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

JKL33 · Aug 24, 2017

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.

Thanks for the reply! I agree with your general take on the situation in acute care. And I agree it can be terribly stressful and that as nurses we need to recognize our reactions to the stress and take steps for our physical, mental, and emotional health. I think those basic concepts are probably how the idea or problem of "nurse burnout" came to be recognized and discussed more. The problem comes in when "working conditions" are overlooked or worse, called "normal", and the individual nurse is called "burned out."

That's only my humble opinion, of course. :)

Been there,done that, ASN, RN · 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.

Your unit does not sound much different than many other units. Your anxiety seems over the top, have you discussed that with your provider?

Only YOU know if 4 K is worth breaking your contract. Start job searching now to see if you get a better offer.

P.S. Never let 'em see you cry.

Ruby Vee, BSN · Aug 25, 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.

I'd venture a guess that your anxiety, rather than your workplace is to blame. Six patients on a Med/Surg/Tele floor doesn't sound all that different from ratios elsewhere. "Demeaning coworkers and healthcare personnels" usually speaks to poor workplace relationships. Regardless of what you see on TV, workplace relationships are not "like family", and they require work to establish and maintain. An anxious new grad who is overwhelmed by her new job probably relegated the workplace relationships to the back burner, and now it's a problem.

The language used is rather dramatic, and I'm wonder if this isn't part of the problem -- a tendency to view things through a dramatic viewpoint. I'll wager this will be an extremely unpopular post, but my advice to the OP is to "woman up". Work is work, and they call it work for a reason. Your director has no reason to enable you to break your contract. You've only worked one year of the two you contracted for. You're not keeping your word. How anxious do you think someone will be to hire you down the road, knowing that you have a history of not keeping your word?

You need to manage your anxiety, not quit your job. That stop thinking that "my heart is crippled to the core" and "where do I draw the line between my mental and physical health and reasoning?" Replace those messages with positive messages: "I'm really busy, but I am learning so much!" and "I shouldn't take what my coworker said to heart because I know she's really busy and really stressed, too." If you keep telling yourself that you can't do it, you can't. Try telling yourself that you can.

Here.I.Stand, BSN, RN · Aug 26, 2017

Sage advice from Ruby Vee!

LovingPeds, MSN, APRN, NP · Aug 26, 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.

I was in a similar situation when I graduated. I signed a two-year contract on a 24 bed pediatric floor that included a "wonderful sign-on bonus" that, as a new graduate, I was thrilled about. I didn't know what I didn't know. This floor worked without techs and when completely full, we would have three to four nurses - depending how many were on the schedule. There were nights that I had seven peds patients, plus most of the IV medications for the LPNs because they were considered push, and all admission assessments. It was stressful. I wanted to quit so many times, but I would have to pay back every cent of that sign-on bonus if I did before my contract ended.... actually more, because they taxed that bonus.... I'd have ended up paying back more than I actually got to quit! I came in angry. I went home ranting, crying, and frustrated. When that got me no where, I became more proactive. I developed professional relationships with my coworkers. I sent emails with patient safety concerns. When that got minimal response, I sent letters return receipt requested to management (can't say it wasn't received) when situations developed on the floor that were unsafe to the patients. I always got back the generic "Thank you for bringing this to our attention. We're working on it." I actually stayed a year over my contract. I was hoping for change. I saw little, but I felt that I had served my patients by at least trying. I changed positions eventually. The odd thing about it was that after I left, a lot of what I was bringing to their attention improved. It is more cost effective to treat staff well than to train new staff.

Your ratios are not unheard of for med-surg. The ratios at my old position for med-surg nurses at that old position was some times as high as one to eleven - a horrifically unsafe ratio. Your nerves are rattled because you're still new to nursing even with a year's experience. You probably still feel like you don't know enough and that you can't keep your head above water. That's a normal feeling often expressed by new nurses. I was two and a half years into nursing before that feeling went away, but it does eventually go away and things do eventually get better. Time management improves. Experience chances a lot. I encourage you to take a step-back, clear your head, and evaluate your options rationally. If you're concerned about the $4000, then work out the rest of your contract. One year goes by so quickly. Mark off the days on a calendar if that helps. Become more proactive on your unit. Form relationships, get involved with making changes to the culture, bring evidence supporting safety procedures or improvements that other hospitals have implemented. If you feel that $4000 is a small price to pay for escaping your situation, then pay it. I would not expect your director to waive the fee. There are consequences and this is a learning situation all around. Leaving this position without fulfilling your contract can have consequences that may affect your eligibility for rehire, your ability to transfer to other departments, and the information from your previous employer if any potential employers call them.

These can be hard lessons, but hard lessons make us wiser. I will never take another time-specific contract nor another sign-on bonus. My lessons were learned and I still learn them. What you choose to get out of yours, no one else can tell you. I wish you luck and that your experience improves however you decide to proceed. =)

**canoehead, BSN, RN** · Aug 28, 2017

Some workplaces are toxic, you may have hit one. It would be worth the 4K to me to get out of a toxic workplace.

New grads have a very difficult time getting their confidence. If it's a new grad issue, rather than a toxic workplace, you'd be better off sticking it out. You've already gotten the routines and common diagnoses of your current ward figured out. You'd be starting from scratch in a new place.

I've been in BOTH situations, and they are like going through puberty- I'd never do it again for a million bucks.