LNDRN19

Hi everyone, I haven't been here in a long while. Hope you're all well! This is a tiny bit long, apologies, but thanks for reading this: I've been a nurse for a bit now—19 years. I'm currently a OB charge nurse and have been for 6 years. I love supporting the nurses, techs, and doctors and the APRNs. My crew seems to like working with me, as far as I can tell. I get positive comments from them fairly frequently. Lately, I have been pushing for them to provide evidence-based care versus doing whatever they want, so maybe my popularity is changing. I don't know. Recently, I've been feeling burnout like never before. I've had to work through several bouts of burnout in the past and have always managed, but now...I don't know how to get through it. What broke me is nurses habitually calling in for dumb@$$ reasons, leaving me to not only run a very busy unit, but to also take a full patient load. I love patient care; that's not the problem. The problem is my patients don't get the best version of my nurse self because I'm constantly pulled away from them. I hear the nurses talk about why they call in—they have often partied the night before and are too drunk and/or tired to work the next day. Then they come to work when they are ACTUALLY sick and spread the illness all over the unit. I recently was sick for a solid week and the only person I was somewhat near was one of the Party Nurses who came to work masked but very sick. They also call in about 30 minutes before work to say they will be 2 hours late to work. (Our state has legislatively-mandated sick time allowances for which you can't discipline employees for using. It's not a lot of hours, but still, no discipline). OR, they are on-call and use that state sick time when I call them in. Other things contributing to my burnout: working at a for-profit hospital where NOTHING works as it should. Phones hardly work. Wi-Fi is sketchy, at best. Ollllld equipment that barely functions. If the doctor goes to the main OR, it's like they are in a concrete bunker and I can't call their cell. Tiny raises, if any. No recognition after selling your soul to the hospital. Big time focus on profits over patients and employees. Etc. I have applied for a few management positions and have not gotten them because I was told I'm "blacklisted" from management since I turned down a management position they offered me a few years ago. I turned it down because we go through managers like water hitting a hot stove and I didn't want to be the next person unemployed a year after taking the job. Also, they "require" 60-70 hours/week, but of course you're only paid for 40. Additionally, I wanted to help the nurses learn since I have so much experience—that was a waste of time because they do whatever they want, anyway, and nothing is done about it. I'm almost ready to leave the profession altogether. Please tell me how you all are getting through these crippling bouts of burnout....

Hi friends, I haven't been here in a while and I apologize. This is a great site and I have missed you. For quick reference, I am a Labor and Delivery RNC with 7 years of experience as a nurse, 5 of which have specifically been in L&D. I have done a stint as a permanent Charge Nurse, during which I realized that I really just love bedside nursing at this point in my career and kudos to all the nurses who enjoy management...meetings drive me crazy...politics drive me crazy...not my gig. I feel like I failed as a nurse yesterday. I felt as though my patient assignment was too heavy. I was barely able to provide safe patient care--and never specifically told my charge nurse that I could not handle the assignment she gave me. I implied, hinted, asked for RN assistance from time to time, but never specifically said "I CANNOT HANDLE THIS ASSIGNMENT," and therefore feel like I failed. I am ashamed of myself. This is not who I am. I am the nurse who speaks up. I am the nurse who confronts MDs and other providers when they need to be confronted. I am the one everyone else goes to when they need to muster up courage to speak to someone "above" them. I am the nurse who brings critical patient safety issues to the attention of the DON if necessary. So, I can't figure out why I didn't tell my CN yesterday that I was drowning. I had the SICKEST patient on the floor. In the other two hospitals I worked at in the past, this patient ABSOLUTELY would have been on-on-one. She had HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome that was steadily worsening. She was on MgSO4. She had a very premature fetus...HIGH RISK. My CN, around 10am said that she was going to have to temporarily give my another pt to watch until RN Suzy Q (changed to protect the innocent) was done with her current patient situation, a C/S that she was almost finished recovering. Well, let's just say that that never happened. That "temporary" situation became permanent. I struggled to stay on top of my HELLP patient's worsening situation. I could barely squeak in enough time to listen to her lungs on a regular basis to make sure her lungs were CTA...she was barely cranking out adequate urine. The (excellent) doctor who was overseeing her care couldn't read the last set of VS because, hey, I hadn't gotten a chance to sit down and chart them because I was in my other patient's room taking care of HER. I could bore you with more details of things I didn't get to do because of that assignment, but they wouldn't matter. The point is, my HELLP patient did not receive the amount of care that she needed and deserved. I want you all to know that this is not a matter of me being upset because I was busier than the other nurses; I LOVE being busy. I PREFER to be busy. I am not complaining about the acuity. Challenge me with the tougher patients--I love to be challenged. This is a matter of the CN having given me an assignment that pushed me past my "tensile strength." What I am wondering from you all is, do I have a legitimate concern, or am I just whining? If I am just whining, I will shut my mouth and learn to deal with these sorts of assignments. I know we all get hosed on pt assignments and I can take my hosing and keep on going. I just felt as though I couldn't provide safe patient care and I failed because I said nothing to my CN. I will never, EVER, say nothing again. I will accept whatever humiliation and being gossiped about that I have to...I WILL protect my patients better in the future. Thoughts??

That's what I thought, too, regarding the insecurity. As far as I know, Dr.G's attendings have a hard time dealing with her and, according to my unit mgr, she's had to be spoken to about these unprofessionalism issues before.

Thank you! I love precepting. Students are cool. Dr. G is not worth my stress, which is why I have been ignoring much of her insolence. It was when she yelled at me in front of others that I knew I couldn't ignore it any longer. She is intent on ruining everyone else's day and making them as miserable as she is and that is going to stop.

Thank you so very much! It was hard to keep my cool--I have enough feisty Irish blood in my veins that I have to watch my responses to people. I absolutely agree with you in that she is creating a hostile working environment.

HAHAHAHAHAHAHAAAA!!!!!! This is AWESOME!!!!!!! You gave me the laugh I needed! I am ROLLING ON THE FLOOR!!!!!!

Wow, these are all great replies and have helped me a lot! Yes, I agree with not friending doctors on FB anymore...completely agree. I quit adding them as friends a couple of months ago, no matter how much I like them. I am going to have a chat with Dr. G the next time I see her. I will not stand for being treated poorly at work. I don't do it to other people and I don't think it's right or acceptable for people with whom I work to do it to me. Thanks for all of the wonderful replies! You all are GREAT!!!!!!!!!!

We are FB friends because up until recently, we got along great. I think you are right about needing to delete her. I've been thinking about doing that. As far as venting goes, she vents everytime she works the floor. It's funny that you mentioned doing my own countdown...that's exactly what I'm silently doing! :) LOL. I think I will try to buy her a coffee and talk to her. Or is that being too submissive?

Thank you, also, SkiMama! :)

I have thought about that approach. Thank you for your kind words!

Hi everyone, I am looking for thoughts and perspectives about a situation so that I can take the next step in dealing with it. I work with a doctor who has been rude to me and others for about the last month. I tried not to take her rudeness personally because I figured she is just stressed out. She always talks about the "countdown" to the end of her fellowship. She has more than once mentioned to people at work how much she hates her fellowship and described it as the "bane of her existence" on Facebook. So, trying to be a cheerful person and brighten her day a bit, I say "hello" to her whenever I see her, to which she bares no smile and gruffly and obligatorily says "hello" back...I try my best to promote a good working environment for everyone. Yesterday, I was taking care of a very sweet, laboring patient. She had a very sweet husband and a sweet extended family as well. We all got along very nicely. I do my best to provide a warm, nurturing, caring environment as childbirth is usually a time of great joy. I want all the kiddos I help see into this to have a very Happy Birthday. :) All those good vibes were wrecked when in walks Dr. Grumpy (I'll call her Dr.G for short). She literally barked off about three "orders" to me...things that aren't medical orders...like "change the pt's underpad" and such...seriously, I don't need to be told how to be a nurse. I am not a lazy nurse who waits to be told to do things. I am busy and proactive. Then she quickly apologized for being "so demanding." Next, she turns to the resident in the room and said, "I'm sorry, but I'm going to be a princess today." Huh? What does that mean, anyway? That you are going to keep up with this ridiculous trend of telling me how to do the job I've been doing without prompting for the last five years of my life? I didn't respond to her "princess" statement. I thought it was just dumb that she said that. Furthermore, I am precepting a nursing student right now and want to teach her to be professional. Long story short, Dr. G kept that poo up all day. I didn't pay too much attention to it...didn't take it personally...until she yelled at me in front of two other doctors, my student and a couple of other nurses. Here's what happened: My patient was completely dilated and was starting to push with contractions. Dr. G is not satisfied with the fact that the pt's contractions are five minutes apart, so she wants an oxytocin infusion started. I didn't really think it was totally necessary but couldn't disagree with her reason for asking for oxytocin--it would be helpful. Well, Dr. G had walked out of the room after demanding that Pit be started. When I came back with the Pit, I asked the resident at what dosage she wanted to start the infusion. She said 1mU, which I did. (She put the order in the computer later). Those of you in L&D know that oxytocin is a high-risk medication and low-dose "Pit" infusions are more effective than high-dose. After 15 mins, I increased the infusion by 1 more unit. The resident them told the pt that she would have her take a short break from pushing and would have her start again when her ctx were 2-3 mins apart. My patient was stable; I stepped around the corner to get a sip of coffee in the "board room." Dr. G is is there looking at a computer. She whips her chair around, stared at me in the face and asked if the Pit had been started, to which I replied, "Yes." She asked me what it was started at; I told her. She immediately yelled very loudly saying, "ONE? ONE? Her contractions are SIX minutes apart! How do you expect her to have a baby with ONE mU of Pit going?" I said, "I just increased it to 2." She said, "We need to CRANK that Pit. This is ridiculous Why did you start it at one?" I said, "Because that's what your resident ordered and I started it according to her orders." She replied, "Well, you need to crank that pit!" and whipped her chair back around. Why in the world was she yelling at me? I went back to my pt's room to help with her delivery, unable to smile for several minutes. My face was so hot I had to step outside the door for a couple of minutes (my charge nurse stayed in the room with the patient during that time). It was at that point that I started to feel like it was personal with Dr. G. She was nice to the other nurses and techs yesterday. What bugs me is, I seriously cannot think of anything I ever did to upset her, personally or professionally. I am so upset about this. It literally ruined my day yesterday. What should I do to handle this? I am definitely not going to let her just get away with being so unprofessional.

Thank you for posting this! What you said was almost exactly what I said to her! :) Thank you for your sentiment on loyalty--I agree with you.

Hi Snuggles--thanks for providing clarification on FMLA usage! I certainly understand that a staffing issue is created when people call in FMLA 1 hour before a shift starts (I call in no less than 2 hrs before) but sometimes issues arise that weren't anticipated sooner. If I have to take my husband to appts, I will let my charge nurse know a week in advance if possible so that any possible staffing issues can be anticipated better. :)

I don't anticipate any long-term usage of the FMLA. There is, however, a possibility that my husband will have to have spinal surgery, so it's hard to say. He had surgery on his arm on 8/30...I took the week off after his surgery and have needed to take a total 3 days off (spread out here and there) since. So, a total time of 2 work-weeks off. Our unit has lost 6 nurses in the past 4 months--major complaints against management is causing our unit to lose nurses like crazy. Most of the nurses that have left were on night shift. (I work days). Some of our day nurses were pulled from days to help out on nights, so there is a temporary shortage issue. I'm sure that contributes to the reason my manager is stressed about staffing. I get that. The problem should resolve very soon because new staff is in the process of being hired. My needing-to-use-FMLA issue should (hopefully) fizzle out soon. Wouldn't life be so much easier if no one ever needed surgery and never got sick. *Sigh*

Thank you for your thoughts, llg.