Nurscee's Freaking Out!

allnurses Guide · Feb 13, 2005

Saskrn - No one is tearing you apart. Really.

There was a time that for awhile I had 10 patients off and on and I did it but to do something like that on a consistent basis is not good for the patients or the nurse. That's all we are saying.

We are also trying to advise the OP to not put up with unsafe situations and that is the real subject here .. .not that you were able to care for 13 patients. Day after day of 13 patients would soon burn the best nurse out.

A new nurse needs to realize something that is not taught in school and that is to stand up for themselves. And their patients.

We appreciate your input - take a deep breath and stick around. Remember that words on a computer screen can take on a life of their own without that being the intent of the writer. No one intended to attack you. It is just . . . 13 patients :uhoh3: whew!!

steph :)

pickledpepperRN · Feb 13, 2005

I don't want to come off as being cold, but when I graduated, I was able to do total care on 13 acute patients. Is seven bad?
If you're having a hard time, I think you should definitely speak with your manager. It is part of professional responsibility and accountability, IMHO.
Hang in there, you'll be ok! :)

We once had a DON who said, "I have been in management for 12 years. I know I was able to care for 12 patients."

She agreed to shadow a nurse for four hours. She did this three times in one month.

Her response? "I understand what you mean. These patients are much more acute than the patients were 12 years ago."

She was a grest leader. I wish she had stayed. The patients a nursing staff at her current hospital are fortunate.

Tweety, BSN, RN · Feb 13, 2005

The most patients I ever had to care for at one time was 11. It was to be from 7 to 11 only and then help was to arrive at 11p. I had six months experience at this time. One patient decided to have an MI at this time, everyone had needs, need for toileting meds, etc. It was a nightmare. The 11pm nurse came on and there were patients in my assignment I hadn't seen. I gave her report on patients I hadn't assessed "they could be dead in there for all I know".

The unit I work on now used to routinely give 9 to 10 patients with a nurse and a tech. It was exhausting, but I did it. Now the ratio is 8:1, I don't sit back in gratitude and say "well I used to to 10". I still struggle with 8.

Ratios matter.

Spacenurse more power to you if you can spend only five minutes a patient, more power to you if you can chart in five minutes. LOL

prmenrs, RN · Feb 14, 2005

closed for time out. Everybody relax, now, please.

prmenrs, RN · Feb 14, 2005

I have re-opened thread. There are a LOT of good comments on her, let's try to stick to the OP's original question.

Thanks, everybody.

snowfreeze, BSN, RN · Feb 14, 2005

I recall writing up incident reports for unsafe patient/nurse ratios, sending them to the Head Intensivist with copies to the nursing supervisors office, and the administrator.

Each incident report described the patients assigned to the nurse writing the report, the care involved and that best care possible under these circumstances was administered but optimal care was impossible.

We always kept a copy of these incident reports ourselves and found a lot of response to them. After they quit responding to these reports we had one patient who was confused, climbed out of bed with a balloon pump...pulled the pump out and bled to death before the nurse could even respond from the room at the other end of the unit to which she was assigned. One nurse had two ventilator patients on her assignment but the rooms were not side by side, while administering to one patient who was relatively stable (yes the stable patient needs care too..DUH) the other very fragile one extubated himself and died, unable to resuscitate. Did anyone hear the vent alarm, sure they did, but could not drop what they were doing immediately and respond. The court figured the response time from the alarm sounding to someone at bedside was less than one minute but the patient was so fragile....that wasn't quick enough.

No facility staffs for "when hell breaks loose" anymore. It costs too much.

begalli · Feb 14, 2005

All I can say that as an RN, who works in a hospital that acknowledges that new-grads need a thorough orientation and preceptorship sometimes even beyond the 3 month period that is usually adequate; that nurses do burn out due to the magnitude of care that is required to care for our sicker patients; and that the voices of nurses working on the front lines is important in planning strategies to deliver excellent patient (and employee) care, is that I'm thoroughly disgusted with what goes on out in the wonderful world of hospital nursing.

I can also say that I'm disgusted from having been the family member of a patient whose inpatient care was HIGHLY impacted by the nurses of this hospital having high nurse to patient ratios (1:12 on one occassion; usually 1:8-9).

Even with study after study showing the effects of overloading a single RN (both highly experienced and new) with too many patients, both on the nurse's well-being and patient outcome, hospitals STILL don't get it.

It's all about money. This is frequently made out to be a "which came first - chicken or egg" problem. Hospitals like to say that having more nurses costs them more money when in the long run it would probably cost the hospitals less by having tighter nurse/patient ratios because of better outcomes (shorter stays because of less complication due to the increased attention to detail nurses with less patients can contribute) and more patient satisfaction (less lawsuits due to the patient and the family feeling that they are being informed of the course of disease and treatments).

It's about the money and who advocates for what, period. Because hospitals have the money to throw into lobbyists who can line the pockets of politicians for their own political benefits, the hospitals win. Nurses don't have that kind of monetary power. That's where the CNA of California comes into play here in the beginning of something VERY BIG in RN/patient ratios.

There will be a shift in the future. As more and more nurses begin to see that we are NOT voiceless. And our voices will grow with contributions from nurses just like nurscee!

plumrn, BSN, RN · Feb 15, 2005

It seems as if the administrators making up these ratios just don't want to listen to what nurses are telling them. They refuse to believe that nurses are telling the truth about the dangers with these high ratios, and choose to believe that we are just trying to make our jobs easier 'so we don't have to work so hard.' Lazy nurses, every one of us!

NurseFirst · Feb 15, 2005

It seems as if the administrators making up these ratios just don't want to listen to what nurses are telling them. They refuse to believe that nurses are telling the truth about the dangers with these high ratios, and choose to believe that we are just trying to make our jobs easier 'so we don't have to work so hard.' Lazy nurses, every one of us!

It's probably impossible, but maybe we should just refuse to work for any hospital that is for-profit; or for non-profits whose spending could maybe, just maybe, be reigned in a bit? How is it that Kaiser was able to knock $100 off my monthly insurance (private pay, through an HIPAA policy, about 25% off) last year when many people complained, huh?

Does anyone remember the scandals of some years back when either BC or BS was accused of some sort of hanky-panky, or the exec was, or something like that?

I'd love to enroll all the CEOs in this country in a "voluntary simplicity" program--ah, but their trophy wives would be sure to object. sigh.

NurseFirst

CHATSDALE · Feb 15, 2005

nurseee..changing your place of employment is something you should take into serious consideration...but...they may think that you are 'experienced' d/t your current job but if you feel like you need more in-depth orientation let them know in writing up front..

when all is said and done most nurses will tell you it took them about a year in nursing before they really felt comfortable with what they were doing...

sometimes with new admits, and staff call-ins you will wind up with a marginal safety load but if you routinely take on a load like this they will just assume that it is a doable workload

weigh your options...put your license and the the years of schooling as the most important thing to keep in mind

BETSRN · Feb 15, 2005

Help! I've only been a nurse for a month and a half.
Last two nights I've worked 12 hours (supposed to be 8) that's not the big deal though.
First I had 7 patients alone....won't even go into the hell that was.
Then tonight I had 6 but 5 were on insulin, and one of them was a every hour 20 units of insulin.
That isn't to mention the wet to dry dressings, pegs, brain surgery, and other various and sundrie items.
Not only that but this antiquated hospital still only does handwritten documentation. No computers.
I dissolved into tears. Don't know if I can do this!
YES, I DID ask help. But we have nurses who have 9 pts. They have their own share of problems.
Did you ever feel like you'd freak out????
Did you ever feel too dumb to do this????
Tell me I can make it, or not. Got ANY solutions?
Is my life long dream to be a nurse just a pipe dream?
HELP!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!

Can we just clarify a few things here? When you say you have only been a nurse a month and a half.........does that mean you ahve been done with orientation for that time or you ahve just been a new grad that long?

wikiwicked · Feb 22, 2005

You seem to be doing good for a new nurse managing near that of a more experienced one. Unfortunately, stress does come with the job. Your skills will develop with time and you'll wonder why you ever worried. Stay on your toes - get a few good pair of Nikes and smile. If you still love what you do, keep doing it!