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I had no idea... med/surg vent

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I am a new med/surg nurse and just wanted to say I hate it. It's been 4 months so far and I have never been more stressed out in my life. I applied for everything BUT med/surg (at first) because I had a feeling that this wouldn't be for me, but as everyone knows, jobs are slim pickings for new grads. My primary complaint is that this is an environment in which you are expected to lie incessantly. Late med administration? Lie or be written up. Couldn't make the pain reassessment in time? Lie or be written up. Stuck with a pt who is tanking for 3 hours until the transfer to ICU? Lie for the rest of them or be written up. Almost every night at the end of my shift, I spend between 2 extra hours charting my lies because there is no time for charting during the shift. Even the experienced nurses are having to stay late with me. And this floor is so busy, it's not uncommon to turn over almost your entire team of patients in one shift. It's insane.

I am a new med/surg nurse and just wanted to say I hate it. It's been 4 months so far and I have never been more stressed out in my life. I applied for everything BUT med/surg (at first) because I had a feeling that this wouldn't be for me, but as everyone knows, jobs are slim pickings for new grads. My primary complaint is that this is an environment in which you are expected to lie incessantly. Late med administration? Lie or be written up. Couldn't make the pain reassessment in time? Lie or be written up. Stuck with a pt who is tanking for 3 hours until the transfer to ICU? Lie for the rest of them or be written up. Almost every night at the end of my shift, I spend between 2 extra hours charting my lies because there is no time for charting during the shift. Even the experienced nurses are having to stay late with me. And this floor is so busy, it's not uncommon to turn over almost your entire team of patients in one shift. It's insane.

Yes, this is the same reason other people hate med surg. But i think most jobs in nursing will be just like this, whether they are icu, er, or anything else is an extension of med surg.neuro, tele, ortho etc is all some sort of med surg. how are night shifts where you work? I would try to get as much experience as possible than look for hospitals/floors with smaller ratios if there are any around.

I sympathize, but I don't quite understand, why are you having to lie so often? What is your nurse/patient ratio? Do you think the other nurses on your floor have the same problem? This has nothing to do with med/surg and everything to do with your hospital and/or your unit.

I don't think I've ever "had" to falsify charts... but I've also never worked in an atmosphere where the threat of being "written up" for fairly common nursing situations was held over my head like that.

I really hope it's not the same everywhere, otherwise there is nothing to look forward to. I know that much of it has to do with the fact that everything is still so unfamiliar, which slows me down. But I have a sneaky suspicion that our manager is more stringent than others. I will have a better idea how we compare when I start floating. On the upside, most of my coworkers are incredibly supportive and have the same complaints, so we laugh together a lot.

Lauryen828

Has 3 years experience.

I am also a new grad and I work on a med surg unit. I am 3 months in and I agree it is horrible. While I do not have to lie about charting I do have unsupportive mean and bitter :argue:coworkers, and a lazy and absent :sleep: Nurse manager. My nurse manager is never there I have seen her 6 times (yes I counted) in the past 3 months. My coworkers take hour to 2 hour lunches. They do not answer call ligths and the list goes on. I NEVER wanted to work in med surg, but jobs were few and far between. While I know that my floor is the problem, the staff, sometimes lack there of and absent management, Med Surg is still last on my list of ideal places to work. I cant wait for my 6 months so I can start looking elsewhere... :down:

I am a new med/surg nurse and just wanted to say I hate it. It's been 4 months so far and I have never been more stressed out in my life. I applied for everything BUT med/surg (at first) because I had a feeling that this wouldn't be for me, but as everyone knows, jobs are slim pickings for new grads. My primary complaint is that this is an environment in which you are expected to lie incessantly. Late med administration? Lie or be written up. Couldn't make the pain reassessment in time? Lie or be written up. Stuck with a pt who is tanking for 3 hours until the transfer to ICU? Lie for the rest of them or be written up. Almost every night at the end of my shift, I spend between 2 extra hours charting my lies because there is no time for charting during the shift. Even the experienced nurses are having to stay late with me. And this floor is so busy, it's not uncommon to turn over almost your entire team of patients in one shift. It's insane.

elprup, BSN, RN

Has 2 years experience.

I agree. I do not like Med Surg either. But congratulations to you for surviving! You really should not "lie". But I totally understand how you feel like you are lying. Make sure you are safe and following your nurse practice act. Also, Be very wary of going into Long Term Care because with 25+ patients, I felt it was worse than med surg. if you can hang out and do med surg for a year, you will be golden for any position you choose. But only you can make that choice. My health and sanity is worth more to me than selling my soul for a paycheck.

BostonTerrierLover, BSN, RN

Specializes in Adult/Ped Emergency and Trauma. Has 16 years experience.

:yawn:This is why Boston is creature of the Night.

Med-surg doesn't have the market on chart falsifying. Your particular floor is just one of the many environments that fosters that habit.

westieluv

Specializes in Med/Surg, Tele, Dialysis, Hospice. Has 26 years experience.

I have worked Med/Surg, long term care, and hospice. You won't find a nursing job that isn't stressful and where you don't feel underappreciated and overworked at least some of the time, I'm sorry to say. It's the nature of the beast and unfortunately, money will always be the bottom line, not excellent patient care. The best that you can hope for is that you find something that makes you feel like you're making a difference in people's lives so that it is at least tolerable. I never felt that way in Med/Surg, marginally in LTC, and more so in hospice than anywhere else, but hospice is extremely stressful as well and the burnout rate is higher than in many other types of nursing.

Good luck. I'm over the 20 year mark as an RN and just awaitin' retirement...; )

I am not sure I would be lying. Could come back and bite you on the butt. Just sayin.....

I am a new med/surg nurse and just wanted to say I hate it. It's been 4 months so far and I have never been more stressed out in my life. I applied for everything BUT med/surg (at first) because I had a feeling that this wouldn't be for me, but as everyone knows, jobs are slim pickings for new grads. My primary complaint is that this is an environment in which you are expected to lie incessantly. Late med administration? Lie or be written up. Couldn't make the pain reassessment in time? Lie or be written up. Stuck with a pt who is tanking for 3 hours until the transfer to ICU? Lie for the rest of them or be written up. Almost every night at the end of my shift, I spend between 2 extra hours charting my lies because there is no time for charting during the shift. Even the experienced nurses are having to stay late with me. And this floor is so busy, it's not uncommon to turn over almost your entire team of patients in one shift. It's insane.

Yesterday, I interviewed for a med/surg RN position and this post is really scaring me. I Don't know what to expect, but for some reason i feel like i will be able to handle it in dew time of course with God's help. I worked as in LPN in LTC for 5 years up until i got my RN license a month ago. I'm still working in one of the LTC that i used to work as a LPN, but with better pay. I know working in the hospital will be more beneficial for me as a new RN because i will be able to use my clinical skills more and learn new things. I understand that you are frustating and you need to vent, but i just hope that is not going to me in 2 or 4 months. lol :uhoh3: :crying2:

psytbs87

Specializes in psychiatry, mental illness, counseling. Has 6 years experience.

i'm not even going to sugar coat it...med surg is the most depressing place to work. ever. this has nothing to do with the patients, more with the staff and EVERYONE always being snippy and having an attitude. I completely understand we have a lot on our plates, but most of my other coworkers pass all their work off to the poor techs, who bust their ass more than a lot of the nurses I work with. The atmosphere on a med surg unit isn't a very comforting one too. Remember always hearing how nurses like to eat their young? well, this is what they were talking about.

They don't care if you succeed or not, and even when I brought this up to the supervisor she dismissed my claims as just being nervous to get to know everyone. Little did my staff know, I come from a very strong psych background of about 10 years with at an inpatient penitentiary as well performing all the initial assessment for patients being admitted into the psych ward. So, you kind of just have to keep acting polite and cordial, make sure the supervisor is aware of how hard you're working.

And as for the meds not being passed on time, either deal with it or become that patient's advocate and make your voice known that you actually care about the people in the hospital, and are making them your first priority rather than denying them their scheduled medications that the Doctor ordered to be given at certain times. I would first make anonymous complaints to another supervisor in human resources or call over to patient rights and responsibilities. At least make it known that people aren't charting accurate information, and you don't want to put anyone in danger by disobeying the rules because the nurses are too busy lounging around ******** how hard their career is.....when ironically, most of them do them do bare minimum to get by each day.

HouTx, BSN, MSN, EdD

Specializes in Critical Care, Education. Has 35 years experience.

"Lying" in the medical record is falsification. At the very least, this is grounds for action by your BON. Worst case scenario? Your false documentation serves as the basis for (false) billing - this gets picked up in an audit and your & your employer are tangled in a Federal Fraud action. Just becoming involved is enough to get you on the Federal exclusion list.. meaning you cannot work for any individual or organization that accepts Medicare/Medicaid reimbursement. Knowingly participating in healthcare fraud is a crime - punishable with jail time and very heavy fines.

We are all accountable for our own behavioral choices. These choices define our personal integrity. What if a patient was jeopardized because of your actions? Think carefully about the consequences you may have to deal with if the truth emerges.

I know what you mean. My preceptor got all the papers and meds (signed/dated) done even before seeing the pts. Pain assessment? Just pick a number, write it down, and give the med.

One time during lunch he asked me if I knew the pt has staples. I said yes because I saw it on the note and I went to do the assessment. He didn't know about it because it was not on the shift report.

But I got to say. He never stayed after shift to finish anything.

i'm not even going to sugar coat it...med surg is the most depressing place to work. ever. this has nothing to do with the patients, more with the staff and EVERYONE always being snippy and having an attitude. I completely understand we have a lot on our plates, but most of my other coworkers pass all their work off to the poor techs, who bust their ass more than a lot of the nurses I work with. The atmosphere on a med surg unit isn't a very comforting one too. Remember always hearing how nurses like to eat their young? well, this is what they were talking about.

They don't care if you succeed or not, and even when I brought this up to the supervisor she dismissed my claims as just being nervous to get to know everyone. Little did my staff know, I come from a very strong psych background of about 10 years with at an inpatient penitentiary as well performing all the initial assessment for patients being admitted into the psych ward. So, you kind of just have to keep acting polite and cordial, make sure the supervisor is aware of how hard you're working.

And as for the meds not being passed on time, either deal with it or become that patient's advocate and make your voice known that you actually care about the people in the hospital, and are making them your first priority rather than denying them their scheduled medications that the Doctor ordered to be given at certain times. I would first make anonymous complaints to another supervisor in human resources or call over to patient rights and responsibilities. At least make it known that people aren't charting accurate information, and you don't want to put anyone in danger by disobeying the rules because the nurses are too busy lounging around ******** how hard their career is.....when ironically, most of them do them do bare minimum to get by each day.

Did I hear right? '...the poor techs...' Really? Someone actually acknowledging that the patient care techs/CNA's sometimes get dumped on with tasks that the nurses just don't want to do? I may faint. **swoons**

nurse2033, MSN, RN

Specializes in ER, ICU.

Med surg is hard work, but I think your issues have more to do with poor management. There are med surg units that are well run. If no one can get their work and charting done then, almost by definition, the patient ratio is too high. I know this might be wishful thinking but can you bring up these issues with receptive charge nurse or your boss? If you are using overtime to finish charting you could do the math and present the cost. For example If 8 nurses who make $25/hr stay 1/2 hour late every day that costs $54,750 per year extra. Otherwise just hang in there until you can find a better place to work. Good luck.

silverbat

Specializes in Care Coordination, MDS, med-surg, Peds. Has 22 years experience.

Ok, I am horrified that anyone would seem to condone LYING on a patients record. I would RUN to any other job if I could not get my DON or someone to be aware of the patient: nurse ratio that may be contribbuting to this action. THe Nurse manage should be reported to her supervisor. POOR management of a unit should not result in FALSIFICATION of records. Are you not aware that your license is on the line for falsification, as well as being on the exclusion list?

You didn't state the raito, but I have worked med-surg 15 years in 2 hospitals and NEVER felt that I had to LIE. If I could not get to a treatment, eg, I told the next shift, they did it, and I did the same for them-24/hr nursing, you know.. I feel that the work CAN be done and so there is no need to lie. OMG.. I am honestly FLOORED by this......

>>>>>

outcomesfirst, BSN, RN

Specializes in Research, ED, Critical Care. Has 28 years experience.

Thirty years later, same sad story - but not every place is like this. You can do something about this. First - nurture yourself. When you are off work - be off. Go to the gym, read novels, fish, hike, swim, watch TV. Eat healthy. Have a variety of friends and interests outside healthcare. Next, every shift - have a smile and have a plan. Outline your priorities/must do's. Who is getting discharged? What time are meds? Dressings? Feedings? Be as organized as you can. Plan in time to chart - DO NOT MAKE A HABIT OF PUTTING IT OFF UNTIL THE END OF THE DAY - know what must be charted versus fluff - read hospital SOP. Start work on time and leave work on time - Everytime, unless you are in the middle of a code. Round on every patient at the beginning - eyes on, if only for a minute. Let the patients know you will do your best to see them every hour. Stay flexible, your plan will be constantly changing - based on needs. But know what you will be doing every hour - rounds, turning, meds, bath, what ever - plan it out as best you can. Plan in lunch/a break/ a drink of water/the bathroom. Most Med SOPs allow 30 minutes before/30 after, so if meds are due at 09/12/14/16, your window is 0830 - 0930, 1130 - 1230 etc. - read your SOP and make this work for you and your patients. Find something to appreciate every shift you work. A patient discharge (finally), a smile, a thank you, a sucessful foley insert, an IV start - anything that makes you feel good and productive. Always be honest. You do not have to buy in to the manipulation/complaining, but you do have to deal with the fallout. Do not join your co-workers coping/cover with laughing off issues - You do not have to participate, and you do not have to comment - smile and walk away, you are too busy and your patients need you, you do not have time to participate. Do help your co-workers when they need it, see one struggle to transfer a patient - help, do not wait to be asked, and ask for help when you need it - can't get the IV? Start asking for help now. It does not sound as if this culture is a new/recent event on your unit - you can be sure that the people who have been there for awhile have reasons for staying, and you can be sure the management/HR are aware of everything - complaining/anoynmous messages will not help you or your patients - and this behavior and the drama it will create will make it worse for you. Remember, you are part of the problem or part of the solution, you cannot have it both ways.Start planning your next move - where do you want to be? What is your interest? How will you get there? Research opportunities. Use this experience as a learning time/ladder out. You can do this for a year, be a great nurse and plan your next move. This time is invaluable and will serve you, and your patients, for the rest of your career no matter where you go.

Chin up!