I’m a new grad nurse who has been working on a busy/understaffed Medsurg/Nephrology/ Transplant floor for a little over 5 months. I worked as a CNA in a level 2 NICU for a year before this job and loved it I really want to work in the NICU or ICU but I was told you need at least 2 years of medsurg experience before you qualify for that kind of position. I am more than willing to put in the time and do whatever it takes to be considered for a position on either of those units. I knew going into medsurg that I wasn’t going to love it but it is a great place to start to build upon my nursing skills.
I love nursing and I have learned a lot on the current floor that I am on. Over the past couple of months however I’ve started to feel really burnt out. My coworkers would describe me as positive, caring and someone who is always willing to help help her coworkers and patients. Lately though I find myself just feeling exhausted and experiencing emotional burnout towards my patients and others.
I’m always willing to help others when they are drowning but I find that I never get that in return. Management has started to float me to other units with little to no support even though as a new grad I’m not supposed to be floated unless I’ve been an RN for a year. Recently I’ve been floated to a unit where I was assigned to a patient who was homeless schizophrenic/aggressive/ IVDU with a large spinal abscess. He constantly tried to climb out of bed and I was told her couldn’t have a sitter because we were understaffed so I was to be his sitter. I was also assigned to 4 other acutely Ill patients who needed constant attention as well. I couldn’t leave the other patients room because it was a safety risk and there was no CNA so I also took on all those responsibilities. He became unresponsive at one point in the night because he had been stashing methadone in his room and had been taking it in addition to all the other narcotics and benzos I had been giving him for his withdawl symptoms and pain management. He continued to have these unresponsive events through out the nights that I took care of him and I had little to no support from other nurses on the floor or the doctors (who wanted to wait for the day shift team before intervening or changing orders). It was a very unsafe situation for all the patients I was taking care of. I felt like I wasn’t able to care for my other patients the way I normally do. I had little to no time to look through my other patient’s charts and complete my med passes. I ended up staying two hours late every day to chart. I usually have all my charting done on time so this has been especially frustrating. I usually give good reports and I understand my patients really well but since I haven’t had the time to write stuff down I end up giving the bare minimum to the nurses taking over. I’ve had nurses yell at me and chew me out during report. I even had one who walked away midway through report and complain to another nurse while I was sitting next to her that I didn’t know when the patients LBM was while rolling her eyes at me.
Unfortunately for the last two months this has been how most of my assignments go and I’m starting to feel really burnt out. We have a lot of homeless/ IVDU on my floor currently so I spend most of my shift being screamed at by them. I genuinely try to connect with them and help but I always end up being verbally abused by them or having them tell other staff members that I am neglecting them because their pain mediation is 5 minutes late.
my nurse manager has also been making mistakes in my schedule. For example I picked up a shift to try and help out and I was scheduled to work from 7p-11:30p. I work night shift so working another shift after this one isn’t a big deal. My nurse manager scheduled me to work 7a-7p the next day. When I emailed her about it she basically told me to suck it up. I didn’t get out of work till 1am and I am expected to work at 7am the same day. These schedule mistakes are very common and sometimes I end up working 4-5 12 hour shifts in a row with the same acute patient assignment. I hate complaining and I usually never complain. I’ve really tried to make the most of my current situation. I hate feeling this burnt out when I am only 5 months into my nursing career. it makes me feel like a terrible nurse.
I also feel like I’m not really making a difference in the lives of my patients. I feel more like a vending machine pumping out medications which is not the nurse I want to be. I feel bad delegating task to my CNAs who are swamped and overworked so I usually don’t. I also feel bad not being able to do everything that my patients ask for and feel like I’m letting them down. I really want to help my patient and I’m looking for suggestions on how to feel less burnt out so that I can be the best nurse I can be.
Specializes in Community Health, Med/Surg, ICU Stepdown.
I don't think you're unprofessional. You're advocating for patient safety, which is what responsible nurses do. I know it's hard to be new, not confident, and up against an unsupportive, exclusionary team of experienced nurses. But just because someone is an experienced nurse doesn't mean they will set a good example. Do you have any mentors/allies on your floor? Are you willing to try other areas of nursing if you can get hired there? And when could you transfer to a different unit in your hospital? Maybe see which have reputations for good teamwork.
Sorry for all the questions! Just brainstorming. If you need any support or have questions feel free to message me. I used to work on a "drowning" floor, not because we didn't help each other, just the staffing made it impossible to help. My unit now is great! I hope you find a better spot soon ?
Thank you for all the great feedback! I’m still having a really hard time on the floor. A night ago I had a patient who was in a MVA and was extremely confused and trying to get out of bed constantly. He was in a room furthest away from the nursing station. I asked charge if I could get a sitter or move him to a room closer to the nurses station because I was afraid that I wouldn’t be able to get to his room quick enough to prevent a fall if he set off his bed alarm. I was told that there were no available sitters or rooms. Later that night he ended up failing and I felt terrible about it. I asked charge for feedback on how I could’ve prevented this and she didn’t really respond. She told me that she will make sure he is moved closer to the nurses station or will have a sitter from now on. I come in last night and he is still in the same room without a sitter. Within an hour into my shift he was trying to get out of bed again. I again asked charge if he could be moved to a closer room or if I could have a sitter because he already fell last night and I’m very worried about his safety. Again I was told that there was no available rooms or staffing but I could sit in the room with him. I had four other patients I was assigned to as well as being this patients sitter. I was extremely frustrated and feel really bad about being this mad about it. I am consistently having these kind of assignments when the other nurses on my floor are not. When I relayed my frustration I was told that every nurse needs to pitch in from time to time (which I am more than happy to do) but none of the other nurses have had to be their own sitter on the floor with a full patient assignment. I’ve started to notice that recourses/extra help is delighted towards the nurses that charge is friends with.
I still consistently have assignments heavy with behavioral patients (IVDU, SUD or CIWA). I’ve tried to set boundaries when patients who are verbally abusive towards me. I had one patient who was screaming at me and I told him that I was sorry he was so upset but I’m just trying to help him and that I would give him some time to cool off and that I would come back and be more than willing to help him. He rang out for me 10 times in 3 minutes seeking pain meds. I told charge the situation and she basically told me to go back in there. It was the first time I had set a clear boundary with a verbally abusive patient and to not have support from charge was very disappointing.
I also am assigned to work 10 12s this week. It was a mistake and a lot of the shifts I had requested were not finalized until this week. I never intended to work this many shifts I just requested days I could work and usually management will figure out the needs of the unit and put me on for a couple of extra shifts. Charge brought it up with me and said that they have never allowed someone to work this many shifts in a row because it is so unsafe and that management should’ve recognized it was a mistake. Charge encouraged me to reach out and cut back my upcoming hours. When I emailed my manager and apologized for the oversight on my end and asked if there is anyway I could reduce my hours because I felt it was unsafe for me she told me that I was leaving the floor short staffed and that in the future I should have more oversight and fully commitment to the shift I agreed to. I understand completely where she is coming from and do agree that part of this is on me but I never call out or complain and the only reason I did was because I felt it was unsafe for me to work that many hours. She gave me two days off so I am now working 8 12s.
Lastly I took care of my first incarcerated patient this week. In report that I got from charge I was told the reason why she was incarcerated. I was also told multiple times by the warden that was in the room with her. When giving report to the next nurse I relayed this information because I thought I was suppose to. Leaving my shift today I was pulled aside by a CNA (who is aways present during nursing reports) to tell me that the report I had given was extremely inappropriate and unprofessional and I had made her feel very uncomfortable by disclosing this information during report. She told me that she took it upon herself to pull me aside to have this talk with me and if she didn’t the other nurse would have. I told her that I was really sorry and that it was never my intention to make anyone feel this way but that I was just relaying the same report that charge had given me. She told me that this was a good teachable moment for me to grow professionally and learn from my mistakes. Looking back on it I do see where she is coming from and I feel bad disclosing the reason why this individual was incarcerated but I honestly thought that I was supposed to because charge had given me the same report.
I have been so sad leaving my shifts and have even cried in the bathroom at work which is very unlike me. I’m usually a happy person who doesn’t let these kind of things get to me but I feel completely drained and exhausted from these experiences. I find myself questioning if I’m a terrible nurse or if I am unprofessional and shouldn’t be in the nursing field.
I’m feeling completely lost and appreciate any feedback.
The "warden" should not have revealed that information period. We never know what our inmates were sentenced for unless we were interested enough to Google them.
Holy hell, you need to find another place to work.
I would not put up with [the sum total of] this for one minute.
5 hours ago, Ashywlms1290 said:
When I emailed my manager and apologized for the oversight on my end and asked if there is anyway I could reduce my hours because I felt it was unsafe for me she told me that I was leaving the floor short staffed and that in the future I should have more oversight and fully commitment to the shift I agreed to.
But it doesn't sound like an oversight on your part. It sounds like you often tell them your available days and let them add on a couple of shifts to help meet their needs.
They screwed up.
You're going to learn this lesson...it will be better for you if you don't have to learn it in so many hard ways.
"I don't know what happened but I can't work this many shifts. I can work [this many (different number of)] shifts."
Even if there was a misunderstanding or you could have done something different that would have prevented this, I would not expect to be spoken to that way. It is not normal and it is not okay. This manager you are dealing with is totally inappropriate and is behaving like a selfish and downright mean human being.
5 hours ago, Ashywlms1290 said:
Leaving my shift today I was pulled aside by a CNA (who is aways present during nursing reports) to tell me that the report I had given was extremely inappropriate and unprofessional and I had made her feel very uncomfortable by disclosing this information during report.
I'm pretty sure I would have just stared and let the silence hang there, since opening my mouth would not have been the kind thing to do.
This is all inappropriate.
All of it.
I would not work there, I would look for another position in earnest.
Specializes in Community Health, Med/Surg, ICU Stepdown.
I am on AllNurses a lot today because on top of covid the CA wildfires are making the air hazardous and we are not supposed to go outside at all =( So I am following this post closely. It's just so horrible. On both Med/Surg floors I worked on we had pts who the doctors ordered sitters for but we didn't have the staff, leading to falls, elopement, etc. I felt like a terrible nurse because we literally had patients who had to be found and returned by the police. It was a huge, unlocked unit with so many confused patients they couldn't all be close to nurse station.
When I transferred and looked back I realized it wasn't my fault these things happened. I ran from start to end of my shift, never had a break. Our manager had never worked Med/Surg, only newborn nursery! She was nice but put into a position she shouldn't be and didn't know how to help us. Supervisors would call people to work extra but everyone was too burned out. Administration didn't care. Only when I left did I realize how much of an effect it was having on me. Staying late to chart every night, feeling like my pts didn't get the care they needed even though we worked so hard. I barely knew my coworkers because we didn't have time to chat, just help someone turn a pt and run!
This is not a sustainable situation. I really hope you don't let them bully you into working extra when you don't want to. You're not obligated, and I wouldn't even feel like wanting to help with the way they treat you.
Whoa. Well after reading your first couple of paragraphs I was about to provide some encouragement about how you are going through a huge adjustment and are processing the gravity of your professional role and it'll all be okay...blah, blah, blah....then this:
?
That is when you call the supervisor. Keep calling people until someone helps. If they won't come help you then call the next person, even if it means calling someone important at home.
Call the provider, tell them you need someone to come and evaluate the patient in person. If they say this insane malarkey about wanting to wait for day shift to change the plan of care, you say, "That is unacceptable. If you can't help me I need to call someone else." Say it and mean it.
Call the supervisor, tell them you need them to come to the room. If they say they can't or they say something insane like "you'll have to be the sitter" then you say "That is unacceptable. If you can't help me I need to call someone else."
[File incident report, of course, at some point before you go home.]
You *MUST* put your foot down hard on things like this. No one can be a sitter while in charge of a full patient assignment. To whomever says that, you immediately say that is unacceptable and start making other calls. Never acquiesce to what you know is a dangerous situation where you cannot provide any standard of nursing care.
The next thing is that you meet with your manager and tell them that can never happen again.
The rest of it with your schedule is just more abuse...for now don't pick up any more extra shifts. Don't answer your phone and if they ask you in person just say no. Don't make excuses.
Start looking for another job.
This meets both of my tests for when not to stay somewhere 1) unsafe 2) management effing with people and totally abusive.
Wow. Reading this makes me angry on your behalf. I agree, you are NOT burned out. You are experiencing the moral distress ANY of us would in these circumstances.
I hope you can find a new position soon. In the meantime, I echo the notion that you continue to stand up for yourself and your patients. It is the RIGHT thing for you to do. If nothing else, hopefully you will leave this unit and those who manage and work in it, with a solid understanding of what it feels like to be called out on unprofessional, unsafe, and unhelpful practices.
By "calling out", I mean - escalating these unsafe situations up the chain of command until they are dealt with appropriately, exercising boundaries ("I can work this, not that", "I can be a sitter for one patient, or I can care for a group of patients that either have sitters or do not need them" -- sitters by the way are sitters bc they are one-to-one). And the CNA who pulled you aside ..... oh my. You are very kind in your assessment of that situation. I would have given her a "professional learning opportunity" right back.
I hope you have some nursing friends in your life that you can talk to about this. What you are experiencing is not normal, not acceptable, and needs to be addressed by someone with the power to do it. That is not you, so I suggest you move on and wash your hands of it at your earliest opportunity.
Thank you so much for all the great feedback! I really appreciate it. Unfortunately things on my unit have not gotten much better and a lot of nurses are leaving. I’ve been applying to other position in the hospital and not having much luck since I am a newer nurse. I will have a year of nursing experience in medsug in December and would really love to go to a more acute area (ICU, PICU, SCU , NICU etc.,). Does anyone have any advise on how to strengthen my application for a job in these areas? I’m currently taking a class to get my ACLS certification. Thank you!?
LibraNurse27, BSN, RN
972 Posts
I don't think you're unprofessional. You're advocating for patient safety, which is what responsible nurses do. I know it's hard to be new, not confident, and up against an unsupportive, exclusionary team of experienced nurses. But just because someone is an experienced nurse doesn't mean they will set a good example. Do you have any mentors/allies on your floor? Are you willing to try other areas of nursing if you can get hired there? And when could you transfer to a different unit in your hospital? Maybe see which have reputations for good teamwork.
Sorry for all the questions! Just brainstorming. If you need any support or have questions feel free to message me. I used to work on a "drowning" floor, not because we didn't help each other, just the staffing made it impossible to help. My unit now is great! I hope you find a better spot soon ?