Pt Load & New Grad Burnout

  1. Hello all. I graduated last May and work as an RN on both the m/s and the tele floor. I work part time, 3 days per week, 3-11. I am experiencing tremendous regret feelings for having become a nurse. I went from first feeling the whole 'new grad anxiety jitters' to now (though I still feel anxiety at times of course) the feeling I mostly have is dread.

    Right now, my hospital is really understaffed and it is also the busiest it has been in a while. On my 3-11 shift (which is a very med-heavy, admission heavy, busy shift) we have 9-11 patients each. To me, this is a pretty absurd patient load. I feel like I am totally shafting my patients in terms of giving quality care and attention. But there is really not much I can do about it seeing I have up to 11 people to care for and do everything for within an 8 hour shift. I feel like it is such an injustice to them. And in terms of myself, feeling like that and being so overworked... not being able to take a break and having to stay 1 to 2 hours extra every night to's really draining me emotionally and physically. I am only part time...I can't even begin to imagine how the full-timers must be feeling!! I've noticed more mistakes are being made, details unattended to, documentations lacking, all because we have so many patients (day shift has been having 7-9). People say the busyness at a hospital is like a roller coaster (up and down), but we are starting to wonder...will it ever come down again?! We are becoming so tired and aggravated (that's an understatement) with the situation. People are calling in sick more and more(can you blame them???) but then the rest of us are even more short handed.

    I'm not sure what I'm trying to get at here other than venting a bit and looking for some support. Is anyone else dealing with this right now? I wish I could like my job and not absolutely dread going there. I wish I could feel like I am making a positive difference, but I honestly just feel like I can't give quality patient care with such a heavy load and it's really burning me out . I'm not sure if I would dislike the career in any situation or if it's this situation that's ruining it for me. I want to stick it out for a while here, and I know from personal experience that the grass isn't always greener.
    Any suggestions? Or uplifting motivational speeches? hehe. Thanks so much for listening
    Last edit by naptimeRN on Mar 19, '13
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    About naptimeRN

    Joined: Mar '10; Posts: 162; Likes: 151
    RN; from US
    Specialty: Med-Surg, Tele, Urology


  3. by   eatmysoxRN
    Sounds absolutely dreadful and simultaneously typical. Unfortunately it seems like nurses are expected to do more and more with less staff and supplies. If possible, the best choice would be to find another employer. If not feasible, really talk to your manager about how ratios are not enabling you to provide acceptable care.

    Best wishes.

    ~ No One Can Make You Feel Inferior Without Your Consent -Eleanor Roosevelt ~
  4. by   Born_2BRN
    Time to apply for another position? I can't imagine how I would feel if I have that many patients in my care.
  5. by   LightMyFire
    Wow!!! I though my 6 pts with increasing acuity was bad. If something doesn't change quick, get out. Any mistakes made will ultimately land on the nurse and his/her license, not the hospital. It's a shame to have this sort of cycle but its no wonder you're understaffed.
  6. by   Kittylin
    I worked 9 years in a busy m/s unit and was ready to quit nursing entirely. That was 20 years ago when I only had 5 patients (no aides or LVNs) on days. I was going to school again for accounting. Then one last effort to save the nursing career, I went to the birth center in a non benefited position. I have been here over 20 years now in the NICU (benefited now). It was a good fit. People tell me all the time I have the best job in the world but that is far from the truth. Some days I still really hate it, but most of the time it is OK. You need to move around either within your facility or another hospital and find what is the best fit for you. Most nurses I know do not stay their entire career in a med surg unit. Too much burn out. Good Luck.
  7. by   RockinChick66
    When wwe are short staffed, we get 6 pts on our MS floor.
    7-9 is way too many much less 11. I would start looking for a new job.
    For the sake of your nursing license and the safety of yours pts.
  8. by   Aurora77
    9-11 patients is insane. Whoever is dictating those ratios is just asking for patient complications and deaths. It's just not humanly possible to adequately care for that many patients. I'd be looking for another job. In the meantime, make sure you have malpractice insurance. A hospital tha is willing to take such risks with its patients doesn't care about its staff.
  9. by   Ella26
    I agree with all the above posters! GET OUT OF THERE FAST! Im sure you worked too hard to risk your license and to put it on the line like that and your patient's lives! I currently work in a clinic, (yeah I know the pay is definitely not as good as it could be what I'd be making at a hospital), but I get rewarded in less stress-at my clinic anyway! For me, my sanity is priceless. I actually love my job.

    I do often wonder what it would be like to get that.... "Hospital=real nursing experience", but then I think back to med/surg clinicals and I wasnt very fond of them and I only had 2 patients then. I cant imagine 9 or 11!!!! Bless your heart!

    And then I read stories like this and think that might be a big mistake leaving a low stress job that I actually like, to get a hospital job with crappy hours, and high stress just to get that, "invaluable experience in med/surg and more pay".

    Then I remind myself that my sanity if not worth the higher pay. I suspect I would be using that higher pay to pay for more anxiety meds and a trip to a Psychiatrist... lol! So you have to ask yourself what do you value? Nursing is a great career choice in that you should never be bored or unhappy because there are so many avenues to go down in nursing. The options are almost endless.

    Here is my nursing diagnosis: "Ineffective coping related to job stress and burnout as evidenced by feelings of dread when going to work...." ...I think its time you really assess the situation, develop a goal or outcome, carryout some interventions (i.e. get a new job, or stay and risk your license and patient's lives), and evaluate the outcomes. Hey I just used the nursing process! Anyhow Im sure you get the drift.

    Good luck in whatever you decide. And definitely get some liability insurance if you do not have any. The hospital could very well throw you under the bus for any mistakes.
    Last edit by Ella26 on Mar 19, '13 : Reason: forgot some info
  10. by   kChoRN
    The only floor that has a ratio like that at my facility is where they do team nursing and usually an LPN and RN care for ten patients simultaneously. I agree with all the above posters. Leave. I couldn't live with my self if I caused an error bc of staffing like that. This isn't healthy for your patients or yourself. Good luck with your decision, but I think you know what you need to do already.
  11. by   naptimeRN
    Thanks for the advice. I actually took a different job a little while back at a different hospital (went prn at my old job) but I really did not like it. The drive, the people, the acuity, the huge hospital, etc. so I didn't stay. The aides didn't help, manager quit, nurses were nasty to students and each other, 12.5 hours turned into 13 and then an hour drive home, 7 patients on a cardiac stepdown, etc. (yeah the grass wasn't greener). My hospital has issues (obviously lol) but I generally really like the people and working in a small community hospital. The only saving grace is that majority of the time the patients are not super high acuity which makes having so many somewhat tolerable. I'm hoping it slows down at some point. . I'd like to be here at least a year an maybe then retry venturing out or get into ICU. Thanks again!
    Last edit by naptimeRN on Mar 21, '13
  12. by   naptimeRN
    I wanted to add to this discussion that the other day I had 5 patients, that's right FIVE! I actually felt like a nurse and not a headless chicken for once. I got to educate my patients, talk to them, teach them all about their meds, upcoming procedures, diagnoses, change all the IV lines, restock the med cart, look through their charts and read up on their progress notes, histories, lab work, etc. I left work only 8 minutes late and I drove home without crying. What a difference. I think based on the acuity of the section I had, 7 patients would still be reasonable. But no matter the acuity, 11 patients is far too much on m/s or tele floor.
  13. by   MissM.RN
    1:9-11 RN patient ratio? One word comes to mind: absurd. There is absolutely no way you can safely administer meds, after checking three times, allergies, dosages, explanation of rationale, etc. to 9 patients within your alloted time. I would give my notice, walk out with my license in-tact, and never look back. I have 1:5 on a high acuity floor and it feels overwhelming quite frequently. Good luck to you. I hope you find a better hospital with a better union.
  14. by   naptimeRN
    Today I randomly received a call from a recruiter at a hospital in the area. I have not applied there since December. What timing.. now that things are so insane at my work place. Very strange! It's for a smallish hospital (<200 beds) which I like (that's what I like most about where I work is that it's a small community hospital). But, I know the grass isn't always greener, and I'm nervous to try venturing out again. And to make it worse, the hospital that called is part of a large health system in the area (they operate several local hospitals and such) and this particular hospital's union contract expired a couple of months ago and the new contract keeps getting voted down. Next vote is a strike vote. I don't want to start on that note! Looks like things are not looking up for us nurses nearly everywhere
    Last edit by naptimeRN on Mar 29, '13