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!

Specializes in Float.

You mentioned you worked in Central Jersey. I'm in North Jersey. At my hospital, we are encouraged to report unsafe practices. There's the whistleblower's law, Corporate Compliance hotline and of course JCAHO. Maybe it's time to make a call. Best wishes to you whatever you do. :redpinkhe

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Specializes in PCU/tele.

well, you could always move the "awesome" midwest and work where I do! i work PCU and our ratio is just about ALWAYS 6:1, while m/s is sitting pretty with 4-5:1!! and we have to monitor all sorts of IV gtts also, AND take pretty much all of M/S's admits thru the noc bc we are essentially the only unit that makes the money for the place!!... and thats straight out of our managers mouth. she also tells us to "suck it up and get over it." this is all from a person who has never worked the floor a day in their life.

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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

I work in northern cali on a med-surg unit and the ratio is 5:1, however there are hospitals that have 4:1 ratio for med-surg h but the law is 5:1 and the starting pay for new grads here is around 80k/yr.

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Specializes in psych, ambulatory care, ER.

I see that you are in New Jersey, and I'll just start by saying that I'm not in the same state.

With that being said, I'm a State surveyor (I know, one of those people), and this may well be a violation of New Jersey's State and Federal hospital regulations (it is where I live). If this lovely institution actually has a staffing grid and is dumb enough to not follow it, that's a violation of their own policies and procedures. They can be cited for not following their own policies and procedures. There are some other regulations (again, in MY state) that pertain to providing enough nursing staff to provide safe care to patients, etc.

Please, please, please make a complaint to your department of state health services. You can remain anonymous. Try to give specifics regarding dates and include anything bad that may have happened on the dates you were under-staffed (med errors, patient falls, elopements) that would help to substantiate your complaint of being under-staffed. Your facility will get a nice little visit from some friendly surveyors that will have the higher-ups pulling so many reports and documents, their little heads will spin.

Good luck to you, and please feel free to send me a message and let me know how it goes. I really hate to see nurses getting the short end of the stick when all we're trying to do is help people. I hope the situation improves. If I was technologically advanced enough to figure out how to drag one of those little smiley faces over here, I would.

oldladyRN

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Med surg is a very difficult place to work, however the experience that you gain will prove valuable in years to come. I currently work on a Med surg unit but I plan to move on. Although we do we have ratios we always get the worst of the worst patients, and it often seems as if we are the dumping ground for the rest of the facility. People that do not work on a medical unit often have a hard time relating to what we as med-surg nurses go through. But hang in there because although times are tough now they will get better. After you get your year in move on because you do not want to get burnt out this early in your career.

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Specializes in Med/Surg, Home Health.

Thats exactly how my floor was when I worked there. I was expected to train for charge and be charge...without charge pay. Plus I was expected to have a team of patients WHILE being charge. I had up to 13 patients at a time on night shift. management tended to think that these patients all slept at night and we didnt have much to do. Little did they realize that at night is when the sundowners occurred, the confusion and ripping out F/C's and IV's, etc. So I went to dayshift, which was no better. Then they took away all raises. I finally quit and went to home health. Its alot better, but its still stressful.

Honestly, your working conditions are unsafe for your license and for your patients. I dont care what the big boss's say, thats too much responsibility and there is no way you can provide adequate care under those circumstances.

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Specializes in Operating Room.

"I'm perplexed why so many facilities ask this of new grads??????"

They ask it because anyone with experience and in their right mind wouldn't want it. A new grad won't know any better, and may be so flattered that they're being asked, that they get suckered.

Trust me, I'm living proof.;)

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Specializes in Med/Surg, Telemetry, Ortho.

Wow! I do feel your pain. This was very much like my first nursing job and it was scary and depressing. It would be a great idea for you to move on. I think you will find that the experiences you have encountered will serve you well in the future. If you can handle that type of floor other floors tend to be a piece of cake.

MP

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The thing is these new grads are all just coming off their orientation, thus all the float nurses who were precepting (who are well-seasoned) are heading out, leaving us cut and dry. (Not their fault) Also, even though these new grads are coming on, they are just filling in positions for the nurses that have left. Total of 9 nurses have come and gone within the past year!! Obviously something is not right! As far as expressing my opinion to NR, I was practically scolded by my director for not following chain of command! Just to give an idea of how bad this floor is turning out to be, the first night with 3 new grads and 1 charge nurse (who is new as charge), we had 1 patient death and 2 errors. I'm not saying it could have been prevented completely but it was utter CHAOS! And nothing is being done about it! As much as I want to share this with the hospital administration, I don't want to be looked down upon by not following chain of command again :nono: It's just so much stress and it's getting much worse. This hospital is in central Jersey...
My experience with management and chain of command scoldings is that they are a tactic used to avoid actually addressing the problem. They have no intention of doing anything about this.
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Specializes in Medical/Surgical.

Thank you everyone so much for all of your input! I knew I wasn't just new and dumb! I knew deep down that everytime I went in just didn't feel right, and the patients were suffering because our hospital wants to "work with the least amount of nurses and take on the most amount of patients" idea. I do plan on talking to someone higher up about this because apparently my voice means nothing in that office! They look at me as a new nurse with too high of expectations! You guys are great :wink2:

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