I've been an RN for approximately 11 months and am not sure that I want to keep doing this. I'm a good nurse. My manager and coworkers keep telling me that I'm doing a great job. But the day to day stress of working a Med Surg floor is really getting to me.
The hospital where I work has increased the amount of documentation required for each patient several times since I was hired. Another new assessment was added just last week. What they don't seem to realize is that every extra form or documentation they require takes away more time from our patients. I feel guilty while I'm charting because it feels like I'm neglecting my patients. We are staffed by the numbers instead of acuity, and the assignments seem to be getting heavier all the time.
I feel like I'm always running behind. Our unit has become a revolving door lately. I can start with 7 patients, discharge or transfer 5 of them, and get 5 admits before I leave that night. I dread taking report from the night shift, because I know I'm going to keep hearing "Mr So-and-So is going home today" or "Mrs Whatsit is transferring to Rehab as soon as a room is ready, so get her paperwork done ASAP!" Every one of those admissions and discharges means more charting, more paperwork, and more time from patient care. Throw in a couple of patients on tube feeds, one in restraints, two that are MR with "sitters" at the bedside who do nothing, one who is about to die, and another who just arrived to the floor in respiratory distress-requiring a call to the Dr for orders to transfer to ICU-and you have my typical day. It's the same thing, with slight variations, every single shift lately. Oh, I forgot the direct admit who decided to show up at 1830, which means I have to do the admission assessment, several other extra assessments, call the Dr for orders, start the IV, insert the Foley, get their med list (and they have no idea what they take) faxed to pharmacy, print and check the MAR, give them the meds they should have already taken today, and then somehow manage to finish charting on all of my other patients and still get out on time. Yeah, right.
Most days, I drive home exhausted. I get home in time to eat my supper at 8:00 pm and then fall into bed around 9:00 so that I can get up at 0500 and start all over again. My days off are spent doing very little. I don't have the energy now to the things I love to do, let alone clean my house or cook a meal. I feel like I'm not really living. I'm surviving work and then merely existing the rest of the time.
Don't get me wrong. The people on my unit are fantastic. We all help each other, from the manager on down. I've figured out the doctors fairly well by now, so the stress of calling them has almost disappeared (there are one or two who are still tough to deal with, but that's life and I don't lose sleep over them). It's not the place where I work, it's just the nature of the job I guess. I've pretty much concluded that floor nursing is not conducive to a healthy lifestyle. I've had more IBS attacks recently than I did even in nursing school. I'm growing depressed and hopeless about my life. I'm not going to be able to do this kind of work long term.
So, I have some decisions to make. I'm working on my BSN so that I can go on to an MSN and possibly teach. (My nursing instructors always said I was a born teacher). Maybe I'll do home health or hospice for awhile (I know this may seem odd, but I enjoy caring for my terminal patients). I may look into massage therapy or aesthetician training, with the possibility of working in a wellness spa setting eventually. Maybe I'll go to work in a clinic. I don't know for certain where I'm supposed to end up, but I know it's not the hospital floor.
I'm hoping that life can be better than it is right now. I'd like to have the energy to enjoy my personal life again. I don't know if that's something that will come with more time, but I'm not really willing to stick around and find out. My one year commitment to this place is up in 2 months. After that, I'm a free agent.
May 15, '09
Indeed, it's rough out there-
You are experiencing the real reason for the so-called shortage- it's just too much work, too much stress, too much paperwork, and nurses are leaving.
Nursing itself is a revolving door.
Eager students desperate to get into a nursing program turn into bright-eyed new grads. Many of them evolve into tired nurses who don't have the time or energy for a life- and many get out.
Then, the media, and clueless hospital administrators, and out-of-touch educators start hollering "Nursing shortage! Tons of jobs! A great career! More nursing programs
And the cycle keeps going.
Last edit by Valerie Salva on May 16, '09
May 16, '09
I just find it all so absolutely and utterly ridiculous. Take intelligent people who work hard, strove hard to complete nursing school, are educated and probably among the cream of the crop in society and just BURN THEM OUT to a crisp.
Why all the paperwork?? We have DOUBLED the paperwork in just one year at our unit also. All to be JHACO compliant? I'm sorry -- which lawyers and administrators are responsible for this silliness??
You are not abnormal to be burnt out. I also feel this way after about 2 years now into it. I mean -- so tired on my days off I can hardly function. It's no way to live and whatever energy I have left I spend it searching for other options.
Why not hire specialists who could do the paperwork? I mean -- I know it's necessary, but nurses are being asked to do almost double duty at this point.
Personally, I feel its just the way they want it. Seems to me the the "cost" of constantly hiring new staff is spent on a position called "new hire coordinator" at our place. She is a nurse who spends her entire day creating more mounds of paperwork in training new grads, (and she seems incompetent to boot) while, in reality, its US NURSES who are precepting them FOR FREE. But there is a cost of what, $80 grand or so per year to retain this one New Hire Coordinator for each unit?? (Gosh, we already have four manager types on staff!) Why not just retain the nurses you have and fire the NHC? Why not just one or two NHC's per hospital and that's it?
Aren't there any more intelligent solutions to this craziness? How can they not realize what they're doing to nurses -- and to patients as a result?
May 16, '09
I am currently on a travel contract where the ratio is one nurse to 2 pts in a chronic hemodialysis setting. This is far fewer pts than I've ever had before, and I thought I would have sooo much time for pt care...Wrong.
There are five computer systems, and almost constant charting is required. No one is adequately trained on any of the systems- and all the systems are all different- some are Windows, some are DOS, one is Linux, and the others are hybrids. They are all so un-user friendly.
Just to give one single med requires documenting in five systems, plus documenting on a paper form, and in a paper med book, in the pt's paper chart, and in two places in their electronic chart.
The unit is newly remodeled and is very pretty, but is totally impractical, and majorly disrupts the work flow.
Even hanging a bag of NS requires going into a computer system and printing out a NS label- the bags come already labeled as NS, what is the deal?
I have only two pts at a time, and barely have time to look at them. It is rediculous.
May 17, '09
Nursing is in such a sad state.
I see people so excited and happy to receive their nursing acceptance letters and all I think is "you have no idea what your getting yourself into, go to college for something else!"
I figured it all out pretty fast and didn't want to waste my life being stressed and tired out so I left hospital nursing after a year and am now in a residential treatment center in psych.....it is a GREAT job, no stress at all, and I'm getting paid more to do it.
So ya, life is too short, find something else because it DOESN'T get better.
I'm planning on going back for my masters as well (FNP) either this year or next.
May 19, '09
[quote=Aren't there any more intelligent solutions to this craziness? How can they not realize what they're doing to nurses -- and to patients as a result?[/quote]
You make some very good points. However, I think that management and "the powers that be" know exactly what they're doing. From their point of view, why should they change? There are nursing schools e-v-e-r-y-where that are continuously pumping out new grads.
There are people who used to be maids, plumbers, electricians, factory workers, HR Reps, etc., who have now decided that they all want to be nurses. So, what do they do? They fill out their application to a nursing school, go to school for 1-4 years (depending on if they want to be a LVN/LPN, a RN with an ASN, or a RN with a BSN)
and then, voila! They're a nurse!
The powers that be don't have to change a thing...yes there are nurses that are going to vote with their feet and walk out, but there are just as many (if not more) people in nursing school to replace them.
As long as Nursing stays exactly the way it is now, the powers that be won't have to change a thing. We will continue to be their committed work horses.
May 19, '09
I don't see the problem as one of there being too many nursing schools or that too many people are allowed to apply to go to nursing school or that training is too short or too easy (compared to law school or med school). If there were fewer nursing graduates, employers would simply say that schools aren't providing enough new nurses or that no Americans want to be nurses so we need to hire from abroad.
The problem as I see it is not at all simple. Quality health care across the life span and through acute and chronic illnesses is expensive. Unless you live a charmed life and keel over quickly one day without fanfare, most of us will at some point incur substantial health care costs that we couldn't individually afford. If that many of us can't individually afford it and if so many of us WILL run up health care costs at some point, then how can we as a group better afford it? In other words, the pooled risk insurance model doesn't work when it's not IF but WHEN each subscriber will have large claims to make.
To improve nursing working conditions would require a combined approach of good pay ($$) and a reasonable workload (= more nurses = more salaries = more $$). Because of the sheer number of nursing hours a person can rack up if in need of nursing care, just paying the doctors or administrators less wouldn't balance out the costs of better staffing. There's simply no way that *everyone* can afford quality health care for *every* need while providing *every* nurse with good pay and a reasonable workload.
One way to keep nurses well-paid is to farm out as much nursing care to non-nurses - who can be paid less. Not exactly the solution nurses really want.
Sorry to sound so pessimistic! Hopefully our health policy experts out there have more ideas than I do!!
May 19, '09
MissninaRN, I have been working the same length of time you have been and feel exactly like you do. It is discouraging. I hate having so much paperwork and charting to "prove" that I am taking care of a patient when in fact that charting keeps me from taking decent care of my patients. My first year is up in a month, and even though there are parts of the job I love, I really think that working in a hospital makes for a very unhealthy lifestyle. The stress at work and the resulting inertia at home which keeps me from taking the time to cook and eat healthy (not to mention that fact that I am lucky at work to go to the bathroom once during a 12 hour shift) makes a lifestyle that I think will ruin me in no time. It's also horrible for my family life. I am either not home for my kids (12 hour shifts that are more frequently 14 hours leave me with NOTHING to give when I get home, and I often have to head straight to bed if I work the next day) or I am so exhausted when I am home that I do not keep up with basic stuff. I keep hearing from my manager and director what a great job I am doing, but I am already checking the internet for other job options. Ideally, I'd like to stay in my current job another year for the experience, but I am just not sure I will last. If nursing was what I thought it would be while I was in school (and hopelessy optimistic), it would be great. Right now, the system has to change somehow, or I cannot see doing bedside nursing in the long run. It's too bad because I think I am a very caring and competent nurse.
May 24, '09
I hear you. My hospital is making us do more charting too. Their reasoning? To streamline so you have less paper to do. I certainly don't know what planet they're on. I'm in oncology and have to chart every prn meds I give, in addition to charting pt's status every 2 hours. If anyone else is in oncology, you know how much pain/nausea medication we give. It's crazy.
I've been at nursing for about 1 1/2 and wonder if I made a wrong second career choice. Mind you I'm also half way through my NP program, starting clinical this fall. Maybe I just need to stick it out for another 2yrs while I'm finishing school. ARGGH!!!
May 24, '09
i've been an RN for 5 months and although it sucks, i'm glad you said a lot of the things i've been feeling so i know i'm not alone...
May 24, '09
I agree...life is too short to be this stressed...started first RN hospital job in Jan and now thinking about quitting to go to a less stressed environment...I do not think hospital nursing is right for me...AT ALL..
May 25, '09
you know i thought that the problem was me and that i wasnt doing enough to combat the stress that is floor nursing. the workload isnt just unbearable its unsafe and if laypersons really knew how unsafe no one would step foot in a hospital let alone camp out and get treated at one! its to the point where i do all the things you would tell your pts to do to combat stress and its NOT WORKING. the next step would be medication to deal. that is dysfunction to the n'th degree! it is a seriously unhealthy career hospital floor nursing. i wonder why it has been this way for so long?
i am planning on voting with my feet but the healthcare does not care about me. a nurse is a nurse too bad so sad. thats the feeling i get from mgmt. its sickening it really is.