frustratedRN

i cant even imagine monitored beds on our unit. holy heck!

we get the overflow from the entire hospital. if there are no open beds on that unit they come to ours. likewise, if the person doesnt really fit into a catagory we get those too. weve been getting a lot of psych patients lately much to my dismay. we arent in a lock down unit like these patients need to be. im not a psych nurse and the same precautions taken in our psych unit, for example, not wearing a name badge, are not observed on our unit. seems like we have turned more into a nursing home than anything else lately. we have patients admitted with basically no acute needs. they are there for placement issues or because the nursing home just wanted to "get rid of them" for a couple of days. they are admitted with strange things. for example we got one of our frequent flyers back from her nursing home. she was admitted with possible aspiration. lol we couldnt figure out what she would be aspirating on. she had tube feeds going. tube in right place, no residual. cxr clear. o2 sat 98 percent on room air. she doesnt eat, swallow or talk. you can tell her lungs are good cos she spends most of her time screaming just to scream. (oriented to nothing) we just assumed the home needed a break from her. we have a patient down the hall who is 39 years old with AIDS and aids related dementia. no nursing home would accept him. he has been in the hospital since june. id say the last month or so we have had the same patients over and over and over. you look at the charts and there is nothing really acute going on. maybe a temp spike once in a while or some other issue that could have been handled in the nursing home. we ARE the dumping ground....thats what med surg is

bout a month ago i had a pt starting on trazadone. i did all of the teaching regarding the meds and had pharmacy send up some pamphlets. i gave them to him to read first and this guy was just mesmerized with the priaprism side effect. i explained about the pain and possible loss of function but he said it would be worth it. havent seen him since so i guess he didnt get it. ive never seen it first hand, so to speak.

for the longest time and until recently i felt the same way and just prayed that nobody would see thru my facade of profeciency. i can remember my first semester in school and thinking i would never be able to be a nurse. most of my classmates had some background in medicine. mostly working as aids in nursing homes. i didnt. the skills came slower to me. once in clinicals i began to cry with frustration and my instructor had a long talk with me. she told me i was going to make a great nurse. of course, i disagreed because it seemed like i just wasnt as good as my classmates skill wise. she said that i had the most important attribute to make a great nurse....critical thinking skills. she said that anyone can learn to bathe, make beds, give meds, ect. but not everyone has the thinking part down. she went on to tell me that out of all her classes my papers were the best. (care plans, etc. ) and that she was going to use them in other classes for examples. she said skills will come with practice and just to hang in there. from then on, anything that happened in our clinicals she made sure i was a part of....complicated dsg changes, death, anything i could get a different kind of experience with. if not for her i probably would have dropped out. later that year with another instructor i made a med error. that did nothing to boost my confidence. my very last semester i had the instructor from hell. she used to choose one student every year to pick on. i was the chosen. at first i didnt believe it but it didnt take long to see it was true. this particular instructor tried her best to make me fail. she absolutely confirmed my feelings of inadequacy. at one point she told me straight up that she was going to make sure i didnt pass. at that time i was having some health problems myself and had to be hospitalized twice. the second time, two weeks before graduation, she told me i missed too many clinicals and i would fail. this came to me as i was in the hospital. i was devestated. my mom reached the head of the nursing program who knew all about this instructor and what she did to the students, but she said there was nothing she could do, and we threatened with an attorney. the head of the program called a meeting with every instructor i ever had and they voted whether or not i should be allowed to graduate, if i made up my clinicals of course. every one of my instructors, except her, voted for me to graduate. my best compliment came from the instuctor of ICU. she was a no bullshit kind of person. she said that during my entire stay at ICU i was great. never any problems and i knew exactly what i was doing. she suggested that maybe the problem wasnt with the student but the instructor. after my second clinical makeup the makeup instructor told me that the one trying to get me told her that i was incompetent. she said...youre not incompetent at all...wonder why she said that...lol i told her why. i graduated with my class and then quit nursing for a few years. all the things that happened in my last semester reenforced my feelings of inadequacy. i didnt want to do it anymore. i was afraid. finally i took a refresher course and went back. im working now and getting more assured with every shift. i know im not incompetent and i wont let anyone try to make me look that way. you will get over those feelings with experience. now instead of looking at the other nurses and thinking i am lacking, i look at them as role models who can teach me to sharpen my skills.

we DO help each other and we DO support each other. and we do vent. if there is arrogance here i dont see it...and if im guilty i dont mean to be. bonster do you really expect us to tell you those lies? you get the same kinds of attitudes in any job you take. the same "kinds" of people work everywhere. it doesnt matter what profession you choose, you will encounter them. the whole bsn/adn/diploma thing is retarded. if the bsn's think they are better nurses than the adns and the adns think they are better than the diplomas....all based on education, thats kinda short sighted. credit is given for life experience. not everything you learn is in a book. maybe entry level SHOULD be bsn but its not so just get over it. im an adn...im going to get my bsn to satisfy MYSELF. will it make me a better nurse? maybe, maybe not. im so tired of competition, especially on our unit. im not competing with anyone. im just doing what im supposed to and trying to learn the best way to help my patients. as far as im concerned anyone who wants to be queen nurse has my blessings. was that arrogant? hmm...maybe lol

you should have told him no i dont know how to unclog them but i do know how to clog them see you in a few minutes then

ive been at hospitals that use both. i like the verbal better because you can ask questions. something you cant do with a tape. we have a conference room where we give and get report. it would be difficult at best to do that at the desk although one or two of the nurses prefer that. yes some of the ancillary departments call. and sometimes the docs need us but we refuse calls not of the utmost urgency. there is a drawback to the verbal report. both nurses are off the floor for a bit and sometimes the patients have to wait. thats usually not so much a problem because we are right there for an emergency. we have patient care sheets so we dont take charts into report. all of our data is notes on these sheets.

we have patients like that all the time. especially now that we are getting the overflow from the psyche hospitals. lots of junkies leaving with needles. makes access ever so much easier for them. they get their fixes and then come back. we take them of course. our docs are pretty good about the sitters. they dont have to state suicide intent to get a sitter. if its someone we cant control they order one. my brother was in an accident last new years eve. he had head trauma and was in a rehab hospital. all the doors were locked and they put a band on him and his wheelchair so that an alarm went off when he neared the door. used restraints too. hated to see him like that but it was better than him running. we generally try other things before we get a sitter. we try the bed alarms, restraints, pharmacutical restraints, and then a sitter when those fail. no you cant watch all those patients.

tim...and i just have to ask...what do you think of YOUR superiors? just curious and wondering if it goes on all the way to the top.

managers have completey different problems than the staff nurse. not that they are any worse or better. harder or not. just different. they answer to different people than we do and have different issues. managers remember what its like in the trenches but they have a different perspective and focus. we dont worry about recruitment lin the same way management does. we are looking at the now picture. they are looking long term. they dont worry about patient care on the same level as we do. dont expect us to see eye to eye. many of us resent management for their lack of concern in regards to OUR issues. at the same time we blatently dont care about their issues. tim is right about nurses bashing the profession. ive always wondered why we do that. i just take it back to nurses eat their young. i encourage people to consider the profession. im not negative about it to the students. i love being a nurse. i just hate the bullshit put on us by the management. from state boards all the way down. in your post tim you openly resent our attitude. at the same time you seem upset that some of us resent yours. all of us are looking at the same crooked picture. we are just seeing different ways to straighten it. but we all agree it needs to be straightened.

where do these nurses and managers find the time to see what everyone else is doing and write them up? why am i so busy i need to stay hours after my shift to finish my charting but they are done in like an hour. how are they finding time to sit at the station and socialize...with my assitants no less...keeping them back from their work? they must be super nurses or something. we have one that likes to check out all the other nurses patients. what that nurse is doing. she butts in to everything. she seems to have plenty of time to make sure i have care plans on my admissions and double check the decisions i make. she has time to do this to other nurses too. she must be a great organizer....lol why cant mgmt see this? she is a great something alright...lol

how absolutely management like. you ask what we think. we tell you and you take it all the wrong way and turn it back on us. you will do well in your position.

during my senior year of nursing i was asked to address the freshmen class. my speech was about this topic. it was unnerving for me as a freshman to hear all the negativity from the nurses and senior students in regards to our profession. the nurses where i did my clinicals told us we had to be nuts to be nurses. the seniors reiterated the sentiments. but what shone through to me was that all of these people were STILL nurses. had to be something to that. you cant really judge things by this forum because as its been said this is our venting place. but you are right in some things you say. i started my career at a hospital i really believed in. i was PROUD to be a TEAM member. only to find when i got out of orientation THERE IS NO TEAM. its all for one and one for one. rather than the nursing staff looking at me as their relief they are trying to make me out to be incompetent and i have been harassed by one or two of the nurses who are mgmt wannabes. i have reported this to everyone and does mgmt care? NO! i was moved to a different unit where i flourished. i begged them to let me stay there or move me to a different unit. they refuse. tonite i go back to the hell unit. much wiser of course than when i left but still dreading it. i now have to find another job because i refuse to deal with the crap that goes on. so this hospital has spent thousands training me. im finally to the point where i can function independently within hospital rules and policy and i have to quit due to unaddressed harassment by some of the staff and the pigheadedness of mgmt. so this hospital is going to lose another great nurse. the staff on this unit is going to have to start all over again orienting another newbie. and if they treat her like they treated me...and they will...she or he will quit too. i dont know about how you are as a manager but i will tell you that our managers ONLY care about how they look and filling those beds.

some very good advice. thank you. thats one of the best things about this forum. :) i liken working in the hospital to being in a war too. in fact the unit from hell (where i must return to tomorrow) is a lot like working in a mash unit...or so i think having never worked in one. you know the unit i have been on has been so pleasant. the patients are mostly renal and i dont mind that. the staff is so nice and there is a sense of peace there even in the chaos. im going back to hell tomorrow...at least until i find another job. ill do what im supposed to. ill watch my back and ill document everything but i will NOT accept harassment from anyone. i really need to get out of there. too bad cos i do like that hospital. i can learn to like somewhere else. burnout is a big issue. i dont want to burn out before i even really begin.

i still think that poem sucks...

great advice enurse. the suit and tie is great. it shows you are serious about being employed there and that you portray a professional demeanor. In addition they will be sure to ask you why you left nursing for that two years and what you did with that time.

id love to chat....just dont know when im nights this weekend

a near fatal car accident put me in the hospital, in traction, for two months. i was pregnant at the time. i went home in a body cast and two months later delivered by c section. so yes i have been a patient. and yes i do see things from the patients eyes AND thru the nurses. i dont think there is a one of us who wouldnt agree that the we strive for quality care. i found the most annoying part was about the food tray...first off WE didnt leave it out of reach. we dont deliver food trays (yet) and the part about discussing nutritional needs in conference. maybe if we didnt have to attend those conferences wed be able to sit with the patient and help with their food. its just another example of the nurses getting blamed. i do agree with your sentiments and at times we get hardened. sometimes we need to stop and remember that mr jones is not a case...he is a person.

im glad im not the only one that found that poem offensive. i DO take the time to fill the water pitchers and provide the extras. i DO listen to my patients and try to give them a little special attention while attending to their NEEDS. and the result is that i stay three or four hours after my shift completing the mandated paperwork. i dont have time for myself or my family if i want to provide the standard of care i have set for myself. and what do you think the administration will think of this? they will think i am screwing around and slow...unable to do my job in a timely manner. meanwhile those nurses who never listen to their patients and really could care less whether they have water or not are getting their charting done and are praised for being oh so organized.... as for some of these patients. one of my coworkers cracks me up when she says...."well that patient is never going to stay at this hotel again"

WHAT???? YOU DIDNT CHART I AND O'S? SHAME ON YOU....WHAT KIND OF NURSE ARE YOU? NOW YOU GO STAND IN THE CORNER! lol it doesnt matter you didnt do that. big deal...what were the consequences of not? did someone die? was their health comprimised? this is pretty much the same kind of crap im getting with my job. well when i was on that other unit. and it was caused by another staff nurse who is not in charge (tho she thinks she is). and yes i LOVE what i do but i HATE my job. so much so that if they put me back on that unit i will be forced to resign. and they will be losing one great nurse. i was just where you are now. my stomach hurt all the time and i dreaded going to work because i knew i was going to be dumped on and no matter what i did it wasnt going to be right...they would find the least little thing to carry on about and then gossip about my "sins". i cant offer you advice other than to be very careful what you say about her and TO her. make sure you have a neutral witness when dealing with her. document everything and cover your ass. oh how i wish i had done that when all this crap was coming down on me. other than that i dont know what to tell you cos im dealing with the same damn thing. i can only offer you my support and empathy. just hope it passes.

this is one of the most disheartening things about this profession. there is nothing more important than the patient while you are at work. you feel that...the hospitals tell you that. but its not true. the most important thing at work, according to the employers is the paperwork. thats really want they want done. making sure their asses are covered every step of the way. if you asked the ceo which he would rather have you do...fill a water pitcher or chart your assessment what do you think he would say? and yes this is why nurses get burned out. we are unable to give the kind of care we want to give. i know that some of my patients are lonely and some need more attention than others. i give them all the time i can which is very little these days. its a double standard...in an eight hour shift on my unit there are so many things that need charting plus all the other tasks that need attending to...id like to get out of there on time at least once. it never happens. i cant. i will spend and extra 20 mns with mrs jones because she is having surgery in the am and the docs never really explained it to her. of course she is scared. i spend an extra 10 with mr smith because he is going home and has questions about his discharge instructions. 20 more minutes with mr johnson because he has been waiting in his room to be taken to the door for discharge. i cant stand to see him in that wheelchair just waiting so i take him. mrs brown would like to have some information on a test she is having in the morning and there are no patient teaching materials on the unit so i need to run down to the gi lab to get her some. another 10 minutes. all of these things together have taken me an hour. they are ALL important. but now im far behind in my documentation. ill prob never catch up because now these patients know i will help them they will ask me for more and i will surely accomodate them. you see...i thought that was my job. but in reality its not what the hospital wants. they want me to show up on time. they want me to follow thru with treatments, they want me to dispense meds and they want EVERYTHING documented. they dont care if i stay late. ive already stayed over 4 hours after my shift just to finish. ive been told they dont care how long it takes, i am not to go home until its all finished. that seems to be their focus. however, i am not the kind of nurse who can do that. i will help my patients and i will take care of their needs no matter how small they might seem to me. i hope i never change

wild do tell...lol

this may not be a poplular opinion but its what i believe. its going to take men to change our profession. as more men enter the field i think the pay rate will go up (after all THEY have families to feed) and the working conditions will improve. male nurses are treated with more respect and professionalism than the female nurses. i never hear docs talk down to them like they do us.

so what do we do? thats the real question.

tomorrow i am bringing a baseball bat to work with me. i want to introduce it to some of the people on my floor. lol