too many post-ops?

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I've been working on a very busy med-surg ortho unit. When I was hired, I was told we would have several discharges, admissions and that it is a very busy unit

Yesterday, I started with 3 patients and from 12 to 7 I had 3 post-ops, 1 admission and 1 discharge.

When we have a discharge, our charge rn immediately starts to continuously ask us when is your discharge leaving because she wants us to receive a new admission/post op etc.

I feel this is an unsafe work environment due to the fast pace of the patients coming and going, the charting that we are responsible for along with the tasks associated with each patient while in our care.

It becomes difficult to monitor vital signs in each room to see how my post op is doing or even going to see my new post op since i'm still trying to work on my previous post op plus my patients that are already in the unit also need care.

Am I being unreasonable? I realize nursing is a multi tasking career on speed and that I need to prioritize however, it is so chaotic no matter how organized you are it's hard to keep it straight. The charge rn does not help with pts as they come, she's too concerned about out with the old, in with the new.

My co-workers face is that of misery as I look around the unit and I know everyone hates this particular unit but no one does anything about it.

I'm considering complaining to my DA but I think she might say, "we told you" type of response.

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That's how my first job in ortho was, except I was in Texas with no ratios, had eight patients , and an LVN to cover who also had eight patients. I had to get report on 16 patients and they came and went all night ...from OR, to rehab, etc. Discharge was never fast enough. Even when a patient died you'd get a call every five minutes asking if the room was clear yet. You California people don't realize how good you have it- even when it's bad.

Get some experience and move on to greener pastures.

Oh! And if anyone didn't have the max number of patients, they'd move them back and forth between floors to make it happen. Charge nurse had a full load of eight, as well, but no LVN to cover.

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That sounds pretty standard for a surgical floor. When I was in surgical, it wasn't uncommon to have all new patients by the end of the day. It is exhausting though

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Specializes in Infusion Nursing, Home Health Infusion.

Whatever you do, Do NOT complain to any higher ups.This is not an unreasonable workload. You need to be very efficient and learn to prioritize.You are going to have to multitask,it's just the nature of the job.Try to figure out what is tripping you up.Are you telling yourself it can't be done and is unsafe. If that is the case you need to change your thinking. I worked on a med=surg floor like this for many years and it does take take some practice and you are constantly interrupted.You can only plan so much on a unit like this.

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yup, I've read these horror stories before on other sites relating to other states not having ratios.

that's crazy; i'm staying afloat I just don't think i'm dotting all my i's and crossing my t's as far as charting goes because of lack of time.

it's an uneasy feeling.

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yes, it definitely is exhausting; I think I may go to a clinic lol

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yes, I do need to do a better job at prioritizing. i'm so glad i'm getting advice from this forum. I was ready to send an email.

funny thing our higher up every now and then asks about our job satisfaction and wants to know whats working, whats not.

we've all requested more help; more initiative from the charge rn when she's available but it hasn't changed. it's a competitive market and I realize if we don't work out, theres plenty others that'll take our job.

yes but its a zoo!

changing my thinking and being more positive is a good change.

I hate the uneasy feeling of not being able to accomplish my tasks and running out of time.

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Specializes in PACU.

I actually think those are pretty good ratios and manageable. It will certainly keep you busy, but as you get into the swing of things you will find that a lot of your tasks, assessments and charting gets faster. You also get better at time management.

Make sure you make good use of your tech/CNA.

Once you know what each surgeon likes for followup and discharge you will find the teaching goes faster and smoother. You will also find that you are doing some of that teaching throughout the patients stay, so when it actually comes time to sit with the paper work, you will be reviewing, not learning(what the needs to be taught) and teaching at the same time.

As you learn the surgeries you'll learn to do a good overall assessment and hone in on the focused assessment based on that surgery.

These things take time. six months to a year to feel comfortable in a new environment.

And while I would not complain to anyone about the ratios, I would certainly ask for a mentor or find an informal mentor in someone that seems to keep it all together.

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Sounds like a typical day on my floor. Start out with five patients, and in twelve hours you end your day with a different set of five patients. You either sink or swim.

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Specializes in orthopedic/trauma, Informatics, diabetes.

I work on an ortho unit and that is what M-Th is like. We have anywhere from 10-14 post-ops a day. Very high turnover. That's why I love my weekends :). Hips and knees usually go home POD 2 ankles POD 1 and shoulders POD 1-2. We have trauma and some off service on the weekends or joints waiting for rehab placement. Teaches you time management.

They try to spread it out for us but there are days I have 3 d/c and 3 admissions. I just hate when they all start rolling up at 1900. That makes it tough on everyone. except PACU, I guess.

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This is not unreasonable. I work in Southern California and the med/surg floor that I work on can be very busy too. We might start with 5, discharge from 1-5, and always admit or have transfers to keep us at a 5:1 ratio. When I started it was nuts but it does get better with time and experience prioritizing.

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Specializes in Urgent Care, Oncology.

Wait - so at most, how many patients did you have at the same time?

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