nursing morale going down the tubes

[sunneeRN]

OK things are progessively getting much worse on my unit as far as staffing and staff morale. The attitude is "if my patients are still breathing, than it's ok." That is not OK with me. Last night, I cared for 9 sick oncology patients. One of them was a nun, and we talked for 20 minutes. When I walked out of that room, I cried. She told me that she felt we were failing her..(poor thing had actually been DROPPED off the OR table, and then proceeded to have a lot of unfortunate events happen post op). I did not become a nurse, only to hear my patients say that. Thankfully, I have stayed true to myself and give my whole heart, and 100% dedication to these wonderful people but my morale is going down the tubes as well. Nurses have tried talking with the manager and nothing is changing. budget, budget, budget. I can't sit back and let this happen. So I need some help. Please, if you are an oncology nurse, or even med surg, what is your nurse to patient ratio, or what do you feel is a managable patient assignment on oncology? And do you feel that the morale on your unit is the same? I keep hearing that it's worse at other places, but that really makes me sad. I'm considering taking an OB position now, so that I can feel like I'm making a difference. (They are better staffed in our hospital than we are.) Oh what to do! Thank you for listening and for your help!

[oramar]

I work Med/surg/Ortho. 6-7 on days, 7 nights. Having the same problems with morale; Yesterday at the staff meeting my director was busting our chops over the fact that they only recieved 15 chart audits instead of 30, onlt 2 from our unit. I pointed out that when it is routine to be leaving work 1-3 hours late, short of coming in on days off, that was why. Not enough time to do the basics and there adding extra. We are supposed to have 3 CNAs, yesterday, busy post op day we all had 6 and the aides had 15. He told me apparently I must have a problem when I am leaving late, as "others" leave on time. All the nurses leave 80% of the time late. Not one person backed me up, they all complain and sit & say nothing. I had just hurt my back lifting a pt, so wasn't in the best of moods, at 4pm hadnt charted a thing and was facing yet another late night and was being told after 22 years, I can't manage my time. I could not back down, in the end, we agreed that I would be on a panel of staff with the goal of identifying and improving things, a management liason. I hate stuff like that, most of the time spitting in the wind. But having spoke up, have to do something. Anyone have any experience/ideas on this sort of thing.

I don't know what to say to help you but I will say that you sound like a fine human being and excellent nurse. Sometimes moral support is all a person can give. PS You have just gave an excellent description of why there is a nursing shortage. The usual reasons given like demographics and women having more career options are all bull. I am currently home watching soap operas and eating bon bons when I could be in there helping out. However, I have had the same experience as you time and time again. Lucky I am older and no longer need to work. Right now the stuff going on in healthcare just makes it better for me to sit home. God Bless and good luck:balloons:

[dream'n, BSN, RN]

I work Med/surg/Ortho. 6-7 on days, 7 nights. Having the same problems with morale; Yesterday at the staff meeting my director was busting our chops over the fact that they only recieved 15 chart audits instead of 30, onlt 2 from our unit. I pointed out that when it is routine to be leaving work 1-3 hours late, short of coming in on days off, that was why. Not enough time to do the basics and there adding extra. We are supposed to have 3 CNAs, yesterday, busy post op day we all had 6 and the aides had 15. He told me apparently I must have a problem when I am leaving late, as "others" leave on time. All the nurses leave 80% of the time late. Not one person backed me up, they all complain and sit & say nothing. I had just hurt my back lifting a pt, so wasn't in the best of moods, at 4pm hadnt charted a thing and was facing yet another late night and was being told after 22 years, I can't manage my time. I could not back down, in the end, we agreed that I would be on a panel of staff with the goal of identifying and improving things, a management liason. I hate stuff like that, most of the time spitting in the wind. But having spoke up, have to do something. Anyone have any experience/ideas on this sort of thing.

We must work for the same place! Isn't it interesting how some co-workers love to complain, but when management is around, they pretend everything is just hunky-dory? I finally started calling them on it (nicely, and in private.) I don't know if it will make any difference, but at least they know I have noticed it and maybe they will do some personal inventory.

[Daytonite, BSN, RN]

i hear what you are saying and i understand. when i was working as a staff nurse i was constantly on my feet doing things for patients and usually staying late for an hour or more finishing up paperwork. however, i have to wonder if some of your problems aren't related to time management.

last night, i cared for 9 sick oncology patients. one of them was a nun, and we talked for 20 minutes.

believe me, i understand the importance of sitting and listening to patients talk and vent. but, if you really don't have the 20 minutes to do that, then i have to wonder if there are other ways your time is being mismanaged.

you can't be responsible or feel guilty for things that happen to patients that aren't your fault. you are only responsible for your own practice. of course, it's awful to hear that someone was dropped off an or table. is that your fault? what do you think you could have done to prevent that? the patient said she felt that "we", i'm assuming she meant the nursing staff, were failing her. she's entitled to an opinion. how did you fail her? that's really the question to be concerned about as a staff nurse, isn't it?

i take offense to the statement that

day shift says that she [the manager] leaves every day at 2:30 regardless of whats going on on the unit. takes 4-5 smoke breaks a day, and never asks to help anyone. one day, they did try to put her to work and it took her 45 minutes to straight cath someone and draw blood from a port. and she still doesn't have a clue.

it's just wrong to criticize the manager for taking a break! i have been a hard working staff nurse and a manager. until a staff nurse walks in a manager's shoes they have no basis of comparison as to what the manager's job is compared to their own. staff nurses don't like it when they finally get a chance to sit for a few minutes, somebody happens to see it at that very moment and goes around saying "all i ever see is her sitting on her butt at the nurses station!" how incredibly unfair! and, one of the manager's job duties is to manage the budget for the unit. i guarantee you that in your first week on the job as a manager that function would be made crystal clear to you. it goes with the management job. and, the last part of that quote is just green-eyed jealousy. if i were the manager and that bit of nasty, spiteful and ungrateful gossip got back to me it would be the last time i helped out those nurses. what kind of nurses are these people? they don't sound kind enough to be working with oncology patients when they can't be sympathetic to their own boss who is also a nurse!

it seems to me that the staff sure finds the time to b & m about their situation. if there's time to b & m then there's time to offer to help another coworker or spend a few extra minutes listening to a patient b & m'ing. might be some attitude problems that need changing on your unit.

[rnanm]

brava my dear

we need more nurses who will speak up for our patients and each other. i too have seen many who complain to each other but are not willing to get involved to make a meaningful change.

i work on a step down unit that is supposed to be 4:1 but is almost always at least 5:1 and up to 7:1. we have mandates in place regulating the ratio, but the hospital laughs at our written protests. yes, it is all about the budget now and patient satisfaction. we are pegs in the hole of the game board with no real power to make things change without a 100% group effort.

i feel sad for all of us. our standards have dropped to an all time low and expectations are at an all time high. no aids to help with patient needs is certainly showing in my unit. perhaps this is why they are having to import nurses from far away lands?

good luck to you in your future nursing goals. perhaps it is time for a change?

i will keep us all in my prayers.:balloons: