Unsafe working conditions - (Graphic)

Nurses General Nursing

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Hi all--

I was in the chat room last nite and talked to a few people and got some pretty good advice but was trying to still process what would be the best thing for me to do. I am a new grad since May of last year. I began working at a hospital in Sept and they just recently began training me for a Team Leader position, since they do team nursing there. Well, it's been a complete disaster. Their turnover is tremendous, they understaff all the time. They only gave me a two week orientation! Most of my friends are getting 6-12 weeks at their hospitals. Well, on my last nite of orientation something happened and I don't know if I could even go back to work there. I was trying to wait until my six mos and transfer to a hospital within the same system. And if I didn't do that, I wanted to give a two week notice to cover my references. People are telling me that nursing jobs are so abundant that it shouldn't be a big deal but I don't want to burn any bridges. Okay, here's what happened in a nutshell---WARNING! It may contain some graphic material but I may not be able to explain it and the depth of it without going into detail. Sorry if I offend anyone. Okay, I work on a med-surg, post surgical unit. We had a lady come from the ER who was in the process of a miscarriage. She was 17 weeks and her US showed that the baby was in her pelvic/lady partsl area. She came to the ER stating that she felt the "baby was coming out". Okay, so I admit this woman - I'm still on orientation supposedly. First of all, she shouldn't have even been on our floor and second, I should have had someone help me through this mess. Well, I get her admitted, she's comfortable, and then the doc shows up. My preceptor or whatever you want to call her, sends me in with the doc and disappears! At this point, the doc is asking for some gloves and lubrication. And before I know it, she's pulling out this fetus. Oh my gosh, I didn't know what to do. The patient was basically in shock. Then the doc says she needs a clamp and sterile scissors which we don't carry on our floor because we are not an OB floor. We had to call the OB floor, and the house supervisor. In the meantime the doc is waiting like 20 mins to cut the cord....then she asks me for a blanket to wrap the baby in. Hands the baby to me!!! I didn't know what to do. And the patient is right there. She tells me to put the baby in the STORAGE ROOM until the mother decides if she wants to hold, have a burial,.....etc. In the meantime, OB comes down, weighs it, takes footprints, and explains all this stuff we need to do, the forms, etc. the grieving materials for the mom....and that we need to take some polaroids of it. I had a new grad nurse with me who was very brave, thank god. Well, then we were told that if the mother decided to "dispose" of the baby that we would have to put it in saline water. So they gave us the things we needed and left. I know that I may have to deal with things such as this in my career but I feel it was totally wrong for me to be left alone. Now I feel like I'm suffering from PTSD or grief or something like that. I am ready to just leave this place but I want a good reference....or at this point I don't know if I care. I was going to call on Monday and tell them I can't work under these conditions any more, that my license is on the line. Someone here mentioned to me to go get a doc's note saying I can't return to work but then others are saying that may look incompetent when I go to the next place. I need some serious advice before Monday when I have to go back to this place. I don't feel safe here. I have only had two weeks of training and they are throwing me to the wolves.....

Please help!

Specializes in Nurse Education, Obstetrics, Surgery.

Hoolahan,

If I was new grad I would be very offended that you think they won't know how to improvise or know what a penrose was. 4XNursing was just using that as an example for something to tie off the cord to cut it. Is there something else that is really the cause for your slash? I wouldn't put down these new grads. Some are far more intelligent than the seasoned RNs.

Specializes in Home Health.

I just re-read that and realized I should have said "some new grads" including myself. I can say I had an OB rotation of maybe 8 5-hour days in OB, saw 2 deliveries the whole time, one C-sec and one lady partsl. No infant deaths. I say again, I personally would never have felt competent enough to manage that pt as a new grad. Maybe you would have. Maybe you already had children of your own, or gave birth yourself once, maybe you went to a diploma school, maybe you had your OB rotation during a full moon, maybe you loved OB and I feared it. Maybe you learn differently than me. Just b/c you felt prepared when you graduated from nursing school, doesn't mean everyone does. I never meant any personal "slash" toward anyone. Why would you even say that?? If you read any of my posts here, you would know I always support students and new grads as much as possible and it is not my style to "slash" people.

PS I never saw a penrose drain or gave meds through an NG tube in nursing school.

Specializes in Oncology, Med-Surgical.

Well, didn't mean to start anything BUT the doc is the one who wanted nothing but a clamp, because this "clamp" remained on the patient until her placenta came out and I don't know when that was because it didn't happen on my shift. Also, I did pull some sterile scissors from a suture kit, but the doc said she'd rather have the sterile ones they were sending from OB.

No, I was not prepared at all for what happened. Going to nursing school taught me nothing. I've already learned that. To do foleys and NGs on a bunch of mannequins in a nursing lab???

And then to have to somehow improvise when I'm basically in a state of shock, because I'm left alone to flounder because my preceptor was irresponsible? Yes I am smart, but when you are faced with a situation like that, it's the "wisdom" that I needed and I can't get that in two weeks of training or nursing school.

Sorry but I must be honest....

Hey, Mickey mom -

I really don't think Hoolihan meant anything LIKE a slash. I've never seen her say an unkind word at all.

I think everybody - well, okay - MANY - maybe most of us - agree that it was just too much for a new grad, somebody supposedly on orientation. The seasoned nurse said SHE couldn't handle it - obviously Amy was just fresh meat there, a warm body being utilized. That's just not right.

I think the ones of us who felt the least prepared are the ones who realized that all of a sudden - IT ALL MATTERS. Desperately, sometimes. I think it's realistic to be afraid and need some support at the beginning. Orientation, I'm thinking.

Love

Dennie

MickymomRN,

I didn't see Hoolahan's post as an attempted "slash." I've never seen her write an unkind word to anybody!!!!

I think that the people who come out of nursing school cool and calm and confident aren't the ones who are paying attention! I think it's reasonable that a new grad, without experience, NEEDS more than "have at it."

Orientation is supposed to help you head the RIGHT direction. The floor nurse (seasoned nurse one assumes, but maybe not, if the turnover is that high) said SHE couldn't handle it and bailed. So Amy was left holding the bag.

I think the advice to suck it up and improvise would be harder on me, more of a slap, because it implies that she doesn't have a valid problem!

Love

Dennie

Originally posted by MickeymomRN

....[i agree with 4XNURSE. She hit the nail on the head.

I'm gonna let that one slide, this time. I've been called a lot worse. - Some of my best friends and colleagues are "SHE".

Amy,

I hope you don't think I was taking the situation lightly. I do not. I am however probably a little jaded in the response department. I had the advantage of working as a NA on a surgical floor when I was in nursing school. I knew about drains and foleys early. They are both sterile, and usable.

As I Rx'ed - a glass of wine and a hot bath is the start. You have to take care of you. Problem is, sometimes we have to finish with our patient first. - That patient needed a nurse. You happened to be the one there at the time. It may be Mickymom next time, or me or hoolahan, or...., any one of us may be there, ready for it, or not.

I did a night in one ER where we had 2 babies, under 2 yrs old, that didn't make it. 1 we coded for about 2 hours, the other about 1.5. Finished with the 2nd one about 0730. When I got off I had to go home and just hug my little ones, and cry. I was there that night. I was experenced, and knew what to do. It was my job. I didn't have a choice that night. It was part of the territory.

YOU have to take care of you and then go on. I also have places I won't return, - For less of a trauma than what you went through. (I can be a real A** at times)

Adapt, improvise, get through, and then regroup. Pick up the pieces, and do the job you love.

Take care.

ken :devil:

Dennie,

I did say improvise, I did not say "suck it up". We do have to do what it takes to get through the toughest of times for our patients. Fall apart afterwords. But, do what it takes to get through it first. The better you learn to adapt and improvise, the easier you will be able to handle the aftermath.

ken

I'm very sorry for what you have gone through and believe that you are taking positive steps to help you through this terrible ordeal. Amy, the patient should never had been admitted to your unit. In some ways, your experience was a "snapshot" of what is wrong in acute care today -- patients being placed inappropriately on floors (a bed is NOT a bed is NOT a bed), lack of support/teamwork. You should be proud of yourself -- you acted professionally and were there for your patient -- unfortunately, your preceptor was not there for you or the patient.

You have gotten some excellent advise on this board. Follow through on EAP, HR, and Risk Management -- document and keep a copy of everything. Hopefully, you will be able to work through this with time and support. I'm praying for you.

Specializes in Everything except surgery.
Originally posted by Mary Dover

Marvelous suggestion Brownie. Amy listen to her. Gotta 'work out the kinks'.

Thank you Mary Dover....:)...LOL. I'm glad you and others agreed it was time to get Amy's mind off the situation, and onto getting the scene, that I know is probably replaying in her mind constantly. I'm glad Amy has some very wonderful and supported posts today! I'm very glad she has sought out further help in "real time".

Amy.... take it all in stride...you did well...and you are now the one that matters! You can't change the events of the past...you can only change the future, and believe me Monday will take care of itself. No amount of worrying about what someone will do or not do will change anything. Just listen to your own heart, and take time to decide what is best for you. Don't allow yourself to be rushed into anything...except what you feel comfortable in doing.

As Shakespere wrote:"This above all: to thine own self be true"..speaks volumes here...IMHO

I hope you took time out for yourself today. Peace with you

tomorrow...and always...(((((((((((Amy)))))))))):cool:

Specializes in CV-ICU.

Amy, I was in chat with you last night and between some of the other stuff you'd mentioned, there is some "workplace mobbing" going on there PLUS the dangerous short staffing and inadequate orientation that you are dealing with. I do feel that what you wrote last night shows that you need some professional help with this whole situation and I'm glad you called EAP. PTS is a very real problem, and I advised you to go to YOUR doctor for a note for your workplace.

I think I would hand in my resignation for the 18th (you hadn't mentioned how close that 6 month date was last night) and call out sick for that time - with my own doctors' note saying that you're out for medical reasons. Then handle some of the other things happening in your life due to the stress of this whole mess. Do meet with your manager and HR as EAP advised; and follow RNcountry's advice about the professional letter to HR and your manager also.

Depending on your energy level, I would follow up with the other letters as she mentioned; BUT ONLY if you have the energy! You may have too much on your plate already at this time for you to handle. Stress somehow ;) manages to drain all extra energy from a persons life.

Good luck, and GET OUT OF THAT TOXIC PLACE!!!!!!

amy,

i work on a busy med/surg unit. we get all kinds of cases, and sometimes we get pregnant patients but thats EXTREMELY rare, although we are the ER dump.

That must have been a horrifying experience. I know it would be for me. But the good news is YOU HANDLED IT WELL. Sounds to me like you actually were more prepared than you thought.

I've had to skate thru a lot of procedures and treatments where I didn't have a clue what I was doing. I didn't feel "safe" but in the end I was able to provide excellent care without letting the patient know I was scared to death. Sounds like you did the same thing.

Another poster said early on that you shouldnt have worried because the er and supervisor deemed it was "safe" for that pt to be on your unit. I really have to disagree. If patient safety were a consideration, she would not have been on your floor.

New grad or not, I don't think it was proper for the PATIENT to be put on that unit. While it's true that her baby was already dead and could be delivered anywhere, there are so many things that can go wrong during and immediately after delivery. A med/surg nurse is not trained to spot these things as quickly as an OB nurse. This could result in delay of care in an emergency situation.

I think its horrible what they did to you.

Especially your preceptor. It is unacceptable.

But I can't say that it's all that unusual for med/surg.

When you work med/surg-unlike the speciality floors-you never know what kind of patients you are going to get. We get EVERYTHING. It is one of the things I like about it though (mostly). I get a lot of experience in so many things that help make me a good nurse.

What happened to you may well be the worst experience of your career. This was not a normal situation by any means. The nurses on that unit, especially your preceptor, should be ashamed of themselves, though I am sure they are not.

My second night off orientation I had a pt go into respiratory arrest. It wasnt a sudden thing and I recognized it right away and called the docs. I had 3 docs calling out stat orders to 1 me.

There were experienced Rn's sitting at the desk and chatting. The charge nurse said she was glad that wasnt her patient and thats how they break the newbies in.

I had 4 other patients along with that one. 2 new admits just up from er, one fresh post op, and a confused elderly who sat on the call bell all night demanding meds.

I was terrified. I was angry at my coworkers for not even once asking me if I needed help.

At the same time I saw something in myself I hadnt seen before. I am a really good nurse. I was able to recognize the problem and carry out the the orders WITHOUT anyones help. I did it well. In addition, I was able to take care of my other patients, tho they had to wait longer than I would have liked.

Amy, they threw some crap at you but you handled it better than the experienced nurses, especially your preceptor who COULDNT HANDLE IT AT ALL.

Only you can decide to stay or leave. You are going to have awful experiences. These things happen to us. It's the nature of our job.

Hugs to you and much strength while you think this through.

Specializes in SICU.

Don't worry about walking off the job without giving notice, although it would be easier to get a reference if you did. However, you'll still find another job.

You may want to take a week off instead, and give yourself time to realistically evaluate your situation as far as a job search goes. So, develop the flu or something!

And just to let you know, it DOES get a little easier. You will acquire the mental strength it takes to deal with situations like that. Give yourself time. It's hard to assist with something like that, but that IS what we're there for.

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