Nurscee's Freaking Out!

Nurses General Nursing

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Help! I've only been a nurse for a month and a half.

Last two nights I've worked 12 hours (supposed to be 8) that's not the big deal though.

First I had 7 patients alone....won't even go into the hell that was.

Then tonight I had 6 but 5 were on insulin, and one of them was a every hour 20 units of insulin.

That isn't to mention the wet to dry dressings, pegs, brain surgery, and other various and sundrie items.

Not only that but this antiquated hospital still only does handwritten documentation. No computers.

I dissolved into tears. Don't know if I can do this!

YES, I DID ask help. But we have nurses who have 9 pts. They have their own share of problems.

Did you ever feel like you'd freak out????

Did you ever feel too dumb to do this????

Tell me I can make it, or not. Got ANY solutions?

Is my life long dream to be a nurse just a pipe dream?

HELP!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!:o

IMustBeCrazy - great post.

No one is attacking - we are all just being honest that 13 patients, in our opinion, is too many, even as a seasoned nurse.

And you can't say you don't have a choice. We aren't indentured slaves. We are professional Registered Nurses and can say no to unsafe staffing. No one forces us to take these assignments.

steph

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Sask, I'm sure you feel as though you are being attacked, I think you are probably a very nice person. However, nice people have lapses in judgement too.

There is no room for ego in healthcare. When ego or even just plain inexperienced judgement gets in the way, people get hurt. We learn critical thinking skills early in our nursing training. 13 patients for a new grad is too many for a seasoned nurse, let alone a new one. Where did I come upon this 'truth' you may ask? I chatted with some friends that, between them, have over a century of experience in healthcare. One of which has 10 years med surg and 20 years CCU experience. To quote this nurse, "that person may believe they gave adequate care, but I would stake my 30 years that was not the case. The amount of charting required alone would preclude adequate care."

You mentioned that you ran your butt off. I believe you. I think someone could run their butt off just to toilet 13 people on a shift, let alone provide sufficient care. Those days will follow you forever, too. Heaven forbid should one of those 13 patients get the notion that they had some ill effect during that hospital stay. I can't even fathom trying to defend your assignment in a court of law. You would be chewed up and spit out, and lose your license besides.

I remember reading some research last year about how nurses handle conflict. The number one method used by staff nurses cited by 4 separate studies was avoidance. Avoiding the problem doesn't mean that there isn't one. We don't have to be 'nice girls' or 'boys' and accept whatever management throws at us. We need to stop passively accepting this type of treatment. We need to speak out when someone accepts an unsafe assignment.

A friend of mine once said, "There are no Supernurses, just Superegos'. I think she's right. :)

I wish you the best in your career.

Well said!! Thanks for adding that.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I agree; nurses accepting unsafe and dangerous staffing levels are NOT doing ANY of the rest of us favors. We need to quit martyring ourselves. Hopefully, the OP sees this. I think, instinctively, she knows this already. GOOD LUCK!

And I in no way meant to attack SaskNurse....If my post is seen that way, may I know apologize.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
I gave good care, but worked like a dog to do it. You don't "know" that cannot be, that is your opinion. You don't know me, you have never worked beside me, don't judge me.

I am not attacking you, believe me. I am sorry you feel attacked!

Still, I can't believe 13 med-surg patients got truly comprehensive total cares from one nurse. I have worked in med-surg (floating)----- no way could they all get what they needed from me as one person. We did team nursing (1 RN, 1 LPN, 1 CNA) per 8-10 med-surg patients, and could barely meet all needs THAT WAY. They are sicker than ever, many now would have been in ICU 15 years ago, what with their mulitple system failures....... Most need multiple med passes (some as many as 6 or 8 meds per pass! and many of these meds like, dig, required assessments PRIOR to giving). Add to that bedbaths, feeding assists, incontinence care, etc. We worked like dogs to get this much done with the team we had. Forget it if we got new admits or other crises like CODES-----omg there went the whole system.

How could anyone keep up as ONE person for 13 of these sorts of patients? Truly, I have to ask, cause I can't see it. I repeat, I would not want to be a patient in that sort of staffing matrix. It's dangerous. Again, I am NOT putting YOU down, just the lack of adequate staffing.

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IMustBeCrazy - great post.

No one is attacking - we are all just being honest that 13 patients, in our opinion, is too many, even as a seasoned nurse.

And you can't say you don't have a choice. We aren't indentured slaves. We are professional Registered Nurses and can say no to unsafe staffing. No one forces us to take these assignments.

steph

Well said!

For the sake of simple math I am using an assignment of 12 patients.

Would you agree that a head to toe assessment requires at least five minutes?

If so for 12 patients and ZERO interruptions you have used two hours.

How about checking each chart? Orders, progress noted, read the H&P atcetera? Checking lab results? IF 5 minutes per patient is all this takes you spent another two hours.

Medication administration including checking the order, MAR, and patients band. Crushing some, getting juice and a straw for another, explaining to another why he needs this medication, being sure the patient on lasix is getting the K+ checked and so on. Five minutes per patient twice a shift = four hours.

Baths - 5 minutes each = 2 hours

Charting 5 minutes - 5 minutes = 2 hours.

This is 12 hours. If you work 8 hours you cannot do it at all.

If 12 where was the teaching? Did a doctor or family member call? Did a patient need an intervention, PRN medication, treatments (dressing change, NG or Foley insertion), pre op instructions and checklist? How long did that take? Oops! impossible.

Was an abnormal lab result missed. Did you take time to evaluate the care plan? Medical orders? Listen to your patients?

Did you take a meal and rest break?

It is no wonder so many new nurses leave the bedside in the first couple years.

We need role models to show how to avoid harming patients by not accepting an unsafe assignment

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Well said!

For the sake of simple math I am using an assignment of 12 patients.

Would you agree that a head to toe assessment requires at least five minutes?

If so for 12 patients and ZERO interruptions you have used two hours.

How about checking each chart? Orders, progress noted, read the H&P atcetera? Checking lab results? IF 5 minutes per patient is all this takes you spent another two hours.

Medication administration including checking the order, MAR, and patients band. Crushing some, getting juice and a straw for another, explaining to another why he needs this medication, being sure the patient on lasix is getting the K+ checked and so on. Five minutes per patient twice a shift = four hours.

Baths - 5 minutes each = 2 hours

Charting 5 minutes - 5 minutes = 2 hours.

This is 12 hours. If you work 8 hours you cannot do it at all.

If 12 where was the teaching? Did a doctor or family member call? Did a patient need an intervention, PRN medication, treatments (dressing change, NG or Foley insertion), pre op instructions and checklist? How long did that take? Oops! impossible.

Was an abnormal lab result missed. Did you take time to evaluate the care plan? Medical orders? Listen to your patients?

Did you take a meal and rest break?

It is no wonder so many new nurses leave the bedside in the first couple years.

We need role models to show how to avoid harming patients by not accepting an unsafe assignment

Not to intrude on this discussion, but the math here is driving me crazy

a 5 minute task on each patient X 12 patients is 60 total minutes

That is one hour not two.

Carry on :)

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Ok, I give up. I am a horrible nurse, with a huge ego. Is everyone happy now? I was only stating what I have experienced. If I am going to be condemned for it, I will not make the mistake of posting again. I'm done here. Tear me apart, as you see fit.

To the OP, please note that the world of nursing is not a perfect 5 or 6 to 1 ratio. Good luck to you.

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Specializes in Critical Care/ICU.

There are plenty of facilities in the US right now that have larger ratios than 7.

Just because there "are" doesn't make it right. In fact, it's very very wrong!

I don't want it to seem that you are being ganged up on, or that your abilities are being questioned, but I have to agree that I would not want to be anywhere near a place that operates like this.

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
Ok, I give up. I am a horrible nurse, with a huge ego. Is everyone happy now? I was only stating what I have experienced. If I am going to be condemned for it, I will not make the mistake of posting again. I'm done here. Tear me apart, as you see fit.

To the OP, please note that the world of nursing is not a perfect 5 or 6 to 1 ratio. Good luck to you.

why so defensive? not ONE nurse here attacked you personally. I agree with those who say just cause it is DONE, does not make it safe OR right. One place allowing 13 patients to 1 nurse ratios compromises safety all over, really. It's not about you.

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Just remember, no matter what the cirumstance, its your license on the line. You will not win if you tell them you "freaked out". They can look at the other nurses with the nine patients and use it as a comparison. I feel for ya, its a very hard job. Alot of ppl are going into nursing because they see these $$$$$$$ signs, but let me tell you, its not for everyone.

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Not to intrude on this discussion, but the math here is driving me crazy

a 5 minute task on each patient X 12 patients is 60 total minutes

That is one hour not two.

Carry on :)

Yor are correct. I was wrong. :imbar

I was carried away with the impossibility of being in many places at once.

I know back when I was assigned 12 patients I could NOT do a complete assessment. Some nights there was NEVER a moment without a call light on. Sometimes every room had the light on!

Charting was begun after the day shift had taken report.

One patient was clearly deteriorating so I called all the doctors, got RT, x-ray, lab, there. Wrote telephone orders, started drips, helped intubate and then was told to transport the patient to ICU while the bed was being cleaned because my new admit from the ER was waiting.

Thank heaven the supervisor took the patient to ICU because medications were late, a patient had pulled out his Foley, another c/o pain, one needed the bedpan, and another help up to the commode. How can any nurse devote 1/2 hour to saving a life and simultaneously care for 11 or 12 other patients?

I apologize for my error.

Still IF these can be done in 5 minutes times 12 that would be ONE hour for assessments and ONE hour to check charts and labs. That is TWO hours before any nursing care is provided.

That is not how we work. We run around doing the best we can. We try to do it all.

That is impossible!

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Saskrn, I don't think anyone here believes you're a horrid nurse. I believe I said you are probably a very good person. But you also have to be open to constructive criticism in order to continually learn and improve upon your practice. That is what I meant by ego. You have to be able to look past any potential hurt feelings to see the bigger picture and the spirit in which advice is being given. And you have to be assertive enough to take a stand for your own safety and the welfare of your patients. Even when that means walking away from unsafe ratios.

Peace. :)

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