Oh, what a can of worms! LOL!
I never understood why people where so negative about nursing. I knew I was a hard worker & I couldn't imagine what was so bad. Well, four years post graduation, I see it a little differently ;-). Bear in mind, I LOVE being an RN! I work on med/tele in a hospital, and I ADORE my dayshift coworkers. I find my work interesting, challenging & rewarding. I like all that I do as an RN from the assessments, critical thinking, teaching, support & even basic hands on care.
BUT... there are certain problems that have made me feel like I want to leave either the hospital environment, or even nursing altogether! What is burning me out, is that we are always staffed by # of patients per nurse.Well, guess what- some patients need frequent nurse attention, and we call this high acuity!
So, for example, my assignment from today was a measly 4 patients.You would think this was easy; it's only 4 people. Well,we had one nurse aid for 20 patients. SO, that means of my 4 patients, and 3 were very heavy...I am incharge of every bedpan call, every missed lunch tray, every pain med, every bed bath, every nuance in health status change, every family member that wants an update, every medication to be given in a timely fashion, every lab that the MD didn't bother to look up when he rounded, every IV that goes bad, every medication that pharmacy didn't send, etc. It is exhausting!
I am also there to lend support for my patients who needed a shoulder to cry on...and the job itself is nearly impossible for one single person. I felt today like my pts needed at least 2 of me. I had to change on pt's bed (entirely) twice, do his dressing changes, empty his commode at least 6 times; clean up my other lady and medicate her every time she vomited (4 times), wound care & specialty bed change for another patient, etc. including drawings & descriptions in the progress notes of his chart.
It's so hard to describe unless you are a nurse, what it is like to have a "heavy" assignment. "Heavy" is when your patients call for you every 5 minutes and you have to change their entire beds 3-4 times, they pull out the IV it took 4 attempts to get in, they don't like the "pancakes" the kitchen sent & want to order up some yummy eggs (2 miles walk to the far end of the hospital to get, and nobody had time to get it but you!), monitor labs, physical status, meds, response, 3 person assist to transfer to the chair (weighs 240 pounds) and call the MD at least 3 times for new orders, etc.
From 7am when I hit the floor till 5 pm I didn't get a single break...oh, I fib there, as I took 5 whole minutes to scarf down my sandwich, but no break other than that. Then at 1600 (4 pm) I started my "charting" where I have to write down everything I did, including measurements of every wound, bump, owie & bruise, all pain meds given (pre and post response), write summary of progress, update careplan, do chart audit, graph all vital signs, blood sugars and intake, outputs.
The problem is we need more help. Honestly, I wish they'd hire a few more nurse aids, to help out. I don't mind putting people on commodes, or running to Timbuktu to get some item of food that someone wants, but every extra 15 minutes I spend, it puts me behind on the "timely administration" of the med pass, or dressing change, or whatever. Missing my breaks & staying overtime is the norm lately rather than the exception.
Often I come on duty in the am, and labs are not drawn, and treatments haven't been done, and the docs are yelling "Why wasn't this done?" and I say, "Oh, I'm sorry, I don't know, but I'll do it." It gets OLD!!!! ;-( We have high turnover & inconsiderate nurses who leave you with IVs about to run dry, IVs infiltrated (pt says "I told her it was burning last night"), commodes brimming with urine, and patients all in severe pain at start of shift! ;-(
I stay over every day & miss the feeling of going home relaxed & fulfilled. I am charge nurse somedays, and sometimes on those days none of my staff RNs & LVNs have had a darned break and nobody can act like a "team" or help out the other because we are all drowning! I am MAD that the hospital can't provide some more staff if nursing care depends on it. I don't care if it's 4 patients or 8. I have cared for up to 8 pts sometimes it's no sweat... it all boils down to acuity. Some people need frequent nursing care.
ON the bright side, at least with my degree I know I have options. I am currently giving serious thought to getting out of acute care. It's a shame, really, as I think I am a conscientious nurse, and I LOVE my coworkers, love my floor & love what I do. Why can't they get me some help! I am drowning every day. I have tried going to rallies for legislation, attend meeting & committees in the hospital, and I feel like nobody gives a dam*.
PS- Today I had this delightful patient, a 50-something year old emaciated man who has probable terminal cancer, and when I walked into his room this morning, he said,"Yay! I'm glad you're my nurse today." I sit home right now, thinking back on it & know that not only did I look out for his best interest in regard to health, but perhaps made him feel cared for & respected (we shared a few laughs too), and made a positive difference in his life for those few hours. It's a great feeling. ;-) So, if after hearing the good & the bad, you have it in your heart to become a nurse...welcome!