Overwhelmed, what's next

[NewRNurse2621]

Hi Everyone,

So, I've been a nurse for about 17 months, and I've worked in LTC and am currently employed on a Sub-Acute/Rehab unit. Next month will make a year since I've been at my current job. To say I am OVERWHELMED is an understatement. We are always understaffed, whether it be nurses or CNA's. I have as many as 24 patients, but these patients, in my opinion, do not belong in our facility. They are sick, and need more careful monitoring. The unit manager constantly says, "Watch Mr. S closely because he could go septic anytime!" or "Watch Mrs. M carefully, because she's a CHF-er and her legs are swollen, and since she's dehydrated we're going to put a bag of fluid on her". I don't feel comfortable taking care of 24 patients when many of them are very sick. They never want to send anyone out to the hospital, even whes it seems clear that they need to go. Upper management argueS with doctors about keeping patients all the time. The DON says, "What can they do for these people at the hospital that we can't do here?" I am sick of it. It is outright unsafe, and we can't keep nurses for very long. But I don't know what to do. I'm working on my BSN but I'm not sure if I should try the hospital, but I'm afraid to do that too. I was thinking of trying another position, but I'm not sure what to do. This job is sapping my confidence. I want to be able to work with people and feel like I'm making a difference, not just someone throwing meds at patients. All of the nurses, even the ones who have been there 10 years + have complained, but management doesn't really care. I just need some advice on what my next move should be.

THANK YOU!!!

[TheCommuter, BSN, RN]

Welcome to Allnurses.com!

I worked in LTC subacute rehab and the nurse/resident ratios you describe are common. In addition, subacute residents tend to have slightly higher acuity than the traditional LTC resident. There's a couple of reason I wouldn't want to work in this environment again unless I faced impending homelessness.

Be assured that you make a difference in the lives of these residents when you treat them with kindness and maintain a competent skill set. However, in the healthcare industry, making a difference is secondary to profits. This is why your DON wants nobody sent to the hospital: it cuts into profits by lowering census.

Always remember that healthcare is a business first and foremost. This reality is not conducive to many peoples' notions of altruism.

Good luck to you.

[Shagce1]

You have worked there long enough. I am sure you have gained some great experience and skills. If this position is that stressful start looking around. You aren't desperate, you have a job, so you can look and interview till the right position finds you. I say spruce up your resume and see what else is out there.

[NewRNurse2621]

Thank you for your insight. I have been there awhile, and some of my coworkers have worked in the hospital setting, and they agree that the acuity is too high for the amount of patients we have. I'm not sure where to go next. I'm working towards my BSN, and in my area it seems that the hospital won't hire RNs without it. I've been applying, and I guess I'll continue to do that.

Thank you!

[Been there,done that, ASN, RN]

This facility is for profit. They are working you like a mule to make money for them.

They do not care about the patient, or the nurses caring for them. They care about their bottom line.

You have your year in. Grow a pair, find something else.. and report this nasty place.

[chiromed0]

Don't be afraid of the hospital. If you ask for help, it's there usually and you have good experience. Hospitals will hire you if you are already in a BSN program and will finish within a year/two. If you haven't started yet look into Western Governors University or Excelsior and just get it done! The BSN is mostly BS and less N. Nothing really different at a hospital except maybe more structure and oversight so you will breathe a little easier. Patient load is monitored better. You have more room to grow. Do it b/c you won't miss your current job--even if you're not happier.