I am a nurse!!! But this....?!

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I am a nurse. I have done alot of different things being a nurse. I believe I can rob Petter to pay Paul, I can certainly make anything work with duct tape, and I always look at the clock and say--"I can do anything for four hours!" I have even--with all my heart, laid my hands on my patient and believed I could cheat death and pass my lifeforce to them.

Today, I find myself frustrated and not knowing quite what to do. I am a Trama/ICU/Burn Nurse that has relocated to a small rural hospital. I work in a six bed ICU with a low acquity and have not floated to a med/surg area for close to 20 years, until now. With no patient's in this little unit I will be expected to float. I have no problem with floating, but I find that I will be expected to take a full load which is 5-6 patients. A chill goes up my spine--I have lost the necessary skills to stay organized, to deligate to a CNA, or to even pass PO meds. The charting system is on computer, but is one of the poorest systems I have ever seen!

Since I have been at this facility, I marvel at these med/surg nurses who work with such a poor nursing system and get the job done consistanly. I watch them drag out after a long shift sometimes 2 hours of overtime later to get finished with their assignments. I always go out and help when I can especially with that difficult IV. I have a different expertise. How many of you out there have faced this? I have tried to ward off a disaster, trying to negociate orientation, possibly taking a 3 patient assignment and being up for the first "hit", and then just flat saying--"this is what I can do for you." Causes some hate and discontent.

Today, with a sigh of relief, I am on call. What will happen next week? By the way, the DON feels this is a "small, rural hospital" and it is appropriate to expect this of me. Advise, please from those of you who have faced this. I want to be part of a solution before my mouth becomes more of a problem than this "little rural hospital" has ever seen. (I have learned from the best in my 30+ years!)

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Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89.

Have you tried to make a list of what you need to know and of what you are totally confident in?

Would it be worth it to you to take a refresher course? They run a couple of hundred dollars, but include all of what you seem to feel you need.

Perhaps you could offer on your day off to shadow another nurse. Not on the clock but just to observe.

I'd make sure I have up to date . I have felt as you do when just floating to another general unit. The ebb and flow of each unit is unique. It goes down to where the bathroom is and who has first dibs on early lunch time.

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Specializes in ER, Infusion therapy, Oncology.

It sounds like you have been a nurse a long time and as you said have learned a lot. This will definately help in the adjustment. I worked in a small rural hospital when I first got into nursing and you were expected to float to ANY unit they needed you on. It ended up teaching me so much. It also taught me what I did not want to do. The people I worked with were wonderful. I do not regret the experience at all. Rural hospital do tend to be behind on their equipment because of budget issues, but you will learn to work around that. Give it time. It could end up being a great experience. Good Luck!

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It is nice to know that someone with the skills of ICU nurse values the orginazational skill of a med/surg nurse. That has been my experience in the past. Most ICU nurses say, " Oh my God, I can't do 6 to 8 patients. There are good reasons for that being that you have to focus so intently on everything about the one or two you have in ICU. Where as with a bigger assignment of 6 to 8 you have to learn to focus on the just important things. Personally I think you might be more comfortable in ER or PAR. Also I have had ICU friends that could handle 4 or 5 patients on step down even though med/surg with 6 to 8 was to much for them. However, I do think eventually you will be able to catch on to med/surg. But it is stressful and frightening. By the way I have done both myself.

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I am a new grad nurse who has been working on a med/surg floor and have been on my own for three months. I can relate. It is very difficult, sometimes i just have to walk into the bathroom and let out my frustration...I hope with time I get used to the fact that nursing in a 24 hour job and I can't do everything for my five high acuity patients. I hope to eventually be an icu nurse once i get experience because I would like to have more time to spend with each patient. I am really frustrated and it is comforting I am not alone and even a nurse of 30 years gets frustrated from time to time.

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Specializes in Med-Surg, ED.

I am in a little different situation, being a rather newbie nurse. But when I oriented to Med Surg,, near the end of my orientation the issue of floating came up. I felt I wasn't ready and so I approached my nurse educator and told her that there were specific things that I wasn't comfortable with and that I was worried about floating without these more or less basic med-surg skills.

I decided to print off hospital policy on things I was not sure with, and made myself a small index-card file to fit in my pocket. I found just by reading and making the cards I learned a lot about some of the things I wasn't familiar with. And the educator made a point of exposing me to as much as she could.

Then when I did float, I just told everyone that I was recently off orientation, that I want to do my best and fulfill my duties, but that I was scared and nervous, and that I would probably ask a lot of questions. They were fine with it---just glad to have a body to cover the patients. So it really wasn't so bad and everything I wasn't familiar with, I asked about.

I have consistently found that floating is not as scary as it seems, and that the other floors are always willing to help.

Good luck to you!

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I moved out of a big, inner city, level 1 trauma, teaching facility--it just came to me one day, "what am I doing here?" I was standing in a crowded ED hallway assisting a flock of sleep deprived wackos crack one more chest. Our facility was bulging at the seams that night (which was normal) and had gone on diversion--what was bad is that every facility had gone on diversion and the powers that be forced us all to open. So, there in that hallway was the only place we could attempt to save some poor kids life. Done it before, but at that moment--it bothered me.

Now, in an entirely different set of circumstances I am laughing that I am again bothered. By the way, the kid survived the hallway, and I will survive floating to medsurg. My husband is also an old nurse, also an old combat marine from a long ago war. He says as a marine you "overcome and adapt!" I think we as nurses do the same.

Thanks for your thoughts and ideas. I am prepared to speak my mind, willing to compromise with my assignment and looking forward to getting to learn and meet my new "commades at arms." I have unfortunately had too many shifts were the supervisors came to me after a long 12 hours and told me there was no relief for me. Had to stay over--some of those shifts were in excess of 20 hours.

I will overcome and adapt! Another area needs help--I have been there, I have been the stressed out nurse and needed the calvary to come and was never so glad to see some poor nurse forced to float from some other area. I embraced them and we got thru:w00t:

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Specializes in Peds; Peds Oncology.

I worked in a "smaller" hospital...and I understand your situation. When the peds census was low, they would float us to adult floors. When the peds census was high, they would float adult med-surg nurses to our floor. I came from adult med-surg, so it was not a problem for me. However, for those who had never done adults, it was incredibly difficult (and dangerous). Adults have issues and problems that peds pt's don't.

After I had left this facility, I heard that a pt on peds had died (a gastro pt) that was being taken care of by a floating adult nurse.

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Specializes in LTC, Med/Surg, Peds, ICU, Tele.

Small hospitals are like this, you have to be flexible and versitile.

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I am not a nurse...YET! I am a third year BSN student now...I have worked as a Tech, PCA,CNA or whatever you want to call me in the ED, radiology, med-surge floor, etc. I cannot give you a nursing perspective but what I can tell you as an aide and a student is...

From the student perspective: you, the nurse is viewed as the gate keeper...one who posseses all the knowledge necessary to evolve into a nurse. I worked in a hospital where at least 1/2 of the staff is per diem and new faces float in and out everyday. I can't tell you how many times I have heard "Help! I haven't worked in the "Pick your floor" since...

Toot my own horn...I worked the same floor for a year as the only aide on a floor of as many as 20 patients, been shared by 3 and 4 nurses and doubled as the secretary. In exchange I received unlimited mentoring...I am allowed to assist with procedures, observe tough sticks, receive indepth explanations on orders and medications, I even had a doc allow me to assist with a chest tube because a nurse told her I was interested in the procedure.

My advice...find an aspiring aide on the floor you are assiged to, buy them coffee and watch what happens. Nurses are greatly admired...you will never be alone.

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sbadalamente, you hit the key. The CNA's at this facility are entrenched, some have worked at this little hospital 20-30+ years. They "run the floor" and believe they can make or break the nurse. Why we have to play this game, I don't know, but I just joke it aside and tell everyone they can be the boss of me and I'm the best pooper scooper this side of the Mississippi.

I am somewhat of a mystery here, I don't take any lip from the Docs and many times have just been passing thru and overhead a few raking a tearful nurse over the coals publically--I just don't tolerate that and jump right in. I am a pitbull and it can either be nice or really nasty--I'm ready to play! (gloves are off in the sandbox).

So, in all I'm going to be fine. I hadn't given a PO med in years until I came here--so that's my biggest concern. Having a six patient assignment with a bunch to PO's--I'll be there looking them all up till the cows come home.

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Specializes in LTC, Med/Surg, Peds, ICU, Tele.

Another tip about small hospitals is that they start circling the wagons when outsiders start telling them about how it's done elsewhere. Don't do anything that makes them feel like you are a bigshot, know-it-all from the big city.

Small hospitals are like small towns. They get set in their ways, everyone knows everyone, and they are suspicious of outsiders.

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