Overwhelmed at work :(

Nurses General Nursing

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Hello all. I'm looking for some advice or maybe hints on how to handle my stress at work. I am not a new nurse. I worked for about a year at a LTC SNF, then 3 years in outpatient with case management and low income patients. I have been at the hospital about half a year now and dread going to work every day. I prayed for a hospital job for years but never got one until after I finally finished my BSN. Now I regret taking the job because I am so stressed out and afraid.

I work on a floor where acuity is high. We take PD, HD, non-critical drips like insulin, heparin, dobutamine, CBI, etc. We also take a ton of addiction/active withdrawal patients and tons of psych issues, complicated telemetry patients, and more. We even can take patients on bipap. However, I received 5 weeks of training with 5 preceptors then was left alone on nights with at least 6 patients every night. All of my preceptors have left this unit and moved on as well as at least 20 other staff members on that floor since I came. I fear so much that I will miss something or do something wrong. Any time a patient's IV infiltrates, I get an admission with a bunch of bedsores, or I hear any alarm, I start to have a panic attack inside. This is not normal for me. I clinically feel I am competent but I am overwhelmed with such a high acuity patient load and there's always 10,000 things going on and going wrong. Is there any advice you guys might have to calm down? I want to cry almost all shift every shift. I am afraid I am a bad nurse because some people seem to be just fine. I have been a nurse much longer than some people who are thriving there as well. I am so sad.

I want to leave and go somewhere else but there are not a lot of jobs in this area and I can't transfer to another unit within this system for at least a year. I am depressed recently and don't know if I can do this 6 more months. :'(

The target is what I fear. I want to keep my head down to be able to get out as soon as I can and be able to transfer. I am fine on days off with a stretch anxiety wise. It's just at work that I struggle and the next day I am stressed and have to work to relax.

The target is what I fear. I want to keep my head down to be able to get out as soon as I can and be able to transfer. I am fine on days off with a stretch anxiety wise. It's just at work that I struggle and the next day I am stressed and have to work to relax.

See, but while I do get what Lev is saying there... I do think (or hope) most of us underestimate HR.

If I would have gone to HR with my last job I am certain that things would have changed for me. Instead, I left.

I want to feel like I could talk to HR but they have so many people applying for each job that I doubt they would want to bother with trying to help me when it'd be easier to just replace me. I am afraid to talk to HR really, and on nights it's difficult because I sleep days and HR is at a different campus.

Hello, I read your post about feeling overwhelmed at work. The comments have also been extremely supportive and helpful. Few people realize how much caring for others can take a toll on the caregivers/care providers.

Specializes in tele, ICU, CVICU.

I feel your pain. Even though not a new nurse, working in case management for a longer time than clinical floor setting (at least in my opinion/experience) doesn't usually help, possibly even was counter-productive to the previous experience in a SNF. And, as far as some saying/feeling "suck it up & deal with it" is because they probably had it worse, or remember how crazy it used to be way back when (and I'm guilty of that as well.. keep reading!)

I sort of feel along the lines of do all you can to stick it out for that one year mark. It is extremely stressful but I think getting that 12th month under your belt (at least to some) prove that you've 'paid your dues'. As some older nurses feel is necessary and builds character.

When I started on nites as a new grad, our patients were identical to what you described (cardiac, drips, CVA's, withdrawl, biPAP, just one low BP away from ICU) and we had four nurses at night, usually always full at 32 patients, bumping out at 0200 for an admit by 0230. Two LPN's, a travel RN and me as a new grad, covering an LPN and charge because the traveler didn't want it. For months, I felt the same as you extremely overwhelmed and wondering if I was going to make it or what I was doing wrong. I was too trusting & actually met with the new NM a few times, to make sure I wasn't missing anything or couldn't improve or do something myself. (another story, but she threw numerous nurses under the bus, new grads & experienced alike; anyone she was 'threatened by') so I never recommend trusting a manager, or even a colleague for that matter. (horribly cynical I know, but when working with so many women, the BS flies and it is simply amazing how quickly a person will turn on someone they thought they knew).

The main thing that got me through (and still does to this day) is that nursing is a 24 hour job. We are there for 8, 12, 16 hours. Then a replacement comes in to take over and unfortunately things are missed, delayed and we deal what we can, when we can. Prioritizing an acute event over getting your 4 day post op hip out of bed happens, and somebodies always got to be pushed to the back burner. It stinks, because what if that's your family member in there, getting pushed back and not receiving optimal care? I've been on both ends being the one delaying someones' care (as the nurse) and I've also been also the family member or patient, pissed I'm getting 'pushed aside'. However, the ability to understand the situation is beneficial (at least to me) as I always know it could be worse even if I am having to wait for care. I think most people will understand that somebody actively infarcting takes precedent to a planned heart cath for stent placement because they couldn't place 4 stents last time.

I know it doesn't help you, or answer any questions. I would try all you can, to keep your sanity on your time off, stick it out as much as possible (and then you know you can) & then you've gotten one less-than-desirable year in a less-than-desirable setting/unit under your belt. Anything is possible!!!

As a fellow night-shifter (for quite some time) is it possible for them to redo some of your shifts? I always preferred like between 5-8 shifts in a row, then 3-4 off consecutively. Most places are somewhat more understanding for off-shift workers than a normal daytime shift. It sounds like you're saying you would prefer more in a row, versus one on one off, one on, on off. I know some who preferred that on one night shift. Is there a central scheduling office, or is that a unit-based variable? Are others on nights desiring a similar schedule, with many consecutive on or off, versus broken up? If so, maybe you could all come together and propose something to management/scheduling or whomever. Especially since it sounds like you're one of the more senior people on nites right now.

Sorry I haven't helped much, but sometimes just knowing that you aren't alone can be beneficial. It was hard for me to do, as a newer nurse, but enough was enough. Got sick of no breaks, just chugging water between patients & eventually, I became more active in my own, (um for lack of a term), you-can-work-me-like-a-dog-but-I'm-taking-my-break-and-not-allowing-you-to-treat-me-like-crap-anymore, kind of mentality towards the employer. So, after about 2 years on said unit, I started TAKING 30 minute breaks. Especially because those who smoked ALWAYS got 2-3 fifteen minute smoke breaks in 8 hours (in addition to their 30 minutes lunch break). But I was never able to leave the floor? not gonna happen anymore. One night I barely got to the commode before my bladder let loose. That was it for me. I had portable phone on me, answered it and unless emergent said I was on my break and would address question when I returned to floor. One CNA tried to report me for sitting in my vehicle for 25 minutes (good music at nite!) and the assistant NM knew I started going out for 'fresh air breaks' as mu lunch break and informed aide when she went complaining. I got a few nasty looks, and quite a few calls from said CNA on my breaks for a few weeks, but didn't change a thing. Also, once we started marking down 8.5 hours (no lunch break) they made it mandatory to have shift supervisor for entire hospital approve said OT every day. Night supervisor started making us take breaks & coming to help cover during breaks, so she didn't get in trouble for not allowing breaks.

I know that doesn't help either, but after you know you've developed your skills enough and there is no reason for you to be so behind (except for unsafe ratios/staffing, IE the facilities wrongdoing, not your lack of skill) it is not wrong to demand and ensure you are being given basic employment essentials (break, restroom etc). Sorry to hijack, got me fired up there.

Regarding HR:

they are not always helpful and it can backfire.

My coworker complained about work conditions and unacceptable behavior from super. She was hopeful that HR would address some of it or mediate. Instead things escalated in many ways with her on leave for insubordination. She left the company.

HR was of no help.

I agree with keeping a low profile because you write that you got written up already , which makes it easier to fire you to being with. Once you start to complain they might not want to bother with you and let you go next opportunity.

Specializes in Critical Care.

Your struggle is not uncommon and your staffing level and acuity is typical. In fact six patients on the night shift would be considered good staffing! This is why I find it ironic that so many nurses feel the need to work in a hospital after graduation as if that somehow makes them a real nurse. It is a foolish ambition for many if you ask me! Leave the hospitals to those who have nerves of steel!

I would advise you to get a non bedside job, perhaps go back to what you were doing before. The whole reason for a nurse shortage in general has been the poor working conditions and stress of bedside nursing. There is a reason for the turnover. Thousands of nurses are simply not working in nursing due to the poor conditions. Others are going back to school in droves for NP for the hope of a better work environment and paycheck!

I don't know what the prestige of hospital nursing is all about. I really don't! They call you a professional, demand a BSN,but you are really the work horse of the hospital! They work you like a dog, back breaking work, many places won't spend the money for ceiling lifts, they are ok with nurses getting injured and then just replacing them with new grads! And now with the foley free environment you spend even more time cleaning people up! Punch the time clock, better not be even a minute late and better not have overtime! Management makes their fat bonuses by not spending money on the department needs such as lifts and essential equipment! A low level supervisor gets a 10% bonus of their annual salary at some places, I can only imagine what the big dogs make! While the staff is lucky to get 2-3% raise a year! Then management bemoans why there are poor satisfaction scores, never mind staff morale!

Do yourself a favor and find a better non bedside job like you had before! There is no need to suffer from depression and anxiety just to have a "prestigious" hospital job! That's the best advice I can offer you!

Your struggle is not uncommon and your staffing level and acuity is typical. In fact six patients on the night shift would be considered good staffing! This is why I find it ironic that so many nurses feel the need to work in a hospital after graduation as if that somehow makes them a real nurse. It is a foolish ambition for many if you ask me! Leave the hospitals to those who have nerves of steel!

I would advise you to get a non bedside job, perhaps go back to what you were doing before. The whole reason for a nurse shortage in general has been the poor working conditions and stress of bedside nursing. There is a reason for the turnover. Thousands of nurses are simply not working in nursing due to the poor conditions. Others are going back to school in droves for NP for the hope of a better work environment and paycheck!

I don't know what the prestige of hospital nursing is all about. I really don't! They call you a professional, demand a BSN,but you are really the work horse of the hospital! They work you like a dog, back breaking work, many places won't spend the money for ceiling lifts, they are ok with nurses getting injured and then just replacing them with new grads! And now with the foley free environment you spend even more time cleaning people up! Punch the time clock better not be even a minute late and better not have overtime! Management makes their fat bonuses by not spending money on the department needs such as lifts and essential equipment! A low level supervisor gets a 10% bonus of their annual salary at some places, I can only imagine what the big dogs make! While the staff is lucky to get 2-3% raise a year! Then management bemoans why there are poor satisfaction scores, never mind staff morale!

Do yourself a favor and find a better non bedside job like you had before! There is no need to suffer from depression and anxiety just to have a "prestigious" hospital job! That's the best advice I can offer you!

Unfortunately I can't go back to my old job as the position was eliminated but I am looking. I want out of the bedside... But I did want the hospital experience. I fear for hospital patients because their safety is the lowest priority to management.

Specializes in Critical Care.

delete as duplicate

Specializes in Critical Care.
Unfortunately I can't go back to my old job as the position was eliminated but I am looking. I want out of the bedside... But I did want the hospital experience. I fear for hospital patients because their safety is the lowest priority to management.

The bright side you are gaining some experience in another area of nursing. Hopefully it will help you be a candidate for a better job in the future. I don't know what you did before, but I worked with an agency nurse who was laid off from her great clinic job and couldn't find another so ended up in the hospital. She would literally cry at times when she had a bad shift. I hope you have more luck than she did!

It is sad that healthcare has become about the all mighty dollar and a race to the bottom. While I know people who found office and clinic jobs, even many LPN jobs, let alone RN jobs have been downsized to medical assistants being paid $10/hr.

For what its worth, I'm a bedside nurse resigned to the present situation, trying to make the best of it and looking forward to a well deserved retirement, but I have a ways to go yet! I remember the days of fear and anxiety as a new grad. Eventually it fades with time and experience. You might want to consider meds and/or therapy to help you cope! I've used both in the past. It's sad a job pushes you to that point, but it is noting to be ashamed about. I can assure you there are many nurses struggling just like you and some on antidepressants and antianxiety meds! Several coworkers have admitted this over the years as well as many on here so you never know someone may appear calm, but it may not necessarily be true!

Hello all. I'm looking for some advice or maybe hints on how to handle my stress at work. I am not a new nurse. I worked for about a year at a LTC SNF, then 3 years in outpatient with case management and low income patients. I have been at the hospital about half a year now and dread going to work every day. I prayed for a hospital job for years but never got one until after I finally finished my BSN. Now I regret taking the job because I am so stressed out and afraid.

I work on a floor where acuity is high. We take PD, HD, non-critical drips like insulin, heparin, dobutamine, CBI, etc. We also take a ton of addiction/active withdrawal patients and tons of psych issues, complicated telemetry patients, and more. We even can take patients on bipap. However, I received 5 weeks of training with 5 preceptors then was left alone on nights with at least 6 patients every night. All of my preceptors have left this unit and moved on as well as at least 20 other staff members on that floor since I came. I fear so much that I will miss something or do something wrong. Any time a patient's IV infiltrates, I get an admission with a bunch of bedsores, or I hear any alarm, I start to have a panic attack inside. This is not normal for me. I clinically feel I am competent but I am overwhelmed with such a high acuity patient load and there's always 10,000 things going on and going wrong. Is there any advice you guys might have to calm down? I want to cry almost all shift every shift. I am afraid I am a bad nurse because some people seem to be just fine. I have been a nurse much longer than some people who are thriving there as well. I am so sad.

I want to leave and go somewhere else but there are not a lot of jobs in this area and I can't transfer to another unit within this system for at least a year. I am depressed recently and don't know if I can do this 6 more months. :'(

Run, Don't stay there...You don't wanna japordise your/your pts' safety ie your license...Don't work in a toxic work environment...I'm a new nurse, been in the workforce thou more than two decades...leaving after 6 months don't make you a job hopper...Staying at least 1 year in a position before leaving for another site is overrated...Your success, hon, at nailing job interviews after this lies on you being honest about why you left the position exuding confidence and showing future employer you are/were aware of your strenthgth/weakness as a human and a nurse.

I agree with FlyingButterfly, I had the exact same issue as you awhile (See my other thread). I left that job at 7 months and never looked back. Just my two cents, its NOT normal to feel overwhelmed, stressed out and going home to cry everyday, esp if you are experienced already. That's not a normal work environment. I had a positive discussion with my manager when I left that job and realized had i stayed I would be in much more trouble and the target was already on my back the entire time. I went back to my old job with no issues, settled right back in and it's been much better. I suggest if you are still under the radar at this job, start looking elsewhere. As long as you have a solid work history prior to this job, a simple "this is not a good fit" explanation would have been sufficient.

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