Drowning on the floor...only 2 months in. HELP!

Night__Owl, BSN, RN · Dec 6, 2018

1:10 is a ridiculously unsafe patient ratio. How do you or any of the other nurses on your floor even pass meds consistently on time? How many techs do you have? Is 1:10 your regular ratio, or your "short staffed" ratio?

allnurses Guide · Dec 6, 2018

Extremely unsafe. Too many med surge patients per nurse.

Not enough orientation. Not by a long shot.

I'm sorry you are in this situation.

JKL33 · Dec 6, 2018

The patient ratio is usually around 1:10 and all I got where 10 days of orientation on the floor(9 of which were spent as a CNA because they were short staffed). So after my one day with an RN, I was let go to do it all myself. I was so scared, but decided my best ally would be a good attitude and willingness to learn.

We are having a meaningful discussion elsewhere on the forum, and one of the major points everyone could benefit from pondering is that acquiescing in the face unsafe care scenarios is just not okay. In and of itself, it is not prudent nursing practice.

I know what you meant by that, though, and your desires to learn and overcome the normal hardships of getting up to speed as a newer nurse are admirable. But our "best ally" in truly wrong scenarios is not to acquiesce and have a good attitude and hope nothing bad comes of it.

I hope you can figure something else out. 1:10 ratio is unsafe.

Best wishes~

Kooky Korky, BSN, RN · Dec 6, 2018

Hello there! I finished my BSN in May 2016 and was unable to find a job until 2 months ago. I started in a med/surg floor. The patient ratio is usually around 1:10 and all I got where 10 days of orientation on the floor(9 of which were spent as a CNA because they were short staffed). So after my one day with an RN, I was let go to do it all myself. I was so scared, but decided my best ally would be a good attitude and willingness to learn. Quitting is not an option. I love this job too much. But after 2 months, I can't sleep (without dreaming about being in the hospital) my stress levels have affected my health, I barely eat and I just feel like a total failure. I struggle to keep up with the workload, I feel horrible asking so many questions (I want my patients to be safe) I worry I can't handle this, and find myself wondering what have I done by becoming a nurse. This feeling fades when I get to make a difference. But as a new nurse, I feel more like a burden. I'm 37 and have never felt so incompetent in my life. Will this ever go away?

Well, they certainly have you where they want you - Feeling guilty for breathing.

Please realize that you are being used and abused. I understand you want to keep the job. But why should you feel horrible for asking questions, why should you feel like a burden when you had next to zero orientation?

By becoming a nurse, you have entered a profession that can be wonderful, but which can also be, as you see, horrible when you work for an employer such as yours.

What have you been doing for the last 2 years?

I suggest you have a serious talk with yourself. Then with your boss.

What would you advise another nurse in the same situation?

**CalicoKitty, BSN, RN** · Dec 6, 2018

Just an FYI, in many hospitals, at 8 weeks/2 months, you'd be finishing up your orientation to a unit with 1:4-7 (7 is generally considered pretty high, 4 dreamy).

Feeling stressed and anxious is very common with new nurses. It can get better, but your unit sounds like a nightmare with staffing.

You should feel absolutely comfortable asking people for stuff all the time. You didn't get the orientation that many/most new nurses get with 1:1 help for days.

applewhitern, BSN, RN · Dec 6, 2018

I assume those are low acuity patients? Our med-surg nurses take 8 patients each. Way back with my very first nursing job, I had a 5 day orientation, and was immediately made charge nurse of a 44 bed telemetry unit! Talk about being a nervous wreck. I think 10 patients is too many; you simply can't do much for anyone with that kind of load. Our nurses do take up to 8, but they are fairly easy patients. Good luck to you, dear.

unknownjulie · Dec 6, 2018

Hi AppleWhite, you are as old as me! Yes, back in the day I was also put in charge of units after only a couple shifts of orientation but things are different now. It was so much more simple then! You could just take the NS off the pumps at night, or maybe there weren't even pumps and a lot of people would mostly sleep. I am assuming she works nights since these are the ratios where I currently work. I am working on a medical unit after many years of being out of the hospital and I appreciate the younger crowd trying to draw a line in the sand regarding bad management decisions. And as a side note, I am really and truly, just so disappointed- that my home state of Massachusetts didn't pass the ratio law!

unknownjulie · Dec 6, 2018

I should also have mentioned the sleep problems. I can't work full time in a hospital because I have nightmares about it. When I was a new nurse, it took me several years to figure this out. I honestly just have nightmares all night long, waking up in a panic, and then would have to go in and do another shift of work. I currently only have occasional nightmares working one shift a week and am trying to assess whether even this is ok, since I am so much older and need my sleep so much. I have never had nightmares about numerous other types of jobs I've had. I think it has to do with the beeping and the lights and seeing the horror of mangled bodies everyday that disturbs me subconsciously or something.

ruby_jane, BSN, RN · Dec 6, 2018

Hello there! I finished my BSN in May 2016 and was unable to find a job until 2 months ago. I started in a med/surg floor. The patient ratio is usually around 1:10 and all I got where 10 days of orientation on the floor(9 of which were spent as a CNA because they were short staffed). So after my one day with an RN, I was let go to do it all myself. I was so scared, but decided my best ally would be a good attitude and willingness to learn. Quitting is not an option. I love this job too much. But after 2 months, I can't sleep (without dreaming about being in the hospital) my stress levels have affected my health, I barely eat and I just feel like a total failure. I struggle to keep up with the workload, I feel horrible asking so many questions (I want my patients to be safe) I worry I can't handle this, and find myself wondering what have I done by becoming a nurse. This feeling fades when I get to make a difference. But as a new nurse, I feel more like a burden. I'm 37 and have never felt so incompetent in my life. Will this ever go away?

Yes. It will go away. But not immediately.

You have a couple of choices here: attempt to find another job in another hospital, citing the unsafe ratio as the reason for your leaving; or

Hang in there, realizing that, as others have said, this is just nuts.

But all this would become better if you could sleep. I had nightmares when I worked the ICU, compounded by my never adjusting to my night shift. All things were made better with a visit to the doctor and sleep medication. We're not allowed to give advice but get yourself to a doc and let him or her know what's going on.

Farawyn · Dec 6, 2018

OP, what is the feedback from your co-workers? I remember when I started I thought I was the worst nurse in the world. Maybe I was> My co-workers, however, thought I was doing great.

JKL33 · Dec 6, 2018

I am going to respectfully disagree that you should ever consider medicating yourself in order to help your performance at an already obviously-abusive place. If that sounds like strong language, remember they have put a brand-spanking new nurse 2 years out from graduation with zero experience in charge of ten sick patients. It should be considered criminal behavior.