I have been in med-surg night shift for 7 months. When I started I knew that I would feel reality shock and this would improve as my skills grew. Well it has been 7 months and I hate my job. I have a sick stomach every day I work and many times the days I do not. I dread going in to work.
First they took the aides away. Next they took away the phlebotamists. Then pharmacy closed after 3 pm. We now have only 1 respiratory therapist for the whole hospital. I work mostly with agency nurses. 2 new RN orientees left before a week had passed. The telemetry techs frequently leave the monitors unmanned while they take frequent breaks. The new trend has also been to admit psych patients, alchoholic patients and IV drug users without any sitters even though they are going through withdrawl or are wandering into other patient rooms or hanging around the medication carts. Management has said that we need to do more with less.
Yesterday a DNR-CCA patient died at 7 am. The attitude of the day shift staff was - hurry up and give me report - I am getting a late start. I wanted to clean the patient up before his son got there because he was on the way. My friend on day shift told me hospital nursing is like this everywhere. I hope this is not true. I have been offered a job in LTC. The facility is nice, they are well staffed, the patients look clean. During my interview they showed me around and the residents kept telling me how nice the nurses were and how they were happy here.
I love the patients on med-surg and love learning involved in dealing with these patients. Is med-surg like this everywhere? Should I make the move to LTC? I fear that I may soon lose it and yell at the next tele-tech who leaves the desk when my patient is in SVT or tell the nursing supervisor " There are 2 new patients in rooms on my floor - I have not received, report, have not been told they were coming- you come here and take care of them because I do not have the time and will not do it". This will undoubtedly leave me unemployed.
I feel hateful. My attitude has hit rock bottom. Thanks for letting me vent and please tell me if I am just not cut out to be a nurse. The patients say nice things about me so I know I can not be a bad person. Maybe just not cut out for nursing.
Even rats are smart enough to flee a sinking ship....but we stubborn humans think we're supposed to sink right on down with it. Not me, no sir, nuh-uh....and not you, either, I hope.
Specializes in Trauma,ER,CCU/OHU/Nsg Ed/Nsg Research.
Originally posted by Rapheal
***************Update******************]
I've accepted the other position. I am leaving med-surg. I hope to go PRN if they let me. If not- well that's their choice. We lost 2 more nurses in the last two weeks and one has been on sick leave for weeks now and is not on the next schedule.
Thanks for all the advice and encouragement. The last night I worked I walked into: A patient on a nitro drip with no tele (against protocol-but still there it was), an irate family member who wanted to talk to her husband's nurse, a patient who was SOB with a panic ABG (they just handed me the paper with a real short explanation), 3 patient's in restraints and only one with a current restraint order, and we were short a nurse until an agency nurse arrived. Did they send help? No. I was expected to address all these issues, get vitals and deliver 8 pm meds in a timely fashion. 2 of these patient's were sent to ICU and IMHO they should not have been on med/surg in the first place. I just cannot handle this. So off I go unto what I hope is a better place.
Please pray and /or think a good thought for me and my future. I truly am grateful for all the responses and encouragement.
You guys have pts on nitro drips on your med/surg floors??? Does your hospital have a PCU? We have telemetry on our floor, but don't take pts on nitro drips, because our nurse to patient ratio is too high (6-7:1). Good luck on your new job- at the very least, you're saving your license.
Nitro drips are only allowed in the unit. The fact that my patient was on one was a major snafu. I called the doc, and the supervisor and got him into the unit. He never should have been to med/surg to begin with if the doc wanted him on the drip.
Specializes in Trauma,ER,CCU/OHU/Nsg Ed/Nsg Research.
I completely understand why you want outta there! I don't understand why one of the nurses on your floor would even admit that pt. The fact that he was there without telemetry even further scares me. I hope you did an incident report.
It sounds like it's more a problem of your co-workers than you. I know what it's like to work in a place where you are constantly covering your own butt by correcting things others have done. You spend half your shift fixing mistakes that never should have happened. No wonder you feel burned out! You sound like a great nurse, especially if you have the fortitude to catch things like that. Be good to yourself. I hope you like the new job and don't get burned out of nursing altogether. We need good nurses like you!
The good news is, not all hospitals are like this. Even though I'm new, where I work isn't perfect, but it's a far cry from what you're saying. For the most part the staff busts their butts helping each other out. They have a lot of faith in each other.
Our management has been supportive and actually Listens to us, though they can't make every change the nurses suggests, they try to make the most important ones.
The pay is competitive with others in the area, benefits are good, and parking is free. We don't have to worry about visitors invading the nurses' station because management has declared it our domain. If a patient or family member gets belligerent and won't settle down, security is there very quickly. I've seen this numerous times.
My NM comes to work in scrubs most days and fills in where she can when she's needed. Even on days where she has to dress for meetings, she's there to lend a hand.
For the most part, the docs treat the nurses with respect. Usually it will be a new resident who might get a little bossy. Most of the seasoned docs will step in then and set them straight.
Still we have our share of problems and whiners, but compared to places where I 've done clinicals this one is by far the best.
If I were you, I'd definitely start looking for something better before the conditions in your place causes a disaster that involves you.
When I came out of school the first job I had was med/surg. I only stayed 5 weeks and in my opinion that was 4 weeks to long.
I worked nights. It was a 20 bed floor and was staffed by 2 RNs and 2 aides. We had trached pts, nitro drips (with no tele) you name it, we drew our own labs and did our own respiratory treatments. Hanging blood was always interesting as it was protocol to have 2 nurses sign of and then one had to stay in the room for the first 30 minutes. So that left ONE nurse for 19 patients.
But I will tell you what did it for me was...I went in one night at 11pm. By the board I saw we were full 20 patients.
I was given report and told that one of my DNR patients had died at 10:45, she had not been pronounced by the md yet so we could not move her, nor could we take her off of the board. The eve nurse said she had called the ER md to pronounce.
Well, I called the Er several times trying to get someone up, to no avail. It was when the house was full, she occupied the only bed and they had another admit that they sent an MD up to pronounce this poor woman dead. IT WAS NOW 3AM.
So the deceased womans room mate.....THATS RIGHT SHE WAS IN A DOUBLE ROOM...had been awake off and on during the night and had been complaining that I had the curtain pulled on her neighbors bed and she could not see out into the hallway. I could not tell her much, of course, but she did figure it out when we came in at 3:01 and did post mortem care. It took a LOT of sedation for the other lady to go back to sleep after that.
The ER had a nerve, after they waited for 4 hours to pronounce they started calling from 3:10 on and demanding that we have the bed available NOW for the next patient.
Needless to say transport and the cleaning crew took some time to come up and do their thing. In the interim, the er doc called and asked me why it wasnt done and told me he was going to call the nursing super and I said "good, I have already called her multiple times trying to get someone up her to pronounce that woman since I got here at 11." The conversation did not get much better from that point.
Anyway that morning I told the NM that when I finished that week I was done. ( I was still in orientation, if you want to call it that)
I also would say dont worry about loosing your skills. Whatever you need to do a job you will be taught. Just like now you are going to LTC, you will need to be taught how to do that job. It is not the same as hospital nursing, there is a different set of skills involved.
I work with a group of nurses now who most have not done bedside care in years. They dont worry about loosing bedside skills, because they have developed others. And if they want to go back at some point, I cant think of one reason why, the hospital will teach them what they need to know for that floor.
I AM NOW A SURGICAL RN BUT I ALSO HAVE MED-SURGE EXPERIENCE. I FEEL YOUR PAIN. HOWEVER, HAVE YOU REALLY DONE ALL YOU CAN? WHAT I MEAN IS, YOU FEEL YOU ARE WORKING YOURSELF TO THE GROUND JUST TO DO THE THINGS REQUIRED NOT TO MENTION ALL THE OTHER ISSUES INVOLVED IN TAKING CARE OF "X" AMT OF PATIENTS. SO MY QUESTION IS WHAT ARE YOU DOING TO MAKE A CHANGE COME ABOUT? YOUR TECHS ARE LEAVING MONITORS UNMANNED. YOU FEEL THIS IS UN-JUSTIFIED FOR A NUMBER OF REASONS, SO? TELL THE TECH UP FRONT, I WOULD APPRECIATE YOU NOT LEAVING THE STATION WHILE MY PATIENT IS ______. IF YOU FEEL YOU MUST LEAVE PLEASE LET ME KNOW...BLAHBLAHBLAH! BY HANDLEING THIS SITUATION WITH THE PERSON OR PERSONS INVOLVED (WHY MUST 2 TAKE A BREAK @THE SAME TIME?) THEY REALIZE THEIR IMPORTANCE TO YOU & THE CARE OF YOUR PATIENTS. THEN THE NEXT TIME WRITE IT UP. MY HOSPITAL CALLS THIS QCR. THEY HAD THEIR WARNING. SAME FOR LABS THAT ARE LATE OR ANYTHING ELSE. MANAGEMENT DOESN'T LISTEN TO VERBAL COMPLAINTS. HOWEVER IF THERE IS A PAPER TRAIL.....NUMEROUS TRAILS... AND NUMBERS (REMEMBER BOTTOM LINE?) NO ONE CAN DENY NUMBERS. THE QCR'S SHOW HARM, RISK, MISTAKES, ETC. EVERYTIME A PATIENT IS OUT WHERE THEY DON'T BELONG OTHERS ARE @ RISK "WRITE THIS UP" SHOW YOUR EVIDENCE (QCR) THAT CARE IS AT RISK & WHY. YOU FEEL SICK BECAUSE YOU FEEL HELPLESS. TAKE MORE CONTROL FOR THE CARE OF ALL PATIENTS BY MAKING OTHERS FOLLOW THRU. THE QCR'S WILL MAKE THE OTHERS REALIZE THEY ARE SLACKING TO AND IN THE END RESPECT YOU FOR IT. AFTER ALL THEY KNEW IT WAS COMING. SO WHEN SOMETHING HORRIBLE HAPPENS (AND YOU KNOW IT WILL @ THIS RATE OF CARE) DID YOU DO ALL YOU COULD TO PREVENT IT? WAS IT REPORTED EARLIER YOUR TECH WAS ALWAYS LEAVING AND NOW NO-ONE KNEW WHEN YOUR PATIENT'S LEAD WASN'T "JUST OFF" THIS TIME? DO WHAT YOU CAN TO BRING ABOUT POSITIVE CHANGE WHILE YOU ARE SEARCHING ELSWHERE. YOU WILL FEEL BETTER ABOUT YOURSELF AND THE CARE YOU GIVE FOR DOING WHATS RIGHT. IT'S NOT ASKING TO MUCH FOR OTHERS TO DO THEIR JOBS TO. EVEN IF YOU HAVE TO PUSH THEM TO DO IT!
Your points are valid and I have made incidence reports. But nobody likes it when the new kid on the block complains. You are considered a troublemaker and all sorts of retaliation accompany that decision. One of the staff nurses told me (confidentially) 3 months ago to stop making waves. She was right. I have had incident reports made against me in retaliation. They were actual lies and I had to defend myself. I learned my lesson because mgmt. is well aware of the problems and will not deal with them.
And truthfully my unit does not desire to change. We have nurses who survived the changes in mgmt. and staff a few years ago and feel very secure in their positions. Some are downright sloppy nurses who stay because they know their ways will not be tolerated anywhere else. They are resistant to change, have developed skills in shifting the blame and are not going anywhere without a fight. They are also willing to work short staffed as long as they can get away with things. So if mgmt. chooses to keep nurses like this and lose nurses like me, that is their choice. I am physically sick almost every day and will not increase my stress level to the point of getting an MI. Yes my patients deserve better and deserve a patient advocate who is willing to fight the war for them. But my kids need a mommy, my husband needs a wife, and I need to treat myself better than this. So I will speak with my feet. Maybe this is not good enough but it is the best than I can do at this point in my life.
I fully understand your feelings. Nurses are a dying breed. We are unable to practice what we preach, in every aspect of nursing. We sing the song of more education (to patients & ourselves) yet have zero time for it and/or anything else. By the suggestion I gave you earlier I was hoping others would follow YOUR lead for patient care and things could eventually work out for you AND your patients. Working in a hospital myself I SO SEE the need for MORE nurses like you and not the likes of what is left. I want to KNOW that if my family/friends, etc. need a hospital while out of town, or otherwise, there are competent, caring, & knowledgable staff to care for my loved ones. I feel that at any facility there is always a some do, some can, some don't, some won't, attitude. It is just gut wrenching that the majority at your "past?" facility was on the wrong side. I'm sure as sickening of an experience it was for you, you came away with a hell of a lot more than what you left behind. You gained knowledge, experience, and by far a greater sense of what kind of nurse you will be, and for the type of employer you are willing to give your great skills to. You will be a great mentor to our profession of new and upcoming nurses and also to those who need a little fine tuning. I'm sure you feel a great burden has been lifted and I wish you well in your next endevor on this road we travel in the wonderful world of nursing. I know your family can already see a change in you. (you probably look 10 yrs younger already!) Somehow we have all got to survive our chosen profession of caring for others. Which is actually I think THE BEST thing about nursing. That if you are burned out, fed up, or whatever you can ALWAYS go in another direction of nursing without getting out of the profession. That's probably the only thing that HAS saved most of us. Well I guess I have babbled long enough. I just wanted you to know for what it is worth that you have my full support in your decision. I just wanted to make sure you felt you had done all you could so that later you would not have any regrets looking back & questioning yourself. So, thank you for taking the time to fill me in on the whole story.
Todd SPN
319 Posts
B]Please pray and /or think a good thought for me and my future. I truly am grateful for all the responses and encouragement[/b]
I'll do it right now.