This is a long vent/ any suggestions, comments, critics or plain snide remarks, let me have it...
I started in healthcare 13yrs ago as a CNA in LTC thought I could save the world, that is a good environment to appropriately downsize that dream!
Graduated w/ an LPN went to work in LTC learned great assessments and got tired of bad staffing, unrealistic expectations and all the backbiting.
Become an RN here we are 5+ yrs down the road and I am so burned out. I get great compliments from my managers, my pts and my co-workers, but I get so frustrated. I quit my staff job to leave behind the concept of unsupportive managers as it relates to new grads and lack of ongoing precepting. 6weeks of orientation and thats it, nursing does not have ongoing mentors for those abnormal crazy pts to help develop critiacal thinking skills problem solving skills and furthering interpersonal conflicts.
Doctors who think you are only taking care of their pt~ as if I only had one person to keep track of... the ones who call well you are doing a code brown clean up and wiping barrier cream on someone because the aid has 15rooms and is swamped to ask why/when there pt's gtt is hung, or the daily wt was taken from a pt admitted thru the ER on night shift only to find out they didnt take it and lets not mention it is bariatric pt who requires a lift to get out so the bed can be zeroed and then the pt can be weighed.
What about the code 90min before shift change so the orders are not doubly documented in the computer as "noted" there fore the night nurse refuses to take report since they are only noted in the chart.
I love the ones that noone is willing to adress, placement issue, code status, the best one to date, pt codes (thank god not mine) ACLS algorithm completed, pt has pulse, ET tube in, oh yeah thats right, pt has DNR on the books, but someone failed to check.. to many pts on nights, days didnt get the msg and pt's family ******.
I have worked M/S, CCU, ICU, LTAC rehab, ED, it is all the same, this society has sick people who have a diverse set of needs and I refuse to be a nurse who doesnt address the pt as a whole. It ****** me off to high heaven when providers dont address the anxiety/depression/family dynamics of the pt, Pt is anxious about family concerns--wow blood pressure is elevated, HR elevated, rather than give MSW a consult, w/ some antianxiety meds, no we increase her cardiac meds, cuz surely that will be her "acute need"! Like hell, acute need of the individual is all other components of his/her life outside the hospital... why is that so difficult to understand?
So over it, love the PCU stepdown units, they are the best, ICU acuity but oh ICU full so we will tx them to PCU w/ a 4:1 ratio and call it safe.
I used to think it is all about the pts, I have learned pt's dont keep the write ups down and keep my job safe. Nursing is a career like any other and it is sad but I feel it is all poltical and therein lies my rub.
People get hurt, meds get missed, bad things happen because there are too many pts, too many expectations and to much crap for one single person to keep track of
I'm in it for the long haul, I feel like nursing is what I was born to do career wise, but it takes an effort to keep up the smiles and the caring some days.
I will do whatever is in my power to be a patient advocate, even if it means fighting the family, docs, and management; but all that seems to get me is a reputation as a troublemaker. God forbid a bedside nurse speak up about what she/he feels is best for the patient, especially if it affects the bottom line in a negative way.
I feel blessed that I work with the people that I do. They are the only reason why I can muster up that smile and pleasant attitude some days. We don't have any truly incompetent nurses on my shift, and the techs (except for one, but I don't see her being there for long) are absolutely wonderful. I feel like we are a true example of teamwork in the hospital setting, and have to say that they are the reason I'm not more burnt out than I am.
The sad truth is that the ones that really care, are usually the ones that get burn-out anf leave the profession--thinning out the herd so to speak.... We get left with more nurses who don't care....
honest to God, i was just going to post this.
and the notion of being replaced by nurses who just don't care, is far scarier than the conditions that are making nurses leave in droves.
I will do whatever is in my power to be a patient advocate, even if it means fighting the family, docs, and management; but all that seems to get me is a reputation as a troublemaker. God forbid a bedside nurse speak up about what she/he feels is best for the patient, especially if it affects the bottom line in a negative way.
I feel blessed that I work with the people that I do. They are the only reason why I can muster up that smile and pleasant attitude some days. We don't have any truly incompetent nurses on my shift, and the techs (except for one, but I don't see her being there for long) are absolutely wonderful. I feel like we are a true example of teamwork in the hospital setting, and have to say that they are the reason I'm not more burnt out than I am.
the bolded statement, is very true yet disturbing.
they teach you in school all about pt advocacy.
yet when you stand up and protest, you suddenly become a target/scapegoat and possibly even be terminated.
bottom line to me is how my actions/inactions affect my ability to nurse with integrity.
once i begin to lose perspective of what's important, it's time to move on.
and yes mama, you are indeed extremely blessed to work with a real team of players.
After 4 years as an LPN, I have to say I have also dealt with all the OP stated. The result is I have stopped Nursing, I am currently taking courses in a program that is so totally different from Nursing. I just can't handle the politics & backbitting. So I'm outta here! To those of you who can stay, God Bless you all.
I have been denied promotions, tx, and other career growth steps b/c of my absolute determination to pt advocacy ahead of company propaganda. However the reputation of "trouble making" has been less than ideal. One think I remind myself of is that I have a stack of thank you cards from prior pts and families for being a pt's nurse first. But as I have said in other posts, that doesnt pay my mortgage!
I wish I could say something that would help. I was embarrassed and sad that after graduating in 2005 with a BSN (in a 16 month program designed for people with a bachelor's degree in another field) and spending a year on the floor of an average hospital. I felt so ineffective and devalued. I knew nursing wasn't the field it was when my mother was practicing, but the money was surely better, and I needed the ability to provide for my family when it became clear that my husband wasn't going to... And even my mom (who knew she wanted to be a nurse since age 5) says there's no way she'd do it today with the changes in the profession. So much multi tasking and so many sick patients... I have 2 bachelor's degrees and am making the same money as if I'd gotten an associate degree. (no offense to ADNs). After only my first year, I had come to the conclusion that the money is not worth it. (Can anyone say "engineering" or any field with that in it's name??) My license was on shaky ground when they give me 7-8 patients, because they can't find someone to cover a call in on nights, and the going over and above--like asking to get more experience by helping with procedures other nurses had, being a true team player, coming in OT and in snow storms because I lived close and the rural people had no access, and trying to keep costs down whenever possible, staying late to finish whatever hadn't been done I thought should have (I've since realized that we run a 24 hour hospital and the next nurse needs to take over where I left off just like I did for her...) while still giving excellent care, etc. My first evaluation mentioned nothing about any of my good qualities, and included a laundry list of issues: that I needed better organization (what new nurse doesn't?), and a bunch of other "input" from coworkers by email (which usually only amounted to complaints by others who only ever have something negative to say, because people who are happy with your work don't want to go out of their way to write info before your eval...) Heck, the wonderful nurse that trained me said nobody is ever organized enough, and that depending on the patients, 4 could put you in the weeds! And we all know the learning curve of a new nurse! Then seasoned nurses told me what a great job I did and that the evaluations always go that way because they tell the managers how to try to minimize raises by finding all that stuff. I would just have liked to hear something good about my work. It wasn't about the money...
I read how many people are getting out of nursing within 2 or 5 years! What an ordeal for only that long to earn and the student loans are immense. I think sometimes that trying to recruit students who want to change careers will not succeed simply because they are not used to being treated like children (did nurses of yesteryear really put up with some of this?) and have experienced other fields which would make them less likely to want to put up with some of the problems with out profession. I can't even be trusted with a saline syringe in my pocket and I have to charge $28 or something ridiculous to have one to use as multidose so I can have some handy to flush an occluded IV--instead of walking so far to get one and hope I don't lose the IV when everyone and their dog finds me in the hall looking like I have time for any and everyone's requests. Like "If You Give a Mouse a Cookie," they all need one more thing... I lose my IV and have to spend the next 4o minutes trying to get another one started or find someone else to try when I am not successful... Etc., etc. And I actually LOVE people and love helping people. But after a 12 hour shifts of demoralizing stress, I could hardly feel like any good was done. Just spinning my wheels. From what I remember in my research, nursing is fairly "inelastic" with regards to giving more money to get more of them (increased pay, etc.) It doesn't help. Some things people decide they won't do regardless of the money. (Prostitution comes to mind...)
You may have to find a different type of nursing to do. We have to advocate for each other to be healthy, and assertive. With the job market like it is, it's hard to want to "rock the boat."
Sorry. I unintentionally submitted my own rant. {{Supportive hugs your way...}}
mama_d, BSN, RN
1,187 Posts
I'm in it for the long haul, I feel like nursing is what I was born to do career wise, but it takes an effort to keep up the smiles and the caring some days.
I will do whatever is in my power to be a patient advocate, even if it means fighting the family, docs, and management; but all that seems to get me is a reputation as a troublemaker. God forbid a bedside nurse speak up about what she/he feels is best for the patient, especially if it affects the bottom line in a negative way.
I feel blessed that I work with the people that I do. They are the only reason why I can muster up that smile and pleasant attitude some days. We don't have any truly incompetent nurses on my shift, and the techs (except for one, but I don't see her being there for long) are absolutely wonderful. I feel like we are a true example of teamwork in the hospital setting, and have to say that they are the reason I'm not more burnt out than I am.