TokenMurse

I want to thank you guys for the responses. Your words were just the push I needed to make up my mind to pursue a positive change. I am not going to our psych unit, rather I have decided to drive to the other hospital. I actually know several nurses who left to work there and I had an opportunity to reach out to them over the weekend; what they told me is really encouraging. Staffing is world's better, they feel supported by their leadership, their base pay is actually much higher than my current facility, the night shift differential is over 4x my current diff, AND they have weekend option positions currently available! Also, I won't have to charge which is such a relief; it'll be nice to not have to worry about all the little extras and just focus on good patient care. So far it sounds like a better working environment and better pay to boot; I'm actually kind if excited(the first time in a LONG time)! However, just knowing that I will be leaving has already lifted such a burden from my chest. Even before I found out I likely would not have a pay cut I felt so much better. Again, thanks for the advice, and the push.

I feel like I have no one I can talk to about this who understands, so I'm hoping to get some advice from fellow nurses. Warning! This is a long rant. I have been an RN for 13 years, and I worked as a CNA for 5 years before attaining my RN. As an RN I have always worked at the same hospital, on the same med-surg unit. I have been a charge RN for the past 7 years and, to my delight, for the past 4 years I have worked as a weekend option charge so my wife can stay home like she's always wanted. Here's my dilemma: it's terrible. We are always so short staffed that I can't remember the last time I charged with less than 6 patients (had as much as 10). The overall experience level on the floor is dismal, with the average nurse on the unit having less than 2 years experience and the turnover is constant. I am incessantly training in new grads whom I feel like I am doing a disservice because I can't take the time to dig in with them like a preceptor should. All we have time for is to run from task to task with no intervals to look deeply into our patients. And speaking of breaks, I haven't taken a lunch in literally years--and I'm not alone in this regard. The "staffing crisis" has been going on for years and I have tried to stick it out for multiple reasons, but I feel like our leadership is not only NOT helping, but at times it's like they are working against us. For instance, they took away our phlebotomy team and didn't even train the nursing staff on phlebotomy. This isn't to say I didn't know how, but I routinely have a unit full of new nurses who miss way more sticks than they hit and need me to draw blood and place IVs for them--and I already have, as a charge, more patients than our staff nurses are supposed to have in addition to my extra responsibilities! Here we are telling our leadership, "we're drowning'" while they smile and nod their heads, then they actually pull resources away and pile onto our responsibilities! Now they want to integrate PCU level patients into our unit (by acuity score over 30% of our current "med-surg" patients are already PCU level--it's a busy unit), so they want to install monitors and train us on different drips. They plan on going live with this in October. I told them I don't read strips, have never worked with these drips, or fresh trachs, and that I didn't feel comfortable charging the unit unless I could work PCU for a couple years under some competent charge nurses; until then I couldn't be a resource to our staff. They basically said we're all gonna learn as we go and iron out the kinks. Oh, and by the way, we have no more staff! They just want to add to the acuity of the patients we care for with up to 6 official PCU level patients. I already worry about who might die under my care! I worry what my new nurses might be missing when I don't have time to review orders on all patients. I worry about labs that are delayed for hours because we have no phlebotomy, and we are staffed to the point patients are waiting a half an hour just to have their call light answered to recieve the most basic care. Now they want to do this? I am breaking. I am burned out. I leave work everyday (for years now) feeling like I am being forced to give substandard care, and generally feeling like crap about myself. For the past year I have been getting sick (vomiting) before work and getting terrible headaches. Sometimes I cry uncontrollably because I am so anxious about what situation I am going to be put in at work. I was never this way before. I went years without missing a shift and now I call off because I'm so anxious I can't stop vomiting. To be clear, no one at work knows this. Everyone thinks I'm the cool, calm, and collected charge nurse--because I always have been and I can project that still for the sake of my co-workers--but inside I am reeling. Here's my dilemma: I want to leave my unit, but leaving means no weekend option (a likely 30% pay cut) and I don't want my wife to have to go back to work, so I feel trapped (She thinks we could tighten our belts and get by). I could leave for a different hospital but I love where we live and don't want to move so I'd be driving an hour each way. Also, I have all this med-surg experience but I am afraid it's going to be the same no matter where I go; I am considering going to the psych unit in my hospital, but I'm nervous because it would be like starting over since I have very little psych experience. I guess my questions are these: 1. Am I being crazy--are these normal working conditions and I'm just too burned out to cope? 2. Should I take a pay cut and leave for a new hospital (1 hour drive one way) or look for weekend option in med surg somewhere else because it is NOT this bad elsewhere? 3. Should I abandon my experience and try psych (and take a pay cut)? 4. Any options I'm not thinking about? Any and all advice is appreciated.