How can I prevent myself from having a nervous breakdown?

[shabbychic23]

I am a new RN with only 3 months on a med/surg unit. Along with transfers and new admissions, there are time when I have up to 11 patients to care for. The hardest part of the job is trying give out meds within the 1 hour before or after time frame of schedule time frame. Many times I find myself on the 6th. patient still giving out 10 AM meds at 12 PM.

To make matters worse, pharmacy personnel are never punctual with scheduled delivery of medications, especially IVPB. The nurses Aide on my unit aren't cooperative and at times insubordinate when I ask them to go to the pharmacy to pick-up meds. Needless to say this ultimately comes down on me if a med wasn't given or was given late. Another source of stress is the demanding nurse manager on my unit. Since JACHO is scheduled to come to our hospital, she has been nit picking at anything and everything. While I can appreciate her concern it has me extremely exhausted.

Finally, there are the patients who are so demanding. I've had demanding patients press on the call bell so many times that I lost count. Am I there just to serve them as their personal nurse?

Two days ago I just broke down in hysterics in the nurse manager's office. The words were so hard to come out in between the sobs. I told her how older nurses have been less than helpful in sharing their experience. In addition, I told her that I felt that I couldn't live up to her expectations. I mean she seemed to complain about everything. That same day, I ended up leaving early because I felt I couldn't provide decent nursing care to my patients in the condition I was in. I've since been off from work for a few days to recoup.

I love nursing so much, but since I started this job, I'm beginning to question whether or not I chose the right career. I can see why many nurses get burnt out from the profession and I'm afraid if things in the industry don't change, such as less patient to nurse ratio for starters, there will continue to be a high burn-out rate among new nurses.

Any words of advice would be greatly appreciated. :o:bluecry1:

sincerely,

Shabby Chic 23

[I<3Nursing]

I seriously think that almost everyone has the "break down" after you get off orientation and start working on the unit on your own. The biggest thing is learning from each day about the experiences that you have. Try your hardest not to be too hard on yourself it's hard not being able to do everything right and having to ask questions and learn. And I guess finally, that is a horrible pt ratio and I may consider finding another job, once you have a few more months experience. I went from a 9 pt load on nights to max of 5 at my new hospital and I couldn't be happier with the higher quality of care I can provide. Things might seem hard right now, but everyone goes through it. I cried so bad I started hyperventalating, thankfully there were younger nurses there that had just gone through the same thing not too many years earlier. Embrace challenges and know that you are a good nurse and everyday you become better. If you want to talk more about it you can send me a message anytime, I have been a nurse since June 08' and I'm still trying to find my way. Hang in there, it gets better.

[Ruby Vee, BSN]

the first year is tough; unfortunately there's no way to just bypass the first year and get on with the second. you just have to grit your teeth and get through it. everyone has to get through it one way or another. i'd advise you to get through that first year and start feeling competent as a nurse before even thinking about changing jobs, specialties, careers, whatever. you'll be glad you did in the end!

[FireStarterRN, BSN, RN]

It does sound like a pressure cooker unit. Your coworkers sound stressed too. I don't know why everyone thinks they can wring hospital staff dry like this. The pharmacy sounds like they are overloaded as well. You are all in the same sinking boat.

[VickyRN, MSN, DNP, RN]

Is there an EAP (Employee Counselor) at your hospital? Sometimes their input can be very helpful. To have a mini breakdown like you describe is not normal, and it is a red flag. You run the risk of burn-out from nursing entirely.

11 to 1 ratios on a med-surg unit, with the high acuity, demands, threat of lawsuit, and everything else that goes along with it, is unsafe. Also, it is troubling that you cannot find the support you need or nurse mentors on your unit. From your account, the overall atmosphere at your facility sounds toxic. My advice would be to keep your job, but to be actively looking for another with better working conditions.

So sorry you are going through this. We care. Please keep us posted and our best wishes to you.

[tryingtohaveitall]

The first year is tough, but this sounds unsafe and a recipe for early burn-out. Definitely talk to your manager and if it continues like this (up to 11 patients?!), I would start looking for a new job. Nursing isn't like this most places, at least not where I am.

Good luck and hang in there!

[MinnieMomRN]

Hey there,

I am a new grad, and have also been working on a busy med-surg/tele floor for the past 4 months. I have 5 patients on the evening shift, and no tele's as of yet (start with that after a 5 day class next month). I am in a very supportive environment, with experienced nurses willing to help me out if I get slammed and answer any of my bone-head questions.

I am telling you this, because I want you to know that not everywhere is like your place. If you are not getting the support you need, you owe it to yourself to get the heck outta there. You worked too hard to get your license to put it in jeopardy.

(((Hugs))):heartbeat

[medmar_mary1970]

I work on a med-surg floor. I have about 8months experience as a new nurse, and there have been many times I left in tears. Thanks goodness I have a 35 minute drive, so I can bawl my eyes out and de-stress in silent misery reasoning with myself that this job has GOT to get easier. And some days goes smooth and I think to myself, "ok, I CAN do this" and other days I think, "Damn, I should have went into Radiology or physical therapy, not NURSING!!" But I keep going because one day I WILL walk onto my floor and will be able to handle anything thrown at me with some kind of comfort. The pt to nurse ratio is something that I believe is an issue in alot of places. 7 walkie-talkie pts with illness are easier than 7 train wreck pts. 11 to 1 sounds insane. The most I have ever had was 7 to 1 on night shift. When your E.R. is crammed with people and every floor is jammed with pts, they have to go somewhere, so all u can do is your best at gettin the meds to them. Your manager can nitpick and scold employees all day long, but until they implement change with the staff working together better, nothing will change. As far as the pts on the call light go, the pt doesnt know nor do they care about your pt to nurse ratio . Their hopsital experience is personal to them and in their mind, nobody is having a worse day then thmselves, so in their mind, yes you are their personal nurse. :bowingpur LOL. I have found that the pts that probably need your attention the most sometimes are the ones that are alone and either don't ring the call bell or they are unable to for some reason. Nursing isn't a thing like it is in the NCLEX world , is it? NCLEX world paints a pretty scenario type picture of nursing. In Real World nursing, some days all hell breaks loose. I don't recall any instruction in our NCLEX study books about what the "nurse will initiate" when hell is breakin loose..LOL:bugeyes: It's hard NOT to be hard on yourself... believe me i know..but listen to those with experience. Its important to be accountable , but don't kick YOURSELF too hard, and relish in your competencies , there will always be someone else to point out your inadequacies to you . Keep going, one day it will all click. Go somewhere else. Sometimes you have to change jobs a few times before you find a niche, just like everything else. Good luck!!

[casperx875x]

The first year is tough, from what I heard, and I definitely have had my fair share of near nervous breakdowns in my 6 months so far. I think that is contributing to how you feel, but your job does not sound safe. I would run. And run fast.

[VivaRN]

I worked on a similar med surg unit as an experienced nurse and I nearly had a nervous breakdown. How did the other nurses care for so many patients? They lied on charting. They didn't do things. The care was horrid, and I felt horrid not being able to provide good care. Patients start to feel desperate and get on the light. They become extra demanding because they've been forgotten before and are afraid you will forget them, too. This is not a good place for you. Start looking for another job. Today. If you want to be sustainable in nursing you have to find a sustainable work environment. Before you accept that other job ask if you can shadow for a shift or two to get past any managerial bull. Sometimes night shift is calmer.

Good luck and hang in there. It's not like that everywhere. Your sanity is #1.

[dorimar, BSN, RN]

I have to agree with all posters. Yes, the first year is a terrible difficult shock and can be rough. However, that place sounds terrible, even for a seasoned nurse. That ratio is ridiculous. I would hate to be a patient in that facility. Patient safety is obviously not a priority for that organization, but I'll bet their mission statement is pretty and shiny.

[lorena_1978]

they always say one patient at a time//but keep your stress level low