need advice desperately!!!

[Nytenurse]

I have recently been targeted by my nurse manager, I have been an RN for a year now on her floor and she has been on me like white on rice the past couple of weeks for the most petty problems. One bad night I forgot to document the I and O's and she proceeded to tell the shift following me to let her know if there is anything that I'm not doing and that she may put me back on orientation. Does anyone have any advice on how to deal with someone like her? She doesn't seem to notice the more important things that I catch that hasn't been done by other shifts. For example a post op pt that should have been on telemetry and was sent to a regular med-surg floor, IV rates that a wrong, pts not getting needed medications when ordered stat on the previous shift, recognizing "silent MI's" and a fib vs tachycardia. I follow a new grad sometimes and you don't want to know the stuff that I find that isn't done. I work nights and the I and O documentation for the day ends with me, however all the shifts are poor documenters when it comes to I and O's and when you are prioritizing in the face of too large of a pt load, very sick pts and what have you the I and O's are sometimes missed by all. You can get a basic idea that yes this pt has sufficient Intake and Output but not necessary by the cc. Anyway it seems that she is more concerned with this right now than anything else. I used to love my job, but now my stomach hurst all the time and I'm having headaches. I am so caught up with watching my step and my aides and lpns that I'm afraid that I will miss something more important. I usually have between 5 and 10 direct pts and cover the lpns 5-10. If the lpn misses documenting the I and O's she comes to me only and doesn't speak with the lpn or nurses aide, they are still memebers of her staff and I feel that she should speak with them as well. Has anyone ever experienced this before and what should I do? Is it possible to love what you do but hate your job? Thanks for hearing me.

[Nytenurse]

I feel like the wool has been lifted from my eyes. I have been comtemplating my current situation and with the help of those who have responded I feel a little better. While I am still afraid of quitting my job and finding something else (even something better) I am determined to get something positive out of this. Like I think I said before, or maybe thought, I have the I and Os down to a science. The dr's come in a 6 am and I like to have them done for the day by then. (Which is chronologically confusing because its actually the next day, you know what I mean. Why do they consider the 7-3 shift the first shift anyway? Is this all over the world or just my neck of the woods?) This is who the documentation is for anyway. I've always prided myself in having that done for them. I am determined also to make my boss see me in a positive light. If someone has pointed out my deficiency (like the i and o's etc) I will point out my good points. Maybe she honestly doesn't know the good that I do. Like I said this is the first time that a pt has complained about me and now I know where I went wrong. Yes, I think I was beginning to get task oriented instead of pt oriented. You have no idea how powerful that statement was to me. I was starting to become the very thing that I entered into nursing to counter. I always intended to put the pt first and I fell away from that. The pca's and epidurals can wait a moment. Comfort first. I can't believe that I missed that, sometimes it takes someone from the outside looking in to point out the obvious. I wish that I could also talk to the pt and tell her what I've learned (although that may not be wise either) Supposedly, although I have no proof, she was a registered nurse, somehow ended up with a lot of money, hires private duty nurses to take care of her and her new hip so she doesn't have to go to physical therapy, did I mention she was only in her 50s? Well, I'm getting back to bitter now so I'll stop here. Learning from my mistakes as usual. Thank you all for your help. Sincerely, Nytenurse

[bagladyrn, RN]

Nytenurse- the previous posters have it right-spiff up your resume and take the plunge. I've done this twice in the last 15 yrs., also as a single parent. The first time I moved 2000 miles, sight unseen, across the country, to a job in a completely different area of nursing ( they were willing to train me). 9 yrs later, with major changes in that system, son now grown, I saw the writing on the wall, and made the jump to travel nursing. In both cases, there were some tough times, but also some really wonderful experiences and life changes. By jumping when I did, I was able to override a less than stellar exit review by demonstrating years of excellent previous manager's reviews stacked up against the review of one who had been my manager for only 3 months. Diplomatically, I suggest that perhaps she did not have the experience to fully review my competence

As for insurance, I have found that all insurance offers the option to self pay for the month or so until your new insurance takes place. You should be able to do this with a sign on bonus for a new job!

Go for it! Get in touch with me any time you want to vent, or just talk over options.

[Thunderkat]

Dear Nyte nurse

I feel for you. I really do. I am prolly gonna get slammed for this but..... Pain is real. I have had my share of problems with those difficult patients, but in your post you stated that the caregiver kept coming out and asking for assistance and then finally a pill, and you kept stating that you had to assess postop pts..... well, it takesa good 30 min to assess a post op pt and get a history and etc....and maybe 5 min to get a pt a pill. Even though she was difficult or a real pain in the butt, you really should have addressed her pain in a timely manner. I have to say I used to think that pain was not that big of an issue and I had other extremely important things to do like assessment, blah, blah,blah. What changed my mind is when I was hospitalized after a MVA with major trauma and I felt horrible. I had to lay with fractures to bilat hips and arms for 2 days before they could stabilize me enough to take me to surgery. The nurses would delay my pain meds and I was suffering. I begged people to kill me. Since that experience, I am the avenging angel of pain control and I make a concentrated effort to medicate my patients and keep them comfortable. I am now a forensic nurse and do not deal with physical pain too much but I have been on both sides of the coin and this is only my opinion.... from what you say.... you have been dealing with a lot of stress.... perhaps a change will do you good. I think it may be a matter of prioritizing and time management that might help.... I truly feel for you and hope I do not come across as a critical B@*#*. I hope things get better for you.... but if you feel you are in a hopeless situation, let go of this stone or you're gonna drown.... move on Good luck!!

[mustangsheba]

To be succinct, the first thing I would ask is "if I'm doing such a terrible job, why keep me here for another six months?"

[frenchfroggyAPRN, MSN, LPN, RN, APRN]

I am going thru the same thing where I work. I was asked to come to the vice-presidents office after I came out of report. When i asked my boss what was up she stated " something came up, it's not a big deal". SOOO I have to give report and then go downstairs. When I walked into the room, she was smiling, I was floored when she pulled out "the form". It seems a patient care rep. complained on me last week. stated that i was talking to the patient in "an irritated tone", also last month, a family member was standing out in the hall and when asked what she needed she stated her brother needed a pain pill (one day post CABG), i immediately went and assessed my patient, while i was in the room, i asked if they had used the call light, since my pager did not go off. they said no they did not, I explained how to use the call light. when i was outside of the room checking the chart, i heard the sister on the phone talking and saying, " i dont know who she is but i am going to report her, i used to work here and know how to use the *&^% call light". I gave my patient his medication, and she was soooo nice to me. I immediately chart what had happened to CYA ( cover your A%$), talked to my boss so she would know what had happened. That was the end of it, so i thought. It came back to bite me last week when i was written up, ( i was rude to the patient) NOT, also one of my dear coworkers complained that i leave too much for them to do, we have been told so many times if you don't get something done, pass it on in report for the next shift. I was also written up for leaving them things to do. WTF. Today i have updated my resume and am about to go in search of another job. I love my floor, but am not going to jeoporadize my career for someone who does not back up their nurses and doesnt even ask for input about something before she writes you up. It is funny because all of my patients tell me how nice and helpfull i am. The two problems havn't even been by the patient themselves, but a sister and a patient rep.