Dysfunctional Unit or Thin-skinned nurse?

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There seems to be chronic short-staffing, and even though I work the evening shift, I've been called to work days and nights, and I've frequently worked on what should have been my day off. This seems to be "expected" and little comments about not being a "team player" are made whenever someone doesn't work extra.

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This sounds very dysfunctional for any unit. If your manager has to "fill in" due to shortages, then he/she is aware of the staffing situations.

Please do let them pull that "team player" doo-doo on you. If you do not want to work extra hours or on your day off, then don't do it. You are not responsible for staffing issues, your hospital management/admin. is.

The "team player" c*** is a way to manipulate you. Being a team player works both ways. If the hospital had your best interest, then they would make sure that your unit is well staffed. If they don't have enough staff, then hiring nurses from agencies is always an option. Their not doing this and instead, prefer to have fatigued and burnt out staff working for them. This says a lot.

Hello every one! I'm a long-time-reader/rare-poster, and I'd like to thank you for all I've learned from you. Could I ask for a little more help?

I'm a new RN. I've been working at my current position for nearly 5 months, and I need to know if my unit is "the problem" or if I am....(especially after the "meltdown" I had last week at work"). I'm currently working in the mother/baby unit, but we also have the occasional ante-partum patients, and gyn surgical patients.

There seems to be chronic short-staffing, and even though I work the evening shift, I've been called to work days and nights, and I've frequently worked on what should have been my day off. This seems to be "expected" and little comments about not being a "team player" are made whenever someone doesn't work extra.

After a run of several especially busy evenings where I had 10-12 patients (a couple of those being new admitts with no unit seceratary or PCA to assist), I told my manager that I was concerned, as a new grad, that I was "over my head" on nights and requested a move to days where there is a smaller patient ratio, a secretary and a couple of PCAs. This was 2 weeks ago, and she still has not adjusted my schedule. Wait - let me correct that - she had me come in and work a couple of DAY shifts when they were short-staffed, but told be I would need to work "at least" another week on nights.

This unit seems especially chaotic with tons of new admits - one night I had 4 new admits within a 4 hour time-period -- 2 of them c-sections! (that shift I had 15 patients) Is this the nature of OB? Or it this unit dysfunctional?

It's gotten to the point that I dread going to work, and I fantasize about calling in sick and never returning. If I do decide to quit this job, will the short amount of time be viewed unfavorably against me by a future employer? Any advice will be accepted gratefully.

Thanks in advance!

You are dreading going to work because you have somehow stepped into a nightmare.

I'm not a new grad but I started on a postpartum unit back in June. We have our busy nights and, yes, we have had some mandated overtime but nothing like what you're experiencing.

Our typical patient load is 4 mother/baby couples and, on a hectic night, one admission. We have 2 PCAs and a HUC besides. The charge nurses try to balance patient care loads so that no one is stuck with all fresh sections. When we have babies in the nursery, the PCAs will help with them if we are busy. So will other nurses when they have some down time.

We all pitch in and try to balance each other's workload. The noc shift staff is really great that way. Besides the general kindness, the more experienced nurses are always asking me and the other newbie on nights if we're doing all right and if there's anything we don't understand or tasks we need help with. Honestly, this is the nicest bunch of nurses I've ever worked with.

My hospital, BTW, is a large urban facility that does 400+ deliveries a month. We get moms from all over the state with just about any kind of complication you can think of. The really sick moms go to antepartum after delivery, but we take care of a fair number that have had things like uterine rupture, pp hemhorrage, PIH follow-up, etc. Typically, a nurse would have only one of these more serious patients in her group.

If I had to deal with the circumstances you are battling, I would sooo be looking for another postion. Seriously, prolonged exposure to this kind of over-scheduling and over-loading will put you on the fast track for burn-out and depression. It would be different if this were a short-term situation and you had all agreed to pitch in for a couple of weeks. But if this is the status quo for the foreseeable future and you're all being forced to put up and shut up, I'd be making tracks to a unit that wouldn't put my license in jeopardy and make me crazy along the way.

Postpartum should be a really positive unit with many happy experiences. Of course there are sad outcomes and snarky patients now and then, but, for the most part, taking care of well moms and well babies should be a great job. You need to find a place that isn't going to suck the life out of you.

Take good care of yourself (during your spare time!),

I work L&D and postpartum. And I have to say...IT IS NOT YOU! It is the unit. Are you providing couplet care or are you providing care for just the moms?? In any case, taking care of 15 patients is exceeding the standard of care as outlined by AWHONN.

I'd consider taking your 5 months of experience and start looking elsewhere.

Best wishes to you and keep us posted. :icon_hug:

I'm a new RN. I've been working at my current position for nearly 5 months, and I need to know if my unit is "the problem" or if I am....(especially after the "meltdown" I had last week at work"). I'm currently working in the mother/baby unit, but we also have the occasional ante-partum patients, and gyn surgical patients.

There seems to be chronic short-staffing, and even though I work the evening shift, I've been called to work days and nights, and I've frequently worked on what should have been my day off. This seems to be "expected" and little comments about not being a "team player" are made whenever someone doesn't work extra.

After a run of several especially busy evenings where I had 10-12 patients (a couple of those being new admitts with no unit seceratary or PCA to assist), I told my manager that I was concerned, as a new grad, that I was "over my head" on nights and requested a move to days where there is a smaller patient ratio, a secretary and a couple of PCAs. This was 2 weeks ago, and she still has not adjusted my schedule. Wait - let me correct that - she had me come in and work a couple of DAY shifts when they were short-staffed, but told be I would need to work "at least" another week on nights.

This unit seems especially chaotic with tons of new admits - one night I had 4 new admits within a 4 hour time-period -- 2 of them c-sections! (that shift I had 15 patients) Is this the nature of OB? Or it this unit dysfunctional?

It's gotten to the point that I dread going to work, and I fantasize about calling in sick and never returning. If I do decide to quit this job, will the short amount of time be viewed unfavorably against me by a future employer? Any advice will be accepted gratefully.

Thanks in advance!

Sounds like the hospital to me!! If I were you and I had only been there 5 months I would definately not be ready for 12-15 pts on any unit, OB or else where!! I wouldn't be ready for that kind of pt load if I had been there 20 years either. This is very unsafe staffing pt/nurse ratios. You worked very hard for your license and if I were you, I would be running out the door. When asked by the next hosp., I would explain to them that it was unsafe for the pt as well as your level of "real" knowledge for the length of time that you have had your license to have that kind of load.

Your days off are just that!! Take em and ignore the other comments, you can't help it that your a tad bit smarter than them and don't give in to management b/c if you do it once, they will continue to expect it and pretty soon you won't have days off!!

Hope you get outta there soon!!

NO! Thankfully, not every OB unit is like this. You are not being oriented, you are being taken-advantage-of. Get out of there ASAP! In circumstances like this, your license is in jeopardy every time you go to work. You and your patients deserve better.

you are dreading going to work because you have somehow stepped into a nightmare.

i'm not a new grad but i started on a postpartum unit back in june. we have our busy nights and, yes, we have had some mandated overtime but nothing like what you're experiencing.

our typical patient load is 4 mother/baby couples and, on a hectic night, one admission. we have 2 pcas and a huc besides. ......,

sounds like i need to work where you work :)

thanks for your perspective on my situation. a more experienced nurse that i work with had told me that our unit was so crazy because "that's the nature of ob nursing" and that i'd find a similar situation no matter what hospital i went to. i'm glad to hear that that is not the case at all hospitals. i love bedside nursing and didn't want to move to a dr. office, but wanted to make sure that i wasn't jumping from the frying pan to the fire.

no! thankfully, not every ob unit is like this. you are not being oriented, you are being taken-advantage-of. get out of there asap! in circumstances like this, your license is in jeopardy every time you go to work. you and your patients deserve better.

i've been off orientation for about 7 weeks now....not every shift is so overstaffed - on occasion i've actually had 4 couplets, but probably 75 % of the time we have above that. but the situation worried me enough that i've spoken to both my preceptor and my unit director about my feeling unsafe as a new grad, but to date, nothing has changed. thanks for letting me know that i wasn't a wimpy nurse.

(one of my co-workers actually gave me a little lecture about how nursing schools were turning out "spoiled" nurses who think that they'll never have more than 6-8 patients. she told me to "get with it, honey - this is real nursing, not some text-book bs they feed you all...." )

thanks everyone for your replies and your support!

i can't begin to tell you how much i appreciate your input. it has truly touched me to know that there are nurses out there who care enough to give advice to a stranger. all of what you've told me i already new in my heart and head, but it gives me strength to have it confirmed by "outside sources"

i have a meeting with my pcd before my shift tomorrow. she wants to discuss "the situation that occured on thursday" (me sobbing in the break room). i can't think of anything she will tell me that will prevent me from turning in my resignation.

i work l&d and postpartum. and i have to say...it is not you! it is the unit. are you providing couplet care or are you providing care for just the moms?? in any case, taking care of 15 patients is exceeding the standard of care as outlined by awhonn.

i'd consider taking your 5 months of experience and start looking elsewhere.

best wishes to you and keep us posted. :icon_hug:

thanks for the hug i can sure use one!

we are providing couplet care for the most part, but we occasionally have ante-partum patients and gyn surgeries

i've checked the awhonn site, but can't seem to locate the staffing ratios you reference. what is considered a safe ratio for postpartum couplet care?

I think that the only way that they are going to take you seriously is if you give your notice. I think that this is a totally dysfunctional unit and if you don't take a change, you'll only burn out or worse possibly lose your license.

I just say RUN!

My experience on pp/mother/baby unit is 4 to 5 couplets on average. Have had more on short staffed days. Admissions are split between the nurses usually decided on who has the least pts at the time. I could have a day handling 4 c-sections admissions one after another, but this would not be the usual or the norm.

Take care of yourself first, then take care of your professional self. If you feel your license is in jepardoy by unsafe pt. ratio and providing safe care, you must leave the facility. If you are not getting support by management and fellow staff, may be time to consider leaving. You deserve to work in a supportative atmosphere.

Where do you think about going? Any positions at other hospitals that seem interesting to you? Let us know the outcome.

Our PP unit does not do couplet care. They take gyn surgeries and stable antepartum (uti's etc...) They have 15 bed and are staffed with and RN and an LPN... day shift and census over 12 gets a CNA... no unit secretary.

Staffing guidelines are from ACOG/AAP. I believe 4-5 couplets is what is recommended.