Overwhelming workload!!!

Why quit? Did you ever voice your situation with your charge nurse? You know well that nothing's going to happen unless you voice your concern. Write to them and have a copy for yourself. I've been there and went through the same situation at one point but that never affected my goal and love of the profession. Good that you have survive the shift and nothing bad happened to you patients but staying quiet and being passive means that you and any of your peers can take the same load as you did. Be courteous as well as professional when you talk to them. Let them know that having such acuity of patients will affects the quality of care and will definitely reflects the facility. You need to be assertive now while your there in the Philippines for when you go abroad you will be thankful that you did.

hi! i'm a registered nurse in one of the training hospitals in the metro. i got a stint there as a staff nurse for six months and then i left because of the workload. most of the time i just want to cry:bluecry1: during my shift because i have 10-12 patients - some have bts going on, some have to under go bt, then some has to go to the operating room or to the ct scan, and to top it all off, i still have admissions to attend to! and not to mention you have to constantly check their ivs, give their medications on time, cater to their needs, do the doctor's orders, and write the charting in soapie format for all of them!! sorry for ranting, i know this is normal in the philippine hospital setting, but is it okay that i quit my job? i'm telling you guys, i don't even want to open my eyes when i know i'm going to work..

i love nursing and i love to be nurse, but do this environment really exist in all of the hospitals here?

thanks guys... i just want to be the best nurse that i can be:heartbeat..

ya,i know what you mean.. i assume you work in a gov't hospital.. i think its okay that you quit your job, like what you said.. you just want to be the best! although in some ways, i think working in a hospital like that would help you be the best.. (thats if you survive without losing your license.. hehe) i heard working in high end hosp. like st. lukes, medical city etc.. is great training.. you get to practice the ideal set up.. i work in a gov't hosp too.. (sigh)

i love nursing too.. but i gotta tell you.. and im sure you know.. nursing- is hardcore! its physically draining, intellectually challenging, and emotionally overwhelming.. i have yet to get used to that..

Hi! I'm a registered nurse in one of the training hospitals in the metro. I got a stint there as a staff nurse for six months and then i left because of the workload. most of the time i just want to cry:bluecry1: during my shift because i have 10-12 patients - some have BTs going on, some have to under go BT, then some has to go to the operating room or to the CT scan, and to top it all off, i still have admissions to attend to! and not to mention you have to constantly check their IVs, give their medications on time, cater to their needs, do the doctor's orders, and write the charting in SOAPIE format for all of them!! Sorry for ranting, i know this is normal in the Philippine hospital setting, but is it okay that i quit my job? i'm telling you guys, i don't even want to open my eyes when i know i'm going to work..

I love nursing and i love to be nurse, but do this environment really exist in all of the hospitals here?

thanks guys... i just want to be the best nurse that i can be:heartbeat..

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I am bereft of knowledge of the current situations in the acute care hospitals in the Philippines simply because I haven't been inside a Philippine hospital ever since I graduated from nursing in 1978. Yeah, I know that was a looong time ago!

I know I was not supposed to be but I was still stunned to read your horror story as a nurse over there in the Philippines. I am aware of the poor staffing and lack of supplies and multitude of other problems encountered in a typical hospital in the Philippines but what you wrote gave me a clearer picture of the very dire situations Philippine-based nurses have to deal with every time they go to work.

I nearly bought a luxury condo in 2005 in Makati City when the dollar-peso exchange rate was still favorable to U.S. residents like us. What prevented me from signing on the dotted lines was the thought of someday that my wife and I would need hospital care in our twilight years and as an experience RN I know the importance of highly experienced, highly trained and very competent nursing staff to deliver the safest care possible. I don't believe that my wife and I will receive safe and competent care from the overworked nurses working in Philippine hospitals.

Nursing audits are a significant part of my RN job where I work and I am sure if I were to do audits there in a Philippine hospital I will discover many errors being committed by Philippine-based nurses. We use excellent audit tools and observation techniques that will reveal the errors and omissions committed by nurses. I don't blame you nor any other front-line nurses but the blame should fall on the hospital head, the attending and chief doctors, the nursing supervisors and the nurse managers of the individual units. Those people know that the nurses are overworked and are over-stressed and it's impossible for them to deliver safe nursing care. Nurses would love to give "tender loving care" but that would be out of the question if the tired nurse is running from one patient to another all day long.

I feel sad that you had to quit your job but in situations like what you described I think you did the right thing. I hope that you will be able to find a better nursing job, but given the current state of health care in the Philippines your best bet is to look for a hospital job outside the Philippines.

That would be another topic and another problem to talk about.

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Why quit? Did you ever voice your situation with your charge nurse? You know well that nothing's going to happen unless you voice your concern. Write to them and have a copy for yourself. I've been there and went through the same situation at one point but that never affected my goal and love of the profession. Good that you have survive the shift and nothing bad happened to you patients but staying quiet and being passive means that you and any of your peers can take the same load as you did. Be courteous as well as professional when you talk to them. Let them know that having such acuity of patients will affects the quality of care and will definitely reflects the facility. You need to be assertive now while your there in the Philippines for when you go abroad you will be thankful that you did.

yeah nyttxrn2008, i should've done that. but the hospital i worked for, of course, is giving us a shut-up-and-be quiet-and-just-do-it-'coz-you're-lucky-we-hired-you vibe. we're professionals, not workhorses:madface:!!! oops, sorry for ranting... Maybe the problem lies in the hospital's management (well, i can't do anything about THAT) - they are preoccupied in beautifying the hospital than providing us nurses with more co-workers... and to think they're cutting down on personnel huh! eeep.

to all my co-nurses - just suck it up and pray that you'll never get your license on sticky situations - i left because i don't want my license to be in jeopardy!

Hi! I'm a registered nurse in one of the training hospitals in the metro. I got a stint there as a staff nurse for six months and then i left because of the workload. most of the time i just want to cry:bluecry1: during my shift because i have 10-12 patients - some have BTs going on, some have to under go BT, then some has to go to the operating room or to the CT scan, and to top it all off, i still have admissions to attend to! and not to mention you have to constantly check their IVs, give their medications on time, cater to their needs, do the doctor's orders, and write the charting in SOAPIE format for all of them!! Sorry for ranting, i know this is normal in the Philippine hospital setting, but is it okay that i quit my job? i'm telling you guys, i don't even want to open my eyes when i know i'm going to work..

I love nursing and i love to be nurse, but do this environment really exist in all of the hospitals here?

thanks guys... i just want to be the best nurse that i can be:heartbeat..

I also work in a private hospital here in cebu, surgical ward with 24 patients maximum for each staff nurse, about 4 to 5 patients are on NGT feeding and each feeding will cost you around 30mins of standing in front of the patient performing the statue of liberty stance. sometimes i'll take my lunch after my 7-3 shift, that would be around 4pm. The most unforgetable is when going down to the first floor to get the medicine from the pharmacy because it is the responsibility of the staff nurse to get meds from pharmacy. Surgical ward is in 4th floor by the way and are not allowed to use the elevator, management said it is only for emergency purposes. My time is consumed on going down to the pharmacy and those with NGT's. No nursing quality time given to patients. Im glad i survived for one year in that area and transfer to ICU which is one on one. After I resigned from that hospital i've heard that they changed the policy of that pharmacy thing. it is now the pharmacist who will go to the floors to deliver meds. Well I resigned because i have to concentrate on my cgfns exam and ielts....and now my PD is current, thank God I survived.

yeah nyttxrn2008, i should've done that. but the hospital i worked for, of course, is giving us a shut-up-and-be quiet-and-just-do-it-'coz-you're-lucky-we-hired-you vibe. we're professionals, not workhorses:madface:!!! oops, sorry for ranting... Maybe the problem lies in the hospital's management (well, i can't do anything about THAT) - they are preoccupied in beautifying the hospital than providing us nurses with more co-workers... and to think they're cutting down on personnel huh! eeep.

to all my co-nurses - just suck it up and pray that you'll never get your license on sticky situations - i left because i don't want my license to be in jeopardy!

Sorry to hear that but I am all for you! It's not only the hospitals fault but I guess it is the government as well. They (the goverment) know the healthcare situation but they rather close their eyes and turn their backs and pretend no such problem exists. Try writing to one of your senators like Francisco Escudero--maybe he'll check on it.:wink2:

Hi! I'm a registered nurse in one of the training hospitals in the metro. I got a stint there as a staff nurse for six months and then i left because of the workload. most of the time i just want to cry:bluecry1: during my shift because i have 10-12 patients - some have BTs going on, some have to under go BT, then some has to go to the operating room or to the CT scan, and to top it all off, i still have admissions to attend to! and not to mention you have to constantly check their IVs, give their medications on time, cater to their needs, do the doctor's orders, and write the charting in SOAPIE format for all of them!! Sorry for ranting, i know this is normal in the Philippine hospital setting, but is it okay that i quit my job? i'm telling you guys, i don't even want to open my eyes when i know i'm going to work..

I love nursing and i love to be nurse, but do this environment really exist in all of the hospitals here?

thanks guys... i just want to be the best nurse that i can be:heartbeat..

I felt the same way before when I first worked as a staff nurse. Coming straight from college gives us this notion that we have to do everything by the book. I mean the idealistic approach. But this is not always the case. It's exactly different on the real world nursing. You'll just be surprised that you see things that isn't supposed to be. I think your hospital is using primary nursing approach. It was so difficult. We have workloads with a maximum of 15 patients but we usually have 12-14 patients. We were so busy that sometimes we have to run so that I can have extra time with the patient. It was hard at first but as time goes by we learned techniques to speed up our tasks. We learned to prioritize, to delegate, to have good assessment techniques. Just like what you said we have to do nursing such as bed bath, change diaper, do vital signs( some times every hour with post-op patients and critical patients), give medications, give NGT feedings. We even have "for ICU" supposedly but since they can't pay for ICU admission they'll have to stay in the wards. Poor us that we have to take care ICU setting in the wards. Most of the time we can't even have our lunch and dinner during our shift. As busy as we are we have to stay 1-2 hours after our duty just to finish our charting. The work is just so stressful mentally as well as physically.

Just like what you said the nursing service doesn't give much attention to the workload. As long the task is done it's ok with them. But later on they switched to function nursing. As the primary nursing is not the best approach in our situation. Due to the high error on medications, not having little time in assessment and we can't attend much to the needs of the patients. They realized that primary nursing is not the best option. Now the situation is better than before. We have functional nursing. The medication nurse gives the meds, the charge nurse carries the doctors orders, then the staff nurse carry out the nursing care. We have workloads of 8-10 patients. Now, can interact with the patients more and have enough time to do assessment, anticipating their needs, and have a good patients satisfaction. I'm just glad we have improve our nursing care. Recently, they assigned me as a head nurse and I'm glad I'm through with staff nurse. My task is now different.

One thing I can say quitting is not the way to do it. Take the task as a challenge. Take time to think every duty time what things you can speed up. You have been working only for 6 months, I know this is just the beginning. I think after 1 year of experience you'll get used to the procedures and you'll have faster ways to do things. I know nurses thrive in difficult situations. We don't quit. My opinion, I suggest you stay and make the most of your hospital experience. I know somewhere along the road you'll have better days. Godbless!

. . . about 4 to 5 patients are on ngt feeding and each feeding will cost you around 30mins of standing in front of the patient performing the statue of liberty stance.

i have good news for you.

ngt feeding in us hospitals is much simpler, as they use pumps.

just turn to run, and they'll beep when feeding's done.

same thing with iv pumps.

however, nurses get 2 patients in icu.

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Also here in the U.S. computerized charting has made the workload of RN's that much lighter. I can do my initial patient assessments and then sit down in front of a desktop computer or a C.O.W. (Computer on Wheels) and do my initial computerized charting. It is soooo easy and so quick once you get the hang of it and you'd never want to go back to paper charting ever again! End result is you will have more time to spend with your patients.

Things will not improve for nurses working in the Philippines until they organize and join unions. I know this concept is so far-fetched for nurses in the Philippines. If the Filipino bus and jeepney drivers, many of whom did not even go to college are unionized and in the process have the power to get the attention of the concerned authorities, then why can't college educated RN's get unionized? Philippine-based RN's can rant all they want about heavy workload but without the backing and political power of a union their voices will hardly be heard. For those leaders or potential leaders out there stop and think for a moment. Make this a call for action!

What is happening in Philippine hospitals these days is a reflection of what nursing was in the U.S. 40 or more years ago. I remember horror stories that my former and now retired nurse manager told us when she started working as an RN in the late 1960's here in the U.S. She said that she had up to 35 patients to take care of with the help of just one Orderly (as Certified Nursing Assistants were called back then). She bragged about being able to give all the meds, do the treatments, carry out orders, etc..

She told us that we, the current generation of U.S. nurses are "cry babies". Of course she was half joking, but when I asked her how much documentations she did back then, her answer was very little. She documented only important things that happened to her patients. If she had to do the kind of documentations that we are now required to do she would never have been able to do all the tasks that she claimed that she was able to do. (OK, with the advent of computerized charting, as I have mentioned before has cut down the length of time to do nursing documentations. Therefore comparisons may no longer be relevant) And I bet you, if someone audited their nursing documentations using today's standards, the auditor would discover that those previous generation of nurses violated many rules and regulations. And did anyone report or even discover the medication errors that were committed?

My point is, many of those things are no longer happening here in the U.S., at least in my home state of California where a maximum of 5 patients per 1 nurse are legally allowed in Med-Surg. units. I have been a nurse here in California for 27 years and I believe that nursing practice, while far from being perfect, is so much safer now than what it was when I started my nursing practice. Take for instance, one month after I finished my orientation as a new-grad RN I was made the charge nurse simply because nobody wanted to be the charge nurse. I was so inexperienced back then I was very frightened every time I went to work. Thankfully, those times are gone. Of course nowadays, charge nurses in our hospital have at least 1-2 years of acute care experience, but the vast majority of our charge nurses have been nurses for at least 5 years and a good number of us have been nurses for more than 20 years.

I am sure that there are nurses out there in the Philippines who are assertive and committed enough to begin the talks of organizing a nurses' union. I firmly believe that there are many nurse leaders or potential nurse leaders in the Philippines who are capable and willing to take the challenging job of being union leaders. These future leaders will have that heroic mandate to make nursing in the Philippines advance to the 21st Century and save its member nurses from punishing working conditions, and make nursing in the Philippines as safe as it can be.

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I felt the same way before when I first worked as a staff nurse. Coming straight from college gives us this notion that we have to do everything by the book. I mean the idealistic approach. But this is not always the case. It's exactly different on the real world nursing. You'll just be surprised that you see things that isn't supposed to be. I think your hospital is using primary nursing approach. It was so difficult. We have workloads with a maximum of 15 patients but we usually have 12-14 patients. We were so busy that sometimes we have to run so that I can have extra time with the patient. It was hard at first but as time goes by we learned techniques to speed up our tasks. We learned to prioritize, to delegate, to have good assessment techniques. Just like what you said we have to do nursing such as bed bath, change diaper, do vital signs( some times every hour with post-op patients and critical patients), give medications, give NGT feedings. We even have "for ICU" supposedly but since they can't pay for ICU admission they'll have to stay in the wards. Poor us that we have to take care ICU setting in the wards. Most of the time we can't even have our lunch and dinner during our shift. As busy as we are we have to stay 1-2 hours after our duty just to finish our charting. The work is just so stressful mentally as well as physically.

Just like what you said the nursing service doesn't give much attention to the workload. As long the task is done it's ok with them. But later on they switched to function nursing. As the primary nursing is not the best approach in our situation. Due to the high error on medications, not having little time in assessment and we can't attend much to the needs of the patients. They realized that primary nursing is not the best option. Now the situation is better than before. We have functional nursing. The medication nurse gives the meds, the charge nurse carries the doctors orders, then the staff nurse carry out the nursing care. We have workloads of 8-10 patients. Now, can interact with the patients more and have enough time to do assessment, anticipating their needs, and have a good patients satisfaction. I'm just glad we have improve our nursing care. Recently, they assigned me as a head nurse and I'm glad I'm through with staff nurse. My task is now different.

One thing I can say quitting is not the way to do it. Take the task as a challenge. Take time to think every duty time what things you can speed up. You have been working only for 6 months, I know this is just the beginning. I think after 1 year of experience you'll get used to the procedures and you'll have faster ways to do things. I know nurses thrive in difficult situations. We don't quit. My opinion, I suggest you stay and make the most of your hospital experience. I know somewhere along the road you'll have better days. Godbless!

As a charge NUrse(Functional type)

-I cater 40-55 patients during my nyt shifts,

-i dont do 5 bts in 1 shift coz its very risky especially if you have a bad line and it eats precious time, especially WB , PRBC, n plasma. but if its plaetelet bring it on.

-I usually have 5-10 line reinsertions every nyt shift

-When it comes to charting its a good thing we do narrative, you know what that means(only 4 linershahahahah"receicve on bed asleep so on n so forth then last liner is need attended to endorsed to NOD) it take me 4-5 hours to finish all the chart.

-I usually report 9pm in the evenng to get ahead start of everything before my shift starts.

-stat OR, FOR ICU pts. its a complete headache

-referrals, your 100 peso load is down the drain

-nyt shift ends- 8am in the morning:yawn:sometyms 9am

As a Medicating nurse(functional type)

if my duty is pm

i usually do prescriptions for the nyt shift so here it goes

40-55 pts---it takes me 2-3 hours to finish all the medical prescriptions(RESETA:D)

By 5pm i give the prescriptions to all the watchers,

by 6pm- i receive all the meds

to be cont.:bowingpur

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Also here in the U.S. computerized charting has made the workload of RN's that much lighter. I can do my initial patient assessments and then sit down in front of a desktop computer or a C.O.W. (Computer on Wheels) and do my initial computerized charting. It is soooo easy and so quick once you get the hang of it and you'd never want to go back to paper charting ever again! End result is you will have more time to spend with your patients.

Things will not improve for nurses working in the Philippines until they organize and join unions. I know this concept is so far-fetched for nurses in the Philippines. If the Filipino bus and jeepney drivers, many of whom did not even go to college are unionized and in the process have the power to get the attention of the concerned authorities, then why can't college educated RN's get unionized? Philippine-based RN's can rant all they want about heavy workload but without the backing and political power of a union their voices will hardly be heard. For those leaders or potential leaders out there stop and think for a moment. Make this a call for action!

What is happening in Philippine hospitals these days is a reflection of what nursing was in the U.S. 40 or more years ago. I remember horror stories that my former and now retired nurse manager told us when she started working as an RN in the late 1960's here in the U.S. She said that she had up to 35 patients to take care of with the help of just one Orderly (as Certified Nursing Assistants were called back then). She bragged about being able to give all the meds, do the treatments, carry out orders, etc..

She told us that we, the current generation of U.S. nurses are "cry babies". Of course she was half joking, but when I asked her how much documentations she did back then, her answer was very little. She documented only important things that happened to her patients. If she had to do the kind of documentations that we are now required to do she would never have been able to do all the tasks that she claimed that she was able to do. (OK, with the advent of computerized charting, as I have mentioned before has cut down the length of time to do nursing documentations. Therefore comparisons may no longer be relevant) And I bet you, if someone audited their nursing documentations using today's standards, the auditor would discover that those previous generation of nurses violated many rules and regulations. And did anyone report or even discover the medication errors that were committed?

My point is, many of those things are no longer happening here in the U.S., at least in my home state of California where a maximum of 5 patients per 1 nurse are legally allowed in Med-Surg. units. I have been a nurse here in California for 27 years and I believe that nursing practice, while far from being perfect, is so much safer now than what it was when I started my nursing practice. Take for instance, one month after I finished my orientation as a new-grad RN I was made the charge nurse simply because nobody wanted to be the charge nurse. I was so inexperienced back then I was very frightened every time I went to work. Thankfully, those times are gone. Of course nowadays, charge nurses in our hospital have at least 1-2 years of acute care experience, but the vast majority of our charge nurses have been nurses for at least 5 years and a good number of us have been nurses for more than 20 years.

I am sure that there are nurses out there in the Philippines who are assertive and committed enough to begin the talks of organizing a nurses' union. I firmly believe that there are many nurse leaders or potential nurse leaders in the Philippines who are capable and willing to take the challenging job of being union leaders. These future leaders will have that heroic mandate to make nursing in the Philippines advance to the 21st Century and save its member nurses from punishing working conditions, and make nursing in the Philippines as safe as it can be.

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I agree on that! Actually we do have leaders. Good leaders who will stand up for what they believe in. But the problem is, though we fight for that, still no one listens no matter what we do.....

Some big hospitals or teaching hospitals do have unions. The unions here are not the same as the unions in the US. Unions here cannot dictate salaries, benefits or safe nursing ratios. The bottom line is being a third world country means being limited on what can be done. The bar cannot be raised.