Leaving Bedside Nursing

This is sad. Yes, bedside nursing is tough. It not for the faint of heart. Yes, there are difficult patients. The saddest part of it all is your work place. I'm here to tell you there are institutions that do not treat nurses like that. I work a very busy telemetry floor where we have 5 patients max. Our shared governance is pushing for 3 to 4 patients max. I have excellent relationships with all staff members -even the ones I don't like. How did this happen? HCAPS. Yes, the most hated part of healthcare has been a great positive for us. How? Nurses decided to change it. My question for you , and every nurse who complains, is what have you done about it? I am on several powerful committees in our institution. Change will come. It takes action, not complaining. And it starts with me, right where I'm at, right here and now. I truly believe that everyday i have the power to change things. So heres to action. Just food for thought.....

Hmmm, for me I think bedside is the most valuable form of nursing. Imagine, simple health education from you can prevent pains and wound infections to patients.

Also, to the contrary when I work hard like at bedside, I feel happy.

In a week, I work 3 days in the out patient clinics and 2 days in a surgical ward and I am very happy with this as I don't work night shifts.

But I will never consider leaving bedside nursing to go for management. I don't believe they do anything.

Bedside nursing is not for everyone.  Every area of nursing has it's own unique set of challenges. After almost thirty years in many roles 10 years in ICU, telephone triage, rapid response, manager of a 30 bed surgical telemetry unit and finally pacu ; I still love what I do and intend to do it as long as they let me.  I just remember a) that it took me almost 1.5 years to be able to approach the UNIT without the sphincter response and b) my case managers when I was a manager had some pretty tough days.  Best wishes.

Bedside nursing was not for me. I hated it. I didn't last a year. I left the minute I could, which was many years ago.

I have nothing but respect for people who can do it, year in, year out. Tough is not even the word for it.

Then throw in an abusive coworker or two.

It was horrible.

It is good we are all made differently, and there is someone who can do that job, because I could not.

That is the great thing about nursing, so many options.

I’ve been a bedside nurse for 15 years.  I can’t imagine doing anything else.  I have pretty thick skin though and I’m lucky enough to work in oncology where 99% of the patients are grateful and wonderful.  I am also lucky enough to work in California where the strong union worked incredibly hard to get us ratios.  If the rest of the country unionized and came together we could get ratios in other states.  It’s been over 10 years that we have had state mandated and enforced ratios.  The union I am involved in has gone to other hospitals to try to help them unionize and sometimes we are met with such hate from the nurses! How do they not understand how we won?!? Nurses would be a lifelong career with unionization! Yet our nurses are leaving in droves. 

I worked at the bedside for 34 years and it became more and more difficult. The hospital I worked for was sold to a for profit outfit and they cut us to the bare bones, cut staff, resources, food and even condiments for the lousy sandwiches we had for the patients on the off shifts. They took away our ward clerks, left us with few or no PCA’s and expected us to get high HCAP scores. Our hearts broke that we couldn’t do more for our patients and give them the care they needed. And yes there were plenty of patients and families who expected to be treated as if they were in a five star hotel and Dr’s. that could care less about what was going on or if staffing was safe,they wanted  their patients induction (elective) mind you  started right away, or their case added to the schedule . I am glad to be away from that mess, worrying that my license is on the line or something tragic will happen because we were short staffed. 

        I missed holidays, events for my kids, put my health in jeapordy working crazy hours and missing breaks and lunches, lifting and turning patients. I completely understand someone’s need to leave floor nursing it’s always been hard work, but now it is becoming dangerous, for the staff and the patients.

Edited Sep 3 by ShellyRN2

I left bedside in 2008. Went to become an Investigator for a regulatory body. Sometimes I do miss it, but this lifestyle can't be beat. 

I graduated from school and was working as an aide in a preop and PACU floor. Right after I got licensed my managers hired me and was really excited to be in such a position as a new grad. After about 9 months I realized it was a big learning curve and did not have the "bedside" experience a lot of my co-workers did and decided to take a tele-float position at another hospital to "learn" and realized what a mistake it was. 

At first it was not so bad because I was learning a lot of new and useful info and really getting to see the disease process. It was exciting at first but little by little I started to see what was really going on. Certain floors I floated too were very strict regarding patient satisfaction scores and it was all the management would talk about, in particular the post-surgical and cardiac tele floors. I remember the first time I was talked to for not bringing a blanket fast enough because I was doing my med pass and realized what a mistake I had done leaving PACU.

I eventually ventured into the ICU and really liked it, but at this time I  had moved to another city 40 minutes away and was tiring with the commute after a year. Traffic became bad at times and a lot of construction often made the commute about an hour and at my current home I lived 5 minutes from another hospital and applied there. None of the day ICU positions called me back, but did get called back for a tele position and took it. This floor in particular just SUCKS the life out of you. The patients are chronically ill and often have multi organ issues. Management is all about patient satisfaction scores and it seems like its all they email me about. The manager who is not helpful at all does "rounds" in the afternoon where she goes into every room and basically logs complaints the patients have and brings them up to you...while you're in the middle of charting, med passes, patient care etc. This in contrast with managers from other floors I have floated to who are active on the floor helping staff with tasks and patient care. 

I remember an incident where a physician wanted to discharge a patient who to me looked awful and just didnt feel right giving him his discharge instructions and go home. The wife had to take him to an appointment the next day hours away and well I didnt feel good at all about this. He kept desatting whenever he would get up to do anything and I mean he would go down to the mid 80s just by walking to the bathroom and needed the cannula running at 6L to get him back up to above 90. He would also get very tachycardic and just looked bad. I called the hospitalist during all of this and he assessed the guy and decided it would be best to keep him another night. 

I come back the next day and the guy isnt there, apparently he ended up crashing during the night and was transferred to the ICU. If I had let him go home he could have potentially died. My manager comes up to me later in the day and tells me in a snarky tone "you were in that patients room for quite a long time yesterday, your patients neighbor was complaining you werent fast enough with his pain medication". Thats when I realized she doesn't give a *** about the patients at all and just basically wants her positive HCAHP scores.

I'm still working for the same manager and really want to go to another setting that isn't telemetry or med surg. Im wanting to stick it out at this hospital for at least a year before trying to go elsewhere so it doesn't look bad on my resume. Each day I'm on the floor I'm just miserable and on edge about getting called into the office over something stupid and potentially getting fired. I get home usually drained and have even developed agoraphobia where I really dislike leaving the house even to go to the store or any kind of social event. The only way I can calm down at home is to drink alcohol which has become a bad habit, I don't binge drink or anything but have found myself drinking two beers on my days off every night to wind down. I don't mind the patient care at all to be honest, but management has some unrealistic expectations and I'm just turned off from floor nursing at the moment. Hopefully something happens next year and I can leave because I feel like I'm losing my mind. 

I am appalled, your manager should have celebrated your great save. I managed a Surgical Telemetry Unit. Go back to PACU ! You clearly have the assessment skills..if necessary go to Phase II first, but let them know you want to eventually go to Phase I. I understand your spiritual fatigue, please see a counselor, you cannot continue to live always waiting for the other shoe to drop. Get some good books i.e Drain's Perianesthia Nursing, while you are looking. Feel free to PM me on FB if I can offer any more advice support. BTW document everything for HR.

 

Amen! I tried bed-side as an RN, and after nine weeks in residency, I said hell to the no, though I did geripsych at a prison when I was an LPN, which I loved btw! I went back to the outpatient clinic and now am a Referral Manager at the Naval Hospital:) But I feel you @Wrestler133 you are strong!

 

Oh, and some of the comments here are just beyond rude! Be empathetic; not everyone is thick-skinned.

Edited Oct 31 by tchampRN

On 10/13/2019 at 5:25 AM, BethWinters said:

I am appalled, your manager should have celebrated your great save. I managed a Surgical Telemetry Unit. Go back to PACU ! You clearly have the assessment skills..if necessary go to Phase II first, but let them know you want to eventually go to Phase I. I understand your spiritual fatigue, please see a counselor, you cannot continue to live always waiting for the other shoe to drop. Get some good books i.e Drain's Perianesthia Nursing, while you are looking. Feel free to PM me on FB if I can offer any more advice support. BTW document everything for HR.

 

Thank you for the helpful advice! What is your FB name? Message me on here 

On 10/31/2019 at 4:10 AM, Zhuriel said:

Amen! I tried bed-side as an RN, and after nine weeks in residency, I said hell to the no, though I did geripsych at a prison when I was an LPN, which I loved btw! I went back to the outpatient clinic and now am a Referral Manager at the Naval Hospital:) But I feel you @Wrestler133 you are strong!

 

Oh, and some of the comments here are just beyond rude! Be empathetic; not everyone is thick-skinned.

Thanks man I'm trying to keep my head on straight.