Lately I've been feeling the strain....

  1. physically. My feet kill me so bad after a shift, I come home in tears. I feel like I was hit by a truck for about 3 days, I'm so sore. Yeah, we've been working without a tech. I've been averaging about 5 patients, but we can be assigned up to 7 without a tech. Usually the mix is two or three total cares and the rest are assists or independent.

    I hate to admit this, but maybe I need to move to an area that's less taxing physically. Or work with techs. Or something. I absolutely know that I'm not interested in taking anything--even Advil, my mainstay--on a very regular basis, and man, am I hurting.

    My feet feel like I'm walking on sharp rocks after about 4 hours. I've bought about a dozen different pairs of shoes and I simply cannot get through a whole shift on my feet without coming home in pain.

    Maybe it's time to get that BSN and go management. ( ---> obviously not thrilled by that prospect).

    Anyone have any suggestions? What areas of nursing should I look into?

    Plusses: I have excellent writing and computer skills and at one time I was a secretary. I have a very good knowledge base and clinical expertise.

    Minuses: I would miss patient contact terribly, I'm not a terribly popular person, and I'm just not good with office politics.
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    About UM Review RN, RN

    Joined: Aug '04; Posts: 9,279; Likes: 4,302

    25 Comments

  3. by   NurseyBaby'05
    Angie-

    Do you notice a difference when you're able to stagger your shifts a day or two apart? I know that three in a row is my limit. I know also other people have recommended changing shoes halfway through a shift to change the pressure points on your feet. With my heels, I notice a problem if I sit too long and then stand up. Are you doing med-surg/stroke now? I noticed a big decrease in body aches after a shift when I moved from Neuro to Oncology. What is considered a complete on the Onc. floor was a partial on the Neuro floor. I would have never been able to do three twelves in a row on neuro/med-surg. Just a thought. Rest your body and see how you feel when you're not ready to fall over dead.
  4. by   hotshot05
    I hear ya. I hate nights when I have to work without a tech. We only have 1 that works nights. So 4 nights a week no tech. Even with a tech I'm running around a lot. I bought a pair of SAS shoes because my mom just swears by them. Yikes my feet/legs still hurt.

    What I have found that works for me is I bought a pair of Dr. Sholl's inserts. The ones for heel pain (they are about 3/4 length of shoe). And I wear support socks. My feet still hurt some in the morning but not as bad as they used to. I try to sit for atleast 5-10 min every couple hours (if possible)

    Thats the only advice I have
    Good luck
  5. by   CseMgr1
    Angie,
    I feel your pain...(quite literally). I can no longer sit or stand for longer than an hour at a time, before my back and feet start going out on me. Ergonomic chairs and multiple (and expensive!) changes in shoes have not helped me in the past, either. I've been out of work now going on five weeks, and am beginning to wonder if I should just go ahead and apply for permanent disability. I'm 55 now, and my age is becoming an increasing obstacle to finding gainful employment...anywhere.

    As for your feet, it sounds like you have Plantar Fasciitis. When I worked for an HMO, I did many preservice reviews for the treatment of this condition, and the symptoms were similar to yours. Unfortunately there is no cure, and treatment is focused primarily on pain relief. If I were you, I'd get myself to a Podiatrist for evaluation.

    Anyway, you could put your experience and expertise to good use in Utilization Management, Disease Management or Case Management. While there are politics associated with every job, at least you wouldn't have to put up with the pain that you are in now.
  6. by   UM Review RN
    Quote from CseMgr1
    Angie,
    I feel your pain...(quite literally). I can no longer sit or stand for longer than an hour at a time, before my back and feet start going out on me. Ergonomic chairs and multiple (and expensive!) changes in shoes have not helped me in the past, either. I've been out of work now going on five weeks, and am beginning to wonder if I should just go ahead and apply for permanent disability. I'm 55 now, and my age is becoming an increasing obstacle to finding gainful employment...anywhere.

    As for your feet, it sounds like you have Plantar Fasciitis. When I worked for an HMO, I did many preservice reviews for the treatment of this condition, and the symptoms were similar to yours. Unfortunately there is no cure, and treatment is focused primarily on pain relief. If I were you, I'd get myself to a Podiatrist for evaluation.

    Anyway, you could put your experience and expertise to good use in Utilization Management, Disease Management or Case Management. While there are politics associated with every job, at least you wouldn't have to put up with the pain that you are in now.
    Thanks for your responses so far. Yes, Nursey, I do notice that I have less pain based on number of shifts a week, as well as the particular day. Weekends, especially Sundays, are way less busy than during the week.

    I'm scheduled for two in a row, starting tonight. Can you tell I'm absolutely dreading it?

    Hotshot, I will definitely try the inserts. I bought some Therapedic ones, but they're too thick for the shoes I'm wearing, so I'll get something thinner.

    CseMgr1, thanks for your understanding. My pain is pretty much equal over my entire foot. My last pair of shoes were good, but didn't last. I knew I had to get new ones when my entire great toe on one foot went completely numb, yet if I just lightly touch one spot at the bottom knuckle, it sends me through the roof with pain. Feels like a bad tooth. The bottom foot pain is more like I've been walking on sharp rocks all over the foot.

    I also get cramps in the middle of the night if I walk a lot, anywhere in my body, but usually in my feet. My father had the same problem, and I know it's not potassium or a vitamin deficiency, so I figure it's hereditary.

    My body is sore after a shift, but nothing like my poor feet. I think I have some neuropathy going on because when they're normal, I have just a little numbness and/or pins and needles.

    I looked up different foot dx's on the Net and nothing really seems to fit well, since the pain is not really localized.

    Anyhow, don't I have to get more than an ADN for Case Management? What's disease management or utilization management? Disease management sounds interesting, appeals to my intellect....
  7. by   CHATSDALE
    i see from your screen name that you are into cardiac pts..yu have a unique talent to shift into a patient education field..these people need someone who understands that this is the most important thing that has happen to them and not just 'the cabg for tues am'

    i also agree the the podiastrist and with the speciality shoes but there comes a time when you have to make decisions based on YOU
  8. by   hopecandles
    I know you are focusing on your feet, or it's mainly your feet that hurt you. I don't know exactly how you feel, but I know days I've left work and it hurt to drive home...it hurt my foot to push the accelerator.
    My big problem is my lower back. One time I was in a class with PT, teaching us proper body alignment while lifting. I spoke up, (which is unusual for me), and asked her..." what does this really have to do with us, we're nurses... I've taken classes like this a dozen times, and I know how to lift a box off of the floor, but what kills me is my back. What is proper alignment when you spend half your day bent over a patients bed. How can you turn someone on their side and hold them with one hand, and wipe their bottom with the other, and do that without hurting your back." She said, that was very true, and we can't really do our jobs with proper positioning and alignment for all the tasks nurses do. In that case she said you have to do the counter position. i.e. if your lower back is hurting, lay on the floor, face down, and push up with your arms, don't do a "push-up", keep your legs and hips on the floor, just raise your upper body. She explained how we spend so much time bending forward, and it puts pressure on our disc, etc, and we need to spend time bending back, to help relieve that pressure. You can do it laying down, or do it standing up. She said most people will bend forward because it seems to stretch their lower back, but it's really making it worse. So, if you are at work, and you can't lay down to do them. Stand with your feet and even width apart, put your hands around on your lower back(kind of like a pregnant women would, at least that's what I always did when I was pregnant), and just gently lean backwards.

    I started trying to do that a few times throughout my shifts at work and they really helped.

    God bless, and good luck with your feet.
  9. by   psalm
    ...get some "arch support" socks and wear them to bed! My feet would just hurt and ache, then I got some of these socks and they helped me wake up to almost pain-free feet. I am on my feet almost the whole 8 hours (I just can't do the 12-hour in the hospital). My whole body would ache and it would hurt to breathe after 12 hours. Maybe 8 would be better fit for you?
  10. by   CseMgr1
    Quote from Angie O'Plasty, RN
    CseMgr1, thanks for your understanding. My pain is pretty much equal over my entire foot. My last pair of shoes were good, but didn't last. I knew I had to get new ones when my entire great toe on one foot went completely numb, yet if I just lightly touch one spot at the bottom knuckle, it sends me through the roof with pain. Feels like a bad tooth. The bottom foot pain is more like I've been walking on sharp rocks all over the foot.

    I also get cramps in the middle of the night if I walk a lot, anywhere in my body, but usually in my feet. My father had the same problem, and I know it's not potassium or a vitamin deficiency, so I figure it's hereditary.

    My body is sore after a shift, but nothing like my poor feet. I think I have some neuropathy going on because when they're normal, I have just a little numbness and/or pins and needles.

    I looked up different foot dx's on the Net and nothing really seems to fit well, since the pain is not really localized.

    Anyhow, don't I have to get more than an ADN for Case Management? What's disease management or utilization management? Disease management sounds interesting, appeals to my intellect....
    I would still go see a Podiatrist for evaluation and let them design a treatment plan for you. You don't need to be in pain like this.

    I worked with several nurses in Case Management who were ADN-prepared. The miniumum prerequisite for an entry-level position is usually experience in Med-Surg or ICU nursing. The HMO I went to work for years ago was looking for a nurse who was experienced in Med-Surg, geriatrics and working with Medicare, as they needed a Case Manager for their senior population.

    Disease Management focuses on identifying those populations at risk for exacerbations of disease processes. http://www.dmaa.org/definition.html
    Case Management involves the assessment, planning, implementation, coordination, monitoring and evaluattion of the options and services needed by patients to meet their health and human needs. http://www.ccmcertification.org/pages/13frame_set.html

    I have done both, and you shouldn't have any problems getting into either area, with your experience.
  11. by   mysticalwaters1
    I can't imagine physically hurting that bad but I did work on a med surg floor for 3 years and it got to the point I HATED comming to work. I was depressed, literally sick to my stomach comming in, exhuasted. What's worse is I started "wigging out" at the nursing station. I'd go "I can't do this." And yea if you could imagine that looked very professional. I actually thought going back to walmart to cashier or even going on to veternarian school. I tried to work /c management to fix lack of tech issues, no help from coworkers and I held out for 3 years /c not much change at all, or yes change, worse. I ultimately realized I liked dealing with pts but not on this particular floor. Very very heavy pts with not enought help. Sounds like you are experiencing similar issues. I would hate being at a desk for an entire shift so I on a whim jumped to the Emergency Department. It has it's own problems but that heavy burden working on the floors is not as intense and the ED has a nice mix of all different kinds of pts critical, to totally nonurgent. You just do what you can. Anyway my suggestion is it sounds like if things don't change on your unit for the better, and maybe explain this to your manager, and if no measures made to improve I'd find another area of nursing. You may not like ED but try anything you may have an intrest. Sometimes you just need to change and if you really don't like the new area go to another or go back if you want. But your symptoms sound like burn out. I've only been a nurse for 3 years and am 25 years old and consider my first 3 years of med surg burnout and I think that's pretty sad about our profession. But if you really enjoy the type of work you can really search to find something.
  12. by   mysticalwaters1
    Quote from CHATSDALE
    i see from your screen name that you are into cardiac pts..yu have a unique talent to shift into a patient education field..these people need someone who understands that this is the most important thing that has happen to them and not just 'the cabg for tues am'

    i also agree the the podiastrist and with the speciality shoes but there comes a time when you have to make decisions based on YOU
    My one coworker couldn't stand working on our med surg floor after 7 years and switched to education as well and is enjoying it very much.

    I've used DR. Scholls arch support things in my shoes that help. I used to use Rockers shoes by Cherokee b/c it had nice arch support but when I switched to 12 hour shifts the sole was to thin. I switched to sketcher shoes mainly for the big cushiony sole and added arch support which helps. I try to sit when I can even if it's for 30sec while I make an addition to my charts.
  13. by   UM Review RN
    Thanks so much for your suggestions. I'll probably try as many as I can, because I don't know what else to do.

    I know a terrific podiatrist, though....hmmm....where's that number?
  14. by   gonzo1
    I have a foot problem too, and have struggled with it for several years. I switched from med/surg to ER a couple of years ago and that helped. Most importantly though I bought a pair of Nike Air Max 360 shoes. They have an air pocket for the sole and you literally are walking on air. They cost 175 and have made a big improvement in my pain.
    Two days ago I bought a pair of Z-Coil shoes as I have always wanted a pair after seeing a write up in the local paper about them. They have a spring coil for the heel and can be adjusted to correct a pronating or supinating foot to normalize gait pattern and they reduce load by a lot. Please check out their website Z-Coil.com and watch the video about how they work. I haven't used them for a full 12 hour shift yet but they really felt great for the 6 hours I wore them. They are 200.00 dollars. I will update you on whether they are helping me or not after I have worn them a couple of days. If they help they are well worth 200.00. After all our feet are so important to us, kind of like hands to a surgeon.
    I have spent hundreds of dollars looking for the perfect pair of shoes and hopefully these are the perfect pair.

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