My morale is shot...

christymwinn · Apr 11, 2007

Although I do not work in a dialysis unti, I do understand how you feel. You just want to be able to come in and take care of your patients and do the job you love but not have to deal with the political/administrative probs. It happens where I am at too. What you need to do your job better is the one thing they jsut won't give you. Have some faith, take some time to think about anything else you would really feel happy doing.

I am going to per diem status this summer to take some time to think about what type of nursing I would feel more satisfied with and not so stressed out I can hardly even enjoy my days off. I am hoping these 3 or 4 months will give me the time I need to make a good career choice and hopefully a better change for my family.

Good luck and hang in there, I know you will find what you need to make you happy.

Roy Fokker, BSN, RN · Apr 11, 2007

I'm just looking for a reason to remain in nursing. As I said, I love the work, I love caring for the patients, but when the system can't be troubled to make necessary changes to benefit both the patients and the staff, why bother?

Hi,

1. You sure you want to jump "Nursing" as a career based on your current job experiences? Nursing is a very broad, varied field.

2. You mentioned that the system you work under cannot seem to be bothered. Any chance you would be willing to work under a different "system" (read: OR, ER, ICU etc.)

3. Is it possible to cut/drop one shift per week (or take some other time of as such) without adversely affecting your financial status? Staffing the unit is management responsibility - not yours.

cheers,

santhony44, MSN, RN, NP · Apr 11, 2007

If you love the work, look into outpatient, freestanding dialysis centers in your area. There are bound to be some nearby. Even fairly small towns have them these days. I suspect that a lot of the problems you have there won't be issues in outpatient centers.

Of course, in outpatient, you would be dealing with chronic patients and so seeing the same ones over and over; that may or may not be a drawback for you.

Definitely look for some sort of change rather than leave nursing.

HaileyRN · Apr 11, 2007

I've been a nurse for 10 months, and to be totally honest with you, I'm starting to look into doing something entirely different.

I work in a very busy level-I trauma center/ER, where the focus is reducing LWOTs (patients "leaving without treatment"), increased patient statisfaction, etc... all with limited supplies and a perpetual problem with being short-staffed. On my days off, I get calls to work because "we're short-staffed again today." On an average day, I have my assigned beds, along with patients parked in the hallway. I just hope and pray nothing awful happens to any of those patients. It is a busy ER, and despite hearing a code occurring in the very next room, patients somehow manage to tune that out and complain that they haven't been seen, or that no one brought them a cup of ice. In addition to all of that, the ER has had constant heat from the med-surg/tele units in regards to receiving ER patients. Until we finally switched back to fax/tubing report, I had problems with "the nurse is not on the unit... the charge nurse is nowhere to be found, and no nurses here are willing to take report." And bypass? It seems like just about every other hospital in the area will be willing to go on bypass, but we're too poor of a hospital to afford it.

Just about everyone gives me grief... "experienced" nurses on the other shift, doctors, patients... it's been less than a year and already, I fell burnt out. Retirement looks good. Dealing with all the b.s. is not what I thought nursing would be about...

oldiebutgoodie, RN · Apr 11, 2007

I hear all of you. I have been a nurse almost 2 years now, and am also going to work a float pool so I don't have to get called in by the nurse manager to b***h about various minor issues, mostly related to documentation. Our hospital recently raised their patient ratios, their reasoning being that because they had to give the nurses a raise, they have to swamp us with patients. I don't feel like I give good care at all, and I go home at night feeling guilty that I couldn't talk to the distressed patient or provide more comfort measures for the pt in pain.

Oldiebutgoodie

RNperdiem, RN · Apr 11, 2007

Maybe that is why I see the $10,000 sign on bonus for experienced dialysis nurses at my hospital.

loricatus · Apr 11, 2007

God forbid anyone should call off ill. As a result we will often be required to work a third shift. Can you say "mandatory overtime"?
As for the unit itself, patient beds cannot be brought in to , or removed from, the unit without moving the beds of patients who are already [there]. Quarters are so cramped that I have fallen more than a few times [have numerous bruising of my arms and legs] trying to negotiate the space to care for a patient. [All of our working] monitors are more than ten years old, [most equipment has already reached] the end of their service life. Our storage space is a joke, clearly in violation of state standards, and we have no means of providing more than the most rudimentary contact and respiratory isolation for patients requiring such.
Couple these with the fact that our unit is under a nurse manager who has no concept of just what [ED nursing] entails and views staffing and supplying the unit as a drag on her financial numbers. Hospital administration seems indifferent to our situation, particularly since [general ED] doesn't bring the big payers in as [surgery] does.
I love the work, but I've really come to hate the job and the system. I've tried to make my views known to management, in a civil manner with realistic solutions and I'm told to basically "sit down and be quiet".
I love the work, I love caring for the patients, but when the system can't be troubled to make necessary changes to benefit both the patients and the staff, why bother?

Sorry for the cut and pasting. My intent was to demonstrate that in the ED where I work I am going through the same type of thing. That is why I am about to leave where I work and start someplace else. I only hope some things improve at the new place. Getting away from where you are now might be the first step to really see if you would be happier away from nursing. I try to imagine what it would be like if all the nurses that really care for patients and love their work leave the bedside aspect of care because of situations like you describe...that is what really keeps me going at this point.

channiek · Apr 11, 2007

I'm an ER nurse and honestly? Most of the time it sucks! Management don't give a fig and the system stinks. Welcome to nursing!! But somehow I stuck it out and enjoy my work in spite of everything. We must support each other. Life gets easier later.

NurseCherlove · Apr 11, 2007

I don't feel like I give good care at all, and I go home at night feeling guilty that I couldn't talk to the distressed patient or provide more comfort measures for the pt in pain.
Oldiebutgoodie

Isn't that just the worst feeling ever...patients and families crying because they just got a terminal dx/bad prognosis or something and you are standing there, holding their hand/hugging them and just trying to be there for them, but at the same time thinking of the 10 other things you are supposed to be attending to at that time, feeling like some kind of cold-hearted beast when you leave so quickly (given the context). So frustrating!

I have so many m/s patients that can be so needy. Every time I leave them so quickly, I am just praying that they are not thinking that I don't really care. I get so sick of feeling like I am treating patients like numbers or mere tasks. I used to just take the time with patients and end up always staying late (which I really did not mind), but our manager's BIGGEST demand is that nurses clock out on time and leave on time (I tried to get around that by clocking out and staying to finish paperwork, etc., but now the house supervisor comes around and documents if any nurses are still there after their shift).

guest64485 · Apr 11, 2007

Isn't that just the worst feeling ever...patients and families crying because they just got a terminal dx/bad prognosis or something and you are standing there, holding their hand/hugging them and just trying to be there for them, but at the same time thinking of the 10 other things you are supposed to be attending to at that time, feeling like some kind of cold-hearted beast when you leave so quickly (given the context). So frustrating!
I have so many m/s patients that can be so needy. Every time I leave them so quickly, I am just praying that they are not thinking that I don't really care. I get so sick of feeling like I am treating patients like numbers or mere tasks. I used to just take the time with patients and end up always staying late (which I really did not mind), but our manager's BIGGEST demand is that nurses clock out on time and leave on time (I tried to get around that by clocking out and staying to finish paperwork, etc., but now the house supervisor comes around and documents if any nurses are still there after their shift).

Completely agree. But what can be done to solve the problem of feeling like we can not give the highest quality patient care because we are so overburdened?

I had a patient not too long ago that was very agitated and impulsive, but ativan did not affect him well at all. Sleeping pills, pain pills, did not touch him that much. He was a big fall risk. I spent a lot of extra time in there trying different meds and talking to the patient and family to decrease risk of falls, decrease agitation and increase comfort for the patient and family. Ended up staying an extra hour and a half after shift to complete paperwork that I hadn't gotten to earlier. Other people have been warned about staying after. I'm wondering if my manager is going to reprimand me for staying late (I'm new to the floor). Really don't know what else to do though when the only other option I can see is potential harm to the patient.

dzadzey, MSN, RN · Apr 18, 2007

It is depressing, but I still go in because, having worked in an outpatient clinic, I serve many of the same patients when they wind up in the hospital. The thanks I get from them, and the reassurance I can give them as a friendly, familiar face is just barely enough to keep me coming back. But even that is wearing thin as so many of them are in such dire condition.

I'll keep at it until I can transfer into, or find elsewhere, a 9 to 5, M to F, no evenings/weekends/holidays/on call position. Can't afford to go contingent or part time.