Leaving a new orientee RN on the floor alone

Nurses General Nursing

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Hi all. I'd really appreciate any feedback regarding this issue that happened last night at work. I'm a new graduate nurse, just off orientation for appr. 1 week. I work on a pediatric/adult med. surg. floor. Yesterday I worked the day shift with one other nurse, (who happened to be "in charge" b/c of another nurse who called off) Anyhow, I had 5 pts. she had 6. My one pt. was a "sickler" who required q 2 hrs. of pain meds. Another pt. was a full dnr who needed his meds. crushed through his peg-tube. My other 3 pts. required iv antibiotics every 6 hrs. and decub. ulcer dressing changes. Yes, some meds. were late, but I administered them as quickly as time allowed. I was asked to stay over for 12 hours b/c they were short a nurse and I agreed to. However....I did not get 1 break, nor did I get a lunch. I was there a total of 13 hours. I know some of you are probably thinking, get used to it, but what irritates me is the nurse who was "in charge" was able to not only finish all of her charting on time, she gave me a new admission AND she was able to leave the floor 2 times for a smoke break. COME ON!!! Leave me, the only RN on the floor w/ all that was going on, for a SMOKE BREAK! :angryfire:angryfire And I didn't even get one bite to eat for 13 hours! Much less a smoke break. I won't be PALS certified until May and I know that the "charge" nurse should not have left me alone on the floor. :uhoh21: Like I said, I'm fairly new to nursing and would appreciate any feedback regarding this situation. Thanks.

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Specializes in Emergency Dept, M/S.

I've only been a nurse about a year. Even though you are just off orientation, you still need someone there to back you up. You should not have been the only RN on the floor with high acuity pts. No question.

Another tip from my nursing assistant days: take smoke breaks! Whether you smoke or not, take 'em! I don't smoke, and I go out with my friends that smoke when they take a break. You know why? Because like you discovered, YOU won't get a break. The smoker's do though. And this is nothing against the smokers at all. I've just found that if they are able to take breaks, the non-smokers should not be "penalized" with no breaks because they don't smoke. There is no written rule that I've seen anywhere that says you actually have to smoke on a smoke break! :)

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hi,

i was scanning the site and came cross this post. i am not sure if this will be helpful but there is something i learned over the years..just because you know something or have some feelings does not mean others know that.. i have learned when my work is completed to ask my co-workers if they are okay and/or do they need help. also i have learned if i am stressed to let my co-workers know.. i am not sure if this would have helped.. but maybe next time you can let your co-worker know that you are not comfortable being left alone and if she can please stay on the unit..on the whole i have found honest communication does help

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hi,

i was scanning the site and came cross this post. i am not sure if this will be helpful but there is something i learned over the years..just because you know something or have some feelings does not mean others know that.. i have learned when my work is completed to ask my co-workers if they are okay and/or do they need help. also i have learned if i am stressed to let my co-workers know.. i am not sure if this would have helped.. but maybe next time you can let your co-worker know that you are not comfortable being left alone and if she can please stay on the unit..on the whole i have found honest communication does help

I second this poster's advice. This nurse may have been selfish and just not cared about you or the patients, or maybe she was really just oblivious to the position she put you in. Regardless, you should definately speak up and let someone know that this is not OK. Otherwise it will happen again and again. It's not safe and you will start to hate the career that you worked so hard for. I am so sorry that you were not better supported by your coworkers. :cry:

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Thanks for the tips. However, I DO have a problem w/ irresponsible NURSES who take smoke breaks and then come back to a pediatric unit and care for very ill children with respiratory problems. :madface: Some of which we end up flying out. It irritates me to no end! As for taking "smoke breaks" per se, I would not feel comfortable leaving the unit with the amount of pts. and the care they needed. Nope, you're not going to see me leaving the floor for selfish reasons. :smokin: I do believe I should've at least had a chance to go in the breakroom for 5-10 mins. to eat or drink something. :rolleyes: Many days I feel like I'm the only one who gives a darn. We have a unit clerk that shows more concern than some of the RN's on the unit.

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Thanks for the tips. However, I DO have a problem w/ irresponsible NURSES who take smoke breaks and then come back to a pediatric unit and care for very ill children with respiratory problems. :madface: Some of which we end up flying out. It irritates me to no end! As for taking "smoke breaks" per se, I would not feel comfortable leaving the unit with the amount of pts. and the care they needed. Nope, you're not going to see me leaving the floor for selfish reasons. :smokin: I do believe I should've at least had a chance to go in the breakroom for 5-10 mins. to eat or drink something. :rolleyes: Many days I feel like I'm the only one who gives a darn. We have a unit clerk that shows more concern than some of the RN's on the unit.

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Specializes in Med-Surg, Wound Care.
Thanks for the tips. However, I DO have a problem w/ irresponsible NURSES who take smoke breaks and then come back to a pediatric unit and care for very ill children with respiratory problems. :madface: Some of which we end up flying out. It irritates me to no end! As for taking "smoke breaks" per se, I would not feel comfortable leaving the unit with the amount of pts. and the care they needed. Nope, you're not going to see me leaving the floor for selfish reasons. :smokin: I do believe I should've at least had a chance to go in the breakroom for 5-10 mins. to eat or drink something. :rolleyes: Many days I feel like I'm the only one who gives a darn. We have a unit clerk that shows more concern than some of the RN's on the unit.

Sounds like the problem was more about her smoking, than her taking her break. As for not eating or drinking for 13 hours...You are going to find out quickly that no one is going to make sure you get your break or meal breaks. You've got to speak up! If you're not comfortable with a staffing situation, then you call a supervisor. This is the reality of nursing.

Sorry if this sounds harsh...it's 24 years of med surg talking!

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Specializes in Telemetry, Oncology, Progressive Care.

I think the big issue is that you were left alone on the floor as the only RN and this is something I would not be comfortable with. It happened to me once. The other nurse left the floor and didn't even bother to tell me. I work tele so I'm not sure if it is different than m/s or not but I believe you should never be the only nurse on the floor. At my hospital if there are only 2 nurses and one of the nurses has to leave then we get someone else to cover. When I was left alone I went to the house supervisor (it was the weekend) and also spoke with my manager. This person was spoken to and guess what. She always tells people when she leaves the floor.

ETA: What would happen if a pt coded or something? It's a safety issue and there should always be at least 2 nurses.

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Specializes in Post Anesthesia.

Those who insist on appropriate break time will get it. I try not to be selfish with my breaks but there is always something you "should" be doing on the floor before you go on break. If you waited until everything was done you would always have the shift you endured every day. I can't blame anyone for taking thier allotted break time. As far as leaving you on the floor alone, with only two of you on duty, what other choice was there? You are off orientation and weren't left as the only nurse for the whole shift. If you got into trouble help is just a phone call away-supervisor, another floor...(I hope there was at least a NA or such to back you up in case you needed a second person). It sounds like you did a great job in a tough situation but you need to learn to take some of your break time not the other way around. If you are going to survive in nursing taking time for yourself enables you to take better care of the patients.

As to us evil smokers endangering our patients- with all the noxious smells in a hospital a little cigarette smoke on my uniform isn't going to make much difference. If someone drops dead from the smell of a cigarette on my clothes they were too fragile to survive long anyway. I am usually careful to cover up with a lab coat to limit the smell, and use mouth wash before any close patient interaction as a courtesy.

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Specializes in med/surg/tele/neuro/rehab/corrections.

As to us evil smokers endangering our patients- with all the noxious smells in a hospital a little cigarette smoke on my uniform isn't going to make much difference. If someone drops dead from the smell of a cigarette on my clothes they were too fragile to survive long anyway. I am usually careful to cover up with a lab coat to limit the smell, and use mouth wash before any close patient interaction as a courtesy.

I believe this is why smoking jackets were invented! :lol2:

I have a friend who smokes and I didn't know it for the longest time because she always took great care to not let the smoke linger about her or get in her hair. She washes her hands too. :yeah:

As for breaks....

Where I work a half hour lunch is automatically deducted from your time so no need to clock in or out. It encourages everyone to take their half hour lunch break and everyone does.

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Smoking aside, you should not have been left alone onthe floor. She should have had someone else cover for her. Did you ask her to help you? In situations likehtese really people do get oblivious. I have worked around new grads when I was thinking about something else in my life and not noted how they were doing until they asked for help. It isn't ideal, but...it happens. If she refused to assist you even a little, then there is a huge problem, and no no nurse, new or not should be left on the floor with that many patients.

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Specializes in Emergency Dept, M/S.
As to us evil smokers endangering our patients- with all the noxious smells in a hospital a little cigarette smoke on my uniform isn't going to make much difference. If someone drops dead from the smell of a cigarette on my clothes they were too fragile to survive long anyway. I am usually careful to cover up with a lab coat to limit the smell, and use mouth wash before any close patient interaction as a courtesy.

I have many friends and co-workers that smoke, and I do not consider them evil. But truth be told, it's not "a little cigarette smoke". Maybe to those who smoke it is, but to non-smokers and those sensitive to smells, it's a lot. I've had many, many patients not want to say anything to the smoker, but will say to me how much it offends them, and can they get another nurse (this was when I was a CNA. Has not happened as an RN). And mouthwash, or Febreze and all the othe cover-ups really don't work. The person just has minty cigarette breath, that's all.

I'm not saying any of this to offend or point fingers. I quit smoking about 18 years ago, and still once in a great while get that craving. I'm just stating what some smokers may not know - people can and do smell the smoke, even if you've been careful and only smoke outside, etc. A friend of mine didn't know - no one told her that Febreze on her scrubs doesn't work. She asked me and I was honest. Heck, I've got my own vices, too, so I'm not one to look upon smokers as "evil"! ;)

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