I'm losing my mind on my unit...

Here.I.Stand, BSN, RN · Aug 24, 2017

I'd carefully consider what is more stressful: the job, or the $4000 debt. Only you can answer that question. I highly doubt you can get it waived, as you signed a contract with the hospital. Your Daisy award didn't do anything to recoup their cost in training you, so it's not really a reason to release you from the contract

Sour Lemon · Aug 24, 2017

I'm considering asking my director (I am closer to her than my manager) if she would be able to waive the fee for me since I have received numerous great feedback and a Daisy award for my time on the floor.

Directors/managers are sometimes willing to bend for good employees because they want to retain them. If you're asking for a special favor that involves you quitting your job, what incentive do they have?

JKL33 · Aug 24, 2017

Directors/managers are sometimes willing to bend for good employees because they want to retain them. If you're asking for a special favor that involves you quitting your job, what incentive do they have?

Agreed. They have no incentive.

Sounds like their plan for retaining new employees is simply to hope that they can't afford to leave. Sad.

OP, as with many questions here, only you can decide if you've done everything possible (within yourself) to enable yourself to see this through. Re-evaluate in case there is more you can do to understand co-worker relations and how you are affected by them, and the same with patients.

If you absolutely must leave (which I will not make an opinion about), I suggest you find another position first, and do all you can to leave on decent terms - including pointedly figuring out whether/how you can leave without being listed as 'do not rehire'. Plan on paying the $4K. That's the contract you signed. Tender an appropriate/professional written notice.

All new grads take note. When you sign these types of contracts what you are saying is essentially that you are willing to pay this organization for your orientation. Consider this as part of your start-up costs if you are going to sign on for it. Secondly, don't fail to understand that there IS a reason that some places must enact such policies.

TriciaJ, RN · Aug 24, 2017

All new grads take note. When you sign these types of contracts what you are saying is essentially that you are willing to pay this organization for your orientation. Consider this as part of your start-up costs if you are going to sign on for it. Secondly, don't fail to understand that there IS a reason that some places must enact such policies.

You're right. These contracts speak volumes about the workplaces that use them. New grads should be very wary of signing them. Unless they come with a nervous breakdown clause.

I wish I had some words of wisdom for the OP. The best thing I can come up with is to level with your director about just how stressed you are and that you are considering just owing the $4000. Hopefully she'll be interested in working with you and finding a way to make this more doable. Good luck.

allnurses Guide · Aug 24, 2017

Hello fellow nurses,
I work for a med/surg-tele unit around the Houston area. I obtained a job by signing a 2-year contract with HCA under the StaRN residency program. I have recently just passed my one year.
Like mentioned on the title... I really am losing my mind working on the floor. Consistently understaffed (sometimes six patients with two techs on the floor only, and it's a 36-bed), demeaning coworkers and other healthcare personnels, and more to mention about the every-day things we deal with from our patients.
Since day one, my anxiety has risen through the roof and I'll be honest, many times I feel like there is no way out. I often end up crying while at work--even on the way to work, and especially after work. I've ended up in my manager's office one day and balled my heart out. I know this may be a regular part of nursing, but it is crippling my heart to the core and I literally cannot stand it anymore.
I am at a two-year contract and have roughly $4k to pay if I left now. My heart is very set on leaving the place, but my mind is reasoning with me. Where do I draw the line between my mental and physical health and reasoning?
As they say, contracts are like hearts; meant to be broken. I'm wondering if anyone has experience with the StaRN residency and/or breaking residency contracts.
I'm considering asking my director (I am closer to her than my manager) if she would be able to waive the fee for me since I have received numerous great feedback and a Daisy award for my time on the floor.

You sound like you are having a hard time right now and while being resolved to quit may be one answer I personally would not advise it. The first couple of years of nursing can be extremely difficult. Your not just learning to be a nurse but you are learning a lot about your self. It can be exhausting and demoralizing at times but it can be handled. I would say it takes about 3 to 5 years to get really comfortable. About the beginning of year three you will start to feel more relaxed and comfortable. In the mean time you really do need to make taking care of yourself a priority. Are you eating a decent healthy diet with minimal fast food. Everybody's got to have a burger or pizza once in a while but if you are eating Top Ramen everyday at least try to throw some veggies in there. Sleep and exercise in at least 3 times I week . I live pretty close to work and ride my bike three days a week. Find a hobby that feeds your soul. I garden and I cook. Find a cause and help with it. I participate in community supported agriculture and teach gardening workshops. Take long bubble baths, get a massage or other pampering at least once a month. It's important to find someone to talk to about how you feel and not necessarily your boss or supervisor. A good therapist s worth his/her weight in gold. Perhaps you could ask for a lateral move to a different unit. It might be just as busy but suit you better and give you some perspective. You have 1 year left on your contract and 1 year goes by really quickly. After that you will have that coveted two years of experience under your belt. I personally would not take the risk of becoming a do not rehire especially if you are in an area where one or two company's own all the hospitals. 5 hospitals with 10 miles of my home will not hire me because I had a mental health crises back in '04 and I was put on a do not rehire status. You don't want a big debt on your back and be out of work. If that's your picture go take that pug for a walk. You can do this. You can PM me if you want to get some private encouragement.

Hppy

CoffeeYogaNurse · Aug 24, 2017

I completely understand the situation you're describing! I was in the exact same place as you are now 2 years ago. 6:1 ratio on a neuro/ medsurg unit with 1-2 techs max. I had signed a 2 year contract and hated it by the time year 1 was over. I took a year to plan my next move and my last day was exactly 2 years after I started. It was the best thing I ever did. I'm in ER at a different hospital and I'm really enjoying it. Don't keep doing something you hate. Its not healthy for you, your loved ones, or your patients.

As as far as the contract goes, I didn't break mine, but several of the nurses I started with did. Our contract was pro-rated, so if we quit with 1 year left we owed 5K, if we quit with 6 mo. left we owed 2.5K etc. two of my colleagues left and received sign on bonuses that would easily cover what they owed. One other coworker left with 3 mo. to go, but the pay rise she saw at the new hospital made it worth it. None of us regret leaving.

I would suggest waiting a few more months and really research your next move and where you want to go. You can tell your director later on, but not until you have some leads for her to try to compete with to keep you. In truth, you've busted your butt on a difficult floor and obviously done well there. You have learned more than you realize and have a lot to offer other units. Be grateful for that experience and knowledge but move on to something you actually like!

NurseSpeedy, ADN, LPN, RN · Aug 24, 2017

OP, some of this sounds like signs of burnout. Do you have a significant amount of PTO that can allow for a much needed vacation/break from it all? If not, I am not clear on FMLA and mental health leave but you meet the 1 year requirement so this may be another alternative that can get you up to 12 weeks to regroup. I don't know how this would impact your contract (if you would have to make up that leave time). It's something to think about. You sound stressed out and another year FT could make things worse. However, I would do everything possible to avoid being blacklisted from this company. They are HUGE and own a LOT of facilities.

JKL33 · Aug 24, 2017

OP, some of this sounds like signs of burnout.

May I respectfully ask why we keep saying things like this instead of, say, "sounds like signs of a cr@ppy place to work?" Even one year of nursing causes "burnout" now?

I'm not saying it's not very stressful; what I am saying is - why are we labeling this problem or general situation as if lies within thousands of individual nurses. Nurses here, nurses there, new nurses, experienced nurses - everyone working in acute care is burned out? We hear of situations where it would clearly be difficult for any one of us to provide care that we felt was excellent - and we call that nurse burnout?

It's really kind of a brilliant concept, not for nurses, but for shirking responsibility.

NurseSpeedy, ADN, LPN, RN · Aug 24, 2017

May I respectfully ask why we keep saying things like this instead of, say, "sounds like signs of a cr@ppy place to work?" Even one year of nursing causes "burnout" now?
I'm not saying it's not very stressful; what I am saying is - why are we labeling this problem or general situation as if lies within thousands of individual nurses. Nurses here, nurses there, new nurses, experienced nurses - everyone working in acute care is burned out? We hear of situations where it would clearly be difficult for any one of us to provide care that we felt was excellent - and we call that nurse burnout?
It's really kind of a brilliant concept, not for nurses, but for shirking responsibility.

FT acute care is not for everyone. I have worked in several hospitals and the ratios are hardly ever desirable and it definitely contributes to the stress. Take several nurses who are overloaded with patients and orders, you have a lot of unhappy coworkers to work with. Now the doctor acts like his patient is your only patient and wonders why it takes you five minutes to meet him at the desk to round (because the antibiotic was a five minute push, one of six that are all due at the same time for a group of patients that day) and now they are a peach to deal with.

I've tried other work environments and acute care is my thing but it can be stressful, especially someone's first year. But if someone is feeling like the OP is, this cannot just be ignored for another year while their mental health further deteriorates because feeling like there is no way out without severe consequences is a horrible boxed in feeling.

I left the first time after 8 years. I didn't realize how bad it was until I felt myself falling asleep while driving over a bridge. I wasn't sleeping at night because I was thinking about what I was in for the next day, I was tired all the time and I couldn't keep hardly any food down, and that's when I could bring myself to eat. I became dangerously thin and was bruising without knowing how I got it. I didn't realize the earlier signs as burnout then. I turned in my notice because I didn't want to hurt anyone on the road and I really didn't want to die either. I didn't even know that I was 'burnt out' until I read an article in a nursing journal that went over the different stages. Hind site was 20/20.

It would be great if we had good patient ratios and staffing based on acuity and not numbers. However, there's been talk about this for decades and there's only one state that has made any kind of law in regards to this issue. Nurses are stressed out because there's too much to do in such a small amount of time and are patients are people. We want to not only be safe but give quality care as well but conditions are far from it many times. I'm not holding my breath on this happening any time soon and, at least in my area, going to a different facility isn't going to solve the problem for someone whose feeling like the OP.

Dealing with acute care again I've learned to notice when I'm needing a break and take the PTO when needed. This usually is enough to get me back to normal. Now, when a facility is so understaffed that you cannot take your PTO, then it's time to look into options where you make your own schedule and take that time when you need it.

Okay, that was a lot longer than I planned. Sorry in advance for any typos. This was sent from my iPhone.

Meeshie · Aug 24, 2017

have you taken your contract to a lawyer? if not, i would... just to see what your options are.

litbitblack, ASN, RN · Aug 24, 2017

Is your contract to that floor or can you change dept? Take an extra day off, rest, try to organize your time if you think you can- i hate that saying but sometimes you can still organize it a bit better. Its a year or $4000. what about PTO? Do you have some you can use to pay back the contract? Look into other positions that have bonus that may help you pay it off but be careful it may not be greener somewhere else.