getting the life drained out of you

[proud nurse, BSN, RN]

I'm in my 8th week of orientation as a med surg RN. The reality of a busy med surg is setting in. I work nocs, so the max patient load is 7. This week I've managed 6. Within the next final weeks of orientation, I'll progress to the max.

Last week when I had 5 patients, I felt comfortable and like I was doing very well. When I progressed to 6, it was different but doable. Now knowing I need to get to 7 is very stressful for me. The last 2 nocs, I had a patient that was end of life care in isolation. Caring for this man and his family was exhausting. I did everything to make this man comfortable and serve the family (anti-anxiety and pain meds, Lasix, scop patches, emotional support, teaching). I left the hospital this morning, somehow made it home, and completely fell out. Right now I have no memory of anything that happened after I left work.

I can accept that my floor has this type of staffing ratio, but how am I supposed to handle that with complex patients? Not to mention, I might start off with a busy 6 and get an admission...if I would've gotten an admission last noc I'd have been royally screwed.

[PediLove2147, BSN, RN]

Honestly some nights will suck and you will feel totally overwhelmed. I have those nights and I have been on my floor for 1 1/2 years.

Not every night will make you feel this way though. As you progress you will get faster and more efficient and be able to handle your patient load. Give it time.

[dandk1997RN, MSN, RN]

As my manager said to me, a new intermediate care cardiac tele nurse, just about a year ago, "I promise it will get better. Give it a year."

You know what? She was right. At about the 5 month mark, things got so much better. I still have bad nights, but provided I don't follow the same horrid nurse every evening, the good nights outweigh the bad.

Give yourself time. It WILL get better!

[Morainey, BSN, RN]

The first night I got floated to med-surg (as a new grad who had never had more than 5 patients before), I had 7 patients, one on hospice, who died at 0600. Oh my gosh, I was so drained by the time I got home. I think you'll be fine - you are still on orientation, which is great, and will give you some time to get used to having 7 patients before being totally on your own. It IS intimidating, but will you have 7 patients every single night? Serious question, because other times that I have been floated there I have been pleasantly surprised with 3 or 4 patients on nocs. But anyway. Hang in there, it gets better :)

[proud nurse, BSN, RN]

No, I don't believe I'll have 7 patients every noc. But it looks like if you have less than that, you're up for the next admission...which can sometimes be worse than starting off with more.

Thanks for the encouragement everybody. I know it'll get better as I get used to it. My preceptors tell me I'm doing really well. The last one said "it was a tough assignment, and you handled it great." Always nice to hear.

[SoCalGalRN]

Damn. That sucks. I'm working a Med-Surg unit, 8 months of experience, and I can't imagine 7 patients. State law limits us to 5 and those 5 can be totally overwhelming. I know that when tele nurses float to our unit the extra 1 patient is tough for them, too. I don't think I could handle moving to another state with less strict patient to nurse ratios after starting in California.

[Caffeine_IV]

Your time management skills get better as you progress. 7 is a lot even on nights though. You just have to learn how to cut out the fluff when possible and make every hour count. Hopefully the wild nights are few and far between.