please help

[NP2BE]

I graduated last may and am in icu. I have been out of orientation less then 2 months and management has recently decided to quit paying incentive pay for nurses to cover scheduling holes. they are also not aggressively hiring (no big ads in the paper vs other hospitals). The result is we are constantly understaffed and I am being asked to take 3 ICU patients tommorow. I did take a 3rd ICU pt for the last 4 hours of my 12 hour shift a few days ago(on thanks giving) and it went badly. the new patient I picked up started crashing and I nearly ran levophed in at 15 mg/hour instead of 15 ml/ hr. obviuosly it has scared me. I am just at a point where I can take care of 2 patients competently , and of course i need help sometimes. should i refuse to take a 3rd oatient and risk getting fired? i am so stressed. this is my 5th 12 in a row. and btw, i am not planning on becoming an np, so ignore the name. Thanks!

NP

[Simba&NalasMom, LPN]

Good grief, Charlie Brown. If I knew where you were working (no, I'm not asking!), I'd make a mental note to not have any of my loved ones admitted to that hospital, or if they were, I'd get them moved ASAFP. What are they thinking? :angryfire

Congratulations on getting licensed and making it through orientation. Now it's time to be good to yourself, KNOW that you are an awesome nurse, and you are totally right to question their staffing.

I'm a new LPN myself, so I know what it feels like to feel bullied into doing what even the most seasoned nurses will refuse; but even this early in my career, I almost had to learn the hard way what it means to my career and license to bite off more than I can chew because of feelings that it's "normal" or "OK" to be thrown that much work as a new grad. It's so easy to feel hesitant about speaking up for fear that you'll be seen as "wimpy", etc. but patient safety has to be the bottom line. If your facility is willing to put productivity before patient care, I agree with the other posts that it's time to move on. Changing jobs is a much more appealing option than taking too much on and losing a patient and then carrying that guilt around the rest of your life.

Stick to your guns. Stand up for yourself, your license, and your patients, and most importantly get some much-deserved rest! :)

[NP2BE]

thanks everyone. I took 3 patients today that i thought were not too sick too handle. one was on low dose dopamine and ventilated on cmv via trach, (ltc pt), another was on levophed/cardizem/diprivan/insilin infusion and intubated on cmv but required minor titrations, the third was on trach collar trials with an insilun infusion, and probably will goto a room in a day or two. Now i get three days off! joy! they actually got a float pool nurse in for the last 4 hours, but she had never taken an icu patient in her life either. I gave her one of my patients. I sure hope this doesnt become habit. I dont' feel like I did the best job for the patients I had, but I did the best i could.