New Grad - Burnout

[bxh5164]

Hello everyone. I would appreciate your advice. I was a new grad in May. I worked at a hospital for a year and a half before I graduated as an aide and got a job promised to me in April. I started working immediately after passing my boards. I chose to do med surg because that's where I worked as an aide, although my real interest was critical care. I figured I would do my time, learn some skills, and then move on. My floor is BUSY and understaffed. Lots and lots of new nurses, about 10 to be exact. Most of the time I get report from people who have even less experience than me and spend most of my shift correcting their mistakes. The other day they left me and one other nurse, two weeks off orientation, on the floor and one aide. I spent my night finding errors in orders and dumping foleys that hadn't been dumped all day. Find that no blood sugar checks were done on a diabetic who is npo. Bottomed out. Admission after admission and eventually they called in help for us. It's stressful. I work with a doctor who doesn't return phone calls, doesn't like me, and never listens to my concerns. It's scary. I have no one to turn to for help because everyone else is new too. I am feeling burn out already. I feel myself complaining all the time and that's not me. I get report from people straight off orientation and everything is a disaster and I just get frustrated right at the beginning of my shift. The aides won't answer call bells and take people to the bathroom so not only do I have 6 patients but I am also providing primary care for a lot of them. Advice please. I go into work 40 minutes early to get started and read about my patients and I leave about an hour late, sometimes more because I am charting.

[Gooselady, BSN, RN]

Wow, I'd be terrified something awful was going to happen (sentinel event, anyone?) in such a place.

You don't sound like you are overly complaining or 'poor me' AT ALL. Just in case you were accusing yourself :)

For the sake of the patients you've worked so HARD to get an education for, please follow the advice of the posters who say to take this to the manager.

Usually a unit with the kinds of problems you are relating is suffering from a lack of adequate MANAGEMENT. I suspect the manager him/herself is not exactly . . . effective. Maybe not? But that's my first impression. This just wouldn't HAPPEN if management was effective, even with a hundred brand spankin' new RNs and exhausted CNAs.

So when you prepare your list of concerns, CC the Director of Nursing too. This manager needs help, no need to go into blaming them, just assume they need help and go forth.

When you make this list of concerns, use factual, objective language without emotionalism. For instance, 'CNA sitting at desk while call light went off. CNA did not respond." No need to flower it up with opinions and interpretations. Also "in receiving report for Patient A, first shift did not inform me verbally of the Vanco trough that was due at 1300 nor was the level drawn then per the lab".

Make each 'point' crisp and concrete. Let the management figure out the patterns and what to do. It is acceptable for you to include a short and sweet description of your experience and fear of having a sentinel event occur. "Sentinel event" is a great term to use, it's their worst fear, especially at the level of DON. Be sure to use that term :)

[Lev, MSN, RN, NP]

I would be careful about going to management about your current unit until you actually secure a position on another unit or at a different hospital.

[tokmom, BSN, RN]

I would be careful about going to management about your current unit until you actually secure a position on another unit or at a different hospital.

Unless they are union

[mh0712, MSN, RN]

If it was me, I would look for another job asap before someone leaves you in a mess that you can't get out of! You worked hard for your license, so don't lose it!!! Go to critical care, find something else, and most importantly protect yourself!

[Caffeine_IV]

I would look for a new position. What is the policy regarding transfers?

If you have friends on other units, talk to them and find out the climate.

[seconddegreebsn]

Why won't the aides answer call lights or toilet patients? Refusal or swamped themselves?

My aides are like this. Can't be bothered. Don't want to be interrupted from their conversation. I wish I was kidding.

[HouTx, BSN, MSN, EdD]

Wow, I'd be terrified something awful was going to happen (sentinel event, anyone?) in such a place.

You don't sound like you are overly complaining or 'poor me' AT ALL. Just in case you were accusing yourself :)

For the sake of the patients you've worked so HARD to get an education for, please follow the advice of the posters who say to take this to the manager.

Usually a unit with the kinds of problems you are relating is suffering from a lack of adequate MANAGEMENT. I suspect the manager him/herself is not exactly . . . effective. Maybe not? But that's my first impression. This just wouldn't HAPPEN if management was effective, even with a hundred brand spankin' new RNs and exhausted CNAs.

NAILED IT!

I have been convinced for a looooong time that Management inadequacy is at the root of most of the problems experienced by staff nurses.

But also - I would advise OP not to tolerate disruptive physician behavior. Check the facility policy on this... they have to have one in order to comply with JC. If physicians are rude, uncommunicative or fail to return calls.. there needs be a consequence. Fill out that incident report with all the details.