NurseEcho

On the other hand, if they kick you out the next day, you are eligible for unemployment benefits, at least in the state where I live. It never ceases to amaze me that we, as professionals, are required to give at *least* 2 weeks notice. But it is just fine for an employer (at least in a "right-to-work" state) to let someone go on the spot, with no notice and no recourse, for no clearly stated reason. I'd be OK with it either way, as long as employer and employee were bound by the same rules. But it just does not work that way. That's my vent on the topic :angryfire

Wow, Agent99, I could have written your post a little under a year ago. I was in a similarly toxic job, was sick all the time, and went per diem to give myself a breather and figure things out. Bless my hubby for bearing with the income cut and covering our health benefits. When I cut my hours and was able to think straight, I started looking for other options and wound up taking a job in a doctor's office. It saved my health. It's not stress-free, and it was a small (but smaller than I thought) pay cut. It was well worth it, though -- I work 8-5, no weekends/nights/holidays/call. I get a lunch break every day. No one bothers me on my days off. I feel like a normal person. And I *really* enjoy getting to know patients. I have the time to do more teaching and preventative care. I'm in an adult cardiology practice, but I would imagine there is plenty of demand in peds since so much of that is OP and clinic based. Just something to think about! Please, though, take care of yourself. You are fortunate that you have a spouse who is supportive and can pick up the slack for now. Let us know how it works out for you.

I'm coming from the opposite perspective -- Yankee born and raised, now living in the South where my accent (not to mention my unusual ethnic last name) instantly pegs me as "not from around here." It's no big deal. I have fun with it; sometimes it opens up interesting conversations with patients and families. Once in a great while, I catch some "Yankee go home" attitude, but I just shrug it off. As long as you're giving great care, nobody with any sense is going to mind your accent. I only wish I could pick some of it up; I love the way Southerners speak but it never sounds right coming from me.

As one who also just quit my job (albeit under well-deserved duress from my MD), I urge you to take some time; step back and plan your next step. If you are still living with your parents you at least have the luxury of being able to take some time. I'm sorry, unless your father is a med-surg nurse he has no business judging you. If you are wishing harm on yourself, such as wishing to get in a car accident, I urge you to seek out your employers EAP. Even a session or two can have a profound effect on your outlook. Do NOT hurt yourself; if you feel you are in imminent danger of doing so get thee to an ER. It is a job. It does not define your life or your identity. You are very young; you have not "wasted" your money on an education. Feel free to PM me and I will share some more thoughts. But just by being where you are at your age, you have a lot going for you. Don't give up now.

I don't just come out and announce it unsolicited, but I will work it into the conversation. it usually becomes pretty clear that I have some sort of professional background because of the terminology I use, precise drug names and dosages, medical history, etc. I have (respectfully) requested that tests be ordered because I think there is a problem there. I am usually right. I know my body and am not afraid to advocate for myself. When I can tell the staff at an office is having a rough day, I recognize and acknowledge it. In no way am I trying to intimidate anyone; I am just trying to send the message that I have more than a passing knowledge of nursing, I empathize, and would like to be spoken to on a peer level. To me, it makes a huge difference in teaching if I know the client's professional background and I would like to afford them the same respect. If I encounter a specialty that is Greek to me (e.g. my DH had spinal surgery; I am a cardiac nurse; I was lost), I am not afraid to speak up there either and say please explain this to me in the simplest possible terms; it's not my area and I am freaked out to start with. What I hate is when a patient comes to me full of complicated questions, seemingly wanting me to take hir questions to the cellular level and projecting that "Let's see how smart you really are" attitude. I mean, really, just go ahead and tell me you're a Harvard-educated whatever-ologist and you're worried about your mom. I may not be able to answer your every question, but I still feel compassion for you and your mom and if at all possible I will put you in touch with someone who can meet you on your level and set you at ease, take it to the next level, whatever.

Well, the inevitable finally happened today -- I had to give up my job. I have been working on CCU for 6 months and was really enjoying it -- I just love cardiology, and there's always so much to learn! Even though I don't think I could have kept up the pace and the stress forever, I was really hoping to give it a good couple or three years. I had an awesome manager and a lot of good supportive co-workers. But, the position was night shift, and despite my best efforts, my body would not let me do it. I wound up with major depression, a 22-lb weight loss, iron deficiency anemia, and recurrent sinus infections. I tried cutting back my hours but even that was not enough. My doctor wrote me the letter today saying that I needed to get off nights effective immediately. My manager was (and has been) very understanding about it, but there is simply nothing available on day shift and in fact a few people are waiting for positions to come up. It is a large organization and I do have another PRN job there for now (I am also an echo tech). So I am not completely high and dry, and there may be other options in other departments. My performance was never a problem. For heaven's sake, I'm an experienced nurse, something will come up either here or in some other facility. Still ... it is just hard. I really wanted to do this. I feel like a failure. My husband does not understand why I'm crying -- "You were always so sick, you should be relieved!" If you've read this far, thank you for listening to my vent. Hopefully there is a happy ending somewhere, but right now I am just sad, sad, sad. Stories with happy endings -- or just a little prayer/good thought -welcome if you can spare it

Salary and benefits aside, the first thing I'd want to know is the nurse-patient staffing ratio. Also, how many (if any) agency/temp nurses does the unit use and how much turnover is there? No amount of pay or benefits is worth being put in an unsafe situation night after night because there is simply not enough staff to provide good care. If the hyper-educated suits could just grasp this simple fact, there would be no "nursing shortage" and I'll bet the bottom line would improve as well.

When I graduated, you needed several years of experience and a battering ram to get into Labor and Delivery. If you have been offered a job, and this is what you really want to do, go for it! As a CCU nurse who is scared to death of all things mother-baby, I salute you

I have been working on CCU (nights, 7P - 7A) and generally like it a lot. But I am curious as to how other CCU's handle baths. There is a lot of pressure on my unit to get most or all baths done on night shift, and it continues to be a sore spot with me. It's not that I don't want to bathe my patients. Certainly, if they are ventilated and sedated and don't know the difference between night and day, it is a great opportunity to do a full assessment of every square inch and catch/treat skin breakdown problems early. But, I also get a fair number of patients who are alert and oriented and TIRED. It's bad enough that there is sound and light pollution, round-the-clock meds, labs to be drawn, etc ... it seems downright cruel to me to wake someone from a halfway-decent sleep at 3:30 am and go through the whole bath routine for basically no other reason than day shift's convenience. Also, we are always short-staffed on nights. Everyone will pitch in and help out with the most critical folks who require multiple assists, but there are only so many hours in the shift. And I only have one back -- I am not going to sacrifice it, or my pt's safety, for lack of assistance. As it is, I do almost always get at least one of my pts bathed. If they are responsive and able to tell me they're just not up for it, I chart it. Still, I get dirty looks in report for saying a pt has not been bathed. Is this common? How does your unit do baths?

Well, I'm happy to say it all worked out. I set up the meeting and my manager seemed pleased that I took the initiative to address my recent excessive absences. She was open to letting me reduce my hours rather than leave altogether. I will have to change status to PRN, thus losing my PTO and benefits and putting myself at risk of having shifts cancelled if the census declines (haha -- not something that seems likely!) I still have the other PRN job (at the same hospital) -- given the pay increase (now that they don't have to subsidize benefits) I will make about the same $$ while working fewer hours. And I still have medical, dental, and vision insurance through my DH. I am very blessed to have that to fall back on. Right now, some sacrifices in benefits seem a small price to pay for having a schedule that will allow me to maintain a decent income without compromising my health further. If I am not well, I can't care for patients well. It's too bad it's come to a choice like this, but I plan to do my best to make it work.

I agree. I have 5 pairs of Crocs in different colors. They are the best work shoes I've ever had, as well as the best gardening shoes and walking shoes. And when they get nasty, I just throw them in the washer with some Clorox Cleanup and an old towel, and they come out like new.

"The Carolinas" is an awfully big region and I can't speak for it all. But in the part of NC where I work ... YES!

I've been in CCU for 5 months now and really love the job. I was not a brand-new grad but pretty close -- only a few months of experience on a tele unit. If they are used to having new grads and have a solid, structured orientation program, you will probably be fine. 16 weeks -- wow, I'm jealous; I only got 8 and am still trying to get into some of the classes I was promised. As for fainting -- well, if you've made it through nursing school without fainting, that's a good start :) I fainted once on the job, about a month ago, and it was because I did not take care of myself. I was helping with a dressing change. The wound was extensive, but far from the worst I've seen, and I'd had the pt before. Suddenly everything turned to yellow spots, my fingers began to tingle, and a perceptive fellow nurse managed to hurl me onto a nearby recliner before I hit the floor. VERY embarrassing! The reason I'd passed out is that I hadn't eaten in over 24 hours. I'm having major problems adapting to night shift (I've mentioned it in other posts and won't belabor it here.) The previous day, I'd decided I would rather sleep than eat, drink, shower, or anything else. I'd come home that a.m., took an Ambien, and literally just woke up in time to throw on scrubs and run out the door. Moral: take care of yourself! It's stressful! I hope you remain free of sleep issues -- most people do just fine. But remember to eat regularly -- even when there seems to be no time -- and stay hydrated. I now have a power bar on me at all times for when there's no time for a decent meal, and I keep a big cup of ice water at my desk to sip every time I'm charting. Congrats on the new position and good luck!

Lori, my DH had a lumbar laminectomy 3 years ago at age 41, and it was a success. His pain was better immediately after waking up, although it is a long recovery and the rehab takes a lot of patience. He'd been having sciatica pain for several months. His doc ordered an MRI, stingy insurance company deemed it unnecessary and refused to pay. His doctor just kept prescribing Vicodin (which he rarely took -- he is very stoic) and stretching exercises. One day, he woke up and the bed was wet. He'd lost bowel and bladder control and had numbness down his right leg with some paralysis in his foot. Finally got the MRI; turned out he had cauda equina syndrome. His doc got him hooked up with a neurosurgeon who took one look at him and admitted him for an emergent lumbar laminectomy. The surgery was successful, but it was a long road. He was in rehab for over a year, and thanks to a wonderful incontinence center and some very patient and skilled nurses was able to regain enough bowel and bladder control to live a normal life, though with lots of bathroom breaks. He was in Depends for a few months and that was really devastating to him as a young, athletic man. In addition, his first urologist (who we promptly fired) told him he would never regain sexual function. Also, of course, devastating -- and DH proved him wrong. He still has accidents, but they are rare, and he has some residual numbness in his foot. He still has some pain that is eased with stretching, water therapy, and occasionally steriod injections. But he has always had a very positive attitude, refuses to sit around and feel sorry for himself. He works full time, plays golf, gardens, swims, and has a full life. The neurosurgeon later told him that in fact he'd had mild spina bifida that was never diagnosed, and the disk had been a ticking time bomb all his life. As far as recovery time, he was back at work part-time six weeks after the surgery, but he has a desk job. He continued to have improvement in function over about a year, when things leveled off and remained what they are. I wish you all the best with your surgery. It can help tremendously, and I will pray that yours does. {{{Hugs}}} to you. :flowersfo

Where I work, the departments all have designated colors (ER wears black, observation purple, telemetry teal, mother-baby pink (men can wear blue), ICU navy, CCU red, etc.) Some have approved prints that fit in with the color scheme, others just wear their "color" and white. Anyone, anywhere, can wear white. I came from a different part of the country where anyone could wear any color; I kind of like the uniformity in spite of myself -- it makes everyone on a given unit look like a team. As for the stethoscope thing -- I am in CCU and diagnostic cardiology and am very fussy about my stethoscope. I ordered mine from a local mom-and-pop shop and maybe paid a bit more, but got exactly what I wanted. Check the scrub shops near your hospital too -- a lot of them have unadvertised student and/or employee discounts that you can get by just presenting ID.

No, days is not an option right now. The wait to get a day position on this unit averages over a year. I would be looking to switch to 2 12-hour nights per week. Actually, I got a nastygram in my mailbox yesterday pointing out that my absences are becoming excessive and if I have another, I will have to meet with the manager for "counseling." This is really embarrassing to me -- I've never been that kind of person. So I took it as an opportunity to set up a meeting proactively. She is a kind and understanding person; she is just stressed because of all the turnover. Hopefully I will catch up with her this week; I'll post what happens. Thanks all for the encouraging words

I am currently working full-time night shift, which is three 12-hour shifts on my unit, with every third weekend and call every 5th. Turnover has been very high, and there are numerous positions open, but they only want to hire full-time. I love the unit, the people are great, and the hospital in general is a great place to work. I don't want to leave. But the night shifts are taking a real toll on my health. I am sick all the time, have had to go on antidepressants, and my marriage is getting rocky. During the little time I do have to spend with my husband, I am usually tired, grouchy, and no fun. We argue a lot, which we never did before. I think if I cut back on my hours to two nights a week, I'd do much better. But how do I go about approaching the manager of a unit that is already very understaffed nurses and ask for a reduced schedule? I am willing to do every other weekend, which is more than the requirement, and then fill in a day or two in between. Money is not a problem; I have another PRN job that is less demanding and pays more and I could pick up more hours there. Any advice on how to approach this? Any managers' perspectives? And how much of my personal "issues" should I disclose? (The already know I'm sick a lot becasue I've called off so many times). I don't want to say this point-blank, but if I can't work out a reduced schedule, I see no choice but to transfer to another area, and then they lose a FTE for sure.

TiaNicole, I started out as essentially a new grad in CCU in November 2005. The first couple of months were completely overwhelming. The best thing for me, I think, was coming off orientation. I didn't even know it was going to happen; I just walked in one night after 10 weeks on orientation and there was my name on the board without a preceptor. In a way, it was freeing -- without someone looking over my shoulder every few minutes, I felt more comfortable in doing things on my own schedule and developing my own style. Not that I didn't need plenty of backup -- and all the experienced RN's were happy to jump in when I had questions. I'm now in my fifth month in CCU, and while I would say I'm far from being an expert, I can usually manage my assignments. If I run into trouble, I'm not shy about tracking down someone who can help. I've been told that if you feel completely comfortable in critical care (as a new grad) in fewer than 12-18 months, you are probably being overconfident. It is a *hard* unit to work on. I hope you are being offered some other training as well -- spending time in CVOR and the cath lab, classes on rhythm interpretation, IABPs, cardiac pharmacology, ACLS, fhemodynamics, fluid and electrolytes, to name a few -- you probably touched on all of these in nursing school, but they are essential to your practice in CCU and you really need to understand them well. Please do discuss any needs you have with your preceptor and/or manager. See what resources are available to you. They did not hire you to watch you fail, but you need to communicate your needs to ensure that you succeed. Make a list of the things you feel you need to address further, and see that it is addressed in both your training and your patient assignments. I wish you all the best -- I too am continuing every shift to learn more and work on my weaknesses. But do hang in there -- with perseverence, a good attitude, and the right training, you can become a great CCU nurse.

Well, I can understand the OP's concern. She doesn't say which part of the country she's in, but I know that in the Southeastern US (aka "Bible belt) it can be a frequent source of pressure, both from co-workers and patients. And there are certainly other areas with substantial percentages of very religious people of various denominations. I am a Unitarian Universalist, while the overwhelming majority of my co-workers and patients are evangelical Christians. There is no question that I am "out of the loop" concerning their interests. It's been very hard for me to develop personal friendships with co-workers because they are so into their church activities, Bible studies, Christian books, political activism, etc. that I often find I have no place in the conversation and it's best for me to just back away and not rock the boat. I'm not going to influence their beliefs any more than they will influence mine; I think it best to just focus on work and not invite a debate that will ultimately just encourage divisiveness. Occasionally patients will also ask me if I am a Christian (which means "born-again Christian" to them.) I will respond something to the effect that my spiritual life is very important to me and I am constantly searching for deeper truth. No one has ever requested a different nurse on this basis, but I would have no problem trading assignments it a pt were to persist in pushing for a nurse with fundamentalist beliefs (there is no shortage!). I work in critical care, so often my patients are too sick to ask such questions. But I do pray for my patients, and will tell them so under appropriate circumstances. I will happily let them take the lead -- and I have also had agnostic/athiest patients whose beliefs I completely respect. If they do not indicate an interest in spiritual support, I will in no way push it on them. I will also respectfully defer to any clergy who come to visit my patients. As long as the pt is stable, scheduled meds, BG's, vital checks etc. can be put off for 15-20 minutes, I would rather they have some private time with someone who can offer a spiritual comfort that is way beyond my scope of practice. It is a touchy subject -- I simply keep quiet about my beliefs unless pressured. For me, the problem is fitting in with the other nurses more than satisfying my patients. But I am not willing to compromise my beliefs, and as long as we can all continue to work together as a team, I am OK with keeping at-work relationships professional but not deeply personal.

More {{{hugs}}} to you, and thank you for sharing your story. It is such a helpless feeling to go through a nightmare shift like that, then come home and really have no one to vent to. I'm sure your DH wants to support you, but how do you begin to convey such an experience? It also comforts me to know that others sometimes need to cry. I had a young man come in a 0200 last week with a large aortic dissection (I work in CCU); his wife and kids were hysterical and he was in disbelief as we prepped him for emergency surgery. 10 minutes after he went to the OR, I just lost it -- heaving, uncontrollable sobs for this young family faced with a grim diagnosis. None of the other nurses seemed terribly affected by it. At the time I felt like a weak, ineffective newbie, but he was my patient and I spent two very emotional hours with him and his family. Thank you for opening this thread, and reminding us that we are human and it's OK to let that show sometimes. You are a great, compassionate nurse -- I wish you peace and many quiet shifts.

I'm in about the same place. If the conditions were ideal in terms of staffing and adequate orientation, I could see myself staying at the bedside for many years. In my heart I love being a nurse. But on my unit, staffing is so poor and turnover is so high that new nurses are often asked to take on far more than we are prepared to handle, simply because there is no one else to do it -- let alone train us to do it right! From what I've heard it is no better, and in many cases much worse, on other units in the hospital. I am in critical care, so the ratios are better but still higher than they are supposed to be. Most of the time I like my job; I am doing my best to suck up a year or two at least. But if the staffing crunch is not addressed, and we continue to lose more people than we hire, I am not about to take on a mentor/charge role before I'm ready (A couple of months out of orientation != ready), and I am already fairly high in seniority after a few months I also have a BA in business and am a registered echosonographer. I would rather practice nursing, but if conditions don't improve, I'm open to other options. I'm already considering advanced practice, or working as an application specialist for medical equipment. With so many people going into nursing with other degrees and skills in their background, I think turnover may become even more of an issue as other options become available. I want to be there for my patients, but I don't want to risk my license (or a life!) in the process. It's very sad that the Powers That Be still don't seem to have figured out that what is going on in many places is simply dangerous. But I know that several people in my nursing class (2004) have already given up bedside nursing, and I can't see things getting anything but worse the way it is now.

I've just not seen this happen at all. We do get a lot of float help, both from tele nurses and ICU nurses picking up extra shifts. We are always short-staffed and are happy to have the extra help. Assignments are made on peoples' strengths and capabilities; I've learned a lot from ICU nurses when we have ICU overflow patients. Of course, every unit will vary. But I've been in CCU 4 months as a new grad and just love it more and more as every week goes by. We have some very sick patients. Most of the time there is simply no time for games of catfights. Stuff needs to get done and the staff teams up and gets itdone.

I am very glad to hear that! Congratulations for taking control of this situation and doing what you needed to do. I wish you all the best in your next job endeavor -- and please, do something nice for yourself, a massage or a nice dinner or whatever helps you relax and celebrate your freedom. You've earned it!