New Nurse Blues (rant content)

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I just took my first nursing job on a lock down, crisis stabilization Psych floor. Most all of our patients come in on a Baker Act (involuntary status) for potential harm to self or others. I work an 8-hour midnight shift 5 days a week (11pm-7am).

After being a tech on a surgical floor for two years, it feels like all I do at my RN job is paperwork (in comparison to being a tech). The only time I have patient contact is when I admit somebody -- usually about 2 a night -- or when there's a difficult med pass that needs to be done with an aggitated patient. Some of the paperwork I think is complete bull 'crap' that placed in the chart just to look good for lawyers, and doesn't serve the patient at all. For example, the care plans. Everybody's plan is either potential for self-harm or altered thought process.

The techs lead the groups in the afternoon (I orientated during days and sat in on one, and it was terrible). So, it feels like my job is to watch people to make sure they don't kill each other or themselves and pass meds. Overall, I think the the 'system is broken' and that patients aren't given enough attention to truly recover, and I hate being a part of the failing process.

***I think the thing that leaves the worst taste in my mouth is the fact that we're discouraged to admit unfunded patients. And, when we do admit unfunded patients they're almost always discharged the next day. This makes me nauseous just thinking about this...how can one rationalize this behavior?***

Finally, at the end of the shift I have such a difficult time passing off undone work to the next shift. I know that it's unreasonable to have 'everything done' before I leave, but I can't get over the feeling that I missed something, or that I could've done more.

I'll committed to this job for a couple more months, but I beginning to realize that the medical side of things is my calling.

If I don't get one reply, I understand, I dislike reading rants myself.

//rant

Specializes in Med/Surg,Cardiac.

I'm sorry you're not liking your job :/ and rant away! I'd probably feel the same way. A lot of times it can be paperwork, even in medical jobs. I've felt like stabbing a pen (or keyboard) through my eye before. In these times I'd be thankful for a job. So many are having trouble. Hope your situation improves. And I agree it's hard to turn away those unable to pay. Doesn't seem fair.

I work for a Level 12 facility as a child care worker and I can see the lack of support as well. I understand where you are coming from, for me the majority of my work is room checks, I feel like a security guard, I work graveyard. I hope all gets better, just hold out those few months and in the meantime find something better.

i totally hear u, it's all paperwork

Specializes in PICU, Sedation/Radiology, PACU.

What happens during the day at these facilities? Do they patients get 1:1 therapy? Go to groups? Is there more treatment happening that you just don't see because you work the overnight shift?

I do agree that the system is probably broken in many ways. You likely have a high nurse/patient ratio and most of your night is taken up by passing medications. I bet a lot of the paper work is delegated to the night shift because it's thought to be less busy. But I'm willing to bet that psych patients sleep just as much as medical patients do (which is not much).

I'd try to stick it out for a few months- a year would be great because you don't want to be seen as a job hopper. But keep your eyes and ears open for opportunities to move elsewhere. Good luck.

Specializes in Emergency Nursing.
I just took my first nursing job on a lock down, crisis stabilization Psych floor. Most all of our patients come in on a Baker Act (involuntary status) for potential harm to self or others. I work an 8-hour midnight shift 5 days a week (11pm-7am).

After being a tech on a surgical floor for two years, it feels like all I do at my RN job is paperwork (in comparison to being a tech). The only time I have patient contact is when I admit somebody -- usually about 2 a night -- or when there's a difficult med pass that needs to be done with an aggitated patient. Some of the paperwork I think is complete bull 'crap' that placed in the chart just to look good for lawyers, and doesn't serve the patient at all. For example, the care plans. Everybody's plan is either potential for self-harm or altered thought process.

The techs lead the groups in the afternoon (I orientated during days and sat in on one, and it was terrible). So, it feels like my job is to watch people to make sure they don't kill each other or themselves and pass meds. Overall, I think the the 'system is broken' and that patients aren't given enough attention to truly recover, and I hate being a part of the failing process.

***I think the thing that leaves the worst taste in my mouth is the fact that we're discouraged to admit unfunded patients. And, when we do admit unfunded patients they're almost always discharged the next day. This makes me nauseous just thinking about this...how can one rationalize this behavior?***

Finally, at the end of the shift I have such a difficult time passing off undone work to the next shift. I know that it's unreasonable to have 'everything done' before I leave, but I can't get over the feeling that I missed something, or that I could've done more.

I'll committed to this job for a couple more months, but I beginning to realize that the medical side of things is my calling.

If I don't get one reply, I understand, I dislike reading rants myself.

//rant

I'm pretty much in your same exact situation. I work as a night nurse (11P - 7A) at a Inpatient, Psych. facility (I work with children/teens) and pretty much all I do is paperwork all night. I too only see patients if I am admitting them or if one of the kids wakes up and is sick in the middle of the night. I have been doing it for over a year now and I have finally decided to take a Med/Surg position at another hospital and staying at my facility per diem so that I can still keep my seniority and maybe now I can pick up some evening shifts so I can actually see the kids when they are awake. I don't mind working nights but I agree that nights in psych. is mostly paperwork and it gets old after a while.

I would suggest if you want to stay in psych. then I would look into CEUs to keep up your knowledge and try to switch to evening shift when you can so you can interact with your patients more. If you think you will want to go into Med/Surg or some other area then I would suggest you look into CEUs related to the field and possibly get ACLS certified or something similar so that when you try to find another position you are more marketable. Keep your head up and good luck! Let us know what you decide to do.

!Chris :specs:

Specializes in Critical Care; Cardiac; Professional Development.

They rationalize not wanting to take unfunded patients because if the hospital doesn't make money, it doesn't stay open at all. Given how much of the indigent population have psych issues, they could quickly overwhelm the hospital's ability to provide services and medications, not just to them but to anyone. Everyone has to make a living. The ugly side of health care. Unfunded patients are a problem everywhere. It may not be the best way to handle them but the options seem to be too few.

Specializes in ICU.

This is exactly what I saw during my psych rotation. It is really, really sad. It turned the one person in our class who was interested in psych nursing completely against the idea. She was hoping for meaningful patient contact and education opportunities...yeah right. I felt so bad for those patients. I can imagine it must be hard for you!

I just took my first nursing job on a lock down, crisis stabilization Psych floor. Most all of our patients come in on a Baker Act (involuntary status) for potential harm to self or others. I work an 8-hour midnight shift 5 days a week (11pm-7am).

After being a tech on a surgical floor for two years, it feels like all I do at my RN job is paperwork (in comparison to being a tech). The only time I have patient contact is when I admit somebody -- usually about 2 a night -- or when there's a difficult med pass that needs to be done with an aggitated patient. Some of the paperwork I think is complete bull 'crap' that placed in the chart just to look good for lawyers, and doesn't serve the patient at all. For example, the care plans. Everybody's plan is either potential for self-harm or altered thought process.

The techs lead the groups in the afternoon (I orientated during days and sat in on one, and it was terrible). So, it feels like my job is to watch people to make sure they don't kill each other or themselves and pass meds. Overall, I think the the 'system is broken' and that patients aren't given enough attention to truly recover, and I hate being a part of the failing process.

***I think the thing that leaves the worst taste in my mouth is the fact that we're discouraged to admit unfunded patients. And, when we do admit unfunded patients they're almost always discharged the next day. This makes me nauseous just thinking about this...how can one rationalize this behavior?***

Finally, at the end of the shift I have such a difficult time passing off undone work to the next shift. I know that it's unreasonable to have 'everything done' before I leave, but I can't get over the feeling that I missed something, or that I could've done more.

I'll committed to this job for a couple more months, but I beginning to realize that the medical side of things is my calling.

If I don't get one reply, I understand, I dislike reading rants myself

I completely understand where u are coming from I am a new nurse working nights in the same specialty area and same days and hours but my biggest problem is trying to get everything done in one shift!!!! i feel like a such a failure because if I get admissions thats soo much more to do and if patients arent sleeping...idk how to get everything done..i feel like im sinking rather than swimming lately..and i am the only nurse on the unit...agggh! and of course there are "night duties" for the rn that i feel get behind in because of admissions, and alot of patients awake... how do you manage to find the time to finish all the endless paperwork?

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