everyone is leaving my floor

[ivyfishbone]

I work at a large teaching hospital and everyone is leaving my floor, mostly because of my manager. No one likes the manager and we have lost most of our experienced people because of this. Basically my manager never leaves the office, and I mean never. I have never seen this person actually out on the floor. Now I am one of the people left to work with all new nurses that have been hired and the problem is I feel like everyone else. There is no team work on our floor and there hasn't been the whole year I have worked there (this is my first nursing job) everyone is very negative, the environment is very negative and I am miserable. I used to cry every time I had to go to work, for the first three months and now I am just angry and depressed. My training was horrible and my manager even said to me I wasn't trained properly when she was reprimanding me for a mistake I made, and I feel like the past month has been so bad because I made two mistakes where I didn't follow protocol which is another story (I wasn't being reckless just honestly forgot in one instance and thought I was doing the right thing in the other.) Now she wants to write me up which will stay on my record for a year and prevent me from transferring to another floor for six more months. I can't stop beating myself up for making these mistakes (no one was injured or anything) it's just I keep wondering if I am cut out for this. I did so well in school, but the real world is so different.So depressed and miserable not sure I can make it six more months. I am not sure what to do. Sometimes I wish I would not have gone to nursing school at all. Any ideas out there for someone feeling this way? maybe I should try another type of nursing? I work on a busy med/surg unit and our patients are so high acuity people have said its almost like step down.

[icuRNmaggie, BSN, RN]

You can apply for a transfer at most hospitals as long as you are not on probation. So you have until April to work on this.

You need some survival strategies to get through the next six months.

Decide who the sickest pt is, see him first.

Give meds when you do your assessment when possible. For example those hs doses of lipitor and protonix can be given at 8pm.

Despite what you may have been told, you are not there to provide customer satisfaction, you are there to provide pt care.

Nobody pt is going to die because you made them wait for jello or ice water.

Do not let family members run you ragged. Do NOT take "drink orders." That is absurd. Tell them refreshments are available in the cafeteria and vending machines.

You can only share information with the designated family contact refer everyone else to her. ( thank you HIPAA).

Find an experienced nurse to talk to when you are unsure how to handle a particular problem.

Forgive yourself for making those errors. Learn from it and put it behind you.

If you have to choose between pt care and a lot of extraneous documentation, choose pt care.

You can only do what you can do. You can not be perfect in every way when you work in a high acuity high ratio med surg unit and they know it.

If you kept everyone safe and stable and they received all of their medications, you did a good job.

If you have a crisis, go to your manager and let her know your ship is sinking and we need you out here now!

Watch Amy Cuddys TED talk about how your body language shapes who you are and feeling like an impostor. Do her exercise when you feel stressed.

It works.

When you clock out, and the door closes behind you, focus on anything but work. Go to the gym, walk the dog, read a book whatever. Do not let this crummy job bring you down anymore.

[icuRNmaggie, BSN, RN]

What was your favorite clinical experience in school?

Make transferring to that department your six month goal.

Earn a reputation for being positive, helpful and a good worker.

Stay far away from the negativity.

[ivyfishbone]

Thank you. It helps to hear some encouraging words. I watched the video and I think I will strike a pose before work tonight to empower myself! Also the advice on prioritizing is great because I need to get better at that. I am going to work on it tonight!

[ivyfishbone]

My favorite clinical rotation was the day I spent in the ED, but it was a small community hospital. The ED where I work now can get crazy since it's a level one trauma center so not sure about that. I thought I might like an ICU setting where you can focus on two patients and it seems a good opportunity to learn. There are so many options in nursing which is what is so nice about it but for a new person sometimes you don't know exactly where you fit. Thanks again : )

[icuRNmaggie, BSN, RN]

Just say "I made it through nursing school and I can make it through this."

There is no shame in preferring the work environment of a community hospital. Having worked both I can say that your knowledge base becomes very wide as compared to working in a specialized ICU. Many people transfer to icu because in general again you can do a really good job.

[firstinfamily, RN]

Even though the ICU nurse to patient ratio is more ideal you have to remember there is a reason the ratio is that way. First of all the patients are extremely ill and may have multiple IV infusions with various medications to help them stablize. Often the nurse has 3 or more patients, rarely 2. Usually there is an Intensivist available or on the unit writing new orders all the time, so you have to keep up with those as well. Maintaining the machines that are monitoring the patient has a part in critical care nursing also.

Getting through this rough time on your med/surg floor will prepare you a lot for what ever nursing holds in store for you. Sometimes you might be the most experienced nurse on the floor!! Learn from your mistakes, let your manager know you need support either from her or from your nurse educator. Become more familiar with the Nursing Policy and Procedure Manual---every floor should have their own copy(or on computer) and when ever you are unsure about something you should be able to find the procedure there. You should also have a shift supervisor who can be used as a resource person. The problem with management is that sometimes they are so tethered to the computer due to the amount of computer work they have to do!!!! They are unable to get out on the floor, however, your manager should be making an effort to be out on the floor throughout the day and she should be interacting with her staff on a daily basis to see what is going on. Management is about more than pointing fingers. Do you have a charge nurse for your shift?? This person should be your resource. For your benefit you should start keeping a record of the meetings you have with the manager and what is discussed, that way if you get called on something you can honestly say you had discussed it with him/her on such and such a day and this was the result etc. Even though some of the "new nurses" are new to the facility, if they have experience they can also be used for resources. It sounds like it has been awhile since this unit had some interventions for team building. It does take time to build a team and with the staff changing it may take awhile for it to actually feel like everyone is working together. Look at some team building exercises and see if the manager could institue those. Hang in there, learn from your mistakes and move on. Don't be afraid to speak up, ask questions, seek out your nurse educator. Good LUck!!

[Lennonninja, MSN, APRN, NP]

I could have written your post when I was a new nurse a little over 3 years ago, right down to crying daily for the first 3 months or so. Everyone was leaving my floor and my manager was doing everything possible to "trap" people there and now allow them to transfer. After my first six months (in which I seriously considered not being a nurse any longer) I started formulating my plan to escape. I got my ACLS (med surg nurses on my floor were not allowed to get paid for ACLS class so I did it all without pay) and started applying outside of the hospital system I worked for. I was lucky enoug to land an ICU spot about an hour away, and I've been there for almost 2.5 years and I love it. I'm so glad I didn't give up back then because I actually love my job now. Don't let a bad manager stand in your way. Formulate your escape plan and start working towards it and it will make your time there more tolerable.

[NickiLaughs, ADN, BSN, RN]

What everyone else said. ICU is definitely a good place to strive for. The things you learn there will help you anywhere. I did that for 3 years and it gave me a great foundation for ER.