Getting bad assignments every shift!

rn/writer, RN · May 23, 2006

You'd be a whiner if you had started complaining after two months. But you've put in two years! You've paid your dues and then some.

Your manager needs to know what's going on and why she's losing so many people. Most hospitals would welcome someone with your credentials and experience, not treat them like a dumping ground for problem assignments. Let your manager know what you've been dealing with, what kind of changes you want to see, and what you will do if you don't see them. While you're waiting, scope out other possibilities.

You deserve better than you've been getting. I wish you the best.

Gennaver, MSN · May 23, 2006

my husband and i moved to the east coast two years ago, and took jobs in the cardiac surgery icu of a large teaching hospital. i;ve been a nurse for 28 years, 23 of them in the icu, he has 23 years of nursing experience. this unit had experienced a period of high turnover -- which should have been a warning to us. but i had stars in my eyes, and wanted to work there.
... do i wait and see if my preceptor status changes anything? i know i probably should talk to the manager, but i don't want to come across as a whiner. on the other hand, nothing is going to change if i don't talk to her.
this patient population is the one i want to work with, and i know i'd love this job if the assignments weren't always so miserable. i'd like to stay, if i could get things to change. am i dreaming???

hi,

i would indeed suggest talking to the manager! if after two years you are getting trouble case after trouble case something is wrong. howeve, since you have never spoken up against it could (and this might sound really dumb) the manger and staff think that you are "super nurse" and that you actually like all these tough patients? good grief, it'd be a totall kick in the pants if they were asssigning you all these because they thought this is what you preferred!

yes, definately speak up, and soon!

two years of avoiding this conversation is two years too long! they may have been waiting to follow your lead.

possibly you want to (do not be offended) discuss with employee services or a mental health counselor to find appropriate ways to speak for yourself so that you have a good balance between being a doormat and exploding and quitting, all the best!! spoken from a "former" doormat who left too many jobs herself before learning to find her own voice too, grateful that i have, what a difference it has made.

gen

burn out · May 23, 2006

I had some of the same kind of experience after I had transferred back to ICU from taking a charge nurse position on med-surg. I have 10 years senority at this hospital..more than any one else in ICU even the manger..but because I had transferred to med-surg I had less senority in ICU. I got the schedule nobody wanted (could you believe that no weekends) and the bad assignments. Finally on my evaluation I wrote in the employee comments that I felt under -utilized , that I had 20 years experience and a BSN and did not feel I was being used to my fullest potential and much to offer (Our eveluations go up to administration). Suddenly I am in the charge position and the CEO seeks me out when she comes to our unit.

Ironically, one of the nurses that insisted that my senority not count when I came back to ICU asked me the other day if I thought it was fair that a new hire with the same years of experience as she had only in peds, make .50 more an hour...what goes around comes around I guess.

dayplay · May 23, 2006

I am very surprised that staff RNs in your hospital are getting the worst pair of assignments. You have every right to be upset, and I don't think you are whining. In our hospital, our staff RN's get priority over travellers and registries unless they have been caring for their assignment the previous day. For continuity, we will give them their pairs, but if an assignment is too heavy...our Charge Nurse will often split up these pairs. How is your assignment given? Is it already assigned before you come in for your shift? If assignments are already assigned by the Charge Nurse, best way to deal with this is to come in a few minutes early and ask the Charge Nurse if you can get a little break from these heavy assignments you've had in the last few weeks/months/over the years. If you still go for group report and then assignments are given at the end of report, you should speak up and state that you're a Staff RN and should be given priority in selecting pairs/assignment before travellers and registries. Good luck.

Tweety, BSN, RN · May 23, 2006

If you've already confronted the charge nurses and assistance, then it is time to go up the chain. Favoritism has no place in the work assignments. Good luck.

Ruby Vee, BSN · May 23, 2006

hi,
i would indeed suggest talking to the manager! if after two years you are getting trouble case after trouble case something is wrong. howeve, since you have never spoken up against it could (and this might sound really dumb) the manger and staff think that you are "super nurse" and that you actually like all these tough patients?

thanks for the advice. i have spoken up, though. i've spoken to the assistant nurse managers (who have much more of a role in the day-to-day running of the unit) and the charge nurses. the only person i haven't spoken to is the manager. since she manages two large units and is rarely around, i wasn't sure it would do much good. now however, she's got all this sudden turnover and has no idea why. i could certainly help her out with that!

ruby

DusktilDawn · May 23, 2006

thanks for the advice. i have spoken up, though. i've spoken to the assistant nurse managers (who have much more of a role in the day-to-day running of the unit) and the charge nurses. the only person i haven't spoken to is the manager. since she manages two large units and is rarely around, i wasn't sure it would do much good. now however, she's got all this sudden turnover and has no idea why. i could certainly help her out with that!
ruby

definately let your manager know what is going on and why she has such a high turnover. she may find it quite interesting how the charge nurses are planning their assignment ( "christy was really a ***** to me last week. i'm going to stick her with this confused guy who's acting out sexually." "this assigment is really heavy, but nancy's leaving in september, so what's she gonna do? quit?" ). people with this kind of mentality have no business being put in charge.

caroladybelle, BSN, RN · May 24, 2006

I am very surprised that staff RNs in your hospital are getting the worst pair of assignments. You have every right to be upset, and I don't think you are whining. In our hospital, our staff RN's get priority over travellers and registries unless they have been caring for their assignment the previous day. For continuity, we will give them their pairs, but if an assignment is too heavy...our Charge Nurse will often split up these pairs. How is your assignment given? Is it already assigned before you come in for your shift? If assignments are already assigned by the Charge Nurse, best way to deal with this is to come in a few minutes early and ask the Charge Nurse if you can get a little break from these heavy assignments you've had in the last few weeks/months/over the years. If you still go for group report and then assignments are given at the end of report, you should speak up and state that you're a Staff RN and should be given priority in selecting pairs/assignment before travellers and registries. Good luck.

And exactly WHY is okay TO TRASH on registry/travelers???????????????

The point is that it should be no more "okay" to dump in anyone - senior staff, junior staff, agency, floats or travelers. That also is the sign of a really lousy charge and no different than the charge dumping on people s/he doesn't like.

The reason that many places have large amounts of registry/travelers is because for SOME reason (like being continually dumped on) no nurse wants to take the job permanently. Treating senior staff/junior staff badly just will increase the need, but treating registry/travelers badly will ensure that no one wants to stay or take a permanent position there...something that also hurts staffing.

And my personal favorite, "dumping" on floats. Someone has the good grace to come and lend a hand only to be treated badly. And they spread the news of how crappy that they were treated, ensuring that no one wants to help.

Someone needs to even out the assignments, or find why the Unit is getting a disproportionate number of high acuity patients. Can some of the problem patients be shifted? Can some with behavior issues have a psych liason consult and be given a behavior contract? Are they playing in their poop, because there are not enough nurses/techs to change them?

It is better to fix the problem rather just dump it on someone else.

DusktilDawn · May 24, 2006

And exactly WHY is okay TO TRASH on registry/travelers???????????????
The point is that it should be no more "okay" to dump in anyone - senior staff, junior staff, agency, floats or travelers. That also is the sign of a really lousy charge and no different than the charge dumping on people s/he doesn't like.
The reason that many places have large amounts of registry/travelers is because for SOME reason (like being continually dumped on) no nurse wants to take the job permanently. Treating senior staff/junior staff badly just will increase the need, but treating registry/travelers badly will ensure that no one wants to stay or take a permanent position there...something that also hurts staffing.
And my personal favorite, "dumping" on floats. Someone has the good grace to come and lend a hand only to be treated badly. And they spread the news of how crappy that they were treated, ensuring that no one wants to help.
Someone needs to even out the assignments, or find why the Unit is getting a disproportionate number of high acuity patients. Can some of the problem patients be shifted? Can some with behavior issues have a psych liason consult and be given a behavior contract? Are they playing in their poop, because there are not enough nurses/techs to change them?
It is better to fix the problem rather just dump it on someone else.

Your right, it's not OK to dump on registry/travelers, agency, or floats. It also doesn't make sense to give a person who is unfamiliar with the unit the worst/highest acuity assignment, and indicates a lack of good judgement on the part of a charge nurse. Who wants to return to a floor where they are treated like crap?

Personally, I don't think charge is a position for just anybody. If someone consistently demonstrates lack of good judgement, or consistently uses the position as a means to "payback," they have no business being put in charge.

Ruby Vee, BSN · May 24, 2006

i talked to my manager this morning, and she said she was going to see to it that there's a change in the way assignments are made out. "i have some work to do with my charge nurse group," she said. i'm scheduled to work with student nurses for the summer, and in the fall i'll have an orientee. that means stable singles and doubles for as long as the orientee needs it, but it also means working with some interesting patients when the orientee is able.

i told the manager that i came to this facility to work with interesting patients, and that this is where i want to be. but if i'm not going to have the opporunity to work with interesting patients, i need to figure out what i'd like to do instead and pursue those opportunities. she expressed gratitude that i'd come to her to give her a chance to fix the problems rather than just present her with another resignation.

i guess i need to reserve judgement until i see what happens, but right now i'm feeling rather optimistic.

rn/writer, RN · May 25, 2006

I'm glad you spoke with your manager. I hope she honors that respect by taking care of the problems. Even if she doesn't, you'll feel better for having given her the chance AND for taking care of yourself.

Good job!