Hey all,
I work 7 am - 7 pm and had a meltdown. Just need to vent and thanks.
Well, it happened... Here I am, post menopausal and seem to have traded PMS for waterworks when stressed, happy or sad.
Yesterday was a good day - I went into work - inherited a section from the night nurse (agency) to find that much of the work was left undone - consent forms for procedures not filled out, pre-procedure checklists undone... That was handled - and I got my work done on time...
Shortly after that was arranged - there was a pt reassignment - I gave away one pt and got one... No prob... did additional assessment, charted, caught pt up on his meds, etc.
The day proceeded normally as possible on this floor. By 3 pm shift change and another reassignment, in addition, we didn't have a charge nurse, so we would need to check our own charts for the remainder of the shift. I was losing 2 pts and inheriting two - plus an empty room... and a patient that was just admitted at the 3 pm shift change.
I quickly saw the new pt, checked up on my other pts, and, fortunately, had another nurse doing the admission on the new pt. By this time, I had to do my accuchecks and begin the evening med pass.
By this time it was nearly 5 pm. The unit secretary walked down the hall and said, "Shawna, you have a report calling holding for a new patient for room XYZ." The patient assignments had changed so much that I didn't even realize I had an empty room! I told her this and took report.
The patient was brought up - he'd had SR on the monitor but that had converted to controlled A-Fib - a new situation. Pt couldn't tell me if this was new for him or not (he was a poor historian). In addition, because there was no charge nurse - and also - the US has not been helpful on several different occasions (as well as to several other nurses on the floor) - I decided I would be proactive and that I would begin to get the new patient's orders underway - specifically a call for a cardiac consult, to inform the doctor of the patient's room number, the change in heart rhythm and to tell the doctor a little about this patient.
I paged the doctor - he didn't call back immediately - so I passed some of my meds to my patients while keeping an ear out for the physician's call back. I didn't get paged overhead about the doctor's return call, so I assumed he hadn't called back. I paged again, waited, no return call while I was at the nurses station - so I passed meds to two more pts. By this time it was 6 pm. The doc finally called back and immediately started berating me - evidently he'd been paged four times and had called back twice and no one had picked up his calls (there were no pages overhead, nor was I notified when I was at the nurses station when I specifically asked if the cardiologist had called back). I apologized and told him that there was a new patient on the floor and that there was a consult ordered for this patient. I told him the consult was for chest pain and pancreatitis and also to inform him that there was a change in the pt's rhythm (I also notified the pt's primary care physician - she told me to call the cardiologist on the case). He continued yelling at me, saying that I needed to provide more information about the patient and to have that info when I called (I had the triage notes from the ER). I told him what meds the pt was on and wanted him to know the condition of the patient at this point.
I finished my meds at 6:30 pm... sort of. The pt that had arrived at 3 pm had not received her meds. Her mars were not available and, in fact, her chart was nowhere to be found when I looked for it at approx 4:30 (and then again 5:30) when it was time to pass meds. Her meds had come up prior to her mars being transcribed and I didn't get her orders, nor did I even get a report on this particular pt - which is why I wanted her chart...
I went into report feeling overwhelmed - thinking that I'd dropped the ball on the 3 pm pt and that I'd yet to do the Hx and initial assessment on the other new pt with the irregular heart rhythm. I'd received a very weak report from the previous night shift nurse and had little info to report to the oncoming nurse. She started asking questions and all I could think was, "This is nuts. I keep getting admissions at shift change, am not getting help from the ppl at the nurses station, am getting b#&$ at by physicians - and all the while, I just want to take care of my patients and help them get better." My throat closed up and my eyes filled. I couldn't stop it. I started crying in the middle report. I walked out of the room and took some deep breaths and came back in. I made it through another pt's report - the third was one of the new pts. I started crying again and couldn't stop. Finally, I wrote out my report for a night nurse that was going to be late. I was done with my charting and was leaving for the evening.
My former preceptor stopped me and told me that I take things "too personally" and need to be "more bold". My manager has told me the same thing - that I need to "stand up" for myself - to the point of getting in other co-worker's faces... I refuse to do that. It's unprofessional... and why oh why should I even have to? If I spend 30% of my waking hours at work, why should I have to defend myself against my own "team"? In my estimation, attacks come from the "outside" and defense should be against the "opposition" - not within ranks - if so, the divided house is sure to fall... It is like being in a dysfunctional environment - and it is - doing the same thing over and over again hoping it will change.
Two weeks ago I had a US attack me in front of a pt's family - saying that she was having to do my work for me - taking care of pt's and doing the job I should have been doing. I did defend myself and she berated me at the nurses station in front of co workers and pt's family members. I wrote my letter of resignation that night and began looking for employment elsewhere (no offers yet). I've been carrying it with me...
Last night - although not normally a hugely stressful end of shift - was simply - the straw that broke the camel's back. The continued example of no help at the front desk, being ignored and ridiculed (by CNAs as well) all merged together last night into a ball of what I considered to be an impossible situation... it was everything - and in that moment I realized I'd been hanging on - doing the same thing over and over, hoping it would change. I cried during report because it finally hit home - that there was nothing I could do to effect good change where I am (was) and that to continue to stay was, very simply, unhealthy for me. I told two of my nurse friends that I plan on leaving.
I'll be resigning Monday. I have heard that there are better places to work and I intend on working elsewhere to determine if it is the nursing profession as a whole that is like this - or if it is this particular floor or hospital.
Right now, I wish I had a mentor. I don't know enough and I want to know more - and know how to do this job well.
Take care,
Shawna
