is this what nursing is supposed to be like?

newnurse012 · Sep 3, 2011

Wow, that's crazy. My last hospital med/surg job had a patient/nurse ratio of 4/1, even on nights. The day shift always had CNAs on each pod, and they tried their best to give them to nights too. I currently do peds oncology and we are 3/1 with aids as well.

...If you don't mind me asking, what area did you work in where you had such great patient/nurse ratios? Sounds heavenly to me : )

nursingstudent85 · Sep 3, 2011

The general consensus among my professors is summed up in how you describe your working environment. I am just starting my clinical and we've been fed information on the good and bad sides to the profession, but mostly we've heard and indirectly experienced a lot of toxicity. I guess I'll find out for myself soon enough.

newnurse012 · Sep 3, 2011

YES...... this is what nursing IS- it doesn't matter what it could be - and this is much better than it was 26 years ago, and 30 years ago, etc.... trust me- you would have walked out with staffing ratios of the past- and the "patients are sicker" only goes so far....a coma is a coma is a coma on a neuro floor- this year or 30 years ago. They just take longer to die now, thanks to the brilliant technology :) !!
You are still new- and probably that contributes to feeling overwhelmed (not saying things couldn't be better- but not having more experience adds to that ). That will get better :)
Your manager is as powerless over upper management as you are over him/her. It is business- that is the bottom line- and the bottom line will always be the most important thing. Nurses are disposable- if you don't want the job, there are 100 who will snap it up in a heartbeat. What really stinks is that people don't find this out until they've gone through school.
I loved working- and wish I still was able to....Yeah- it's hard, and frustrating. If nurses are going home crying, maybe some EAP help would improve coping skills (everybody goes home crying at some point). It's a hard business- and it is business. You can improve it by giving the best care you can- do YOUR part- the rest is too big for any one person, and if you can find enough people who aren't fried, to tell the CEOs they don't really need so much money (that covers the uninsured, and underinsured) go for it :)
Good luck- and deal with what is- not something that was dead and buried decades ago.... you'll save yourself some frustration

Thanks for the feedback. It's encouraging to hear that it gets better with time! Was there less paperwork 26 or 30 years ago? I'm still fairly new, but it seems like a new flowsheet is added to our to-do-list every day. I hate that we are indirectly encouraged to spend more time charting than with our patients at their bedside... and yes, I realize that complaining will get me nowhere : ) but sometimes a girl's got to vent

MInurse.st · Sep 3, 2011

I was recently hired at a large teaching hospital (union) where I also did my clinicals. Med-surg is 4:1, peds gen med was 3:1, and stepdown was 3:1, all w/ PCTs. While unsafe staffing may be common, it does not occur everywhere.

xtxrn, ASN, RN · Sep 3, 2011

Thanks for the feedback. It's encouraging to hear that it gets better with time! Was there less paperwork 26 or 30 years ago? I'm still fairly new, but it seems like a new flowsheet is added to our to-do-list every day. I hate that we are indirectly encouraged to spend more time charting than with our patients at their bedside... and yes, I realize that complaining will get me nowhere : ) but sometimes a girl's got to vent

No- it was ALL done by hand back then- no computers for documentation :) And yes- you do need to vent :up: We had some flowsheets, but mostly it was all Q2H narrative charting, starting with the head-to-toe system review to begin with; when the doc came, new orders, prn meds, to and from surgery/tests, etc.....all had to have narrative notes by hand. Careplans on computer (dot matrix printer) were a BIG deal in 1988. Before then, the care plans were all done by hand also...where I worked, there were no form careplans- it was like school was- from start to finish by hand :)

Repetitive flowsheets seem to come and go. Seems they would get them narrowed down to avoid charting the same thing in 3 places, then someone wouldn't like it and add another flowsheet, until the next manager, and it would get all mixed up again. Nothing changes, just goes through new people !

It does get better :) Hang in there, and know that lots of people have survived it !!

xtxrn, ASN, RN · Sep 3, 2011

Anybody curious where your hourly wages went??? To the other nurse you work with to meet the ratios.... can't have both :)

newnurse012 · Sep 3, 2011

I was recently hired at a large teaching hospital (union) where I also did my clinicals. Med-surg is 4:1, peds gen med was 3:1, and stepdown was 3:1, all w/ PCTs. While unsafe staffing may be common, it does not occur everywhere.

What hospital/area were you hired at? I am looking to re-locate if it means safer staffing.

MInurse.st · Sep 3, 2011

What hospital/area were you hired at? I am looking to re-locate if it means safer staffing.

Michigan. Not that I would recommend a move here. Are there any hospitals in your area where nurses are unionized? They would be more likely to have safe staffing.

xtxrn, ASN, RN · Sep 3, 2011

Michigan. Not that I would recommend a move here. Are there any hospitals in your area where nurses are unionized? They would be more likely to have safe staffing.

You can also find non-union facilities in the same areas as those with unions, as everybody tries to stay competitive.... just know who you work for, and what they offer if you get a job wherever you are.

This is nothing new. :)

Orange Tree · Sep 3, 2011

What stands out in my mind is the fact that hospitals are a business and that they act just like every other business in the world. Staffing at the hospital floor I work at is not ok. Nurses are going home crying after their shifts due to the stress from poor staffing and fear that they will make a mistake. Management is aware of this and says staffing is ok despite the fact that our patient satisfaction scores (on a general med-surg unit) are lower than the ED's scores and our staff satisfaction is the worst in the hospital. In fact, management is sending our staff away, floating them to other floors and staffing us with the bare minimum. I have worked here for 2 years and am one of the most senior nurses on 2nd shift. Course, the 2nd shift Clinical Manger has only been a nurse for 2 years...
I have never worked anywhere else, so my question..is it this bad everywhere? Is this just what nursing is? Having no aides or LPNs to help out.... each RN expected to work the floor, assess 7 patients, give meds to those patients, perform all patient care, pass dinner trays, feed patients, perform wound care, walk the halls with patients, take out discharges, etc.
I have heard stories of hospitals that have multiple CNA's and LPN's to help with care & med pass but I wonder if they are true. Is the grass really greener on the other side? I am considering leaving my current job but don't want to go through all that to find more of the same. Advice would be appreciated : )

That sounds almost like my job. The differences are:

1. they are giving us 8 patients instead of 7 (6 was our max last year!)

2. we do have LVNs, but they have 8 patients of their own and we have to do their admissions, hang their blood, etc. on top of caring for our own 8 patients

3. we do have CNAs, but they often have 20+ patients, and sometimes even the whole floor (40+)

4. I am VERY lucky to have VERY good and VERY experienced nurses around! There are three of them who save my life (or at least my sanity) on a weekly basis and make me want to stick around. A lot of people who started after me have already quit after finding something "easier".