By far my favorite population is the pleasantly confused, 80 - 90 yo... I know crazy. Especially because I work on a med-surg tele unit. The old ladies are always the sweetest... I can usually connect with them quickly and they are so cooperative after they trust you. We have plenty of combative patients too... I walked on to a patient that was called "the demon" all week... I worked fine with him, some issues, but it was due to understaffing r/t our now budget issues and low census.
This is my issue... My favorites.. these old crazies are always the most frustrating when you're understaffed, bc they require so much! Many are not made DNRs when they should be... Almost all require two people to get them up or to pull them up... all are incontinent.. Since our staffing has been changed... so many are neglected or left for hours soiled/new bed sores... mouths crusty /dry... I had a patient I was told was blind until I walked in to assess him and realized that this nurse just didn't clean the drainage off from an eye infection that noone looked into... even the ones that are the "lighter" load... as in cooperative, are so sick that they can't even lift their water without assistance... I know the obvious is to report it, but its become so frequent, even with the good nurses I follow. I know how our floor can be, its crazy somedays... today being the worst I had in some time. Nothing changes... seems to me that its either manageable or horrible... but one thing is steadfast... I am still very passionate about this population of patients.
I enjoy being that one nurse that broke through with them.. And knowing when I walked away leaving them A LOT better off than when I found them... I usually don't even tell anyone all the stuff I do... I know that I just care more about this group than most.. so I want to do something with that, but I'm about to burn out on this.. This weekend I walked into five patients, all of them total care/elderly/two were combative or confused and one was so unbearably sick with a chronic condition... oh and one FTT with family in denial and crisis... that's the hardest, when you do so much, but really there's not much you can do and the family lets their anger out on someone.... And lastly one that was snowed from night shift... I can tell none of them have been bathed in days... or they're incontinent with bed sores... just people leave them bc they can't do anything for themselves. This is also while we only had 14pts on the floor so our staff was cut down to 3 nurses and 1 tech who was just getting vitals and accuchecks. I walked into the worst couple of days I've had in a while. I'm ready to go in and quit tomorrow... I really thought I'd be on my floor for a couple more years while I went back to school (ADN - BSN - MSN/NP)... But feeling like this, I just can't do it anymore.
I don't want to lose this passion.. and its the environment, not my patients... That is one of the few things of why I still walk out of work feeling rewarded about something... I find it an honor to take care of them.. I don't care how nasty they are, that could be my granddad and with our staffing so low.. They are being neglected to a point that's almost unbearable for me to watch now... So, I need a new change of plan... I've stayed on our unit because of the diversity of conditions, we see everything.. and of course, that I love the age group so much... Being that I haven't really been thought out a change too well, what do I do from here... Eventually I'd love to be an adult outpatient NP... But without even having my ADN loans paid off... It seems so out of reach right now.
The economy is scary out there for us... I'm not sure what to do and feel pretty trapped to be honest. Its sad because everyone's lost all trust in our manager in the last several months... her agenda is very different than ours and she's lost touch with her staff... staffing to census is now the priority.. our sister unit always causes us to be overbudget.. we're the more acute unit and always over budget that makes it more frustrating.
I've tried reporting things that were really bad... Nothing done... I've worked on our floor for so long, the few that were there when I started have all given up... Some of the other nurses I work with I wonder if they've even turned that patient during the previous shift...
I've tried being proactive... I advocate with families, doctors, our manager for small changes... sometimes it works, sometimes it doesn't... I've been on our leadership group... fall prevention team... clinical coach... I'm the acuity documentation monitor. in hopes to improve our staffing through showing the true needs of our patient population bc noone's ever been educated on how our charting affects our staffing ratios... Nothing's done or changed... I still had hope... I lost all of that this weekend...
Right after I walked in and saw what I was dealing with, I emailed my manager on the weekend about staffing.. first time I've ever emailed her about something related to staffing (and as charge nurse weekend nights for almost two years... my manager never questioned my judgement on staffing decisions and we were able to keep that extra tech/nurse based on judgement of acuity, I was trusted to make those decisions). Now with our staffing matrix... there's no variations/no supervisor involvement really... We have what we have... and we have way too little... So I emailed her, simple request now looking back, could've saved me from where I am now actually and that's what makes me more angry... Asked to keep our 2nd tech... (she usually emails back in minutes and its bc I don't do it unless its important... but she never responded... not even worth a response??)... I have really just gotten to the point of just finished.. There have been other things lately with her that all of the staff has become distrusting of her.
I'd like to go in tomorrow am and tell her where to shove it.. Honestly, money is not why I'm working there, I don't need this job like some of my coworkers and I won't just sit and let this happen anymore... If that means I'm not a part of it, then so be it, its obviously affected my mental stability... Hence my rant here?! And I try to explain it to my husband, I love being a nurse. I don't want to quit... I just want to provide the standards of care that I'm expected to provide. And its been two months like this... I'm done..
Another assertive, hard working and loyal nurse down... so sad it happens like this...
So, all that being said... being as dumb as I was to how this was going to be... and literally at my breaking point... what do I do?
I have been just unprepared for the whirlwind of career change.. nursing school... then developing myself as a nurse... I thought it would be smart to focus on my education and experience... I got married.. and Now I'm not ready to quit but I swear I have to or I'm going to end up giving up this profession forever. I have not updated my resume in almost six years.. Would hate more than anything to go to another place I think will be great and ends up like this... I worked in PR with a business degree for many years and had management experience... and I had planned to start back for BSN and eventually NP... and here I am, this far along, disgruntled and still with a lot of student loans to pay back from just my ADN! I love working... I worked outpatient gen med while I was in nursing school... but don't even know where to start.
I'd like to tell my manager how awful she is and where to shove it, but I work for the best hospital group in town... sadly after this rant! I'm totally type A... controlled for the most part since adjusting to autonomy as a new nurse... I've adjusted to the different personalities at work and how to work with them... my coworkers are some of my closest friends... But I've learn that I thrive much more in a pampering/extras sort of environment... Guess it was my PR experience... but I had accepted that standards of care are what I shot for... And it shocks me what happens at the hospital.
Tell me, there are so many good nurses here... how can you walk away when someone who can't do anything for themselves?? How can anyone clock out from this job and not feel like I do?
Should I try to stay at the same hospital? I really don't think my manager is looking out for anyone but herself... and I don't know how it would go down if I told her how I want to quit like yesterday...
Iheartadvice
31 Posts
Noone ever suggested that we didn't know what you were going through... We're all in this together for the best interest of our patients...