need advice desperately!!!

Nurses General Nursing

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I have recently been targeted by my nurse manager, I have been an RN for a year now on her floor and she has been on me like white on rice the past couple of weeks for the most petty problems. One bad night I forgot to document the I and O's and she proceeded to tell the shift following me to let her know if there is anything that I'm not doing and that she may put me back on orientation. Does anyone have any advice on how to deal with someone like her? She doesn't seem to notice the more important things that I catch that hasn't been done by other shifts. For example a post op pt that should have been on telemetry and was sent to a regular med-surg floor, IV rates that a wrong, pts not getting needed medications when ordered stat on the previous shift, recognizing "silent MI's" and a fib vs tachycardia. I follow a new grad sometimes and you don't want to know the stuff that I find that isn't done. I work nights and the I and O documentation for the day ends with me, however all the shifts are poor documenters when it comes to I and O's and when you are prioritizing in the face of too large of a pt load, very sick pts and what have you the I and O's are sometimes missed by all. You can get a basic idea that yes this pt has sufficient Intake and Output but not necessary by the cc. Anyway it seems that she is more concerned with this right now than anything else. I used to love my job, but now my stomach hurst all the time and I'm having headaches. I am so caught up with watching my step and my aides and lpns that I'm afraid that I will miss something more important. I usually have between 5 and 10 direct pts and cover the lpns 5-10. If the lpn misses documenting the I and O's she comes to me only and doesn't speak with the lpn or nurses aide, they are still memebers of her staff and I feel that she should speak with them as well. Has anyone ever experienced this before and what should I do? Is it possible to love what you do but hate your job? Thanks for hearing me.

:o
Specializes in Med-Surg Nursing.

When I was a new grad, I accepted a job on a Progressive Care Center, basically an in-hospital nursing home environment. The Administrator must not have liked me very much as I kept getting written up for petty, silly things like Mr. Smith said that you were rude to him--NOT TRUE! She always did this WITHOUT hearing my side of the story first. Yet her "pets" could make MAJOR med errors or other serious things that could have had a detrimental effect to the patient and those people not ONCE got written up! After a year of this crap, I decided that it was time to get the heck off of that unit and transferred to a med/surg floor. That was the best thing I ever did. I stayed on the med/surg floor for a year and a half before I quit that facility for a closer and better paying job. I have been working there for now for 9 months and have not been written up for stupid things once!

Sometimes, there will be managers that for some strange reason, do not "like" you and look for things for which to write you up. They usually get "help" fom back stabbing brown noser co-workers. I say get off of this unit ASAP! Before you lose your job completely. And if a manager has a strong dislike for you, they will "black-ball" you for other jobs in the future. This has happened to a nurse who worked in the unit that I first mentioned. She is an excellent RN, I have yet to work with a better one than she. But because she was a whistleblower, the Administrator "black-balled" her from getting a great job at the local Veterans Administration hospital.

Get out now!

Kelly:)

I think that everything happens for a reason...signs are all around us if we choose to see them etc... It just so happens that last night at work one of my patients was an RN in our OR, she was happy to talk to me at length about it and it sounds great! After some soul searching I think that this is best. My nurse manager and I will probably butt heads forever if I stay. I think that it is best for all involved. Especially me. Sad thing is some of my coworkers are just as unhappy, being victims of her before. A couple have left, and I know that I won't be the last. I hope the higher ups will see what the common denominator is here and why she can't hold on to her staff. Thank you everyone for your advice and support. You have no idea how helpful you all have been. If I get the job in the OR though, I'll have to change my name. No more full time nights for me. Again Thanks... Nytenurse sleepy girl.

Please reread Lillian's advice. To which I would add: Additionally, if acuity has suddenly increased (i.e., if the night is really going to hell) contact the nursing supervisor on duty and ask for help. The sup is in the position to redeploy staff from less acute sites, and many sups will come down themselves to help out if they can. At the very least, contacting the sup validates the fact to your head nurse that things really did go to hell quickly.

If your body is giving you physical symptoms, listen to it. Life is too short to remain in a environment which is making you ill.

With the nursing shortage, you can get another job in about 2 minutes. It's their loss.

I thought I would be a labor and delivery nurse forever. Loved it. Loved the adrenaline rush. There finally came a time that I realized that the hours, the stress, and the injuries I was sustaining because of a MS problem I have, these things were not worth working myself into an early grave, no matter how much I loved L&D. I went through an actual mourning period when I finally made the difficult decision to switch. I found another job immediately. It pays more, the hours are mine to configure, and the opportunities for advancement are already acheiveable. Downside: not as much "glamour". But you know what? I am happy, home in the evenings and weekends with my family, and bringing home a good paycheck and benefits. I am valued at work and my job is quite secure.

Bottom line: It's your call. Dig down in your soul and evaluate your priorities.

Best to you,

Pammie Sterling RN BSN RNCM

Quality Assurance Nurse

where do these nurses and managers find the time to see what everyone else is doing and write them up?

why am i so busy i need to stay hours after my shift to finish my charting but they are done in like an hour.

how are they finding time to sit at the station and socialize...with my assitants no less...keeping them back from their work?

they must be super nurses or something.

we have one that likes to check out all the other nurses patients.

what that nurse is doing.

she butts in to everything.

she seems to have plenty of time to make sure i have care plans on my admissions and double check the decisions i make. she has time to do this to other nurses too.

she must be a great organizer....lol

why cant mgmt see this?

she is a great something alright...lol

my dear friends,

you have been very supportive to me through this and your support is again needed. I was written up for an incident that occured the other day. This is what happened: They way our floor is divided we have a 28 bed floor. 2 rns and 2 lpns and 1 asst. This is then divided into 7 pts each for each rn and lpn. The rn covers the lpns resulting in 14 pts total responsible for. On this night we had (we meaning the lpn and I) 10 pts that were post op. They had had surgery that day. All were elderly with cardiac conditions. 1 pt who was my direct meaning that she was one of the 7 that had me as their nurse only, had a private aide with her, this aide came out to me and told me that she needed help repositioning this pt. Now this pt has been a difficult pt in that she feels that she is the only pt on the floor. She expects everyone to drop what they are doing and tend to her immediately. I explained to her aide that I had post op pt that I needed to see first and that I would be there as soon as I could. She came out again and said that she needed to see me. I told her again about the post ops that I needed to see first. Then she came out one last time and asked me if she could have a pain pill and that if she could give it to her. I said that no she couldn't but I would be there as soon as I could. Of course this wasn't good enough and the pt called the night supervisor. This resulted in my nurse manager writing me up for not delivering care when requested. I explained to her the necessity of needing to see post op pts and what their medical history was. This did not matter. If I had dropped everything and saw to her I would have been delaying care on someone else. I have not learned yet how to be in two places at once. Because I was written up I cannot leave this floor now for 6 months. I am stuck on this floor for 6 months. I had the director of nursing present at this meeting and she stood by the nurse manager. Is there anything that I should have done differently? I told them that I am really unhappy with the way the floor is run as a whole and what are they going to do to make me happy there. They told me it is not their responsiblitly to see to my happiness there. I was every inch a professional at this meeting. It didn't matter that this was the first time a pt complained about me. It didn't matter that I had a pt who was very good friends with the head of the hospital who was so happy with my care his family baked me brownies to show their appreciation. I feel that being kept on this floor is a fate worse than death. To hear them say that they don't care if their employees are happy or not, to know that they will risk post op pts for a pt with pain. This one pt, no one could make happy, every shift has had a hard time with her. My manager knows this, it was told to her by the other shifts. Part of me feels like she got wind of me wanting to leave and in order to keep her floor staff she wrote me up so I can't leave. Like I said this is the first time this ever happened. It is the first time a pt complained about me. The first time I was unable to get to someone in a timely manner. The first time we had 10 post ops on the same night. All had either epidurals or pcas that the lpn couldnt touch. Who will make sure that the setting are right if not me? no one.

part 2,

regarding the i and o's. I showed her the check system that I do now inorder to make sure the i and o's are always documented on. I showed her every note that I take and told her that at the end of my shift I check every chart to make sure that this is all done. She said that I shouldn't have to do this and that I should just ask the lpn or ca what their intake and output was. Well thats all well and fine but if they don't put it on the chart, if they forget to write it down but know what they put out or whatever isn't that the same thing as not doing it at all if its not on the chart? this happend just the other day. An lpn told me how much the pt put out in her foley. She didn't write it in the chart I somehow missed checking this one and the next shift called me at home and asked me what it was so she could write it in. She understands what I am going through and thinks its ridiculous. She has been very supportive. Most of us are supportive of each other. We realize that nursing is a 24 hour job and that not everything can be gotten to in 8 hours. We have each others back so to speak. I know who followed me the day in question regarding my i and o's. It was a float nurse. She didn't document on a pt that day and I brought this up to my nurse manager who said that she knew about it and spoke with her. She said that she also spoke with the lpn and ca. This is not true. I already spoke with them. She didn't even realize that one of the pts not charted on was the lpns and a member of her staff and should be spoken to directly. Is there a worse feeling knowing that your manager is lying to you and you can't do anything about it. My only options are to stick it out and be entirely miserable for 6 months or quit. That means starting over in a new hospital, new orientation, waiting for benefits. As a single mom I don't know if thats wise. I have a lot of thinking to do. In the meantime it may not hurt to look into other hospitals. I know that I may run into this again, but to turn my back on post ops, on pts who don't have a private aide to stand outside another pts door and wait for me to come out? Pts who have dementia who cant ring the call bell? I had one pt who was pressing the morphine pca button thinking it was the call bell because the place where she was from, that was what the call bell looked like.

Please keep telling me what your experiences are with people like this. What you have done, whats worked for you. Your experience is very valuable to me. With all thats happened. I can see why having a union is important. My hospital has been good to me in that they have given out bonuses to us to say thanks for hanging in their through the nursing shortage. Every bedside rn got 1500 dollars. lpn a little less. After taxes it was like 800 but it was still nice. The benefits are great. I guess. I don't really have anything to compare it to. Agency nursing is looking really good right now. I am so sad thinking about staying there for another 6 months. I feel so trapped. I feel that there is no one at the hospital that I can trust to talk to about this. Thank you all for being there for me. Sincerely Nytenurse.

Lillian Bradley

As a nursing manager, I can't agree with you more. I hate to see I&O that is not up-dated, full or errors or fabricated . They serve no purpose at all except wasting the nurses' time and our time to find out the culprit. It' the matter of attitude towards your work. If you can't do an I&O right, what else you do is reliable.

I'm sorry, I really don't have much advice. I just have an ear and shoulder. However, I can say your story sounds framiliar. And, this is one big reason why I've really cut my nursing hours down and choose to do other work instead.

I've always been so frustrated. You work your tail end off and provide good NURSING care. You give baths, teach, provide comfort to ill patients. Only to come on and get a note or reprimandiation for forgetting to change the NS K.V.O. bag that was due to be changed at the end of your shift. One day a nurse came to me and said something to the effect of "Dr. Smith was really upset that you filed the I&O sheet behind yesterdays". "He didn't know where to look and could have written the wrong I&O for the day". Now, ask me if I care. Dr. Smith just happend to work out of this hospital for 5 years or more. He, by nature of his occupation, must have at least average intelligence. And, I presume he can read dates.

I wish I could offer more advice. I think your head nurse is probably jealous, something not uncommon in this profession, I'm afraid. You can try another floor, but, nurses like this are everywhere, I'm afraid.

Sorry to be such a downer. But, stories like this get to me. This is the reason why the nursing profession is in such great demand. We loose good nurses everyday because of junk like this.

:(

I'm very sorry to hear that you are having problems. I realize that leaving may not be an option due to your need of insurance for you and your children, but it sounds like you are getting set up to lose your license. If you are getting BC/BS, do they have a "cobra" plan there? When I quit my factory job to go to school full time for nursing I went through the cobra plan and was able to keep my insurance for an additional 18 months. You have to pay the full premium, but it would be worth it if that is the only thing making you stay at your job. Start searching for another job now! I know what it's like to be stuck in a job where you're treated badly and no one cares if you're happy or not, granted, that was my factory job, but it's still no way to live. I hope you're able to get out of there with your license. Take care.

Run run run as fast as you can to the nearest computer and update your resume. Don't let this experience ruin nursing for you. It is very possible to love what you do, but hate your job. I've been a nurse for almost 14 years and recently left a job because the new supervisor was straight from satan's loins. You don't have to work in that type of an environment. There are plenty of POSITIVE nursing experiences out there for you to find. Good Luck.

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