Here I am, it has been 6 days, since I have been off of orienation, I am disgusted. I took boards yesterday, keeping fingers crossed, but actually I'm a little worried about having the RN title, because that means more things that I have to do. Which that would be no problem, besides the fact that today alone I had a 9 patient assignement! Come on 9 patients? A experienced seasoned nurse shouldnt be taking care of 9 patients. I am a new graduate with 6 days under my belt, by myself. We are on a med-surge unit specializing in orthopedics and gynecology, due to the recent close of our OB/Gyne floor that is our newest addtion. My head is spinning, I cant keep up, I am trying like heck to get everythign that needs to be done, but I am not even coming close, I do not feel that it is my inability to do things quickly, I am moving at a very quick pace but, here is the question i pose, Why is it that a new graduate nurse or any nurse for that matter should have to take care of 9 patients on a daylight shift? Why do we allow these things to happen. I am curious to know from the California RN's how the patient:staff ratio is working out, does it work to have mandatory Ratios? Make no mistake it was not an easy patient assignent load either, I had 2 patients on complete bed rest, which were complet cares, I had 4 post ops, which besides PCA's, Foleys, dressing changes, and routine meds, have to be down for Physical Therapy twice a day. Also you have all your routine meds, pain management for the other patients, I was lucky if I say 2-3 of my patients once in the 9 1/2 hours I was there, and that was to give them there medications and give them a very brief once over, which is complety inadeuquate, but what are you to do... I was still passing medications at noon, of course no breaks, no lunch, and the 2 RNs, and Myself along with the LPN whom which all carried the same load today were sinking. We have a charge nurse who was taking off orders ect, and another RN that got mandted due to not having a unit secretary. Another RN came out at 11 to take over for the mandated night shift nurse. Why are these things happening, I feel fortunate enough that I am able to keep my cool and keep moving and doing the best job I can do. I feel that this is such a joke, and such an inadequate way to do nursing, THIS IS NOT WHAT THIS PROfESsion is about , I feel like im doing TURBO nursing. You walk in the room, and are trying to keep moving you cant talk to the pateitns, your in their for only 5-10minutes at the most, how are the pateints getting good care, why is our patients not getting excellent care! Why are we not able to do what we are taught a nurse is suppose to do? Doctors are coming in and out writing orders that you come and find or are told about 2-3 hours later. You simply dont have time, I did not sit down today, until 4pm 1/2 hour after I should be on my way home, I sit down to chart, and try to look at my hands my papers, and sort through and see who had what going, and what I need to chart, I finish that after about 45minutes, and I am not satisfied with it, but hey its 5:15, I am exausted my feet ache. One of my co-workers come to me and says, do you have heart burn yet? Dont worry you'll get it, and turns to our other co-worker and asks what do you take, prilosec or protonix? I sit and wonder to myself, they are serious aren't they? This is so sad. I love this profession, I love what a nurse is suppose to do, I want to help people and I want to go to work everyday and do the best job I can possibly do but this is rediculous, I am managing for the moment but I do not know how long this will last, until it catches up to me. I knew this was a tough profession, and that is one of the reasons I got into it becuase I wanted a challanging profession, BUT i didnt want a unsafe, tiresome, work yourself into the ground, barley remember your patients names at the end of the day. On account of HIPPA, I can not paint a complete picture of my patient assignment, but believe me when I say, It was definitly not an assignment anyone should have. My manager and charge nurse, knew it was bad they were trying to help, I can't complain about my co-workers, they try as hard as they can to help you, but they have 9 patients a piece, and their own problems to worry about, I cant blame them for not being a little annoyed, but again why is this happening?
I know this is not new, I know this is not a new concept, I also know this is happening all over the US. I just am very disgusted. My question to all of you out there is, WHat can we do to change this? Or has anyone encountered this at their hospital or facility and took a stand and decided to do something about it? I know that my co-workers want these things to change, but nobody knows what to even do about it. We dont even have time to think about it, we cant even stop for a moment to think, wereway to busy trying to give our patients 1/10th of the care that they deserve. Were doing our best, I am doing my best. I just cant keep asking myself WHY, and What can I do to make a change?
YIKES!! That is outright FRIGHTENING. I know that I am the type of person to stand my ground when it comes to safety with myself, others and especially patients. Will I lose my job if I say I don't think it is safe to take another patient, etc? Why aren't the nurses standing up for themselves? How can "we", the new grads coming into the profession take a stand and have our voices heard? How can "we" work to change this? There HAS to be a way. Whenever there is a small will, there is always a chance for change. I guess more and more nurses need to really start advocating for themselves instead of the patient alone. Someone told me yesterday that I should be careful because if I advocate in the wrong voice, I might lose my license. How is this possible if it is in reference to safety and it is done in a diplomatic way? I just found out the nurses union isn't very strong here in NYC. Sad. I want to work somewhere with a strong union behind me because of exactly what you have experienced.
Anyhow..
I just wouldn't take 9 patients. If I was forced, I would leave and find another job. Maybe I am being to extreme, but nothing scares me more than making a mistake and killing someone:(
I hope you figure things out and find better working conditions.
one thing to consider - even though the law says an employer can only say your start date end date and weather they would rehire you or not - they DO tell tales of WHY you aren't there. it will NOT look good and you will have a very difficult time even getting another job with fired or asked to leave due to refusal of patients.
So, do nurses typically get fired for refusing unsafe assignments? For taking a lunch, or for using the restroom too much? I know these sound like ridiculas questions, but it seems like many people complain about these things and put up with being treated badly that I just have to think that hospitals must fire nurses who demand better working conditions, and keep the ones that will take their crap. I only ask because it is my goal to work in a hospital, and I already know that I will not tolerate being treated poorly. If becoming a nurse means that I have to be abused to keep a job then I think I should spend my time and money on a different degree.
honestly if i could afford it id get a differnet degree - as much as i love my residents - i have even went and took a full time factory job just to get out of nursing but health issues made it impossible to work full time and the only way to support my family was to go back into nursing - at least working per diem i get to choose who i work with and when i work usually so my nights may get hectic but are rarely tragic anymore- dont have much money but at least im happier and healthier
I am soooo freaking out reading this post! I am a new nurse (LPN) and I start my new job in a few weeks. I was told I get 4 weeks of orientation. I asked if I would be granted more time if I needed it, but was told that they have only had to extend orientation 3 other times in the last several years. I kind of got the feeling that they really didn't want to extend orientation either. I'm scared I'm going to be eaten alive at my first nursing job. This is just so harsh....are hospitals really like this? What a nightmare!
4 weeks is better than what our place has been giving any new body ( not necessarily new grad but to me doesnt matter ) everyone gets one day on book/paper work and if they are lucky one maybe two days orientation to the wing - sigh - sad but true
one nurse - cause she had worked there before - ( like over a yr before - ) got NO orientation - she came in and they gave her a wing - now over the yr some residents were the same but still - so much was new- new rules - new residents and staff - just made me sick. i got 3 days - i guess i was blessed.
Sorry to hear that you're having a rough time with your new job, and new role as a nurse!!! It sounds to me as if the facility where you are working is probably not the safest of places, for patients or staff! I do have a question for you though.. If you just passed your boards two days ago, how is it that the facility you are working in has had you off orientation and on your own now for that past eight shifts??? Correct me if I'm wrong, but have you been taking patient assignments and providing nursing care for the past eight shifts???
i can only speak for what our interns do - they get a full wing- we have to know and believe in thier skills because we the RN has to be in building and basically back her stuff as well as do our own stuff - we also have to do her Dr calls , check her orders she has done and her charting, - sign it off and so far any NI or GN i work with has been great thank god - dont know what id do if i had someone I wasn't comfortable with thier skills.
I have noticed an interesting trend in the hospital I work for. There are many nurses working here as travelers because of the deplorable hospital working conditions, poor management, poor pay, and no ratios in other states. This is what the traveling nurses are telling me about what is going on in other states, I have always worked in CA. I am not trying to make it sound like CA is the best place to be, I know there are fine hospitals and nurses all over the USA. I only have info from nurses who left for a better situation. We have nurses from Kentucky, Tennessee, Mississippi, Louisiana, Arizona, West Virginia, Georgia and Florida who are here for the high pay and low ratios. My nurse friend from Tucson says it is like a vacation for her to work here because at home she has 8-9 patients on nights and has to be in charge. Here she has 4-5 pts and never has to be in charge. My nurse friend from Tennessee is making triple the wage she made at home. It seems that the rest of the country is losing some good nurses to CA because we do have the ratios in effect. We do have strong unions here in the Bay Area (I am mid-peninsula for those who know the area). I think something has to change for the rest of the country. Whether it is ratios or staffing by ACTUAL acuity (not supervisor enforced acuities based on staffing grids) nurses need some relief. For those of you who are staying in your home city/state and trying to make things better for your pts, God Bless You all. I hope things change for the better before we lose our new nurses to burn out.
wisconsin license goes to california - i think - maybe i should move - i wish......
Well, as you can see I am DEFINITELY NOT a new RN. i have been doing this for the last 40 yrs. I have been a Manager and I have been staff for a MUCH longer. The Politics of Management go to me early in the game & I knew I wasn't meant for that. SO........ it was nack to staff.
The last 30 yrs has been on 8 hr. nites--full time.
It has been quite a trip!!
First off-- It is most certainly legal to refuse an assignment--as long as you have not yet accepted that assignment. I have always been told that once you acctually accept the assignment, if you then try to refuse, you could be cited for patient abandonment. So, If you come in & see that type of assignment, you need to refuse & speak to whomever is in charge BEFORE getting any type of report. You need to say that you feel this is an unsafe assignment & the reasons; Also your license is at risk here.
You know, I know you have worries about loans & such, but this does not sound like a really good place for you.
If by some awful circumstance, you end up sued or whatever for some mistake you might make when you have this unsafe assignment, you will have even more money problems. Just remember that if you get sued, they can say that a prudent RN would NOT have accepted an unsafe assignment.
Our Hospital is owned by one of Illinois's largest employers. We are a not-for-profit teaching hospital. Our management has been trying to go by california staffing guidelines. They really are trying & most nites now we don't get more then 6 pt's. Our day shift 5 at most. we also have Nurse Aides who are terrific. We are not Perfect, but better then it has been; HOWEVER, patient's today are sicker then ever. 10 yrs. ago, my patient;s would all have been in an ICU; Today, however, they are on my Med/Surg/Hem/Onc floor. The patient's in the ICU wouls probably not have made it, so nursing is a harder job then ever.
I know, at my age, you'd think I'd give it all up--it's TEMPTING--Believe me as the old bady is failing, it is tempting. However---I DO LOVE BEDISE, HOSPITAL NURSING!! And you know, there are not so many of us left anymore.
I also need the really good benefits I get here--a great HMO & a good pension plan. At my age, we think about those things.
However--Like I said---you can REFUSE an unsafe assignment; I have done it--i did not get fired.
Think about yourself and your future career.
mary Ann
when does one accept the assignment - when you punch in or when you get to the floor and see the list and then do you have a chance to say no - if not so what then would you do - go in early see what the assignmnet is and the go punch in - i never thought of this area before. interesting question if someone can give me an answer itd be great.
Amen. Shouldn't it be against the law to give a nurse 9 patients? Thats like asking for medical errors and a lawsuit.
they do not care cause nowadays the lawsuits are falling on the nurses instead of higher up - all new grads and coming ins - please get yourself some nursing insurance of your own = never rely on the place you work to protect you cause they will only protect themselves and will turn on you like a lion cornered.
Lots of people ask me (perhaps because I'm a guy) if I like nursing, and if it is a good career. My standard reply "Well there is a REASON that there is alsways a nursing shortage". This is the reason why.
Everyone knows why there is always a nursinf shortage. It is beacause the salary and working conditions mean that few people would ever want to do this. Employers know there are 2 ways to solve the shortage:
1) improve the salaries and working conditions.
2) import lots of immigrant nurses from third world countries who will be more likely to tolerate the salary and working conditions just to escape crushing poverty in their home countries.
It is clear the heal care industry has chosen option #2
If it sucks where you work, then either speak up and complain, or find someplace else to work. However, it just may suck just as bad at another hospital. Choose carefully.
I have to disagree with the salary part. The majority of hospitals pay overtime..so if you work the hours you get paid for it.
The benefits at hospitals far exceed most companies in Corporate America and the job stability (for the ones that can do the job) is rock solid.
I'm going to nursing school hopefully in the Fall of 2007, I'm the daughter of an NP and have worked for the past 10 years in the lending industry as an underwriter so I know what a huge variety of professions make and how long they have went to school, b/c it's on their loan application
I have never seen a broke RN...they are usually buying very nice homes, and have very nice salaries, and seem to do well with investing. I have seen RN's, yup, RN's, making $85+ a year. That isn't pocket change.
It may seem like low-pay to a BSN, but try getting a job at a bank on SALARY where you don't get paid to work 12 hour days at the end of the month or when you come in on Saturdays, getting e-mails the next month saying that there won't be a bonus this time, but then you hear on the news where your bank just reported a record quarter. I worked in the mortgage industry and made MORE than most of my friends that worked other jobs...and I have never even had a course in economics!
But to ASN's...there aren't too many professions where you can come out of high school and get a job with 2 years of education and get paid $35k plus.
There are also not many jobs that are economy proof....nurses work even during wartime.
Guess what - another nurses had to pick up the patients I refused, and it did not improved my day with everyone hating me and talking behind my back that I made them to work harder.
But this is the thing that drives me crazy. YOU did not make this nurse work harder. SHE CHOOSE to take on extra work she could not handle because she chooses not to be assertive and set boundries. She could have refused just like you did. I believe this is what CrunchRn is saying about sticking together.
I wonder if this varies by healthcare system? I lived in Charlotte, NC and when I was a patient for 2 weeks in the Presbyterian Hospital, I was in the high-risk maternity ward. If my nurses had a ton of patients, I never knew it, because anytime I needed anything she was joannie on the spot. The NICU where my daughter was had only 1 nurse per 2 babies, 2 Neonatologists physically at the hospital 24 hours a day, plus a Nurse Practitioner.
Because of the excellent care we received...that is where I want to work b/c that is how I think it should be done.
Am I crazy? Were they just having a good week? Or are they just a great Hospital system (feel free to answer..not a rhetorical question).
I never, ever was concerned with my daughter's care....I worried about HER, but not about the care....and I was watching them like a hawk.
Here I am, it has been 6 days, since I have been off of orienation, I am disgusted. I took boards yesterday, keeping fingers crossed, but actually I'm a little worried about having the RN title, because that means more things that I have to do. Which that would be no problem, besides the fact that today alone I had a 9 patient assignement! Come on 9 patients? A experienced seasoned nurse shouldnt be taking care of 9 patients. I am a new graduate with 6 days under my belt, by myself. We are on a med-surge unit specializing in orthopedics and gynecology, due to the recent close of our OB/Gyne floor that is our newest addtion. My head is spinning, I cant keep up, I am trying like heck to get everythign that needs to be done, but I am not even coming close, I do not feel that it is my inability to do things quickly, I am moving at a very quick pace but, here is the question i pose, Why is it that a new graduate nurse or any nurse for that matter should have to take care of 9 patients on a daylight shift? Why do we allow these things to happen. I am curious to know from the California RN's how the patient:staff ratio is working out, does it work to have mandatory Ratios? Make no mistake it was not an easy patient assignent load either, I had 2 patients on complete bed rest, which were complet cares, I had 4 post ops, which besides PCA's, Foleys, dressing changes, and routine meds, have to be down for Physical Therapy twice a day. Also you have all your routine meds, pain management for the other patients, I was lucky if I say 2-3 of my patients once in the 9 1/2 hours I was there, and that was to give them there medications and give them a very brief once over, which is complety inadeuquate, but what are you to do... I was still passing medications at noon, of course no breaks, no lunch, and the 2 RNs, and Myself along with the LPN whom which all carried the same load today were sinking. We have a charge nurse who was taking off orders ect, and another RN that got mandted due to not having a unit secretary. Another RN came out at 11 to take over for the mandated night shift nurse. Why are these things happening, I feel fortunate enough that I am able to keep my cool and keep moving and doing the best job I can do. I feel that this is such a joke, and such an inadequate way to do nursing, THIS IS NOT WHAT THIS PROfESsion is about , I feel like im doing TURBO nursing. You walk in the room, and are trying to keep moving you cant talk to the pateitns, your in their for only 5-10minutes at the most, how are the pateints getting good care, why is our patients not getting excellent care! Why are we not able to do what we are taught a nurse is suppose to do? Doctors are coming in and out writing orders that you come and find or are told about 2-3 hours later. You simply dont have time, I did not sit down today, until 4pm 1/2 hour after I should be on my way home, I sit down to chart, and try to look at my hands my papers, and sort through and see who had what going, and what I need to chart, I finish that after about 45minutes, and I am not satisfied with it, but hey its 5:15, I am exausted my feet ache. One of my co-workers come to me and says, do you have heart burn yet? Dont worry you'll get it, and turns to our other co-worker and asks what do you take, prilosec or protonix? I sit and wonder to myself, they are serious aren't they? This is so sad. I love this profession, I love what a nurse is suppose to do, I want to help people and I want to go to work everyday and do the best job I can possibly do but this is rediculous, I am managing for the moment but I do not know how long this will last, until it catches up to me. I knew this was a tough profession, and that is one of the reasons I got into it becuase I wanted a challanging profession, BUT i didnt want a unsafe, tiresome, work yourself into the ground, barley remember your patients names at the end of the day. On account of HIPPA, I can not paint a complete picture of my patient assignment, but believe me when I say, It was definitly not an assignment anyone should have. My manager and charge nurse, knew it was bad they were trying to help, I can't complain about my co-workers, they try as hard as they can to help you, but they have 9 patients a piece, and their own problems to worry about, I cant blame them for not being a little annoyed, but again why is this happening?
I know this is not new, I know this is not a new concept, I also know this is happening all over the US. I just am very disgusted. My question to all of you out there is, WHat can we do to change this? Or has anyone encountered this at their hospital or facility and took a stand and decided to do something about it? I know that my co-workers want these things to change, but nobody knows what to even do about it. We dont even have time to think about it, we cant even stop for a moment to think, wereway to busy trying to give our patients 1/10th of the care that they deserve. Were doing our best, I am doing my best. I just cant keep asking myself WHY, and What can I do to make a change?
Welcome to nursing after nursing school. Yes - it's strenuous, hectic, discombulating, and you feel completely worthless while wondering if you're doing any good. There will be good days, better days and absolutely horrible days; wondering if you should ever be a nurse. Then when you're ready to quit, you have moments when you are truly connected with another soul that makes it all worthwhile and you wonder what crazy moment possessed you to quit nursing.
The rewards are few and far in-between, yet monumental. I started as a paramedic and went on to nursing school because of the desire to maintain patient contact. After 20+years in medicine, there are still moments of pain, yet moments of indescribeable joy. Hang in there - you do make a difference.
This is exactly why I left nursing 6 years ago to become a SAHM. In the suburbs of NYC, that's the typical nurse/patient ratio, if not worse. While practicing, I routinely got 10-11 patients at a cardiac only hospital. The floors had 42 beds and were divided into 4 districts. We almost always were at full capacity. 4 districts - 4 RNs. Each RN had 2 aides. Almost always one of the aides called in so you rarely worked with a full staff.
There was no way to refuse an assignment as that was the standard ratio. I swear that working there shaved years off my life. I spent all of my off-time recovering from my on-time. All of it. Many times just laying on my couch trying to get up the energy to do something. I was single then so I could do this. Now that I'm married with kids, no way. Sometimes I miss nursing and feel nostalgic. Like today, when I came to the boards and started reading. I read your post. It brought back the full reality of nursing. I'm glad I'm out.
My advice: find a hospital with better ratios. They are out there.
Get thee to an ICU! I've never had more than 2 patients. Sure there are swans and pressors and vents and all that, but it's totally manageable. I could never do your job and keep my sanity.
-S
After not being able to hack the ratios on the floor I transferred to CCU. The hospital I worked at more often than not gave us three patients instead of two. At least 80-90% of the time, I got a three patient assignment. The nights I had a two patient assignment it was completely doable. When they tacked on the third patient, the house of cards crumbled.
This hospital was trying to make 3 patient assignments the standard. It was and is a well-respected cardiac only hospital. So, not all ICUs are alike. It depends on the hospital.
twotrees2
913 Posts
one thing to consider - even though the law says an employer can only say your start date end date and weather they would rehire you or not - they DO tell tales of WHY you aren't there. it will NOT look good and you will have a very difficult time even getting another job with fired or asked to leave due to refusal of patients.