justmanda

Our hospital has started deliberately understaffing the floors. No secretary. Only one tech for 18 patients. No phlebotomy department. This is not because we don't have enough staff...they actually send techs home all the time because they have redesigned the staffing grid. As a result, the nurses are now the secretaries, the lab, the tech, etc. We usually work one to two hours over our shift. The management is getting tired of the nurses clocking out late and attached a note to our pay checks that said we must clock out on time. If we don't, we must fill out a form that says "why" we didn't and then have the charge nurse sign it. Of course, the charge nurse has six patients of her own. We are always so swamped, that we are not in the position to help one another. We never take lunch and usually don't even have time to pee. We are encouraged NOT to fill out a missed lunch form because we must also list all the reasons why we did not take lunch. We must also have this "approved" by the charge nurse. The management thinks we are so dense that we don't realize they are hoping we won't have the time to fill out these forms and, as a result, won't get paid for these extra hours. One manager says she doesn't understand why we can't get our work done. It took everything in me not to look at her and say, after my 14 hour shift, "You are a horrible human being. How dare you treat your employees this way." I have been a nurse for ten years and I can't believe how bad it has become. I am seriously thinking about a different career. Am I wrong to assume that satisfied employees make satisfied patients? Our management cares NOTHING about the patients. If they did, they would make sure they had enough staff to take care of them.

A nurse's heart is covered with a thick black shell but when you peel the black away, uhhh....more black. I am only half kidding here. Maybe because we deal with such serious issues we lack the sentimentality that most people have. But I don't quite get why we are so mean to one another. It's the only career I can think of where it seems you get a job performance evaluation at the end of every shift (during report). You don't know how many times I have heard "so-and-so left me a bad IV and a lab he didn't draw" So many nurses refuse to just pick up the slack and move on with their shift. They blame everything bad that happens during their shift on the shift before them. What's the hardest part of nursing? NURSES ARE!!!! Sometimes, they make me want to chuck it all and go work at McDonalds.

This morning, after a twelve hour shift, I found out that my relief was just getting out of bed and wouldn't be at work until 9am. I was expected to stay, without complaint, until my relief arrived. When I dared to mention that my young children were going to be two hours late for school if I stayed, the manager of the floor called me a "whiner". I don't mind staying a little late every now and then, but this frequently happens and the powers that be actually seem surprised and irritated when nurses have other responsibilities they have to tend to. The manager finally took report from me at 8am, seething the entire time. I don't blame her for the person not showing up. It wasn't her fault, and I thanked her for taking report. Her attitude though, made me furious! Just a rant....ahhh. I feel much better now.

Just the other night at my facility a nurse was sick and wanted to go home. The supervisor could not find a replacement and we each GLADLY took one of her patients on. We ended up with one more patient than our max load a peice, but the poor girl was sick. Was there nobody on your unit that could pick up the slack considering your family emergency? Did you not hand your patients off to someone on your unit, the charge nurse maybe? If so, that isn't abandonment. It sounds like your Supervisor is a heartless sweat shop matron. Nice choice you were given there...your job or your kid. You made the right one dude. I know our job is supposed to be this thankless contribution to society, but if my child needed emergency assistance and my Supervisor refused to let me leave, I would report HER to her boss. Find a hospital that doesn't treat its staff like cattle.

I think the nursing profession is the only field in which a promotion means less money. The director of our unit makes only about 60,000/year. The nursing supervisor doesn't make much more than that. I'm an ADN and made 90,000 last year. Granted, that is with some overtime mixed in, but the salaried administrative nurses get paid the same regardless of the overtime they put in. Less money....more headache. I'll stick with my little 2year degree.

I am an RN in Florida and made 100,000$ last year. This is with overtime though. Most hospitals give you overtime pay plus incentives to work extra shifts, so it is easy to make 100k as a nurse. Well, I shouldn't say EASY because you have to put in all the extra time...but do-able. I work 60 hours one week and 48 the next (two weeks on each paycheck). Sometimes I only work the three days (so I can have four days off in a row) and then I make it up on the next week. I am the bread winner in my family, so I have no choice. But if you just want to do it long enough to pay off some bills, it is definitely possible.

I agree. Whenever I see a forgotten prescription pad lying around I cringe. Like you said, I wouldn't touch it with a ten foot pole.

What happened to computer testing? I took a computer exam for my boards. You guys have to sit for paper tests now? How long does it take now? Mine took an hour.

Sometimes correctional facilities contract out for nurses. I know they started doing that in Florida. Try calling the facility and asking them if they do this and if they do ask for the company's info.

The only problem with being slow but thorough is the patient population. You can't be slow in a crisis, even if you are being thorough. You have to be quick and thorough. Quick thinking, quick acting. Not saying that is me...but I do understand the importance of efficiency.

Go ADN....more money, more autonomy and you can get a job anywhere.

Major problem in the nursing field? How about Nurses! I speak of the grumpy self-righteous,backbiting type who make your job a living hell. It may be the poor staffing, poor funding, and poor management listed above that turns someone into this kind of co-worker, but it IS one of the major complaints I have with our profession.

I cried my first two weeks as a nurse. Thought it was the worst mistake of my life. Nursing is a hard profession. You will be worked like a dog. But, after awhile, you'll get used to the workload and will be more comfortable with the environment, the people, the procedures, etc. After you reach a certain level of comfort, you will think more clearly and be more efficient. I work at two hospitals (just started a new one) and still cringe and sigh before I clock into the new place. I have said "I hate being a nurse" at least ten times to my husband in the last month. (btw, he pointed out that I always say it before I go in to the new place for a shift). So, in a way, I'm a new nurse again with all the insecurities that go along with being in an unfamiliar environment. I do see it getting better as I am getting more accustomed to the new hospital. It will get better for you with time. Unless your place is awful, I would stick it out long enough to see if the comfort factor is what is making you unhappy. If that's all it is, time will cure it.

Don't forget to DRINK and PEE....you could throw a rock in a crowd and hit at least 10 nurses who have had a kidney stone.

always wear a mask and goggles when doing trach care....the stuff that flies out of there during a cough is high powered. "Now here's spit in your eye"

I can cath a lady from across the room but have a HORRIBLE time with men, for some reason. It always gets hung up on something and I practically have to give the guy a hand job (with all the repositioning of the member) to get it in. Someone in nursing school told me (regarding female cath) "You will see a little star" And I look for the star every time and get it.

You don't have to know the entire chart. Just have the chart in front of you when you talk to the doc. Tell him "give me a sec I have the chart right here" You don't know how many dumb things I've said to a doc, and you will too. It will give you a funny story to tell your friends. Don't be afraid, then you will avoid it and never become comfortable. The phone calls from other departments....I probably say "I don't know, hold on" a couple times a shift. I get the chart and give them the info. Don't sweat the small stuff. You're expecting yourself to know everything? Nobody else expects you to.

Someone will always think you suck...no matter how good you are. That is just the way a lot of nurses are, unfortunately. If a nurse following you has a busy day, she will find a way to blame it on the shift before her. Not all nurses, but a lot. If your shift is not all tied up with a big pretty bow, you will get "the look" and a sigh and then will be bad mouthed after you leave. I'm telling you this for a reason. There is NOTHING you can do about this. It is just the way it is. So don't waste a second of your time thinking about it. Just do a good job and find satisfaction in that instead of what other people think of you. Now, to all you nurses who feel compelled to send me a snippy post about my assessment of the above mentioned nurses, don't waste your time. My intent is to prevent this poster from needless stress put on her by her co-workers. The job is stressful enough without trying to please the unpleasable....and I have NO DOUBT that each of you work with a couple of these types.

I agree 100% You don't know how many hours I wasted as a newbie going back to charts a million times to see if something was missed. Now, once it is checked off on my list, I don't give it another thought. Chart check DONE! Instead of Chart check STILL DONE, chart check STILL DONE, chart check STILL DONE. Oh...the time I wasted.

---->I don't nor do I want to live, eat and breath nursing. I like to leave the stress and the job behind when I go home. Uh oh...wait, I'm on this board talking about NURSING! Would that come under the Living, the Eating or the Breathing category :)

Unfortunate fact about nursing. For every one minute you spend with a patient, you will spend ten minutes, if not more, with the chart (checking boxes, doing chart checks, doing checklists, consents, rewriting mars, studying history, looking up labs, getting educational materials together, etc.) The surly doctors just come with the territory (and most of them aren't bad). You'll get used to them in no time....just like after awhile mothers aren't bothered by the sound of shrieking kids.

And how is taking her out of the fire going to make her more competent in handling emergent situations? She can't go back and change what she did and many of the responses in this thread are trying to do just that. She knows she did something wrong and aside from taking her out in the parking lot and beating the tar out of her, I don't think there is anything we can do about it. She was overwhelmed because she didn't know what to do. It was her first crisis and she froze. Yes leaving the patient = bad choice, but what made her leave the patient in the first place is probably what should be the focus here since we are here to help one another and not to be self-righteous finger pointers. And my advice on admitting it to management (I'm sure I will get a lot of flack for this) is NO! You could lose your license. The DON may even be required to report you to the board even if she doesn't want to. The fact is, a patient was abandoned. There is no getting around it. Now live and learn. This is no place for the timid. ENGAGE MAVERICK!....(haha I love that movie) and do what you were taught to do.

Listen, you are new and are still grasping what your role as a nurse entails. It's pretty simple, when you boil it down. Keep your patient safe and report any changes to the Doctor. Of course we do other things, but those two will guide you through the rest of it. Don't get scared when something goes bad with a patient...what do you do? Keep him safe and call and ask what the Doctor wants you to do. Seizure precautions and a phone call to the Doc. would have been a wise choice in your case, but don't beat your self up about it. Chest Pain...(if there are no standing orders) slap a bp cuff on him and call the doctor otherwise, follow the protocol for your floor (EKG, nitro, etc). Patient starts vomitting blood....give him an emesis basin, take his vitals and call the doc. Patient falls and busts his head on the floor. Get him back in bed, assess the wound (apply pressure) and call the doc. PATIENT STOPS BREATHING.....ABCs and code team. I'm trying to throw out horrible scenerios here to illustrate my point. Don't let fear prevent you from taking care of your patient. When something horrible happens, take a few deep breaths and think for a minute. I've been a nurse for ten years and the other day a patient passed out on me while she was on the toilet. I may have been calm on the outside but my innards were doing the panic dance. I took a deep breath, got her back to bed (with help) and called the doctor. He gave orders and all ended up well. A patient going bad will always be unsettling. I think that is normal. But, do learn your unit's standing orders since they allow you to intervene with meds/tests, etc prior to calling the doc.

My floor has tried it both ways and, truthfully, it sux both ways (for the charge nurse anyway). That's why I detest being in charge. Here's why. Imagine you have no patients and are in charge on a floor with 9 nurses. You are the one that has to do what nobody else wants to do. Start IVs, deal with hospital to hospital transfers, assign beds to nurses who all complain that they're too busy to take an admission. Take admissions because you don't want to have 5 nurses mad at you. Assist with bedside procedures. Handle fights between understaffed CNAs and the nurses who they say are "working them to death" Fight with Patient Placement when they try to send too many admissions. Change diapers because the CNAs are being worked to death. Help the float nurses who don't know the unit. Make the day shift assignment. And so on... Now, imagine you are in charge and have 6 patients and read the above list of duties....it's exactly the same! Granted, there are a few independent nurses out there, but for the most part, you are the relief pitcher when you are charge - patients or not. Some people like that type of chaos and it is those people who probably make the best and most efficient charge nurses. On another subject...when it comes to calling doctors for other nurses, I have always found that to be very odd. It is the primary nurse who best knows the patient and can give the MD the full picture. I wouldn't want another nurse calling a Doc for me.