's been a nurse a little over 1.5 years. It was my third shift in a row and I came back to a new assignment, I asked why? Her response..... she wanted the patients I had because she's familiar with them. I was BEYOND mad! I get it sometimes assignments have to be changed but not for silly reasons! We have a new manager that started this month, will see how it goes. 

[Aloe_sky]

JBMmom said:

Clearly you have a reason for being at that hospital, otherwise you already would have moved on with that environment. It sounds like you are making the best of the situation by not engaging as much as possible. I would also be livid if people starting intervening on my patients without my request. 

I suppose that Trendelenburg is one way to raise blood pressure, but it's going to be a transient help and with intubated patients you're directly going against VAP prevention guidelines and increasing aspiration risk. Your coworkers are clearly in the "a little knowledge is dangerous" phase. They're likely scared and to cover it up they act over confident and put other people down. 

For whatever it's worth if you can move on it will probably be better for your mental health. But if you have enough reasons to stay, keeping your head down sounds like the best way to go. Good luck. 

Thanks, I actually sold my soul for my daughter's tuition to be covered by the hospital haha. 

[Aloe_sky]

JKL33 said:

In my opinion your mode of functioning is just fine under the circumstances. Thoughts I think will help you:

1. You say you're not a team player. Maybe that doesn't mean what you think it means (or what management wishes you would think it means). Those who are not team players rarely take care of their own portion the way you are doing. After all, if everyone just took good care of their own portion, you'd have a pretty high functioning "team" at baseline! What management wants from conscientious hard workers is for them to take great care of their own portion and to flit about picking up everyone else's slack, too. That's a fantasy. Don't emotionally buy into the idea that you aren't a good team player if you are "only" doing your very best with the portion on your plate.

2. Whether you are burnt out and bitter is a matter of the way you feel about or react to your situation. I'm not criticizing those who feel bitter--I've been there. But, having made it through to the other side I can see that I could have done things differently and felt better much sooner.  It boils down to this: Either decide not to feel bitter (change one's internal dialog about the situation) or make a situational change that will lessen your need to constantly fight against internal bitterness.

Change yourself, or change the situation in which you find yourself.

(Both are often necessary!)

Hang in there ~ ??

 

I completely agree!