why does medsurg nursing have to be like this?

xtxrn, ASN, RN · Sep 6, 2011

i got off work today 2 hours past my clock out time to chart. I am so burned out. I was literally on my feet the whole entire 12 hour shift. Doing this doing that. call lights here call light there. Family complains, md orders, blah blah blah. Seriously, I feel sorry for myself for becoming a nurse. In school, I have 3.7 GPA. Since I started nursing, I feel like I wasted all all this to become a CERTIFIED, GLORIFIED MAID for the patient and MDs. I should have taken a degree on something where I will feel appreciated and respected. Not like working my a*s off and not getting something back in return. Whenever I see student nurses in our unit, esp in private schools, I feel sorry for them cause they have no idea what they're getting into (plus all that school loans they have to pay for). If I could only take back time, I wish I have taken a different route than nursing. I didn't know then thats why im here and i hate it.
PS: If only the economy is better, I would have quit nursing and get a lower paying job that i can say im truly happy. Sucks!

It's not just med-surg I'm sorry you're having a hard time with this. And, I think you're right that school doesn't prepare nurses for the reality of the job- happened back when I was in school, also. I was lucky- I really liked it. Some days were horrible (as with any job) but I liked the overall nursing job.

Are there areas beyond med-surg nursing that you're interested in? There are so many specialties that maybe one of the others would be better? You're right- it's hard to do something you don't like even if the pay is better than something else.

Do you find most days regrettable? Or was today particularly bad? Maybe see what some of the specialty nursing forums are talking about, and see if there's something that sounds better to you. Just an idea, to help make nursing less objectionable until you can do something else. Just an idea- good luck :) :up:

Anna Flaxis, BSN, RN · Sep 6, 2011

I have felt the way you do. I don't know how long you've been a nurse, but I can say that the first year is almost universally like you describe. It does get better as you develop better time management skills, learn to prioritize better, and develop your assertiveness.

There will always be a certain percentage of patients and family members that will be unhappy no matter what you do. However, many people are very understanding when you tell them, very politely, that their fresh blanket, cup of ice chips, or Jello will have to wait a while so that you can take care of something more urgent.

Learning how to take control, so that rather than reacting constantly, you are anticipating, nipping things in the bud, staying ahead of the game, is a skill that comes with time.

You cannot be everywhere at once, and you cannot be all things to all patients. You will set yourself up for frustration and anguish if you even try.

Also, maybe Med/Surg isn't your niche, or maybe it's the shift you work. Different shifts on the same floor can be drastically different due to the pace of different times of day, different leadership, different co-workers, etc.

Just a few months ago, I sounded just like you. I almost left the Emergency Department, thinking it just wasn't for me, but instead I changed to a different schedule, and now my interest in Emergency nursing is renewed. I'm excited about my work, and actually can honestly say I *like* my job, rather than just tolerate it. I still bump up against the same issues, but for some reason, working a different schedule made all the difference in the world for me.

I hope things get better for you. Inpatient nursing is tough, and not for the faint of heart. If you can do this, you can do anything.

singingtothewheat · Sep 6, 2011

I have to tell you that if you expect this to change you will have to get busy making it change. The "man" is all about money. Period. It really stinks that it's like that but in my twenty years of nursing it's only gotten worse.

The most ridiculous part about it is the time we spend doing the jobs of ancillary staff. It makes it impossible to do our own jobs there right way and all the corporate folks want to do is demand more.

If you want out of this pickle, go back to school while your still young. Don't wait twenty years to know that's what you should have done.

pale_pilsen · Sep 6, 2011

90% of times its like this. I regret coming into this unit cause I have no choice. I need to get experience somehow. most of the good units or they call it a retirement unit where no one quits rarely have any openings. So the only ones left out is mostly medsurg units cause no one wants to stay there.

Its not about prioritization, its about the workload itself. Its insane to be called by 4 diff people at the same time wanting something. Its much worse than a manual labor cause not only your physically drained out, but mentally and emotionally as well.

Its not that easy to transfer to another unit or hospital due to this economy. Hounestly, hospitals are downsizing left and right.

xtxrn, ASN, RN · Sep 6, 2011

My only other suggestion would be to make a list of what this job does FOR you- it might be little things, or big things (paycheck to pay bills), and just go into the shift thinking about what the hours you put in are going to give you back- purely financial, experience, feel good when you can _____, etc.....how is this job working FOR you.... not what you have to do for the job. It might not sound like much (or even useless), but if you can somehow turn this into something that is benefiting you, it might be a bit easier to hold on until you can get into the field you want :)

Nursing is hard- just in different ways in each specialty. They'll all be pulling you from different directions- so that part won't change- but if you can work with a type/group of patients you have more interest in, maybe it won't seem as bad. Where ever you end up working, the med-surg experience will make you better at it :) That is a big plus.

Hang in there :up:

Aurora77 · Sep 6, 2011

What's your patient load like? Do you use computerized charting--what about it is taking 2 hours to chart? Something that helps me is to take notes immediately after my assessment. I write a little outline on my notes so I can fill in the blanks. Maybe making up some kind of more extensive flowsheet would help so all you have to do is circle what you need to chart.

Can you delegate more to your CNAs? Sometimes it's easier and faster for me to help out pts when I'm in the room, but if there's something you can delegate while you get back to passing meds (or whatever else), do it.

How do you prepare for your day? I work nights and pharmacy leaves at 2300, so the first thing I do is set up my meds for my pts--basically verifying that everything is there. They stay in the locked drawer ready to go when I need them (with the exception of narcc). That way I can just pull them out, do a quick recheck and admin.

I hope things get better for you!

Edit--I realize I'm not sure how I'm coming across with this post; I hope you don't take offense to anything I've said.

I've only been a nurse for a few months, but I worked for years in a production environment (I was a professional potter). I was really good at what I did and was very efficient. The thing that helped me develop my art as well as make a living was that I had a routine. I did the same things, in the same order, every time. It may sound restrictive and counter-intuitive, but by having a semi rigid routine, I had the flexibility to create works of art and be part of a successful business.

I have tried to use these same skills in my new nursing career. I realize that it's not the same and there is always the unexpected. BUT, I try to have a routine when I come for my shift and do things the same way every time (as much as I can anyway :) ). I try to do this with all of my skills, so that don't miss a step. I do this with my assessments and with my med passes. I still have to spend a lot of time looking up meds, but I know I'll learn more as I go.

Now I really am done. I hope this helps.

Anna Flaxis, BSN, RN · Sep 6, 2011

Its not about prioritization, its about the workload itself. Its insane to be called by 4 diff people at the same time wanting something.

Okay, I don't mean to be nitpicky, but yes, this is about prioritization. Take this scenario:

Rm. 101 is puking everywhere and needs something for nausea.

Rm. 102 is requesting pain medication.

Rm. 103 just pooped the bed.

Rm. 104 is climbing out of bed.

In the meantime, you're behind on your med pass, have 2 patients on TPN and insulin gtts, haven't done a lick of charting, and you need to call the MD for a change in patient condition (the LOL in Rm. 105 is satting 85% on RA and c/o sharp chest pain). Your bladder is about to burst, and you feel like you're about to pass out from hypoglycemia. A family member is hovering in the doorway glaring at you with their arms folded. Your CNA just went on break. The family members in 106 just brought some damn french fries onto the unit and the smell is driving you nuts!

Been there, done that!!!!

Obviously your priority is the person who is going to die the quickest if you don't do something. The rest can wait. No refilling ice waters, no fetching blankets, no spending time with family members answering their questions. Not until everyone is safe. Learn how to say "No" to patient requests that you just don't have time for (I never actually say "No", usually something like "Sure, no problem. I'm in the middle of something right now, but I'll get to it when I can.", with a smile and in a friendly tone of voice).

If you need help, don't be afraid to ask for it. If another nurse is caught up, ask if they can check your insulin gtts for you, or pass meds to just ONE of your patients, or give a PRN. Just be willing to help them out if you are caught up. I find it's really good team building practice to offer help to others whenever I'm caught up. Some will take advantage and have you do something they totally have time to do but just don't want to, but overall it enhances cooperation and is really good insurance to have for when all hell breaks loose.

If my feedback is completely inapplicable and useless to you, I apologize. I do know what it's like to be so crazy busy that by the end of your shift, you're just glad you didn't kill someone, and I'm just trying to help.:heartbeat

LouisVRN, RN · Sep 6, 2011

Honestly I know that med-surg can be tough and sometimes you feel unappreciated and worn too thin, but there are many things about the job I really enjoy as well, for example, you never know what you will get. I actually really like med-surg.

Anna Flaxis, BSN, RN · Sep 6, 2011

Just wanted to add, that if you just wanted to vent and didn't want any advice, my apologies. I'm a "fixer", and sometimes I just don't know when to shut up.

NurseLoveJoy88, ASN, RN · Sep 6, 2011

Vent away. Hope it gets better for you.

nyrn5125 · Sep 6, 2011

Okay, I don't mean to be nitpicky, but yes, this is about prioritization. Take this scenario:
Rm. 101 is puking everywhere and needs something for nausea.
Rm. 102 is requesting pain medication.
Rm. 103 just pooped the bed.
Rm. 104 is climbing out of bed.
In the meantime, you're behind on your med pass, have 2 patients on TPN and insulin gtts, haven't done a lick of charting, and you need to call the MD for a change in patient condition (the LOL in Rm. 105 is satting 85% on RA and c/o sharp chest pain). Your bladder is about to burst, and you feel like you're about to pass out from hypoglycemia. A family member is hovering in the doorway glaring at you with their arms folded. Your CNA just went on break. The family members in 106 just brought some damn french fries onto the unit and the smell is driving you nuts!
Been there, done that!!!!
Obviously your priority is the person who is going to die the quickest if you don't do something. The rest can wait. No refilling ice waters, no fetching blankets, no spending time with family members answering their questions. Not until everyone is safe. Learn how to say "No" to patient requests that you just don't have time for (I never actually say "No", usually something like "Sure, no problem. I'm in the middle of something right now, but I'll get to it when I can.", with a smile and in a friendly tone of voice).
If you need help, don't be afraid to ask for it. If another nurse is caught up, ask if they can check your insulin gtts for you, or pass meds to just ONE of your patients, or give a PRN. Just be willing to help them out if you are caught up. I find it's really good team building practice to offer help to others whenever I'm caught up. Some will take advantage and have you do something they totally have time to do but just don't want to, but overall it enhances cooperation and is really good insurance to have for when all hell breaks loose.
If my feedback is completely inapplicable and useless to you, I apologize. I do know what it's like to be so crazy busy that by the end of your shift, you're just glad you didn't kill someone, and I'm just trying to help.:heartbeat

Good suggestions. This is definitely the usual in med/surg. You can't feel guilty about telling family that they have to wait for a blanket, they don't feel bad interrupting you a million times for extra cups when your pt has crushing chest pain. If really busy I tell them nicely that they need to use their call bell because that is the proper way to get an aide to help them. Sometimes the word nurse is meshed with nurses aide and the pt doesn't understand that the aides are there for bathing,toileting,blood sugars and the RN has different responsibilities. Yes they may get nasty when you don't jump to get them water, but so what, you have a job to do and safety comes first. If they are a demanding family I will say to them politely," Can you press the call button from the room and the person answering will send in the proper person, chest pain she calls me, straws for water she calls the aide"

If they don't work in healthcare then they don't know that everyone has a job all they know is call the nurse for everything.

I once had a pt that aspirated food into his lung and we were about to intubate and a family kept coming over and telling me that I need to get her stable husband a room so they could leave the ER room that was too loud. I flat out said "mam we are not stopping what we are doing. that is not a priority!" and turned my back to her and ignored her requests after that. If she had bothered me one more time- Calling Security.

I used to feel like I was responsible to do everything until a manager told me that everyone has a job and you can do everything that the aide, housekeeper can do as far as cleaning pt, cleaning bm off the floor,toileting, ambulating, fetching water... but the aides can't do the rn job-meds, assessments and the list goes on. And don't feel bad asking for help from other nurses. If you need the experience then try to get at least a year on your floor and then look for a lower pt ratio somewhere else or go to icu. Get certifications, ACLS so you might stand out more in getting hired. Good luck and I hope it gets better