I am a little hesitant posting this thread but here it goes...
I have been working on a busy Med-Surg unit for a few months now. I have been off orientation for a month and while I enjoy learning new things, I feel like I am stuck in med-surg hell.
Today I almost snapped at the day shift nurse who had the nerve to complain about having seven patients knowing I had seven patients, no unit clerk and only two techs for the entire unit (but she had three more techs, a unit clerk). I was also forced to sit with a suicide patient for nearly two hours while call lights went off (did I mention there were two cases?) while the day shift nurses weren't expected to waste nursing time by acting as a sitter.
One of my patients complained she had waited over an hour for someone to help her off the bedside commode. I was furious. I was stuck sitting with a patient and no one bothered to answer the call light. When I am not sitting, I am answering call lights and helping with beeping IVs and ADLs but there are some nurses who will walk past a beeping IV or a patient in need of toileting assistance if it isn't their patient.
There are some nurses and techs who take smoke breaks which forces me to cover their patients as well as mine. That isn't fair to me or the other patients, nor is it safe.
I know all the seasoned nurses are probably going to say "suck it up, Buttercup" for a year but to be honest, I am just so disgusted. I want to be proud of the care I give, but I can't give good care to seven patients while being forced to sit for two hours at a time or having coworkers and techs leave for smoke breaks and leaving me and one other nurse and tech to cover the unit while acting as the unit clerk.
I am currently in the nurse residency program. The coordinator knows the unsafe working conditions but doesn't seem to get it. When told about the nurse to patient ratios, she asked why didn't I just say no and refuse to take on a patient? I don't have the option...I have to take it.
As a new grad, I have no clout. If I go to the manager, I might screw myself over and put a target on my back. Everyone seems complacent and they seem to have accepted poor working conditions, sub-par care and embarrassingly low patient satisfaction scores.
As a new grad, I don't have the power to make any changes, nor do I have a choice. So I have a few options:
1. Quit
2. Ask the coordinator about transferring at six months- which may not be possible as a new grad in the residency program
3. Put my neck out there and try to come up with new strategies to improve patient care
4. Ask to be moved to day shift where there is better staffing and more support.
I will be meeting up with my manager soon regarding my progress...should I even bring up my concerns? She has been manager for quite for sometime so I am sure she is aware of the issues of the unit.
I am sorry about the long post, but I don't know what to do. I am leaning towards trying to transfer at six months or requesting day shift.
No one was covering for me. They let my patients IVs beep, they let my patient sit on the bedside commode for over an hour, they didn't answer the call lights...the patients literally did not have a nurse when I was sitting. My patient could have been crashing.
Joint Commission would have had a field day. I almost wish they would show up unannounced and fine the hell out of our unit. Maybe that would get upper management's attention.
That is totally unacceptable to have someone sitting with a patient while their assignment is uncovered. Anything could have occurred within that time frame. What happened after you stopped being a sitter and why didn't they have a dedicated sitter?
I don't think day shift is going to be much better but it doesn't hurt to ask about your options/chances.
I know it sucks but I would wait a year to transfer OR start applying at other facilities.
First of all, I'm a well seasoned nurse (36 years) and I would NEVER expect anyone to "suck it up, Buttercup" if they had to work like this.
I worked as a hospital bedside nurse for 20 years, half in Peds, half in MedSurg. I saw the good, the bad and the ugly.
My first question: Why did you have to sit with a patient who wasn't even yours? Back in the day, if we had to sit, it was for no more than 20 minutes at a time, and everyone took their turn. It was inconvenient, but at least we could still get our other work done.
You've probably figured out by now that the manager doesn't want confrontation. Allowing your patients to sit uncared for for two hours? Inexcusable. The inmates are apparently running the asylum.
Ok, so what to do?
First of all, keep a record of all the crap that happens, for your own protection.
Second, do NOT discuss transferring with anyone, including your manager. People can get really nasty.
Doubtful that you can get day shift. It seems like the competition is even stronger now than when I worked the floor.
Start putting out feelers to other hospitals, clinics, etc. See what's out there. You might just fall into something. You DO have experience-so what if it isn't that magical "one year"?
If these toxic conditions persist, you do have recourse in your Corporate Compliance hotline-it's anonymous, at least.
Keep your head up, and good luck. Please, keep us posted on what happens.
Specializes in Oncology; medical specialty website.
OCNRN63,
No one was covering for me. They let my patients IVs beep, they let my patient sit on the bedside commode for over an hour, they didn't answer the call lights...the patients literally did not have a nurse when I was sitting. My patient could have been crashing.
Joint Commission would have had a field day. I almost wish they would show up unannounced and fine the hell out of our unit. Maybe that would get upper management's attention.
That's unconscionable. How in the world did your manager/charge expect you to be a sitter and take care of your patients?
To be honest, I would have rather had the techs cover the sitter cases and let the nurses do primary care nursing. But I imagine the other nurses would have whined about doing vitals, repositioning and toileting and lab draws.
We rotated the sitting cases, but I was the only taking initiative to help with other nurses' patients.
That is totally unacceptable to have someone sitting with a patient while their assignment is uncovered. Anything could have occurred within that time frame. What happened after you stopped being a sitter and why didn't they have a dedicated sitter?
I don't think day shift is going to be much better but it doesn't hurt to ask about your options/chances.
I know it sucks but I would wait a year to transfer OR start applying at other facilities.
I understand that you work nights but, when you can, try to get friendly with nurses from other services you chance to meet, like acute dialysis or even other units if you do a transfer, for example. They may put a good word about you if you get interested, and then your year-or-less of experience will not be that of importance. Just an idea I've seen working.
Otherwise, I am out of words. To keep an acutely suicidal person in the unit which is not equipped for this and has no experienced personnel is almost the same as put there a patient on 6 drips, vent and ECMO running. It is not safe, and irresponsible action by your management as well. And at least where I am now, if an RN needs to watch patient 1:1 for more than 30 min or so, then she reports all her other patients to other nurses and there is no talk about any of them being not turned or toileted, and if an RN has to do that, so be it.
you sitting with another patient that isn't assigned to you is absolutely, unequivocally ridiculous. I had to sit with my patient one night for one hour and the rest of the nurses took turns medicating my other patients. (I did get charting done so it wasn't totally wasted time).
OCNRN - we frequently got psych patients, OD's and suicide attempts until they were medically cleared, however if they were a 302/201 (involuntary or voluntary commitment) they came with a sitter. Our hospital was trying to do away with "safety sitters" by making the nurse check on the pt Q15 minutes and chart in the room if possible.
Specializes in M/S, Pulmonary, Travel, Homecare, Psych..
I have to point something out at this point, because you should know before making your decision. I vote for not quitting BTW.
Med/surge *is* hard, but avoid letting yourself believe Med/surge is the problem. You will be very depressed when you find out all the same problems go on at other specialties.
Instead, focus on getting what you can from the situation. Time management, being assertive with other difficult co workers and many other clinical experiences M/S offers.
If you fall into the trap of believing the specialty is the problem, you will be blind to what good can come from your situation. Being a new nurse, as with everyone, you got placed on the unit, on the shift......that everyone who is 'in the know' about refuses. It's your first year, this is the unfortunate path many of us walk: Accepting less than safe conditions in order to get our first experience.
I worked five years M/S before moving on. I became a Travel RN. I can tell you, while M/S is hard, it wasn't the worst unit I've ever seen. Was on a tele unit that was so disjointed, they didn't bother admitting patients. They left that "red tape" for other units to do. When they saw me doing it, they tried to tell me I had to do it for all the patients, not just my admits.
Don't run "away from" your current situation. Put yourself in a position to run towards your goals. This probably includes facing up to the challenge before you. When you are ready for something else, it should be because where you are going to fits your long term plans, not because its the first thing that let you run from
M/S.
Again, this myth that all things get better once you leave M/S just simply isn't factual.
.thumb.jpg.e7b5bd336d518053002d5b4dbeef882b.jpg){kind=small}
ThePrincessBride, MSN, RN, NP
1 Article; 2,594 Posts
Thanks for the replies.
Emergent,
The thing that kills me is that the patient I was forced to sit with wasn't my assigned patient. I had my seven patients who needed me.
You are right that it is an unfortunate cycle. I don't blame nurses for wanting to jump ship. Who wants to work in this kind of environment?
I am definitely planning an exit strategy. I don't know how I am going to last a year with this kind of workload.