Disheartened at work

[Ellekat]

How do you deal with changes in your job? I have become very disheartened in the last month. On top of caring for a diverse population of patients (peds, ortho, surgical) we have been given a very user-unfriendly computer system to work with that we are supposed to know with no training. We are expected to help answer the phone, input our own orders (including meds) into the computer system, and work with a pharmacy that is usually 2-3 hours behind on filling orders. We are of course expected to care for, assess, and respond to patient and family needs. Now, along with the long admission form that takes about 2 hours to complete on each admission, we are expected to reconcile reported medications from admission and to update and print a discharge list of medications-sometimes thirty or forty medications long-and about half our computers aren't tied to the printer. I work 12-hour shifts, usually with no breaks other than 10-15 minutes for lunch, and I just can't get it all done. Plus they've developed a "team leader" approach designed to make a nurse with a full load of patients also be responsible for the work of other RN's on the floor with no additional compensation. If we complain, our director laughs and tells us to find another job. We are not allowed to take vacation on our weekend to work and are expected to work at least one weekend day and one day a week beyond our scheduled time. I am exhausted and my off-work life has been destroyed by the lack of routine and scheduling. Is this happening everywhere, or it is just this facility? I don't want to change jobs and drive 40 miles each way just to be treated the same way I am here. I have always gotten good evaluations and don't feel they are out to get me personally, although I do believe they are trying to eliminated older (I'm 55) workers for reasons I won't go into here.

[guest64485]

Sorry Ellekat, I don't have a whole lot of encouragement for you as I've found it to be the same way. Hospitals seem to treat their med surg nurses very poorly, and both nurse and patient suffers from it. It can truly be dangerous for the patient at times. I know there are those rare good floors out there, but it seems like more often than not med surg floors are rough wherever you go. I don't know the answer besides getting a non-floor job or possibly icu(I only base this on the fact that I had a friend in icu who said she was always appropriately staffed, and almost always got out on time)?

[iluvivt, BSN, RN]

Although I am an IV nurse I have to say it sounds just like my place of employment. Medication reconciliation is one The Joint Commission (TJC) National Patient Safety Goals. The hospital has to implement a strategy to get it accomplished if they want the accreditation. I too have been practicing a long time ( 28yrs) so I can tell you that as you get used to new policies,computer systems, and work restructuring strategies it will get easier. Almost every day I work our team has much more work than we can get done. I can not seem to change that no matter how much I or our team complain BUT I do have a say in how I respond to to it. I realized that if I let it get to me that I was paying a high price and was stressed in trying to please everyone. So now I tell myself..I will always do my best BUT I can only accomplish a certain amount of work and I will control how I respond and organize my workload. Believe me, I understand everything falls on the nurse and they keep adding more without increasing staff.....BUT you have to find a way to organize it all and focus on priorities. So make yourself a priority as well..do what it takes...space your days out..take your breaks...bring protein bars....figure out what gets you derailed and fix it.....take the computer on-line course if you have one (I bet you do)...I am certain you can think of may more things...stay positive you can do it!!!!!

[Ellekat]

Thank you; it is good to hear that it is not just me. No computer on-line course (no computer training beyond a two-hour course six months before we got the system). But you're right-I need to just realize I can't get it all done. What's sad is that I see newer nurses coping by cutting the patient care. Since we often have two aides on days for 24-28 patients, it makes it really difficult and the full-time aides are starting to quit. They are being replaced by twenty-somethings who work PRN 2-3 days a week and who want to watch procedures (IV starts, Foley insertions, spinal taps, etc) rather than do their job. They roll their eyes when some of the needier patients put on their light and want help with everything they do-I know it's because they need reassurance, but I just can't do it all anymore.

[abundantjoy07, RN]

As a med-surg nurse I have to say...it's a jungle out there. It's like eat or be eaten, sink or swim. All I can say is consider changing your specialty. I am currently in the process of re-evaluation myself.

[Ellekat]

Thank you, abundantjoy07. I think it's the same throughout our hospital except in ICU. I just need to start looking at other facilities-and a new specialty.