My first few days, as a new RN - page 6

Here I am, it has been 6 days, since I have been off of orienation, I am disgusted. I took boards yesterday, keeping fingers crossed, but actually I'm a little worried about having the RN title,... Read More

  1. by   rktele
    I started out at a ECF and it was like that for me too. I was made an LPN charge nurse on a 38 bed unit after being an LPN for 1 month- all the meds, daytime skin treatments, all the orders, and the phones- all by myself. The day after I took my RN boards, "congratulations, now you get to be a RN charge on our medicare floor." It was also on the evening shift, and I was the only RN in the building, which made me house supervisor by default. And I had just taken my boards. I was hating nursing, my job, my life. And every day that I worked I was in fear for my license, because I was spread so thin no matter how hard I tried, I knew that a mistake was going to happen if given enough time.

    GET OUT NOW BEFORE YOU BURN OUT!!!! It sounds like the culture of the place is to overload the nurses. You're tap-dancing on a license you've just earned.

    Good luck.
  2. by   twotrees2
    Quote from starryx2
    Here I am, it has been 6 days, since I have been off of orienation, I am disgusted. I took boards yesterday, keeping fingers crossed, but actually I'm a little worried about having the RN title, because that means more things that I have to do. Which that would be no problem, besides the fact that today alone I had a 9 patient assignement! Come on 9 patients? A experienced seasoned nurse shouldnt be taking care of 9 patients. I am a new graduate with 6 days under my belt, by myself. We are on a med-surge unit specializing in orthopedics and gynecology, due to the recent close of our OB/Gyne floor that is our newest addtion. My head is spinning, I cant keep up, I am trying like heck to get everythign that needs to be done, but I am not even coming close, I do not feel that it is my inability to do things quickly, I am moving at a very quick pace but, here is the question i pose, Why is it that a new graduate nurse or any nurse for that matter should have to take care of 9 patients on a daylight shift? Why do we allow these things to happen. I am curious to know from the California RN's how the patient:staff ratio is working out, does it work to have mandatory Ratios? Make no mistake it was not an easy patient assignent load either, I had 2 patients on complete bed rest, which were complet cares, I had 4 post ops, which besides PCA's, Foleys, dressing changes, and routine meds, have to be down for Physical Therapy twice a day. Also you have all your routine meds, pain management for the other patients, I was lucky if I say 2-3 of my patients once in the 9 1/2 hours I was there, and that was to give them there medications and give them a very brief once over, which is complety inadeuquate, but what are you to do... I was still passing medications at noon, of course no breaks, no lunch, and the 2 RNs, and Myself along with the LPN whom which all carried the same load today were sinking. We have a charge nurse who was taking off orders ect, and another RN that got mandted due to not having a unit secretary. Another RN came out at 11 to take over for the mandated night shift nurse. Why are these things happening, I feel fortunate enough that I am able to keep my cool and keep moving and doing the best job I can do. I feel that this is such a joke, and such an inadequate way to do nursing, THIS IS NOT WHAT THIS PROfESsion is about , I feel like im doing TURBO nursing. You walk in the room, and are trying to keep moving you cant talk to the pateitns, your in their for only 5-10minutes at the most, how are the pateints getting good care, why is our patients not getting excellent care! Why are we not able to do what we are taught a nurse is suppose to do? Doctors are coming in and out writing orders that you come and find or are told about 2-3 hours later. You simply dont have time, I did not sit down today, until 4pm 1/2 hour after I should be on my way home, I sit down to chart, and try to look at my hands my papers, and sort through and see who had what going, and what I need to chart, I finish that after about 45minutes, and I am not satisfied with it, but hey its 5:15, I am exausted my feet ache. One of my co-workers come to me and says, do you have heart burn yet? Dont worry you'll get it, and turns to our other co-worker and asks what do you take, prilosec or protonix? I sit and wonder to myself, they are serious aren't they? This is so sad. I love this profession, I love what a nurse is suppose to do, I want to help people and I want to go to work everyday and do the best job I can possibly do but this is rediculous, I am managing for the moment but I do not know how long this will last, until it catches up to me. I knew this was a tough profession, and that is one of the reasons I got into it becuase I wanted a challanging profession, BUT i didnt want a unsafe, tiresome, work yourself into the ground, barley remember your patients names at the end of the day. On account of HIPPA, I can not paint a complete picture of my patient assignment, but believe me when I say, It was definitly not an assignment anyone should have. My manager and charge nurse, knew it was bad they were trying to help, I can't complain about my co-workers, they try as hard as they can to help you, but they have 9 patients a piece, and their own problems to worry about, I cant blame them for not being a little annoyed, but again why is this happening?
    I know this is not new, I know this is not a new concept, I also know this is happening all over the US. I just am very disgusted. My question to all of you out there is, WHat can we do to change this? Or has anyone encountered this at their hospital or facility and took a stand and decided to do something about it? I know that my co-workers want these things to change, but nobody knows what to even do about it. We dont even have time to think about it, we cant even stop for a moment to think, wereway to busy trying to give our patients 1/10th of the care that they deserve. Were doing our best, I am doing my best. I just cant keep asking myself WHY, and What can I do to make a change?

    welcome to the world of nursing - i tired to make a change - all it got me was a change of jobs and not by my doing. sigh - well - we can only do the best we can. hang in there kiddo.
  3. by   twotrees2
    Quote from weetziebat
    I think your post should be required reading for everyone who is so intent on going into the nursing profession. They need to read it slowly, let it sink in, and realize you paint a totally realistic picture of day-to-day nursing in the U.S.A. in 2006.

    I wish I had an answer. The only thing I do know is that nothing will change unless we, the nurses who are routinely being assigned ridiculous patient loads, that are truly dangerous to the patients, do something about it. Administation cares only about the almighty dollar, despite whatever lies they tell, and will do nothing to lighten our burden.

    Unless patients start dying off like flies in the winter, and it could be proven beyond a shadow of a doubt that it was not a nursing fault, but instead it is the fault of the greedy system, we are on our own. And being good little caregivers, they know we're not likely to all get together and walk out at once, till decent nurse/patient ratios are established.

    I will be interested to see what other posters think. There should be something we can do, IF we can manage to get us all to stick together. I'm actually amazed that more patients don't die of neglect. Goes to show what a bunch of great nurses we have! But no nurse can stick around any length of time working in these conditions, and no matter how many new nurses they graduate, that won't increase the number of working nurses if things don't improve.

    O.K. I've ranted on long enough. I'll step down off my soapbox and hope for some good ideas from others.

    when i went to state ( of course thier investiagtion showed adequate staffing as they can run those numbers quite well to cover thier butts regardless of the staffing ) i THOUGHT i had the backing of EVERYNE and when push came to shove i toolk the fall alone - even by what i thought was my best friend - no longer even an aquaintance thats for sure.
  4. by   anne74
    The only leverage we have as nurses is the nursing shortage - and this is huge leverage - use it! Simply don't work at a place that uses you like that! It's terrible to put you in that position - it's unfair, and it's unsafe to you and the patients.

    I don't understand why anyone continues to work in an environment like that - by doing that, you're basically saying it's acceptable practice and it's OK to be exploited and put patients in danger.

    If you quit and go somewhere else (which with nursing is easy to do) then these places will be forced to make policy changes. They simply can't function without us.

    I was working on a specialty med/surg unit with a 4:1 ratio, which was decently safe, but still didn't allow time for critcial thinking, care plans, and psychosocial interventions with patients. Even with only 4 patients, I couldn't stand the conditions - no lunch, no bathroom breaks, major stress, backaches, sleepless nights, no life outside of work. I put up with that for 7 months, but tomorrow I'm starting a new job in pre-op/PACU. No more than 2 patients, consistent schedule, you get to eat, pee, etc. Interestingly enough, this unit has no problem getting nurses to work there, and they're always properly staffed - imagine that! Even more, the patients get great care.

    It's as simple as supply and demand - hospitals have a demand for us, and we supply our services. When we stop supplying our services to bad environments, hospitals are forced to compete and offer us what we need. They will have no choice!

    If you continue to work in an unsafe place you're not only hurting yourself, you're hurting the nursing profession and most of all, the patients!

    Maybe not all states can band together like California did, but there are statements you can make on the individual level. Refuse to "enable" these places and go where it's safe.
    Last edit by anne74 on Sep 24, '06
  5. by   twotrees2
    Quote from CrunchRN
    Jenni - you said it all. Because they put up with it is the correct answer. If we banded together and stood up against unsafe assignments things would change very quickly. Unfortunately nurses just will not band together, and will not be assertive enough to help their patients in the long term.

    Harsh words? Yep. You all know that it is true though. The only ones who can make them change is the nurses. I would love to see the day that we hung together and all refused unsafe assignments.

    tell you what- i wil stand beside the nurses and in the end i will be there with them but i wil never ever ever again take it in my own hands thinking i got them beside ME cause been there done that and i know they aren't.

    not only that - the places can run the numbers till they are sickeningly wrapped around us and make us look like fools. sad but very very true.
  6. by   twotrees2
    Quote from Epona
    Wow. All this is terrible and makes me wonder if I want to be a nurse. This post has certainly opened my eyes. I am supposed to start nursing school in Jan.

    I know it may be difficult to find, but I hear that there are many opportunities in nursing. Why not try a docs. office? Get invovoled with research?? Be an educator?? Being a floor nurse is not the end all. I for one, am not planning on working in a hospital when I get out of nursing school. I may start there to get my feet a little wet, but I will not stay. I have already determined this. My hat goes off to those who do it, but I do not see myself here. I have heard it's difficult to find jobs out of hospitals, but I am sure they are there. You have to look very hard. I am prepared to do that.

    Hope things get better for you and you find your niche!! Hang in there!! Epona

    i can tell you it is no different in LTC.
  7. by   twotrees2
    Quote from Epona
    Wow. All this is terrible and makes me wonder if I want to be a nurse. This post has certainly opened my eyes. I am supposed to start nursing school in Jan.

    I know it may be difficult to find, but I hear that there are many opportunities in nursing. Why not try a docs. office? Get invovoled with research?? Be an educator?? Being a floor nurse is not the end all. I for one, am not planning on working in a hospital when I get out of nursing school. I may start there to get my feet a little wet, but I will not stay. I have already determined this. My hat goes off to those who do it, but I do not see myself here. I have heard it's difficult to find jobs out of hospitals, but I am sure they are there. You have to look very hard. I am prepared to do that.

    Hope things get better for you and you find your niche!! Hang in there!! Epona

    also - if your in a small town and are going to be an RN you can usually forget the docs office - they aint buying that price usually - home health is great but in a small town area not a good idea if you need a full time job as there arent a lot of home health issues around. no research in the small towns. just FYI in case anyone is in a small town - need to look at bigger cities.
  8. by   twotrees2
    Quote from StudentNurseBean
    YIKES!! That is outright FRIGHTENING. I know that I am the type of person to stand my ground when it comes to safety with myself, others and especially patients. Will I lose my job if I say I don't think it is safe to take another patient, etc? Why aren't the nurses standing up for themselves? How can "we", the new grads coming into the profession take a stand and have our voices heard? How can "we" work to change this? There HAS to be a way. Whenever there is a small will, there is always a chance for change. I guess more and more nurses need to really start advocating for themselves instead of the patient alone. Someone told me yesterday that I should be careful because if I advocate in the wrong voice, I might lose my license. How is this possible if it is in reference to safety and it is done in a diplomatic way? I just found out the nurses union isn't very strong here in NYC. Sad. I want to work somewhere with a strong union behind me because of exactly what you have experienced.
    I just wouldn't take 9 patients. If I was forced, I would leave and find another job. Maybe I am being to extreme, but nothing scares me more than making a mistake and killing someone
    I hope you figure things out and find better working conditions.

    one thing to consider - even though the law says an employer can only say your start date end date and weather they would rehire you or not - they DO tell tales of WHY you aren't there. it will NOT look good and you will have a very difficult time even getting another job with fired or asked to leave due to refusal of patients.
  9. by   twotrees2
    Quote from jenni82104
    So, do nurses typically get fired for refusing unsafe assignments? For taking a lunch, or for using the restroom too much? I know these sound like ridiculas questions, but it seems like many people complain about these things and put up with being treated badly that I just have to think that hospitals must fire nurses who demand better working conditions, and keep the ones that will take their crap. I only ask because it is my goal to work in a hospital, and I already know that I will not tolerate being treated poorly. If becoming a nurse means that I have to be abused to keep a job then I think I should spend my time and money on a different degree.

    honestly if i could afford it id get a differnet degree - as much as i love my residents - i have even went and took a full time factory job just to get out of nursing but health issues made it impossible to work full time and the only way to support my family was to go back into nursing - at least working per diem i get to choose who i work with and when i work usually so my nights may get hectic but are rarely tragic anymore- dont have much money but at least im happier and healthier
  10. by   twotrees2
    Quote from sunbeach73
    I am soooo freaking out reading this post! I am a new nurse (LPN) and I start my new job in a few weeks. I was told I get 4 weeks of orientation. I asked if I would be granted more time if I needed it, but was told that they have only had to extend orientation 3 other times in the last several years. I kind of got the feeling that they really didn't want to extend orientation either. I'm scared I'm going to be eaten alive at my first nursing job. This is just so harsh....are hospitals really like this? What a nightmare!
    4 weeks is better than what our place has been giving any new body ( not necessarily new grad but to me doesnt matter ) everyone gets one day on book/paper work and if they are lucky one maybe two days orientation to the wing - sigh - sad but true

    one nurse - cause she had worked there before - ( like over a yr before - ) got NO orientation - she came in and they gave her a wing - now over the yr some residents were the same but still - so much was new- new rules - new residents and staff - just made me sick. i got 3 days - i guess i was blessed.
  11. by   twotrees2
    Quote from BAndersonRN
    Sorry to hear that you're having a rough time with your new job, and new role as a nurse!!! It sounds to me as if the facility where you are working is probably not the safest of places, for patients or staff! I do have a question for you though.. If you just passed your boards two days ago, how is it that the facility you are working in has had you off orientation and on your own now for that past eight shifts??? Correct me if I'm wrong, but have you been taking patient assignments and providing nursing care for the past eight shifts???

    i can only speak for what our interns do - they get a full wing- we have to know and believe in thier skills because we the RN has to be in building and basically back her stuff as well as do our own stuff - we also have to do her Dr calls , check her orders she has done and her charting, - sign it off and so far any NI or GN i work with has been great thank god - dont know what id do if i had someone I wasn't comfortable with thier skills.
  12. by   twotrees2
    Quote from RNinSoCal
    I have noticed an interesting trend in the hospital I work for. There are many nurses working here as travelers because of the deplorable hospital working conditions, poor management, poor pay, and no ratios in other states. This is what the traveling nurses are telling me about what is going on in other states, I have always worked in CA. I am not trying to make it sound like CA is the best place to be, I know there are fine hospitals and nurses all over the USA. I only have info from nurses who left for a better situation. We have nurses from Kentucky, Tennessee, Mississippi, Louisiana, Arizona, West Virginia, Georgia and Florida who are here for the high pay and low ratios. My nurse friend from Tucson says it is like a vacation for her to work here because at home she has 8-9 patients on nights and has to be in charge. Here she has 4-5 pts and never has to be in charge. My nurse friend from Tennessee is making triple the wage she made at home. It seems that the rest of the country is losing some good nurses to CA because we do have the ratios in effect. We do have strong unions here in the Bay Area (I am mid-peninsula for those who know the area). I think something has to change for the rest of the country. Whether it is ratios or staffing by ACTUAL acuity (not supervisor enforced acuities based on staffing grids) nurses need some relief. For those of you who are staying in your home city/state and trying to make things better for your pts, God Bless You all. I hope things change for the better before we lose our new nurses to burn out.
    wisconsin license goes to california - i think - maybe i should move - i wish......
  13. by   twotrees2
    Quote from nursemary9
    First off, Congratulations on becoming an RN.

    Well, as you can see I am DEFINITELY NOT a new RN. i have been doing this for the last 40 yrs. I have been a Manager and I have been staff for a MUCH longer. The Politics of Management go to me early in the game & I knew I wasn't meant for that. SO........ it was nack to staff.
    The last 30 yrs has been on 8 hr. nites--full time.
    It has been quite a trip!!

    First off-- It is most certainly legal to refuse an assignment--as long as you have not yet accepted that assignment. I have always been told that once you acctually accept the assignment, if you then try to refuse, you could be cited for patient abandonment. So, If you come in & see that type of assignment, you need to refuse & speak to whomever is in charge BEFORE getting any type of report. You need to say that you feel this is an unsafe assignment & the reasons; Also your license is at risk here.

    You know, I know you have worries about loans & such, but this does not sound like a really good place for you.
    If by some awful circumstance, you end up sued or whatever for some mistake you might make when you have this unsafe assignment, you will have even more money problems. Just remember that if you get sued, they can say that a prudent RN would NOT have accepted an unsafe assignment.

    Our Hospital is owned by one of Illinois's largest employers. We are a not-for-profit teaching hospital. Our management has been trying to go by california staffing guidelines. They really are trying & most nites now we don't get more then 6 pt's. Our day shift 5 at most. we also have Nurse Aides who are terrific. We are not Perfect, but better then it has been; HOWEVER, patient's today are sicker then ever. 10 yrs. ago, my patient;s would all have been in an ICU; Today, however, they are on my Med/Surg/Hem/Onc floor. The patient's in the ICU wouls probably not have made it, so nursing is a harder job then ever.

    I know, at my age, you'd think I'd give it all up--it's TEMPTING--Believe me as the old bady is failing, it is tempting. However---I DO LOVE BEDISE, HOSPITAL NURSING!! And you know, there are not so many of us left anymore.

    I also need the really good benefits I get here--a great HMO & a good pension plan. At my age, we think about those things.

    However--Like I said---you can REFUSE an unsafe assignment; I have done it--i did not get fired.

    Think about yourself and your future career.

    mary Ann
    when does one accept the assignment - when you punch in or when you get to the floor and see the list and then do you have a chance to say no - if not so what then would you do - go in early see what the assignmnet is and the go punch in - i never thought of this area before. interesting question if someone can give me an answer itd be great.