AnLe

One of our coworkers left our unit after the initial surge died down and became a traveler. Their current year-to-date is double our salary. They have been a nurse for about 3 years. It's making us talk to our Director and HR. Will it change anything? Maybe not, but at least an attempt is made. Two of our coworkers already plan to leave within a month, our two most experienced nurses. We barely hired 1 new grad while the rest are travelers. Some days, there is only 1 core staff member who is charge while the rest are floats or travelers. If this continues, I may want to leave too.

No joke. We currently have our covid patients split up on multiple floors based on care level. I get 6 tele covid patients, but 3 are total cares. Confused feeders who are incontinent and don't appear to be getting discharged anytime soon. But for continuity of care, my load doesn't get balanced even if I ask. We have staff refusing to go into covid rooms for x or y reason, giving me more to do. Our hospital system is offering contracts to work x days * x weeks for a bonus but it doesn't amount to what the travelers are making. Apparently travelers are meant to float first, but sometimes they complain and nurses have to be switched around. The new grad who was hired got a sign-on bonus and makes what I do. How is this fair? I'm trying to provide safe care for my patients and educate my orientee while helping our staff of floats and travelers. If it weren't for the core nursing staff and my fear of possibly working on a toxic environment, I'd go elsewhere.

I haven't had many patients ask if we're vaccinated, especially in our new growing covid section of the hospital. It's almost confession time, if you do. Most of them are unvaccinated for one reason or another. Less than a handful are vaccinated. Back to the topic at hand. I would address the wife's concern by educating her that the vaccine does not prevent you from getting the virus, it decreases your severity. "A small percentage of people who are fully vaccinated will still get COVID-19 if they are exposed to the virus that causes it... no vaccine prevents illness 100% of the time" (CDC, 2021). Just like with flu shots, you can still get the flu. If she feels uncomfortable with her nurse if they don't wish to disclose their status, the nurse is not required to answer due to privacy. Vaccinated or not, the hospital staff will wear face masks and perform hand hygiene as dictated by hospital policy. If they see someone who is not adhering to it, she is free to speak to our charge/director.... is how I would handle it. https://www.CDC.gov/coronavirus/2019-ncov/vaccines/effectiveness/why-measure-effectiveness/breakthrough-cases.html

Our policy currently states that ED will call to give report. If the nurse does not answer, ED will callback in 10 minutes. If nurse does not answer the 2nd time, charge will take report. Our current problem is the ED trying to send patients up during shift change. I have had the issue of the ED trying to give me report on a patient whose heart rate kept decreasing. We avoided receiving report and not a minute later the heart rate was zero. Mind you, I'm on a medsurg/tele floor night shift.

Same in regards to TPN and patients receiving steroids. Another post mentioned IV insulin and IV glucose for potassium shift.

I owe 15k/35k. It was in college for 10 years total; graduated in 2018. I wasn't sure what I wanted until I joined nursing school and didn't look into programs that could help until late in the game. I'm paying my way for my BSN. Started with 11 loans and I'm down to 5. Soon they'll be done.

So much this. When dayshift says they're sorry about not getting to a task, it's fine, just tell me what it is and I'll do it. I get it. They talk to many individuals, get stat orders all day, and the patients are awake who call for whatever reason. It doesn't bother me. What does bother me is when I tell the nurse if the doctor can do the medication reconciliation or if they can order x med for y reason. Then I return and neither has been done.

I don't get mad when that happens. The board can change any moment for balance. Secondly, it helps to get a 2nd pair of eyes on the board, like when people get 2 stroke patients or patients with the same last name and gender, which happens a lot.

I have a coworker who goes in 1.5 hrs before her shift. I'm not sure of she clocks on or not, but she calls the doctor to clarify orders or for anything extra the patient needs. She says she needs to get there early to get out on time. I go on 15-20 minutes early. I work on a med-surg/tele floor and our ratio is 6:1. Our turnover has been better lately, but we still get new people every few months. I just find it helpful to see what meds I need to give and what labs/vitals have been abnormal. A few people of the dayshift staff give a very short report or forget to do things. For example, I had a patient with stat ABGs ordered at 1430 that had never been done. When I questioned her, she said lab hadn't come up yet. I had to mention that lab doesn't draw ABGs, RT does. I had her call the RT that was on, they weren't happy about it. Besides us, everyone else either gets there 10 minutes before or right on time.

I love the crazy mess my work is. Take that as you will. I experience great fulfillment some days and others I get burnout. I've been in medsurg/tele for 2 years now. The staff helps. If you have a supportive staff that you can ask questions or assistance from, it's a godsend. Most of my coworkers have stated they've stayed so long because of the people they work with.

I work night shift. I put in telemetry orders when applicable for one doctor. Stroke, chest pain, seizure, etc. She has stated if a chest pain patient comes in to do one troponin and an EKG. This doctor tends to put in orders rather late. Other than that, I am not comfortable adding or amending any order that I did not hear verbally from a doctor.

I wouldn't. Potassium is very irritating to the veins alone. Running them concurrently would definitely make them go bad. Is oral replacement not an option? There is liquid forms for potassium if the tablets are a problem.

I have a few coworkers who are similar. One has had syncope episodes at work causing her to go home early although her bloodwork looked fine. She has also been out for the flu and other ailments. We now remind her to drink water periodically during the shift and encourage her to eat a healthier diet. She meal preps now. I'm not sure how her sleep is, but at least we can help out with the other two. You're not alone in this.

Don't feel bad for saying no to extra shifts. You are not obligated to say yes. As Rose_Queen said, staffing is management's problem. They can/will figure it out. I always considered how my schedule would look like and how comfortable I was for that day. Also, you can pick up a shift and be floated to another unit.

I work in a medsurg/tele unit in a 39 bed hospital. We're currently understaffed. Charge has to take 6 patients along with the other 5 nurses. We are supposed to have 3 aides, but usually it goes down to 2, sometimes 1. Although, according to our 10 year veteran charge nurse, the norm 3-4 years ago was to take 7-8 patients. Yikes! I'm already struggling with my 6. Shift starts at 1845 and I don't sit down until 0100. Assessing, medication administration, answering questions, ensuring their needs are taken care of takes a long time. My preceptor would tell me, "15 minutes AnLe. I'm going to call you to make sure you come out on time." If I am performing my job as we were taught in nursing school, without taking shortcuts, wouldn't it take longer than that? For the first 6 months of working, I would stay until 1000, to chart. Now, the latest is 0830. My admissions take around... 20 minutes to 1 hr to complete. I will say that I have seen a few instances where the charting appeared falsified. For example, I say appeared because the patient should've been on a waffle overlay to help prevent pressure ulcers with a Braden of 15. I got an order for one, because one didn't exist and applied it. When I went to chart, every day she had a waffle overlay documented. Could they have removed it that day? Maybe. The patient was oriented to self, she couldn't answer me. The are so many times I want to message our director or MIDAS something to shine a light on it. Patient care comes first, it's been a long shift and it's already 0830, I need to return tonight so I'll be leaving - which is why those messages never happen.