new rehab nurse - should I stay? (long-ish post)

Specialties Rehabilitation

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Hi - after reading many of the posts here, and descriptions of the patient loads, I feel kind of funny posting this here. On paper, my unit would seem like a dream job, but I am not happy here, and wish feedback about a possible career change (still nurse, but different specialty). BTW, I have been working on my rehab unit for 7 months as a nurse, and was working as a therapy aide on the same unit for years before that. I am in my forties.

Well, one thing is easy to communicate...I was moved to day/night rotations without it being discussed with me. This is what really prompted the idea of moving. I was not told that we would ever have to cover 0700-1900 & 1900-0700 in the same week, and they switched me without notice. I just noticed that they were putting me down for Mon 7A-1330P, Tues1900P-7A, Wed2330P-7A, Friday7A-1900P etc. on certain weeks. When I asked they said "oh, that was a mistake, you should have started on day/night rotation". Hmmm. I don't like the flip-flopping, and fee that they did a bait-and-switch on me.

The other thing is constantly feeling harried because of our demanding patients. Don't laugh, because we only have 4-5 pt. per nurse when working with a CNA, or 3 pt. per nurse working alone. It's just that our patients are SO demanding, have the 9AM therapies you all know and love, we have tons of paperwork, the CNAs aren't responsive to pt. tioleting needs etc. (nurses do as much NA work as the NAs sometimes in addition to our Qshift assessments, meds, wound care, etc)) and our patients tend to be much more sick than they were years ago. Just when I think I am crazy for not being able get used to the demands, the experienced nurses tell me they are feeling it too.

Maybe I'm just not being realistic, but I am a hard worker and don't mind running around. It's just that between the patients riding their call bells, management breathing down our necks over our documentation (we have someone who does little else besides scrutinize our documentation), the tons of meds, the wound care, the variety of diagnosis, the sometimes poor contributions of the assistants, the bathing & toileting, and the getting pulled to committees/projects/etc., I'm wondering if this is where I want to work. The nurses who seem less stressed frankly just don't seem to actually do their jobs - fudged assessments, etc.

I was thinking about trying to find work in hospice or home care. I realize there is a ton of paperwork in home care, and other stressors. I just would like to be able to work with patients in a more meaningful way without constantly running.

So, look for another rehab job with day/evening and just toughen up, or consider a move to HH or hospice? Thanks.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

If you don't think you will ever be unhappy with your current employment situation, then I think a job change might be in order.

Gosh, I wish I only hand 5 patients! I always had 15 patients with only 1 aide!

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Gosh, I wish I only hand 5 patients! I always had 15 patients with only 1 aide!

Yeah, I have read the stories on here!

I'm not sure what the deal is, and how different rehabs might be different in terms of demands, but the nurses on my unit are always running. In any case, I had not considered leaving until they switched my hours. Before, if I was stressed, I always thought it was because I was new and inefficient. I never listened to the "so, do you see how difficult it is?" comments the nurses made to me (who had known me for years as an Aide on the unit), until they got me thinking. Now that I'm thinking, well, there is a lot out there.

...and I'm keeping in mind the fact that the nurses reading this might just be a heck of a lot tougher than me, or even my workmates. ;)

Thanks for your reply.

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Specializes in inpatient rehab (general, sci, tbi, cva).

Boogs:

Ask them for what you want--no overnight hours. If they say no and that is something you absolutely must have, then get another job, then quit.

I took my job because I knew I needed experience and that I would be looking for another job in about 6 months. I held on to almost nine months because I waited for the best job I could find out there--best pay, benefits and similar hours. I had some other family changes (spouse unemployment) so I also had to get more money, so I had no choice but to look elsewhere.

Am I sorry about leaving for money? No way. Look at the constant rate of inflation right now. If I am going to have to work really hard for my money, I am going to go where I can get the best package, and incidently, the best pay so I can afford to support my family.

Get the job with the best combo of things for you. Don't settle for less, unless you know one thing can lead you to another place you want to go.

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Thank you for your response. I am back to work tomorrow, and will start to work on the situation again.

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Specializes in ER, Rehab, TCU, Medsurg.

Boogs,

Your unit sounds like mine. Our unit is connected to the hospital and we are also part of the university which is does organ transplants and a multitude of surgerys. Consequently, we are able to take complex patients with new LVADS, kidney and liver transplants etc. I believe this is why we only have 4--6 patients per nurse.

We also have peeps who are constantly checking our documentation. We have a rehab director who seems to have eyes everywhere. Not to mention that they are cracking down on overtime. So, there have been times when I logged out and stayed to do my charting. Some nurses leave without finishing their charting. They say, "well, they don't like me to work overtime."

I am frustrated by the nurses who have no sense of urgency. These nurses tend to be from a different culture where timlienss is not as important. It may be due in part to the fact that they have seen people killed in war or people dying....and they are thinking, "it'll be okay. these people aren't dying. They are fine." They are correct.

However, they don't understand the legal implications from poor documentation and lack of timeliness in giving meds. They don't understand that a family's/patient's complaint can put their job on the line with a complaint in your employee record.

One nurse (from another country) has been fired d/t taking long breaks, coming to work late, charting that she gave meds B4 actually giving them....

Float nurses hate coming to rehab because it is physically :bugeyes:demanding, esp when you have lazy aids who aren't quick at answering lights. Also, patients seem to develop "needyitis," When in fact they are supposed to learn and practice the skills they are learning in rehab so they can go home!

Yes, I love my job...truly. Cuz, our nurse manager has been proactive in making changes on our unit. People have improved their workstyles. ... And, she is cracking down on things one step at a time. I know she'll get on the nurses who don't chart.

If you have a nurse manger who's not proactive, then leave. You need support to do your job. There is a nursing shortage. So, network and find out where people like to work!:smokin:

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Boogs,

Your unit sounds like mine. Our unit is connected to the hospital and we are also part of the university which is does organ transplants and a multitude of surgerys. Consequently, we are able to take complex patients with new LVADS, kidney and liver transplants etc. I believe this is why we only have 4--6 patients per nurse.

That's us! I'll never forget the LVAD inservice...we were like "WHAT!!!!!" ;)

We've had patient admissions cancelled because the patient...who was supposed to come down to us for 3 hours rehab per day...coded in the acute hospital trying to digest their breakfast. Let's put it this way, we check on our patients VERY often for a rehab.

I really love this job in a lot of ways, it's just that the flipping between days and nights and CONSTANT running is getting to me. I as working with two very experienced nurses last night (11-7AM) and we all stayed late finishing our documentation, with only six patients each! (no techs/assistants) It's rehab, Jim, but not as we know it.

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Specializes in RN CRRN.

yes they are demanding ... think about it (not being rude here-just an a+b=c thing). The CVA TBI patients are told they cannot get up alone, must wear a gait belt. If they do get up alone they get a bed alarm put on them. And just imagine what it is like on SCIs - a terrible thing to happen to anyone...they have no control over much of their day on rehab go to tx, eat this, bowel program that. So it is no surprise they will try to gain control over what they can. Yes they should get off their coccyx and get in bed for their bowel program but they put it off to watch the game. I will never forget the pt who yelled at me for not folding up his nylon pants. They are nylon they will not wrinkle you finally want to shout, but then remember while on rehab this is what he can control, then I tell him I am sorry and I will pass on that he wants them folded and hung on a hanger from now on....so yeah demanding but not without reason....that is for those new rehab nurses thinking "is it just me or do they call all the time?" no they call all the time and we are there to answer....with a smile and an "absolutely I can do that for you!"

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