Life is too short to be this stressed

[missninaRN]

I've been an RN for approximately 11 months and am not sure that I want to keep doing this. I'm a good nurse. My manager and coworkers keep telling me that I'm doing a great job. But the day to day stress of working a Med Surg floor is really getting to me.

The hospital where I work has increased the amount of documentation required for each patient several times since I was hired. Another new assessment was added just last week. What they don't seem to realize is that every extra form or documentation they require takes away more time from our patients. I feel guilty while I'm charting because it feels like I'm neglecting my patients. We are staffed by the numbers instead of acuity, and the assignments seem to be getting heavier all the time.

I feel like I'm always running behind. Our unit has become a revolving door lately. I can start with 7 patients, discharge or transfer 5 of them, and get 5 admits before I leave that night. I dread taking report from the night shift, because I know I'm going to keep hearing "Mr So-and-So is going home today" or "Mrs Whatsit is transferring to Rehab as soon as a room is ready, so get her paperwork done ASAP!" Every one of those admissions and discharges means more charting, more paperwork, and more time from patient care. Throw in a couple of patients on tube feeds, one in restraints, two that are MR with "sitters" at the bedside who do nothing, one who is about to die, and another who just arrived to the floor in respiratory distress-requiring a call to the Dr for orders to transfer to ICU-and you have my typical day. It's the same thing, with slight variations, every single shift lately. Oh, I forgot the direct admit who decided to show up at 1830, which means I have to do the admission assessment, several other extra assessments, call the Dr for orders, start the IV, insert the Foley, get their med list (and they have no idea what they take) faxed to pharmacy, print and check the MAR, give them the meds they should have already taken today, and then somehow manage to finish charting on all of my other patients and still get out on time. Yeah, right.

Most days, I drive home exhausted. I get home in time to eat my supper at 8:00 pm and then fall into bed around 9:00 so that I can get up at 0500 and start all over again. My days off are spent doing very little. I don't have the energy now to the things I love to do, let alone clean my house or cook a meal. I feel like I'm not really living. I'm surviving work and then merely existing the rest of the time.

Don't get me wrong. The people on my unit are fantastic. We all help each other, from the manager on down. I've figured out the doctors fairly well by now, so the stress of calling them has almost disappeared (there are one or two who are still tough to deal with, but that's life and I don't lose sleep over them). It's not the place where I work, it's just the nature of the job I guess. I've pretty much concluded that floor nursing is not conducive to a healthy lifestyle. I've had more IBS attacks recently than I did even in nursing school. I'm growing depressed and hopeless about my life. I'm not going to be able to do this kind of work long term.

So, I have some decisions to make. I'm working on my BSN so that I can go on to an MSN and possibly teach. (My nursing instructors always said I was a born teacher). Maybe I'll do home health or hospice for awhile (I know this may seem odd, but I enjoy caring for my terminal patients). I may look into massage therapy or aesthetician training, with the possibility of working in a wellness spa setting eventually. Maybe I'll go to work in a clinic. I don't know for certain where I'm supposed to end up, but I know it's not the hospital floor.

I'm hoping that life can be better than it is right now. I'd like to have the energy to enjoy my personal life again. I don't know if that's something that will come with more time, but I'm not really willing to stick around and find out. My one year commitment to this place is up in 2 months. After that, I'm a free agent.

[DLS_PMHNP, MSN, RN, NP]

the grunt work- there is no shame in doing bedside nursing- this is the essence of nursing- where nursing begins, it's reality - not nursing administration. a bedside nurse with razor sharp assessment skills often times mean life and death for a patient. you new grads are the reinforcements. we need to get the controllers of the purse strings to take off their greedy blinders to see this. and put some money into the workforce. that staffing ratios of 1:6,7,8 on med/surg and tele floors are deadly- then all the money the budget and finance offices horde have to be given out in out of court lawsuit settlements. how disqusting- the first to go should be this garbage of customer service/ satisfaction.

Wow... you totally hit it right on the head- Thank you!!! :yeah:

[Meriwhen, ASN, BSN, MSN, RN]

This is why I went straight into psych. Med/surg SUCKS!!!!! I learned that during clinicals. Always hated the med/surg rotations, and tele is no different. Psych is the bomb, it's clean, very little charting, entertaining, and I have about 7 hrs. of downtime a shift. In fact I am at work now! We even have a bed set up if any of us needs to take a nap on night shift. And since most of the pts. are frequent fliers you REALLY get to know them well. My fellow nurses and the techs are all as crazy as I am (you need a warped sense of humor to work psych) and we all have a good time at work.

That's some psych hospital you work at. At mine, it is also clean and entertaining (very little blood and body fluids to deal with), but I have lots of charting and not much downtime. Occasionally a day will be really show that I can relax a bit, and occasionally a day will be hectic from the moment I come in. Most days though are at a constant but manageable pace.

Then again, I don't work nights...and from talk about 7 hours of downtime, you probably do, and most of your patients sleep through it thanks to that lovely wonder drug Trazadone

[solneeshka, BSN, RN]

One night I just had to know how much time all of this charting eats up out of a 12 hour shift. Except for meds, I saved all of my charting to start at about 2.00am. I charted straight through, stopping here and there for a few call lights. (It was a rare quiet night.) I finished at 5.00a. And I'm not a slow or excessive charter. I am someone who would LOVE to be an excessive charter, but learned very quickly, just the facts. It's all clicking radio buttons, almost no commentary from me, just clicking all these bazillion stupid radio buttons on all these different worksheets. All computerized. THREE HOURS. Of a 12 hour shift. It was a very discouraging discovery! There are 2 completely idiotic flowsheets we're supposed to chart on, one about meeting patient goals (no one EVER charts anything but "making progress" on each of the goals) and one on pt education that may or may not have actually taken place. I haven't charted on either one for a single patient in 3 months. No one has noticed, no one has said anything. Completely USELESS charting. Most of it is just restating things we've already charted elsewhere, so it's not even covering my...self. It was just someone's bright idea one day that makes no sense and steals time away from patients.