How can I prevent myself from having a nervous breakdown?

[shabbychic23]

I am a new RN with only 3 months on a med/surg unit. Along with transfers and new admissions, there are time when I have up to 11 patients to care for. The hardest part of the job is trying give out meds within the 1 hour before or after time frame of schedule time frame. Many times I find myself on the 6th. patient still giving out 10 AM meds at 12 PM.

To make matters worse, pharmacy personnel are never punctual with scheduled delivery of medications, especially IVPB. The nurses Aide on my unit aren't cooperative and at times insubordinate when I ask them to go to the pharmacy to pick-up meds. Needless to say this ultimately comes down on me if a med wasn't given or was given late. Another source of stress is the demanding nurse manager on my unit. Since JACHO is scheduled to come to our hospital, she has been nit picking at anything and everything. While I can appreciate her concern it has me extremely exhausted.

Finally, there are the patients who are so demanding. I've had demanding patients press on the call bell so many times that I lost count. Am I there just to serve them as their personal nurse?

Two days ago I just broke down in hysterics in the nurse manager's office. The words were so hard to come out in between the sobs. I told her how older nurses have been less than helpful in sharing their experience. In addition, I told her that I felt that I couldn't live up to her expectations. I mean she seemed to complain about everything. That same day, I ended up leaving early because I felt I couldn't provide decent nursing care to my patients in the condition I was in. I've since been off from work for a few days to recoup.

I love nursing so much, but since I started this job, I'm beginning to question whether or not I chose the right career. I can see why many nurses get burnt out from the profession and I'm afraid if things in the industry don't change, such as less patient to nurse ratio for starters, there will continue to be a high burn-out rate among new nurses.

Any words of advice would be greatly appreciated. :o:bluecry1:

sincerely,

Shabby Chic 23

[bestbabynurse]

My first year was similar. I got the 1.5 years in and switched to psych for a while. How appropriate. :-D

[Ruby Vee, BSN]

a lot of people are saying "the first year is tough". well, i've been a nurse for 15 years and i would be close to a nervous breakdown working under the conditions the op describes.

there's absolutely nothing wrong with the op. she sounds like she's having a reasonable reaction to the circumstances. she shouldn't need to see a shrink because she works in a hellhole. the people creating the hellhole need the shrink.

the op is saying that sometimes, with transfers and admits, she has up to 11 patients to care for in a shift. not that he expected assignment is always 11 patients. i work in icu and sometimes i have 5 or 6 patients in a shift -- not that i have more than 2 at any one time. usually. transfer two out, pick up sally and susie's assignment so they can go admit, transfer one of them out, pick up one of jesse's patients so he can go home . . . . when i worked on the floor in the days i was just starting out, i had 10-15 patients at a time . . . depending on whether there were 2 or 3 nurses on our 30 bed floor that day. there were one or tow cnas. it was brutal, but i got through it and i learned organizational skills.

i didn't see anything in the original post that indicated that the place was especially brutal or a hellhole.

[Ayvah, RN]

Patient acuity in hospitals is getting much higher/more complex over the years as more and more people are being taken care of at home.

Just getting your papers together/looking up labs on 11 patients and getting report will take at minimum 10 minutes a piece, so that's 2 hours spent right there. Tack on another 2 hours for giving report and preparing discharge paperwork/explaining it to patients/coordinating their discharge (if they are smooth discharges), and that's 4 hours total just for giving/getting/discharging patients. Your 8 remaining hours divided by 11 patients is 44 minutes a piece to do medications, dressings, tube feedings, tpn, trachs, prep for tests, coordinating care with other specialties, check orders, talk to families, do prn meds, assess, chart, misc patient requests, etc. And that's with figuring that none of your patients are an ER admit or direct admit, and that all of your patients are fairly stable, and that there are no "bumps" in any of the aforementioned duties.

11 patients on a typical med surg unit these days is not doable, safely, in a 12 hour shift, especially not on day shift.