I've realize most of all the places I've worked have had high turnover, but my current job takes the cake. In the six months I've been employed here I have seen 10 nurses come and go or reduce their status from full to part time or per diem on day shift alone, nights is worse. I've seen both new and experienced nurses quit while on orientation, or interview and not take the job. A few doctors even jokingly begged me not to leave as that nurses and docs just came and went.
Nurses who just came off orientation who are already proclaiming how much they hate it. The medical residents are stressed and have been openly complaining about their concerns, the attendings are detached. Techs could care less and don't work together.
Staff both RNs and ED techs are burned out from working short which leads to increased sick calls.
I've never seen such a mess of a unit. I'm calling out tomorrow for the 3rd time in 6 months and I feel awful but although its so early in ...I'm tired of being dumped upon. Last few shifts I've had full ICU, intubated patients with at least 7 other ED patients, 2 of which were potential strokes and another possible sepsis.
Equipment doesn't work... 3 of our 4 defibrillators stopped working and still have not been replaced.
Working ED in this town is rough. Less hospitals, terribly high acuity, and atrocious nurse turnover numbers. And yes there have been multiple meetings with administration and on the nightmare goes...
I think I'm sadly thru with bedside nursing after about 9 years. I'm just hoping to stick it out another 6 months here, then hopefully transfer to any ICU adult or peds/PACU or OR/Cath lab heck anywhere but the ed which I really do love. After that advanced practice here I come. It won't be easy but at least it'll be less physically demanding... sigh.
IT wont get better! Some thing is wrong with management. INcompetent. CAll your member of parliament, or congressman. CAll the media..they love blood. For an HR to admit outright, ask her if she knows. She need helps, because she is frustrated.
Absolutely true. I just walked out of such trouble. I felt my licence was being threatened working with so much nurse shortage and equipments that either so stale or not working at all. Always feeling that I am not doing enough for the patients. I got tired of begging to get new oxygen tanks and crash carts. I went to work one day, 4 hours into the shift, I wrote my resignation letter and turned it in with my badge at the end of the shift. I am yet to find another job but I am relieved
...the broadcast is free and open to listen to : but in addition, i strongly suggest joining IHI's efforts to improve healthcare by joining their efforts and taking their training courses ...if you call them you will find well educated, compassionate people who are ready and willing to help and support : ) ...but why not just start by listening to the broadcast : ) ...the title alone will hopefully give you a sense of the support that is available ...keep us abreast, okay
[h=1]WIHI: 10 Things Every Hospital Needs to Know to Be Safe[/h]
"I think the elephant in the middle of the living room here is the fact that, today, hospitals are being run by MBAs and CPAs rather than MDs and RNs."
OMG Yes could not have said it better myself. But, this has been going on for a LONG time.
OP, if you really have 7 patients AND a vented patient, then you have to think of your licence, because that situation is just an accident waiting to happen.
Especially when supplies are low and machines not working, you have to waste time looking for things and borrowing from other areas. How can you watch a vented patient when you have run to the next area to borrow something?
We generally run at 4 patients, and up to 6 in a 'situation', like when other nurses call off at the last minute, or when we reallocate to allow those with the higher dependency patients to focus on them.
Our main problem is the inequality in staff, we have some excellent nurses but also a lot of lazy indifferent ones, who are just cruisin to retirement and really don't care anymore.
Let us know what you decide, my 2cents worth is that it all sounds too unsafe to risk your license for.
We staff at 1:4 but for the past couple of months the load has been more like 1:6-7. And that's when all staff are there. And yeah, callouts are up & morale is down.
Run far and fast. I worked in an ED like that. Nights, 6-8 (sometimes 9) patients, half with high acuity, several unstable, treating patients in the halls is the norm, bringing people to rooms that aren't clean to try and clear the waiting room that 5 minutes faster... staff turnover crazy, 3 managers in 2 years...
I left for a slightly smaller ED, and am very happy there. I took a slight hourly and shift diff paycut, but am not so completely ragged after my 3 shifts like I was at the last place, so I can actually pick up some OT and easily make up the difference. My worst nights at my new place are better than most any night at the last place.
I also kept hearing "things are getting better" and they'd look like they were for a few weeks, and then it would crap out again when burned out staff left or they cut the travelers before we were fully staffed. I talked to a bunch of long-timers there and they said it the cycle has been going on for 5, 6, 10 years and it has never changed for long enough to retain staff.
The funniest thing was that I was basically told by a few people when I left that I just wasn't "elite" enough for that ED. If ruining my health and mental well being while jeopardizing my license is what it takes to be "elite", then I guess I'll have to settle for a little less.
I don't know what it takes to fix a place like this, but a good friend of me said, "hon, you can't fix that hospital's ED and you shouldn't kill yourself trying." At a certain point, follow your gut and protect your health, safety, and license.
More than four ER patients..! Wow. Unless I'm working urgent care I'm really incapable of attending to more than three ER patients. My department is a 4:1 off peak hours and 3:1 peak hours, and I still think that's unsafe and over taxing.
"Staff both RNs and ED techs are burned out from working short which leads to increased sick calls. I've never seen such a mess of a unit. I'm calling out tomorrow for the 3rd time in 6 months and I feel awful but although its so early in ...I'm tired of being dumped upon. Last few shifts I've had full ICU, intubated patients with at least 7 other ED patients, 2 of which were potential strokes and another possible sepsis.
Equipment doesn't work... 3 of our 4 defibrillators stopped working and still have not been replaced"
This sounds exactly, and I do mean EXACTLY, like the ED I'm working in. I can't help but wonder if it's the same one! I shudder to think that more than one "house of horrors" like my ED exists. I am routinely left to care for up to 21 patients while my partner goes on break, no charge nurse to be found, and this includes caring for critically ill, sometimes intubated patients awaiting admission to ICU. I was hired as fairly new grad. The only experience I had was a few months of home care nursing. Although I'm very sorry for your plight, I'm relieved to hear that I'm not the only RN having this horrific experience. I accepted the position under the belief that it would be an incredible learning experience, however the reality is that I feel like I'm learning very little. I waste unconscionable amounts of time on indefensble treasure hunts, searching for supplies as basic as adult pulse ox sensors, water pitchers, and as hard as this is to believe, IV poles! In fact, we have exactly ONE working IV pole in the ED. I had a trauma patient with a haemothorax with a chest tube that needed STAT transport to CT. After attempting to use the only 2 portable suction units available, and finding neither had a charged battery, the physician finally gave up and we transported the patient without suction! I understand that things sometimes go wrong and that in an ED we sometimes need to improvise, but ALL THE TIME?! In what universe is this acceptable? This is a Level I Trauma Center, I'm talking about! This is the kind useless waste of energy that wears me right down to the bone. I have actually been told by a resident, as well as as an attending physician that it's an extremely risky enviroment to be working in, with regard to my license. I've never experienced such a level of apathy or disorganization anywhere, and I've worn many hats in my life. I came to nursing as a second career, so I've experienced a variety of work environments. Patient centered care? What a joke. I've actually been told by RNs in this ED that I have learn how to ignore patients who aren't acutely ill because I'll "never get my meds or notes finished." I've questioned/vocalized/protested the horrible state of affairs to other long-time RNs here, only to be told "Welcome to the emergency room!" and I can't help but think, "Really? Well then maybe this isn't for me." In fact, this experience has been terrible for my morale and self-esteem. It has even made me question my choice to go into healthcare. I have at least one anxiety dream about this place per week and dread going to work. I never expected to feel like this. I'm at a complete loss. Any advice would be very much appreciated.
Roy Hanson
211 Posts
IT wont get better! Some thing is wrong with management. INcompetent. CAll your member of parliament, or congressman. CAll the media..they love blood. For an HR to admit outright, ask her if she knows. She need helps, because she is frustrated.