I am officially broken. Vent.

[missladyrn]

I feel totally beat up and wiped out. I had a full patient load last night, 4 of which were confused. This was my second night like this, I asked NOT to have them all back. So what did they do?

Split them up for the day shift and gave them smaller patient load and gave them all back on night shift plus a fresh post op total care. Sorry we are short? AGAIN? Bed alarms are no good if no one comes when they go off.

The staff is spread so thin everyone is literally too busy to see past their own mess. No one CAN come. I literally can't be in all 4 of these rooms at the same time, forget the rest of my patients possibly calling.

One confused patient, over 6'2 decided to jump out of bed take off all his clothes pull out all lines, ivs, and drains and run down the hall. He spit on me and pushed me out of the way. My forearm is purple from where he grabbed me earlier in the night. Bed alarm going off, no one comes to help.

Then I get chewed out for "letting him get out of bed". I had called the md twice about his agitation and asking for something, md said no. House supervisor came after I called to see my patient load and laughed and told me good luck.

Thanks a lot. I hurt all over and just got spit on, I did not LET him do anything, I am simply not big enough to even come close to getting him back to bed if he doesn't want to. I don't have time to start all new ivs and clean up the blood bath because all my other bed alarms are going off.

I have been trying to keep these people in bed all night for 2 nights and I JUST CAN'T DO IT ANYMORE. Charge nurse had a full patient load herself. I am not superhuman. And neither is the CNA, who is just off orientation. I have a feeling she might not come back at all after the week we have had. I am considering the same.

I can't even sleep and I am so tired. No matter how much you do and how much you kill yourself to get stuff done, all they care about is what you didn't get done. I am sick of the abuse. I am sick of killing myself coming home tired and broken. I have not called in sick in over 4 years, but tomorrow night I think I might need to.

I just can't even imagine going back right now. All I do is work and sleep. I tried to take a vacation in May, but working nights and trying to be normal for a week just made me more tired.

[eleectrosaurus]

I'm new and probably naive to the reality of what is going on. But heck why weren't these folks in restraints?! I am not a fan of em, but the situation sure sounds like "risk for harm to self and others" I trained in a facility that had float CNA's for when there were a lot of confused pt's, it was great. I also trained in a facility where 3/4 people coming through the door were confused and everyone was hogtied to the bed, I spent alot of time on safety checks, releasing and roms. But I was grateful to avoid the above mentioned craziness.

[IsmeAmanda, LPN]

My god, what sort of facility do you work at? I assume a hospital?

[brandy1017, ASN, RN]

I think float CNA's are an excellent idea! Oh yeah, we used to have two aids on a wing, but then they cut it to just one and then when the crazy's act out your SOL! But I know many places don't even staff CNA's on the night shift so things could always be worse!

[nursefrances, BSN, RN]

My heart went out to you missladyrn when I saw the title of your post. :hug: Hope you took that day off. My last two day run was the same way, it was horrible. It would have been better if they wouldn't have sent all our CNAs home 3 hours into the shift and sent an RN home because "we can handle it". With 3 bedbound total cares(2 confused and nonverbal and unable to turn) one on q 1 hour golytely through peg tube, my only semi walkie talkie was VERY needy (and at the last room down the hall as far as possible from the supply room and nurses station) and she needed a last minute hibiclens shower right at the busiest time of the morning. Also they tell us they basically disolved the medical records dept and we RNs need to copy our own charts when a patient goes to SNF and when any of our patients are discharged we need to go through each page in the chart and make sure there is a patient label on each page and no staples in the chart because the chart is going to be scanned. I don't have time to do my job and they expect this too? They said the CNO of the hospital was "upset" by this news but will anything change? Nope. And in the same breath they talk about patient satisfaction scores and to use the slogans, blah...blah..My stomach has been flip floppy, I notice I am losing more hair in the shower than I usually do. Yesterday I decided it is time for a change. Something other than bedside nursing and I am doing research today. I work this weekend and hope it is better. Wishing well for you missladyrn and all else who feel our pain :)

[Worldtravelgirl]

This is exactly why I left the floor and went to the unit. The unit is tough, but you can get an order for anything (basically) that will help keep your patient alive/safe. I worked on a geriatric unit, and I have had so many horror stories. You are not alone! Don't get discouraged, but do take a mental health day. You will be useless to your patients if you are sleep-deprived and stressed. I've only been in my current position for 6-7 months and I've taken a mental health day. We all deserve them. Hugs to you, fellow RN. :)

[wooh, BSN, RN]

Been there, done that, have the grey hair and wrinkles to prove it. I agree, take a sick day. Mental health is just as important as physical health (if not more than).

[catebsn25]

"Tending the fires within so others can feel the warmth." You deserve your day off, take care of yourself for a change. I hope things get better for you.

[RNsRWe, ASN, RN]

I'm new and probably naive to the reality of what is going on. But heck why weren't these folks in restraints?! I am not a fan of em, but the situation sure sounds like "risk for harm to self and others" I trained in a facility that had float CNA's for when there were a lot of confused pt's, it was great. I also trained in a facility where 3/4 people coming through the door were confused and everyone was hogtied to the bed, I spent alot of time on safety checks, releasing and roms. But I was grateful to avoid the above mentioned craziness.

Because more and more we're seeing "zero restraint policies" being activated across the country. People don't like the idea of people in restraints (and by "people" I mean people who don't have to DEAL with UNrestrained patients). And when there's an accident or injury that occurs when someone is in restraints, HOOBOY.

Last hospital I worked in moved to the Zero Restraint thing in favor of "sitters". These were people who were hired to stare at the patient, and if he/she tried to get up, to CALL us. Yep, useless as a tit on a bull as they say....the sitter couldn't put their hands on the patient, so they became a real live bed alarm. And if one wasn't available? Why, then, you could just move Patient Nutzo into the hallway so WE could see his every move (yeah, right). Or, failing that, stick a much-needed aide or gd-forbid a nurse in there to stare at him.

More bureaucratic BS.

[RNsRWe, ASN, RN]

...

I was seeing the same trend in my ED, so I left for a small specialty niche. It's with the same company that owns the hospital, but it's an outpatient service, and we actually make lots of money for the company, so they're not looking to cut our staff or downsize us. It reminds me of the Eye of Sauron in the Lord of the Rings. I feel like my department has this cloak of invisibility that prevents the eye from being able to see us.

There is a lot I miss about the acute care environment, and someday I may go back, but not until I see the pendulum swing back the other way. Sadly, I think it's going to take a few sentinel events and wrongful death lawsuits for that to happen.

Much of your story sounds like mine....I do miss acute care (even miss med-surg!!) but NOT the insane understaffing and insanity of the shifts. Now, in specialty care, I have far less drama and more actual quality care.

[RNnbakes]

I will advice the OP to fill out an incident report and document the bruise for workers comp. And please take the night off.

[sistasoul]

We have the same useless sitters. The only way the hospital wil learn is when they get sued a few times. Of course the nurse will be the one to take the fall.

[RainMom]

Had a couple nights last week where 3 of 5 of my pts were confused, 2 actively trying to get up; those shifts suck! And there were 2 or 3 other pts on the floor who were confused. Thankfully, my facility allows us to call in sitters when needed, not official "sitters" but aides or nurses who are on call. We are also allowed a little leeway with our staffing; the manager allows for us to keep an extra staff member when we have more than the usual number of confused pts or a pt causing a lot of difficulty. If no one is available, we do call family to request that they come in themselves, giving them details of what is happening. Often family members are willing to come in to keep the pt safe.