Impossible job expectations

[annmariern]

Last week, handed a booklet detailing my job expections; I work 7am to 7.30pm on a surgical/tele floor.

7am meeting huddle, 5 -10 mins, mostly on what more we need to do; then get assignment, paperwork, do walking rounds, check all lines, answer lights, be on top of meds, phone calls, escort any pt with a chest tube, heparin drip. etc, to various tests, chart your assessments on 5-6 pts, mostly post op, within two hours.

We have CPOE, which means the docs enter their own orders, except they enter nursing comunictation orders, which mean i have to enter them. Check every pt hourly and sign a sheet. We take high dependency type pts, despite being med/surg floor.

The Unit secretary, and LPNs, can no longer imput orders, check orders do admits, give narcotics., and all post op pts must have a full history and admit done on arrival. Discharges must be done within 60 mins. Meanwhile Im supposed to give pts the best experience ebver by sitting with them, making eye contact etc.

Is this normal now? Just wondering what other facilities do. Been a nurse for 20+ years, and I can't handle it.

[giveface]

For all the reasons you describe above I have decided to leave the profession after only 7 months. Fed up! See my thread about it at this link https://allnurses.com/men-in-nursing/career-advice-required-673132.html#post6140584

[Wave Watcher]

I use to work floors but no longer! Bailed out within a year and went to school nursing. I will go broke before I head back into a hospital to work. My health and happiness are more important than their unrealistic timelines.

[Vespertinas]

It will not get better, soon 30 percent of hospital reimbursement will be based off pt satisfaction scores.

Not from insurance companies. I was told that's not legal since satisfaction scores are subjective. The HCAPS are important to us because of patients who do their research and shop around hospitals before selecting one for elective surgery. And those elective surgery folks are the money-makers.

[tokmom, BSN, RN]

Reading this thread makes me so sad. Does anyone who is working in a hospital really like their job? I previously worked in a hospital that did not (still doesn't) treat employees well. I thought it was the norm until I quit and found the hospital I currently work at. I love, love, love it there and I have found my niche.

I really do hope that others do as well. It is not fun to work in a facility that treats you like crap.

[nurse2033, MSN, RN]

Thank you for your post. National leadership needs to step up and mitigate this situation. The workload and responsibilities seem to increase every week. In my old unit we (nurses) got together and agreed never to enter MD orders. If a doctor gave us an order we would then ask them to enter it (CPOE). That is their job. Your manager should address this. This is the entire reason that CPOE exists, to eliminate the middleman and reduce order errors.

[Vespertinas]

For the record, I work in a hospital. I've never worked elsewhere and what the OP described sounds PERFECTLY NORMAL. I stretch myself to the limit everyday, I come home frazzled, but I still love my job. I'm also possibly delusional.

Anyway, I would suggest for the OP's unit to maybe hire an RN who only does admissions & discharges. I've heard of that in other places. For a unit with high turnover, it could make a great deal of difference. Then again, we're talking about making a new hire and that'll probably get a good laugh out of the manager.

[giveface]

I'm just thankful that I at least got something out of all this time and effort and money regarding schooling: my BScN degree magna cum laude. At least now I can use that to parlay some kind of career in a different field. Imagine if I had absolutely no useable papers to my name after all this. That would be just terrible.

[Guttercat, ASN, RN]

Delivering the actual care, has become so burdened with technology and inefficient processes that what used to take two minutes to do ten years ago, now takes five.

The "thinking" is being squeezed right on out of the profession in favor of assembly-line task completion.

[Guttercat, ASN, RN]

I'm just thankful that I at least got something out of all this time and effort and money regarding schooling: my BScN degree magna cum laude. At least now I can use that to parlay some kind of career in a different field. Imagine if I had absolutely no useable papers to my name after all this. That would be just terrible.

I'd like to be optomistic, I really would. But there's a growing sense that as health care reform continues to unfold, the economic recovery forecasts are for "slow and dismal with occasional freezing," and reimbursement continues to decline and becomes more difficult to obtain...we will be ever increasingly required to perform as Trained Monkeys.

[everydaynurse]

I was ready to quit nursing and go back to school to get different training. My physical and mental health was deteriorating, and I was crying all the time. I have been in nursing since 1966, and loved it until the last 6 years. Maybe I'm getting to old (64) and just burned out, but I love working with patients and helping them understand their part in their health care. Then my wonderful daughter, who knows me better than anyone, suggested a site for different careers in nursing. Yeah! Didn't know about Wellness and Health Coaching. Now starting on learning about this new area and hope it will pan out. I have been an agency nurse the last six years, and from my limited perspective feel the bigger the hospital the worse the care and all employees are expendable, just robots. Is anybody listening to us?

[Psychcns]

Is your hospital unionized? A good union would negotiate working conditions which includes safe staffing levels. If your hospital is not unionized, contacting a union might encourage management to provide extra staff.

[KelRN215, BSN, RN]

Last week, handed a booklet detailing my job expections; I work 7am to 7.30pm on a surgical/tele floor.

7am meeting huddle, 5 -10 mins, mostly on what more we need to do; then get assignment, paperwork, do walking rounds, check all lines, answer lights, be on top of meds, phone calls, escort any pt with a chest tube, heparin drip. etc, to various tests, chart your assessments on 5-6 pts, mostly post op, within two hours.

We have CPOE, which means the docs enter their own orders, except they enter nursing comunictation orders, which mean i have to enter them. Check every pt hourly and sign a sheet. We take high dependency type pts, despite being med/surg floor.

The Unit secretary, and LPNs, can no longer imput orders, check orders do admits, give narcotics., and all post op pts must have a full history and admit done on arrival. Discharges must be done within 60 mins. Meanwhile Im supposed to give pts the best experience ebver by sitting with them, making eye contact etc.

Is this normal now? Just wondering what other facilities do. Been a nurse for 20+ years, and I can't handle it.

Sounds familiar. We do not have LPNs at my institution and we are lucky if we have a CNA to help with VS and total care patients. My hospital does not have a transport department so RNs are required to transport patients to the OR, Radiology, other departments, etc. Our secretaries do not input orders nor have they ever since I've been there. For the most part, physicians are expected to enter their own orders (though the NPs do most of this) but there are often orders entered as "Nursing to order" and then we have to re-enter them. Our discharges usually want to be out the door 15 minutes ago and the minute the paperwork is signed, we have an admission waiting in the wings for us. There is no one else to do an admission or a discharge, it's the nurse caring for the patient who has to do it. Oh, and admissions must be seen and assessed within 15 minutes from arrival on the floor.