How do you deal with the stress of the job (too busy to take a break, etc.)?

Celia M, ASN, RN · Jan 7, 2005

AS a manager of a small ICU in California we are required by law to provide coverage for breaks to maintain our ratios. I or the Nursing Supervisor provide the coverage. i always take over patient care and perform those tasks that are needed during the nurses break. Talk to your manager if you feel able about having a formal relief at least for lunch so you can get away and not feel that if you leave you'll just have to catch up with everything that was due during your lunch. Make sure you eat and drink even if you are on the run. Give yourself time to develop you own stratergies for organising your time. Watch seasoned nurses and take from them what you think might work for you. Good luck :)

bjpeace · Jan 9, 2005

Give yourself time to develop you own stratergies for organising your time. Watch seasoned nurses and take from them what you think might work for you. :)

What good advice! I agree with the protein snacks while charting. But the main focus is giving yourself time to develop an organizational plan to your day. I have been a nurse for almost 8 years. I have progressed as far as I have by watching others, and how they handle certain situations. I adapt their best qualities and make them my own. My advice to you is pick someone with a few years under their belt that seems to do their job smoothly. Take them out for coffee- or spring for dinner - and chat. Tell that person what you want to accomplish and (gulp) ask for their help. I hope you won't give up. And as for feeling burnt out... think yourself through it. Meditate or pray before you go to work. Put yourself into a positive mindset. Remember when you go to work complaining, you are affecting the attitudes of your coworkers as well. Good luck!

staceylynn · Jan 14, 2005

give it time, 5 months is very new! I believe that every new nurse should work on a regular floor at first to get used to the stress. It hard jumping right into to critical patients!

Morguein · Jan 16, 2005

When you make out your "to do" list, put yourself on it for a q 2 hour bathroom break and glass of water, and then cross it off just like everything else after you've done it.

Hey I like that idea! :) I think I'm going to start doing that.

BeenThereDoneThat74, MSN, RN · Jan 16, 2005

Float nurses do not have an assignment except for the rooms that they cover for breaks, to help out in emergency or code situations, and to just help out the nurses they're assigned to with general things like baths, turning, etc. The float nurse is in the count and is usually a mentor type of person who has experience and can help out with problem solving with the newer or less experienced nurses (the way the floats are assigned make for a good match with the less experienced nurses).
When my breaks are covered (or when I'm a float), the RN covering is looking after ONLY my patients so I'm able to delegate things while I'm away such as doing blood sugars, gases, suctioning, etc.
The float asks each RN (not more than 3-4 nurses beside themself) what time they'd like to go and coordinate all breaks making sure everyone gets all of their time before the end of shift. For a 12 hour shift, that's 3-15 minute paid breaks and a 30 minute unpaid lunch/dinner break; 8 hour shift is 2-15 minute breaks and a 30 minute lunch/dinner break.
With this great experience, I don't think I would work anywhere that doesn't encourage an RN to get out and regroup.

Sounds like a nice place to work!! :)

Silverhawk · Jan 16, 2005

You are so fortunate to live in CA with it's patient ratio, and enforced break laws. Indiana has break laws, but they are not enforced./ I have 50 residents on my hall, and two aides, although occasionally it's just one aide. This sucks!

I literally work non-stop save restroom stops and a 5 minute lunch. It's getting old. I have been a nurse just one year now. I'm thinking of hospital work because it may offer me my breaks and less patients. Florida has a new staffing ratio law too! Indiana won't get ther for another 25 years. Any thoughts are appreciated. Thanks!

UOTE=begalli]I can only describe how it is on my unit. Fortunately, we have the staff to cover breaks keeping within the max ratio in the state of CA of 1 nurse to 2 patients. We take turns being the "float" nurse for the unit. There can be anywhere from 1-3 floats depending on the census.

Float nurses do not have an assignment except for the rooms that they cover for breaks, to help out in emergency or code situations, and to just help out the nurses they're assigned to with general things like baths, turning, etc. The float nurse is in the count and is usually a mentor type of person who has experience and can help out with problem solving with the newer or less experienced nurses (the way the floats are assigned make for a good match with the less experienced nurses).

When my breaks are covered (or when I'm a float), the RN covering is looking after ONLY my patients so I'm able to delegate things while I'm away such as doing blood sugars, gases, suctioning, etc.

I know I've said this before, but we take all of our breaks that are afforded us by law, we're practically forced to take our breaks. Rarely do we miss a break, I mean rarely! And if we do, we are paid for the 30 minute unpaid break and a report is filled out (don't remember what kind of report, that's how rarely). I think my hospital (or at least my unit) takes the law seriously (probably because of the union).

The float asks each RN (not more than 3-4 nurses beside themself) what time they'd like to go and coordinate all breaks making sure everyone gets all of their time before the end of shift. For a 12 hour shift, that's 3-15 minute paid breaks and a 30 minute unpaid lunch/dinner break; 8 hour shift is 2-15 minute breaks and a 30 minute lunch/dinner break.

When I first started out, I felt really frazzled. I felt so behind all the time. It took time for me to utilize my resources...like my float. It's hard to learn to delegate and what can be delegated and to who. It took me a good year at least to feel comfortable being kicked out of my room to take my breaks!

I've been known to tell docs that I really genuinely wish I could get everything done at once, but I just can't. Usually that disarms them and they realize where I'm coming from. With our docs, if you don't get defensive, they're cool.

It really makes me sad that nurses everywhere don't get those so important rest periods, even if for only 10 minutes. Sometimes, I think, one gets so bogged down, they really need to just step away or a mistake will happen. I find this especially when I'm orienting new grads or new nurses to the unit - I have to literally tell them to GO, I can do the gas, or GO, I can turn your patient, or GO, that can wait 15 minutes!

With this great experience, I don't think I would work anywhere that doesn't encourage an RN to get out and regroup.

laurakoko · Jan 17, 2005

I have to agree with 3rd shiftguy.... You must take your breaks! I usually TELL my patients, on a round, "ok, I am going to eat for about 20 min now, is there anything I can get you?" Most of them respect that, and I come back when I am done! It works for me......:)

askater11 · Jan 17, 2005

I am a pool nurse. I work everywhere but medical surgical units.

I'm more comfortable in ICU than any where else. My nursing history has been more step-down/telemetry floor but the past two years I've occasionally worked ICU.

Perhaps ICU will be what you're looking for. I love ICU b/c I get to "KNOW" my patients more. On the other units I barely know them and there's so many of them.

I'm a nurse that has trouble taking breaks. I'm anal retentive and things much be just so. But I do feel more comfortable in ICU and tend to take more breaks.

Keep your head up--everything will work out fine.

oakmax · Jan 17, 2005

Hang in there/ I found with experience/sicker patients I find myself managing my time better. So look for the sickest patients, that being said I find myself more "frazzled" with 2 post op extubated cabg pts, they are almost always more needy and are more work than the sedated intubated patient.

Also try other shifts, may be slower at nite.

If it doesen't work out I'd stay in critcal care, I find stepdown busy but non stimulating if that makes sense.

BeenThereDoneThat74, MSN, RN · Jan 18, 2005

perhaps icu will be what you're looking for. i love icu b/c i get to "know" my patients more. on the other units i barely know them and there's so many of them.

i agree with that. not an icu nurse (but have been in there on occasion, and am considering a switch), but on bmt, we have between 1 and 3 pt. sure, we do everything for them, but we also know everything about them. when i get stuck on onc. (5-6 pts), do you think i know any of their lab values? do you think i know their baseline bps off the top of my head? do you think their i&0's are accurate? no!! i'm sorry to say this, but it is the truth. they deserve better care. maybe i'm not as good at multi-tasking, but it's hard to stich gears from critical to non-critical (even though the floor pts are sometimes just as sick). rant over now

to the op- how many pts. are you usually responsible for?

HillaryC, RN, CRNA · Jan 19, 2005

to the op- how many pts. are you usually responsible for?

our ratio on my simc unit is 2-3 pts per nurse. it's a 9-bed unit, and on days we're usually supposed to have 5 nurses and usually one pct. on nights, we often end up with 3 nurses for 9 pts and usually one pct. i know the ratio isn't bad for stepdown at all (half the time, the icu nurses have 2 stable pts. also). even though our pts. are less critical than icu pts, they seem to be heavy in other ways (lots of contact isolation and antibx, almost all are actively vent weaning, sometimes bad wounds, they're often alert enough to be big pains in the a$$ (not to mention their families), and then on top of that, we're expected to be doing rehab (total lift oob -- no hoyer lifts). i'm really sick of it. i feel like i don't get to use my brain at all.

to the poster who said "i find stepdown busy but non stimulating" -- thank you! that's what i was hoping to hear! i put in for my transfer as soon as i hit my six month mark, and i'm meeting with someone on thursday. i really want to learn the complete critical care picture (hemodynamics, etc.) -- not just this chronic vent wean stuff.

i'm still having a hard time stopping to take breaks. i'm hoping that part of the problem is that the people on my unit aren't very teamwork-oriented -- some of them are downright horrible and i try to avoid speaking to them at all costs. when there are only 2 other nurses on a shift and one of them is unbearable, you end up having to be pretty independent. i'm cautiously optimistic that things will be better if i get to go to the bigger, friendlier sicu unit i applied to :)

thanks to all who have responded so far :)

hillary

BeenThereDoneThat74, MSN, RN · Jan 19, 2005

i feel like i don't get to use my brain at all.
to the poster who said "i find stepdown busy but non stimulating" -- thank you! that's what i was hoping to hear!
hillary

i think that says it all!! and i agree (not about stepdown, but floor nursing!!)