Basically my issue is a moral one. I graduated in April and since then I have been working in a poor, inner-city hospital. This hospital desperately needs good nurses, but I am miserable there. I am overworked, I have WAY too high a patient:nurse ratio. I feel like an unsafe practitioner, and my patients are miserable, ungrateful, impoverished people, who are more often than not verbally abusive towards me because they are recieveing inadequate care....due to the fact that I have too many patients, and not enough resources. I believe in serving all populations, and I'm not new to the innercity population, but I am become physically and emotionally drained.
This hospital has put many hours into my training, and I feel incredibly guilty at the thought of leaving them for the hospital I previously worked at (Which I really liked, but they didn't hire new grads). My nurse manager is supportive and always gives me positive feedback, but it still doesn't balance out the abusive patients, and unsafe conditions. Should I feel guilty? Should I stick it out? Does anyone have any ideas? Thoughts?
I have thought about this for awhile. You do have to do what you feel is best.
However ,you have worked as a brand new grad for a total of 5 months on this unit. Five months in the scheme of things is not a long time.
As I said before .I felt the same way at my first job in psychiatry. Talk about verbal abuse, and GOD knows my husband about had heart failure when both my wrists ended up with hairline fxs from a patient.
However my goal was stick it out for one year. That one year turned into twenty and I ended up loving it. Did I mention I hated it at first? I was scared to death. I felt inadequate. I felt ill prepared. I hated it for at least the first 8 months. Slowly it changed. I changed.
I would as you have been doing,back then it was my Head Nurse I would talk to as you do your Nurse Manager. Explore your options with her.
Consider asking for a transfer, if it is allowed and you are positive you can see no light at the end of the tunnel.
It is not an easy decision, but it is you who has to make the decision. It is far too easy for any of us to give advice, but we are not the ones who then have to live with the decision.
We can only share our own experiences from when we stood where you do today. It is one of the ways we give back to the younger nurses.
In the end once you have explored your feelings, explored your options. I believe you will not have to feel any guilt.
If you feel like its time to move on, go ahead. Its great that you gave time and energy to these low income patients. I also work at an inner city hospital. I just started and think these hospitas prepare you for anything. Its a great experience.I plan on staying at least 2 years to get good experience. I grew up going to these hospitals so I feel for the patients. They get frustrated for the long times and get sicker and sicker. The average wait time for my hospiyal is 12-24 hours, sometimes 30 just to get a bed in the ER!!!! I think there will always be bad patients who are mean everywhere. I know it is hard to be a nurse with the high turnover. Its not healthy for you or the patients. don't feel bad, you did make a difference. :)
If you feel like its stressing you, move on. You're health is what matters. You can't take care of others without taking care of yourself. Good luck and let us know how it goes.
It sems like you have given your best to that hospital-you can only do so much.
If management was concerned about giving good patient care, you would not be so understaffed, since I am sure that agency or travelers could be brought in to help. Do you ever see administrators or nurse managment pitching in to ease the load?
When conditions deteriorate to what you have described, it is usually based on a general lack of concern for patients and staff, alike. You are as much a victim of the poor practices of this hospital as the patient are. There should be no guilt for electing self preservation. Getting this far, with those deplorable conditions, says a lot about your character. If you wish to help the underserved, there can be many other ways to do so without having to jeopardize your career though losing your license.
I have been an Emergency Care Practioner for 29 years.
EMT, then Paramedic, Navy Hospital Corpsman, LVN in ED and Finally an RN.
I work in a knife and gun club level one Trauma Center. I have only been an RN for a little over two years. A CEN for a month.
My urban hospital had a great new grad program, a weak contract for two years of service after training.
So I finished the training. I finished the contract.
In the last two weeks I have had to stop taking public transport and walking to work. DT 8 homicides in an 8 block radius of my hospital.
Last noc, another homicide with about a hundred people of color wailing and mourning yet another sensless death. The cycle will not stop.
My place has ratios, big deal, we break them all the time, one to one ICU care for 3 hours while your other 3-4 SICK people are not cared for. Scary.
I have been ****** on, assaulted verbally and phyiscally and I finally realized my quality of life sucks.
So now I have had two interviews in rural hospitals surrounded by scuba diving, surfing and a better quality of life and patients who know how to read.
Patients who don't do crack, smack or meth...
Do I feel guilty, yup, a little sure, that is my problem.
But I need to take care of myself.
And if one of my ETOH ers, with a fatty Liver and coags off the chart falls and has yet another SDH, my lisense is at stake and mgt will just remove me like a zit.
So right a list of pros and cons, use ENA, network, use this bord and then decide.
You may decide that my life is more important than being spit on, harrassed and overworked and run for the ocean.
So now I have had two interviews in rural hospitals surrounded by scuba diving, surfing and a better quality of life and patients who know how to read.
Good luck.
Don't count on a lack of drugs and alcohol from your rural hospital clientèle. Meth is epidemic in rural America, and alcohol is very prevalent as well...
At first when I read your post I thought "don't feel guilty, do what is best for you and your practice".
Then I realized that you've only been working there for 5 months. I don't know that your feelings of being overwhelmed would be different in another hospital.
ED nursing is hard. If you started as a new grad (which is kind of what I get from the post, but correct me if I'm wrong) then you need to give yourself at the very least 8 to 9 months before you can consider yourself proficient in the basic skills involved in the work we do.
Your manager seems supportive, so have a talk with her. Explain your feelings and let her know that you cannot safely care for the amount of patients she is giving you. As a new grad, the nursing administration at your hospital has a duty to support you in your practice. Put it to them from the point of view of Patient Care. This is what they care about. It is not about you or your license, it is about the safety and life of your patients.
If they in turn throw the ball back in your court, then by all means get the heck out of there and make sure that your exit interview reflects the reasons why you left. Tell them they put the patients in a dangerous situation by leaving a new, inexperienced RN in situations beyond her training. This is not your fault, it is the hospital who decided to hire you as a brand new nurse who has the obligation to make sure the staff can practice safely.
Good luck! and don't be discouraged. You'll see how 5 more months will make a world of difference in your nursing practice.
lpnflorida, LPN
1,304 Posts
I have thought about this for awhile. You do have to do what you feel is best.
However ,you have worked as a brand new grad for a total of 5 months on this unit. Five months in the scheme of things is not a long time.
As I said before .I felt the same way at my first job in psychiatry. Talk about verbal abuse, and GOD knows my husband about had heart failure when both my wrists ended up with hairline fxs from a patient.
However my goal was stick it out for one year. That one year turned into twenty and I ended up loving it. Did I mention I hated it at first? I was scared to death. I felt inadequate. I felt ill prepared. I hated it for at least the first 8 months. Slowly it changed. I changed.
I would as you have been doing,back then it was my Head Nurse I would talk to as you do your Nurse Manager. Explore your options with her.
Consider asking for a transfer, if it is allowed and you are positive you can see no light at the end of the tunnel.
It is not an easy decision, but it is you who has to make the decision. It is far too easy for any of us to give advice, but we are not the ones who then have to live with the decision.
We can only share our own experiences from when we stood where you do today. It is one of the ways we give back to the younger nurses.
In the end once you have explored your feelings, explored your options. I believe you will not have to feel any guilt.