I work in a hell hole!!!

Nurses General Nursing

Published

Okay, let me start off by saying that I'm a new grad and started working on a Med-Surg floor in Feb of this year. I work the 7p-7a shift and we never have less than an 8 patient assignment! It's always 8-11..this includes post-ops, isolations, telemetry monitoring, dementia patients, you name it! Is it me or is there something extremely wrong with this situation?! The turnover on our unit is unbelievable, and 5 new grads were hired on nights to fill positions. Guess who they want to train for charge nurse very soon--yup ME! I told them I was nowhere near ready for this responsibility especially with all new grads but I was pushed away and ignored! The other night, I had 3 blood transfusions, a neuro check patient, an active GI bleed, 2 tube feedings, 3 isos, and of the 10 patients I had 7 were complete cares/incontinent! Mind you we only have 1 aide for 30 patients on our unit-and that never changes! I really am just trying to stick it out a year so I can go elsewhere stating I have experience, but can anyone offer me ANY advice on what to do?! Thanks!

Your situation is sooo scary! I hope you survive until you're ready to move on. No one should be subjected to this. It's so unsafe. Hang in there!

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Specializes in Med/surg, telemetry, ICU.

8 to 11 pt per RN with only one aide (especially if the pts aren't "walkie-talkies") - definitely unsafe and excessive. It is understandable that you are overwhelmed and exhausted. It is great that you have lasted at this job this long. I am sure you have plenty of experience by now to move on to a different job. If you can juggle assignments of this size/acuity, you could do anything! I would definitely start looking for a new job. Have you started updating your resume?

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Specializes in Mixed Level-1 ICU.

How about a ratio of 14:1?

That was my first job but I was too timid at the time to complain and too inexperienced to know where to direct my anger and concern.

Send an anonymous letter to the CEO and one to risk management stating clearly how dangerous a situation, let alone the crappy care the patients are getting. Tell them it is only a matter of time before a catastrophe results in hospital lawsuit. Far better, if families mention how strung out you are tell them, in no uncertain terms, that you are overloaded and that patients inevitably suffer. Tell them they have the power to make changes by writing to the CEO about how unhappy they were with the situation.

Most CEOs don't want to know what's happening and managers never want nasty situations to filter up. That way they don't look like whiners or complainers and seem in complete control.

But once a CEO or risk management is made aware of the situation(especially from the mouth of a family) they he/she can't plead ignorance and blame a director or manager.

Finally, you need to get out of there before you get taken down with a bad error. But let them know in some sort of correspondence. Otherwise, you're guaranteeing the same nightmare for the next 100 nurses. It takes courage to take a stand. But going through life without courage prevents great things from ever happening.

Be courageous!

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Specializes in OR.

get out. 9 months is perfectly acceptable time frame to be in med-surg. Start looking for jobs now!

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I hate to say it, but that would be a pretty typical assignment at my facility. The med surg nurses are just expected to suck it up and deal. No, you can't give very good care under those circumstances. Now you know why there are always positions available on med surg.

Some people will say you should stay and work to get better ratios, but the reality is you probably will get nowhere with that. If it could be done the staff who came before you would have accomplished it. Hospitals today are all about the bottom line and the folks with the power will continue to staff this way until something bad happens (and depending on the quality of their lawyers and who is willing to be paid off, even after something bad happens.) You're almost at your year mark, start looking--but be sure to do your homework. Often all the hospitals in an area staff similarly. Make sure you'd really be moving to a better place before you leave where you're at.

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I work on a very similar floor as in having 8 patients with a couple of trachs and usually 2-3 total cares with out much in the way of PCT's. I know what you are going through, the question is can you safely make it to a year or not. I'm moving on in my case because I'm tired of the housekeeping.

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Okay, let me start off by saying that I'm a new grad and started working on a Med-Surg floor in Feb of this year. I work the 7p-7a shift and we never have less than an 8 patient assignment! It's always 8-11..this includes post-ops, isolations, telemetry monitoring, dementia patients, you name it! Is it me or is there something extremely wrong with this situation?! The turnover on our unit is unbelievable, and 5 new grads were hired on nights to fill positions. Guess who they want to train for charge nurse very soon--yup ME! I told them I was nowhere near ready for this responsibility especially with all new grads but I was pushed away and ignored! The other night, I had 3 blood transfusions, a neuro check patient, an active GI bleed, 2 tube feedings, 3 isos, and of the 10 patients I had 7 were complete cares/incontinent! Mind you we only have 1 aide for 30 patients on our unit-and that never changes! I really am just trying to stick it out a year so I can go elsewhere stating I have experience, but can anyone offer me ANY advice on what to do?! Thanks!

I guess you don't have staffing ratios where you work!! 10:1 is unsafe and insane; you do realize that if, God forbid, something bad occurs, the hospital will say, "we never would approve this type of assignment, the nurse should have spoken to his/her supervisor, blah, blah, blah . . ." and then fire your butt!

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Specializes in Medical/Surgical.

We're working on getting a union into this hospital-hopefully soon! We do have a grid but by NO means do they follow it. Beginning of shift they look it over. If we only need one more patient to keep a nurse they still will send a nurse home..yet all throughout the night they will send us more ERs without hesitation even with knowing our staffing on the unit! Always leaving us short throughout the night into the AM. I'm glad I brought this up and hearing everyones opinions, making sure it's not just me!

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Yeah, you need a union there, big time. In Calif we have SEIU and CNA and we have staffing ratios by state law. I work in ICU and our ratio is 2:1 max; never worked med-surg but I think it's 4-6:1 . . . The other benefit of our unions is much better pay . . . starting RN's make $60-70K/yr . . . at 4+ yrs, well over $100K

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Specializes in LTC, Memory loss, PDN.

I have very fond memories of my last med-surg job at a major hospital. We had exceptional team work on all shifts (I did work them all over several years) and the pay and benies were good. This is the reason I quit: When we had eight patients, times were good, busy, but well managable. Then the assignments changed to ten patients, I stopped taking my lunch break, waited longer to go to the bathroom, etc. Then more often then not we'd have twelve patients, I was always running behind, had to stay late to catch up on charting (not good and my charting declined in quality). I'm an LPN and cannot do blood transfusions, except for auto, but took over tasks for the other nurses who did my transfusions. One day I was in such a hurry, I almost hung the wrong piggy back and when I got the correct one pierced the bag itself with the spike and it spilled all over the floor. I called the pharmacy to ask them to tube me up another piggy back when I was informed that I had just waisted $ 400 (that was ten years ago). Fortunately, I knew the guy in pharmacy and he sent me another bag without making a big deal about it under the condition he would not receive another Rx related call from me. I loved the bunch of people I was working with, but resigned the next day. Certainly I'm not the gold standard of efficiency, but I'm no slouch either. I've worked with several different assignment models such as having patient care coordinators or more than one charge nurse where the charges would do admits and discharges, but no matter how you cut it, more than ten patients is a no go in my book. The fact that you are to be trained as charge nurse not only reflects positively on your performance, but will also look good on a resume (hint). My fear is, as a charge nurse, you will have even more on your plate without having any more influence as evidenced by " I was pushed away and ignored".

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Specializes in Medical, Peds, Surgical, Clinic.

I am sorry to hear that nothing ever changes on the Med/Surg floors. It is a lot of work and hard to handle night after night,but hopefully it will change as it usually does as more nurses are hired. It sounds like you need some more experienced nurses on the floor. But they have probably moved on to other positions as it sounds too crazy and disorganized.

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Wow and I thought I had it bad with my ratio of 4:1 without the help of nursing aids. I too am a recent (Feb) nurse and still consider myself a fish out of water but there is something seriously wrong at that hospital. Safe patient care is not a priority for them and neither is nurses sanity. I can see why the turnover rate is so high. Do you have a nurses union at the hospital? Dept of Health for the state? Somewhere else to turn with your concerns other than the hospital management since they do not seem to care.

Good luck

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