Need Your Opinion: Am I Finished in Med/Surg or Not?

[VivaLasViejas, ASN, RN]

That is the question still uppermost in my mind today as I chew over the 'conversation' I had Friday with one of the assistant department managers regarding "concerns" that have evidently arisen over my reluctance to perform certain back-breaking aspects of the job, namely, moving our 300+ pound beds (that's unoccupied) up and down carpeted halls.

I've actually been refusing to do this for over a year, only because it strains my back so badly that I've spent nights in excruciating pain after having done so. I'll help with lifts, turns, transfers, etc.---even with bariatric patients---but I have told people repeatedly that I can't push beds, and I've told them WHY I can't do it. I've had back problems ever since I was 14 and thin enough for the breeze to blow away.......this is nothing new.......and now that I'm older and heavier, it's certainly gotten worse, and yes, I baby it more than I did when I was younger. I've had chronic pain for almost as long as I can remember, but I literally can't afford to screw my back up for good---my dh doesn't make much money, and if I go down, my family is back in the food-stamp line.

I can understand where the management is coming from; they need nurses who can do ALL the tasks demanded of them, and I never have been really forthcoming about my back problems until now because I wanted to WORK. It's also been a point of pride that I've managed to 'gut it out' despite the physical pain, and keep up with nurses who are decades younger and many pounds lighter. But I guess I've been living in Fantasyland......I CAN'T do it all. I strained my back again last summer trying to keep a very large patient from falling out of bed, and I never reported it to anyone because I thought I'd be OK, and since I already had the pre-existing back problems, I didn't want anybody to think I was malingering, or trying to 'take' the hospital for money for a disability claim.

Now, of course, I know that was a mistake, because it did cause some damage, but it's way over and done now and I can't fix it. I still think I'm a good nurse, and I still think I can be effective; but now I wonder....is there no place in Med/Surg for someone like me, who isn't physically able to do the hard physical labor but is great with patients? We have a nurse who can't manage anything near a full patient load, and goes into orbit if you hand her an admission; we have several nurses who are pregnant and can't do the lifts or move beds; we have nurses who are older, heavier, and more crippled-up than I am........yet my hospital continues to employ them, and I haven't heard any veiled threats leveled against them. (Of course, I don't know everything that led them to the places where they are, and I don't think I'm going to be fired just yet.)

Is there any hope for me? Inquiring minds want to know!!

[Dixielee, BSN, RN]

Med surg is grueling work. There are other areas of nursing that are not so physically taxing. Depending on your educational background and interests, you may look into education. Many BSN nurses have been hired teaching LPN and CNA programs. The money may not be as good as hospital, but you may be able to supplement with an agency shift here and there.

I worked in dialysis for a few years. While you may be on your feet a lot, there is generally not a lot of heavy lifting, moving etc.

PACU is not bad IF you have transporters to take patients to their rooms. Outpatient surgery PACU may work as well as the patients go home.

Home health is generally a safe bet, but you may occasionally be in a situation where a bedbound patient needs help. You usually have family and other support there though. Getting in and out of your car all day can be tiring but generally not too bad.

Nursing consists of a lot of different areas. You may want to start to explore other avenues before your back gets any worse, and you are really in trouble. Good luck.

[Mulan]

Why the necessity to be moving those beds in the first place?

[Marie_LPN, RN, LPN, RN]

Why are you expected to move those beds?

[ktwlpn, LPN]

Are you having to move empty beds to accomodate admissions? Why can't housekeeping or maintenance do it? If it is an occupied bed you can walk right beside it....I love how nurses are just expected to DO IT ALL>...I don't know how to answer your question-I don't know too many nurses that have stayed on med-surg throughout their careers as floor staff-I know my older fatter body can't take it any longer....I loved it--but I love lots of other settings also-that's the great thing about nursing-we can do ANYTHING!

[Tweety, BSN, RN]

To those who aren't in med-surg, we have to transfer patients to different places, sometimes in their beds. When we have to make a room change for instance to create a female bed, we move the patient in their bed to another room. Or if a room needs to be isolated, then we move one bed out of the room. Moving beds, unfortunately is part of the job. Questioning why nurses have to do it, or asking another department to do it, isn't going to cut it. Fortunately my employer got rid of those nasy carpets years ago and our beds roll relatively easy, so easy in fact one person can easily roll a bed from one room to the next.

Too bad Marla more capable people can't just help you out. But, as you're well aware, first and foremost you must take care of yourself. Denial will get you in a wheelchair. Trying to please will get you in a wheelchair.

Good luck in whatever you do.

[unknown99, BSN, RN]

:icon_hug:mjlrn:icon_hug:

I wish I could help you with this situation. They should not be able to terminate you because of this. You have a proven good record I assume. Do you have copies of your evaluations? I would ask for copies if you don't. Also, possibly you could get a doctor's note stating your specific limitations? I wish I knew more what to say; how to help you.

:icon_hug: :icon_hug: :icon_hug:

[Mulan]

I do work in med-surg and can't remember the last time I moved a bed. I do recall when room transfers were necessary the charge nurse had the cnas move the beds. It seems like it would be a more efficient use of time to have the cnas rather than the RN do it. Is that not an option where you are?

[VivaLasViejas, ASN, RN]

Thanks to all who've responded thus far.

Yes, the CNA's do most of the bed-moving chores, but our aides have been cut to the bone---we often have only two on day shift, and after 3 PM we usually have only one. In exchange, we have better nurse-to-patient ratios (I generally have no more than 5 patients on days), but we also have to do most of the pottying, room changes, lifts/turns, etc. So it's really six of one, half a dozen of the other.

I wish I could go into teaching, but I lack both the education (I'm an ADN) and the money to pursue a higher degree. (I still owe many thousands of $$ in student loans that will take me until I've got one foot in the grave to pay off.) So that's out......but I know there are other areas I can look into without having to have the BSN or higher. I just didn't want to HAVE to look into something else just yet........I love my work, and had planned to stay with it for at least several more years.

No, I'm not going to be fired anytime soon---you have to be a real screw-up to get booted out the door entirely, and I have both an excellent reputation AND the evaluations to prove it. But I do have the feeling I'm being set-up to be eased out of med/surg........and maybe it's a blessing in disguise. There is an opening for a wound-ostomy-continence nurse at my hospital, they want someone with certification in that specialty (I'm certified in med/surg only), but there are indications that they would be willing to train and/or set the person up with the necessary educational courses. I've already made a discreet inquiry via E-mail, and if there's half a chance of getting the position, I'll go for it, as wound care has always interested me.

And if not, well, I can always check into transferring to ICU. Yes, those patients can be very heavy care---literally, since that's where all our bariatric pts. go---but it's already a familiar area since I float there frequently, and there's ALWAYS help just outside the room. Besides, you never have more than 2-3 patients, and if you have someone on a vent or multiple titratable drips, it's generally 1:1.

That's what I've always loved about nursing.......there's an infinite variety of things you can do if you don't like, or can't do, one type or another. The only thing I WON'T do again is LTC, especially management; otherwise, I'm open to just about anything as long as it's steady (no casual/on-call, I need the bennies too badly!)

[barefootlady, ADN, RN]

It sounds to me like the boss and other higher ups have put their heads together and are indeed pushing you towards this wound care job. Instead of being open and honest, telling you they feel you would do a great job and fill the need, they are putting pressure on you because you cannot move a 300+lb empty bed. Go for the job, let them train you, it will only open doors for you.

ICU is an idea but the wound care job is the one I would go for. Tweety is right, if we don't take care of ourselves, who will?

As a med/surg nurse I do know about moving beds to accomadate incoming patients. It is silly that there are no workers besides nurses to do this. I have pulled on beds and ended up with sore arms,back, and legs while big, strong men mopped floors. The would not and did not offer to help, it was not in their job description.

Do you have all of the other equiptment necessary to assist with the moving of these heavy patients? I went to the inservice for them, even used some of the hover equiptment, but the doctors got in a huff and took their business to another facility. Seems they wanted their patients to be assigned 2p:1n, but facility would not agree. Marla, give this some thought, a move to keep yourself working is better than off on comp with an injury that may prevent you from working ever again.

I will keep my fingers crossed for you and hope you can get into something a little easier on the back soon.

[VivaLasViejas, ASN, RN]

That's what I'm thinking too, barefoot.......what I'm really afraid of is hurting myself so seriously that I can't work at all. It wouldn't take much, either........just a couple more bad strains, or another rescue of a 300-pounder whose legs go out from under him, and you might as well stick a fork in me because I'm done. :stone

I fought my way out of poverty and off of welfare to go to college and get my nursing degree, and I can't bear the thought of having to go back to that way of life again. Hubby makes less than $10 an hour, and we're still supporting four and-a-half kids (three of 'em our own, along with a son-in-law and a grandchild-to-be).......who's gonna take care of things if I get injured and can't work?

Maybe everyone's right: this could just be the impetus I needed to start looking for a kinder, gentler line of work before the decision is made FOR me, either by my supervisors or my own body. :uhoh21:

[meownsmile, BSN, RN]

I really dont understand the musical bed thing either unless you have ortho patients who are taken and brought back from surgery on their room beds. But why on earth would they have carpet in a med/surg hall? Infection is hard enough to control with floors being scrubbed on a daily basis, but carpeted floors on a med/surg unit? All i can think of is all those urine incontinent/bowel incontinent patients, drips from drains/catheters being emptied ewwwww..