I am a relatively new RN at a major city hospital. I have been off an 8 week orientation for about a month now and I am encountering some problems. I am hoping some of the more experienced nurses can give me a little guidence.
My problem is not with my job. I love my job. It's with some of my coworkers.
I work on an extremely busy medical unit. Of course the nursing shortage has an impact on us and our assignments are ridiculous at times. I have had as many as 11 patients. Our normal ratio is 8 to 1. This is with an assistant. Without the assitant it is 5 to 1.
At times this is unreasonable as well as unsafe.
The pressure and stress is enormous.
Still, I enjoy the pace for the most part. I am working very hard to improve my performance and learn my job. There is little to no support from management. I've been thrown to the wolves so to speak.
As if this isnt hard enough I work with some exceptionally mean and vindictive people. Most of the assistants do nothing besides vital signs. I have been yelled at by some of them for asking them to do their job (change a sheet, see that a room is ready for a transfer). I've been told that the requests I make, taking a patient to Xray, are not their jobs but mine. I have to look for them when I need something done and 9 out of 10 times they are not on the floor or are socializing on another unit.
When I do get them to do their job I always have to go back and check what they did. I don't have the luxury of saying the assitant didnt do it or the assistant didnt tell me because as you all know, whatever they do and whatever happens, its my fault.
Management is more than aware of this. I have reported it as well as other RN's. Nothing is ever done.
As if this were not bad enough I am having a major problem with the clique tof RN's that think they run the floor. I do not socialize with these people. They are gossip mongers who are malicious. I've seen them do things to their coworkers. And now its my turn.
I have done nothing to this small group of people other than refuse to get involved in their crap. I have had the worst experiences with them. I ask a question and I am told that they are not going to answer because they are busy charting. I ask for a witness to a waste and am told no. I get the worst assignments on the unit. Not only the worst patients but they split my assignment up into two units on opposite sides so that I have to walk all night. I have had as many as 5 patients without an assistant, on daylight, with 4 of them being completes. All had fluids going and there was one with a feeding tube who took massive medications that all had to be crushed and pushed thru the tube. I complained. Oops...how did that happen. I got help at the end of my shift in the form of an assitant who was on light duty and too sick to be much help.
One nurse in particular has been on me for weeks. I have finally had enough. I feel like if I don't handle this my way they will never stop. She is extremely rude and sarcastic to me. She will not offer any help unless she has to and then she makes a huge deal of it. It doesn't matter where her assignment is. She is all over the unit and has her nose in everyone's business. I had the misfortune to work with her last week night shift. She assigned me 8 patients on two different zones with the rooms all over the place. On top of that she gave me an admission. My patient load was difficult to say the least. She was well aware of this.
At 6 am I recieved a call from a distraught family memeber who was flying in to see her mom from Florida. She was furious about the care her mom was recieving from the doctors. Her sister stayed overnight and I took her to a conference room and tried to explain her mothers condition. I was there about 30 minutes. The family member was calm and I felt good about what I had done because nobody had ever really explained the infection their mom had with them.
This nurse saw me in the conference room twice. After that I went to the other part of my unit to work on some labs and a PICC line that was sluggish. After fixing that and administering pain meds IV I gave report to the nurses on that part of the unit.
I was headed to the other part of the unit when the phone rang.
This other nurse was on the line screaming at me:
"where were you?"
"in report"
"for an hour? no you werent"
"yes i was"
"no you werent"
"what business is it of yours?"
"when your patient is screaming at me for pain meds for an hour it is my business"
"are you talking about mr_? he was medicated. he is drug seeking and you know that" (mr _is a junkie.he knows his med schedule better than we do. he can be abusive when he doesnt get his fix but we have been dealing with him for a month so we all know whats up. he had his morphine but he wanted his percs cos his buzz wasnt enuff. i told him id be in at 7 to give him the percs...it was a lil after 7 and he was freaking out)
"look, I'm telling you I was in report"
"no you weren't"
at this point I realized there were a number of ways I could go. I didn't have the time or the patience to argue with her. It didn't matter what I said.
very calmly I said.."I was playing with myself" and I hung up.
I headed for the medroom and she came up the hall, smoke pouring out of her ears and nose.
We had an encounter in front of an audience (that was what she wanted all along) and I very calmly and quietly told her that if she had a problem with me or my performance she should discuss it with the manager. She put her face right up to mine and said "I will, oh I will"
then she got a contorted satisfied smile on her face.
I told her, "In the meantime, get out of my face"
I got called into the office the other day and had been written up for this incident and more.
She rounded up some of her friends to report me for things that are petty. Some of them were true. I have left things undone. There were some mistakes. Yes I say the "f" word on occassion. So do they. I only say it in the confernece room, never on the floor...like they do. Some things said were untrue. They said I had a patient with a BP of 60/49 and I ignored that and they had to hang fluids on their shift. That never happened. They said they came on duty and I had 4 IV bags empty. Again, that never happened. So many things were said I couldnt keep track of all the accusations. Some of these things that were left undone were reported by me to the next nurse. One was an injection of insulin that needed to be given. The doc was in writing orders as I was leaving and she told me to let it go until the next shift. I reported this to the oncoming nurse and she was ok with it. There were more orders written after I left that I was unaware of. None of them were stat. This nurse reported me for ignoring stat orders.
I got reported for not doing a timely admission when I had spent the entire day paging docs and trying to get this patient admitted. This whole scene was reported to the nursing supervisor as it was happening but still I was reported for it as well.
I realize I have to go back and document these things and from now on C Y A is my motto but I just don't know how to handle this. I could go to management and report them for all the things they do but frankly, I don't have the time and it's not my style.
I am not the only new nurse having these problems. Others have reported the same thing, the same people. Management is well aware. In fact we have nurses in the registry that refuse to work on the unit for just these reasons.
Everything stays status quo.
I just don't know how to handle this since I am not established and managment seems to be believing what they say. any suggestions?
