ThatNurseThough

We aren't union at our hospital, which was a shock to me when I got hired as my last job was with the state and I was union and nurses and nursing staff had a lot of protection (even if they didn't protect us from constant mandation). Honestly, the way management is (when they are there) is a shitshow, I've brought up issues before and gotten reamed out and kind of thrown under the bus especially with dayshift staff. The nightshifters I work with are actually incredible for the most part and stuck up for me. I'm at the point where I'm coming up on a year and a half here and honestly I'm considering leaving next May once my contractual obligation and my lease are up if I can find another job. If nothing else I'm going to leave this job being able to say that I've handled Tele/ICU/stepdown patients, neuro, renal, pulmonary and detox patients, and psych and corrections through my old job. And you know what, if I could handle being pretty severely assaulted at the prison, I can handle getting raked through the coals for another year if need be. Realistically, even though everyone is saying that I should be mad, I understand that the way the administration and power system at my hospital currently is, nothing I say or do is going to change anything. I'm just trying my best to change what I can, and accept what I can't so I don't make myself crazy in the meantime.

About a month ago I got written up for the first time, for a mistake make by the pharmacist that I reported. I've been at my job for about a year and a half working my first acute care nursing job on a TELE/ICU Step-down unit at our regional STEMI center. I work night shift and we are fairly understaffed and the administration "to streamline admissions" instated a policy that nurses on the floor are not entitled to report from the ED, we are just supposed to read through what minimal documentation is in the chart and hope for the best. About a month ago I had a night where I got an ICU downgrade transfer and an ED admission at essentially the same time, the ED staff dropped the patient off while I was getting my downgrade patient settled and didn't notify me that the patient was here. Well the ED patient had come up on a Heparin gtt (hooked up and pump running) and between getting both of my patients settled, assessed, and safe, I wasn't able to really look into the heparin gtt other than confirming that the set units/hour on the pump was as stated on the order in the MAR, for about an hour. Once I had a moment to think, I realized that the heparin order made absolutely no sense as it was way way way too low to be appropriate. I double checked with a more experienced nurse that I was seeing what I was seeing and then called the on pharmacist and got the order corrected. In following with policy I filled out an RL6, our incident reporting system. When I came in for my next shift about three days later, I was called into the clinical coordinators office and presented with a write-up for a medication error and put into mandatory heparin education (I don't disagree with the education). I agreed to sign that I had been presented with the write up, but I didn't sign acknowledging wrongdoing. I know I shouldn't be so bothered but now I have a write-up in my file for an issue that I really don't consider my fault, and that I did the necessary things to get rectified, the pharmacist had even admitted and put in writing that the error was on her side and not on the nursing side.

If you wanted to get your PTO and possibly have some insurance coverage until your new insurance kicks in, put in for vacation time and burn up your leave when you start your new job. After you get your approval for vacation time use then put in your notice. Then you not only use up and get paid for your leave but it extends your insurance coverage as you are still "technically an employee".

When I was an inpatient psych nurse in the prison system I was the only nurse on a unit of about 30 serious felons, it was a super-max unit where all the patients had been convicted of murder, attempted murder, rape, arson, or terrorism. In the job I currently have as a nurse on a Tele/ICU stepdown unit, we are supposed to be a 1:3 flex to 1:4, but in reality we are at 1:4-5 flexing to 1:6. Our facility really will just push nurses to take more patients and try to shuffle patients around with any patient who can be maybe downgraded getting shipped to medsurg and bringing all the new patients up if there is an open room.

I work on a Tele/ICU stepdown where we also cover pulmonary/renal/dka/neuro-tele. Per our own policy we are supposed to have a 1:3 patient load but flex to 1:4, in reality a light night is 1:4. More often lately we have been at 1:5 but flexing to 6 which is dangerous. The problem is that even though we are considered the main hospital for the tricounty area we are still really just a small community hospital and since we don't advertise to nursing schools that we exist we have very few new staff coming in to fill holes so we depend on travel nurses when they are available.