Is this normal practice-my unit feels unsafe.

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Hi, I have been employed at a local hospital for 4 months now. I work a general med surg floor and I am hitting the point where I feel unsafe and like I am screaming at a brick wall.

We often get ER patients who meet sepsis criteria (we have a protocol) and within 3 hours fluids need given, with a lactic drawn, and an antibiotic. During ER report I tell the nurse these things need done before pt can come to the floor. Her reponse is that they can't get an IV. We had to page the supervisor and complain and suddenly she has an IV in. Then we had to call the dr after she arrived and get the orders (after the 3 hour mark). He was told he didn't know her labs were that critical. This happens, often. We actually have a frequently filled sheet to add admissions that shouldn't have came to our floor... is this normal? To have to take unsafe pts at least once a shift?

No one between days and nights knows policies for AM procedures. I've tried to be proactive and ask for a sheet, but no one has done anything. So during AM report, I am always yelled at for doing something that no one knows to do.

Advice is absolutely terrible. I will ask how to approach a situation and be told "I dont know" (from nurses for 30+ years) or "don't worry about it." Example: distended abdomen with fecal management system and decreased output from it. I asked how to know if its clogged or not in right or how to irrigate it and was told to not worry about it.

These are just a handful of things I've witnessed.

There is just no continuity between what I'm scolded for during days and what I'm told at night. We often get patients meant for ICU or a telemetry floor, neither of which we are prepared to handle. Our DON actually stayed late one night to lecture me and tell me I should have RRTd a stable patient when she came to the floor, as they shouldn't have came there originally. (Not any blame on the supervisor or ER for sending her like that)

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To add to my post, I have also been shorted a sitter, and received a patient assignment. I had to be my own sitter on top of my other 5 patients.

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Sounds like a cluster. Get out.

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Sounds like things haven't changed much since I've been a floor nurse.

The attitude of "don't worry about it" is what concerns me the most.

Start putting out your feelers. Good luck.

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Specializes in Case manager, float pool, and more.
To add to my post, I have also been shorted a sitter, and received a patient assignment. I had to be my own sitter on top of my other 5 patients.

Oh that just ain't right. That sounds like a terrible place. Once in a rare while we may have shifts like you described but that is sure NOT the normal. I agree that the "don't worry about it" mentality is most concerning.

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Specializes in OR Nurse.

So sorry to hear you are experiencing this. This sounds exactly like my first nursing job. I was worried sick I would lose my license because of how unsafe the working conditions were. I left after 6 months because we work too hard to get our licenses and deserve (as well as our patients) safe work environments. I would try to find something else that is safe and makes you enjoy this profession. Best of luck to you!

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It's irresponsible on their part for the floor to continue admitting patients it is not equipped to care for and to not have policies set in place for certain procedures. Also if someone doesn't know how to approach a situation, they need to at least know how to look up what to do should the situation arise. If someone is going to say "not to worry about" something, they should at least have a good rationale as to why something is not concerning. It doesn't sound like they did in your case. I agree with everyone else that it's time to move on if you can.

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It's irresponsible on their part for the floor to continue admitting patients it is not equipped to care for and to not have policies set in place for certain procedures. Also if someone doesn't know how to approach a situation, they need to at least know how to look up what to do should the situation arise. If someone is going to say "not to worry about" something, they should at least have a good rationale as to why something is not concerning. It doesn't sound like they did in your case. I agree with everyone else that it's time to move on if you can.

This is also something I agree with. I had an NG tube in for 5 days. I know they're temporary. I call our GI floor to ask how long our policy is for them after looking through manuals and references and finding nothing. I'm told "oh we've had them in longer, don't worry about it." I tried to explain I wasn't worried but still just wanted to KNOW for reference in my brain! And I was told they didn't know. :(

I feel like half my shift is a big guessing game and/or fighting with my supervisor over a mess from ER. Especially with this protocol. There is just no consistency between standard of care. Google is a better resource than my coworkers, which is terrifying. I have often asked for and received wrong advice I knew wasn't safe for the patient. Example of this is getting an order at 10pm at night from a specialist. The computer flagged it as an interaction with an SSRI. My charge nurse told me to override it as physician aware. I wasn't comfortable doing that because it's not like he physically had that pts med list with him and it was late and antidepressants probably aren't high on the ID drs concern. I ended up digging for info from pharmacy and getting tons of new orders (including telemetry) because the risk of ssri syndrome was actually extremely high and common with these 2 meds.

I know my first year is supposed to suck but I am just feeling so stressed any time I get an admission or am scheduled to be there. I worked LTC as an LPN (different world, I know) but I have never watched so much inconsistency or lack of care.

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Get out. Now. That is your license waiting to be forfeited cause that place and its managers sure won't cover your butt when something goes wrong.

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Make sure you have private (not hospital based) . You can buy it as a rider to car insurance, personal property insurance etc. Don't tell anyone at the hospital you have liability insurance.

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Sounds like your unit is in desperate need of a CNS or nurse educator. Being busy is par for the course, but the blatant lack of knowledge is not the norm. Your instincts are right, this floor is a poor outcome waiting to happen.

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Are a lot of nurses on your unit newer? When I'm on a floor with a great deal of "institutional knowledge" (aka experienced nurses), I feel so supported and safe. But when I go to a floor manned by a bunch of newer nurses, well, it can be much more chaotic. Sometimes, newer nurses don't even know what they don't know. Everyone of us was (is) new at some point and we make mistakes, miss things, and doubt ourselves. However, it's not ok to be nonchalant about it. Keep asking question, researching and being the best nurse you can be.

But, I would try to find a unit full of experienced nurses.

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