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.
Does your hospital have a house supervisor at night? At our hospital if we had something that needs to be resolved we call them if our charge won't try and figure something out. Your charge nurse should have helped with your patients or relieved you from sitting with that patient. That is their job to make sure all the nurses are doing their job and there if the need help. On our floor our night shift is the complete opposite than our day shift. At night we all go over and beyond to help each other out and our day shift is like dog eat dog world from what I can tell. If your manager is one that does not have an open door policy that you can't go to her about your concerns like these situations then that's another topic. Don't throw anyone under the bus when you talk with your manager. When you bring up your concerns focus on patient safety! That is the key that gets anyone's attention in a hospital. I am a newbie nurse technically I am almost to my one years mark at the end of the month, you have to bring up situations that you do not think is safe. After all it will be your patient safety care that gets noticed and it is your license on he line not anyone else just remember that.
7 patients is never acceptable in acute care. I dare say even 5 patients is marginal. 4 patients is the maximum acceptable ratio I believe in any med/surg setting with telemetry. My last travel assignment (outside California mind you) was great about keeping ratios at 4:1 on medicine floors, even ones without tele. There were literally 2 times when I had to carry 5:1 ratio on days and that was due to short staffing. I felt I could do my work at a decent place and not worry about being overwhelmed and providing good patient care.
I've had 5-6 patients in other places and sorry, I've cut corners just to get the job done. Patient wants to chat? Sorry, I am too busy for that, please gulp down these 10 pills so I can move on to the next. I have never worked with 7 patients and I hope to never will. That to me is pure neglect.
bcmRN2014
4 Posts
Does your hospital have a house supervisor at night? At our hospital if we had something that needs to be resolved we call them if our charge won't try and figure something out. Your charge nurse should have helped with your patients or relieved you from sitting with that patient. That is their job to make sure all the nurses are doing their job and there if the need help. On our floor our night shift is the complete opposite than our day shift. At night we all go over and beyond to help each other out and our day shift is like dog eat dog world from what I can tell. If your manager is one that does not have an open door policy that you can't go to her about your concerns like these situations then that's another topic. Don't throw anyone under the bus when you talk with your manager. When you bring up your concerns focus on patient safety! That is the key that gets anyone's attention in a hospital. I am a newbie nurse technically I am almost to my one years mark at the end of the month, you have to bring up situations that you do not think is safe. After all it will be your patient safety care that gets noticed and it is your license on he line not anyone else just remember that.