heather1999

Thank you everyone who posted. Night before last, I had the stay problem and my NM was the other nurse on my team. She says she's written up techs 3 or 4 different times and it seems nothing is done about it. And a tech did it to me AGAIN...my patient was on FOUR different BP meds (so vitals were VERY important to me) and I find my tech charting some vitals, but I suspected they hadn't been taken. I even asked my patient if she had had her BP taken at 6 am and my patient, told me "no, no one had taken her BP since last night", yet there in the chart was a BP (and HR) with an 0600 time marked by it. And while I'm angry about it, my patient's safety is my primary concern, so I took vitals myself (and my tech saw me doing it, too). But I didn't say anything except to my NM. I've got to do something about this situation, but what? I must learn to assert myself, not for myself so much, but for my patients. I'm their advocate; I'm their voice...I want them to get the best care possible, but I can't do it all by myself. Does anyone know of a good book about asserting one's self?

I know what you mean, Peachy, about wanting to be dilligent in your nursing and wanting to care for patients hollistically. I've only been a nurse for 6 months now. I always think to myself "This patient is someone's mother or father, sibling, husband or wife, friend, someone's child... what if that was MY parent or MY SO or My friend laying in that bed? How would I want them treated?" And because I do that, I end up taking it to heart and worrying about my decisions and actions, too. Did I remember to tell the oncoming nurse about such-and-such? There is ALWAYS something to do, even when I could take 5. I don't know how some of my co-workers are sitting in the nurse's station chatting (maybe they're jaded or something). But you're not alone and your thread and the posts that have followed have helped me, too. Thank you.

I have been a nurse for about 6 months (still so much to learn) on a 66-bed Med/Surg/Oncology unit at a community hospital (it's hard work, but I believe it's God's work). We have team nursing-10 patients with 2 RN's and a Patient Care Tech or Nursing Assistant. I work nights. There are several techs that we work with that are just plain lazy! Often they "disappear" off the floor without telling us. They sit around and gossip. They act "put out" when I politely ask for their assistance. Some just "skip" 2 am vitals signs. One of them makes up vital signs even (I know, because I suspected a patient was running a fever- this tech documented a normal temp and when I followed behind her 5 minutes later, the patient had a fever of 101). I have even had a Tech question my nursing decision to put a patient on fall precautions! So this morning, at 6 am, there are 4 techs sitting around at the nurse's station (doing nothing!) while we were scrambling to not only get our final charting done, morning meds passed and our other morning tasks done, but also giving baths and making beds! And I don't mind giving baths (Great time for skin assessment and skin care), but this morning I had a pre-op patient, 2 patients having pain issues and I was awaiting a call from an MD. I am a passive person anyway (yes, I need to work on that) and I've never had to delegate tasks before becoming an RN. I haven't said anything to the techs (none of us have) because we're under-staffed for techs as well as RN's. We feel like we have to handle our assistive personnel with "kid gloves" because we are under-staffed. Nursing is difficult enough dealing with patients, families, catty co-workers, and MD's....please don't tell me I must also deal with lazy techs! Has anyone had similar experiences? Any advice?

Oh, you don't know how relieved I am to know I'm not the only one that feels miserable as a new nurse (graduated in Dec, like you.)! I work on a Med-Surg Oncology floor (66 bed unit) and I'm so overwhelmed and stressed! There's so much to remember....not only are we learning about being nurses, we're learning our hospitals policies and procedures! I'm right there with you... I don't cry EVERY day, but I cry often. The other day, I got 2 admits within a 1/2 hour of each other...not only did they both need to be admitted, one needed to be prepped for emergency surgery and the other had to go to ultrasound. At the same time, blood bank calls to tell me my blood was ready..."what blood?" I thought (I wasn't informed in report that I would be giving my MRSA patient 2 units of PRBC's). At the same time, my diabetic patient needed insulin coverage and my other patient was due to have her Q2 hr antibiotics hung. I mean, how do you prioritize care in situations like that? Everything is important! I felt I was gonna go crazy...I nearly burst into tears and my coworkers could see I visibly upset. I think it will get easier as we get more experience. In talking with seasoned nurses, not everyday will be miserable the way it is now for us. But they tell me there will still be days that are rough with "heavy" patient loads that upset even a seasoned nurse. I fear marks against my license also...I frequently check our state board website to make sure my license is in good standing. I pray to God that I haven't had any mistakes with my patient care. I even started smoking again, I've been so stressed! I think that we need a nice vacation after all the stress of nursing school and Nuclex...laying around on a beach somewhere or staying in a cabin in the mountains. I feel like I need to re-charge my proverbial battery. I'm exhausted and stressed and emotional and afraid all at the same time. We're gonna be ok...nursing is tough, but it's rewarding, too. Our patients need us! Hang in there and I will, too!

'Twas the night before Christmas and in SICU All the patients were stirring, the nurses were, too. Some Levophed hung from an IMED with care In hopes that a blood pressure soon would be there. One patient was resting all snug in his bed While visions- from Versed- danced in his head. I, in my scrubs, with flowsheet in hand, Had just settled down to chart the care plan. Then from room 17 there arose such a clatter We strang from the station to see what was the matter. Away to the bedside we flew like a flash, Saved the man from falling, with restraints from the stash. "Do you know where you are?" one nurse asked while tying; "Of course! I'm in France in a jail, and I'm dying!" Then what to my wondering eyes should appear? But a heart rate of 50, the alarm in my ear. The patient's face paled, his skin became slick And he said in a moment, "I'm going to be sick!" Someone found the Inapsine and injected a port, Then ran for a basin, as if it were sport. His heart rhythm quieted back to a sinus, We soothed him and calmed him with old-fashioned kindness. And then in a twinkling we hear from room 11 First a plea for assistance, then a swearing to heaven. As I drew in my breath and was turning around, Through the unit I hurried to respond to the sound. "This one's having chest pain," the nurse said and then She gave her some nitro, then morphine and when She showed no relief from IV analgesia Her breathing was failing: time to call anesthesia. "Page Dr. Wilson, or May, or Banoub! Get Dr. Epperson! She ought to be tubed!" While the unit clerk paged them, the monitor showed V-tach and low pressure with no pulse: "Call a code!" More rapid than eagles, the code team they came. The leader took charge and he called drugs by name: "Now epi! Now lido! Some bicarb and mag! You shock and you chart it! You push med! You bag!" And so to the crash cart, the nurses we flew With a handful of meds, and some dopamine, too! From the head of the bed, the doc gave his call: "Resume CPR!" So we worked one and all. Then Doc said no more, but went straight to his work, Intubated the patient, then turned with a jerk. While placing his fingers aside of her nose, And giving a nod, hooked the vent to the hose. The team placed an art-line and right triple-lumen, And when they were through, she scarcely looked human: When the patient was stable, the doc gave a whistle. A progress note added as he wrote his epistle. But I heard him exclaim as he strode out of sight, "Merry Christmas to all! But no more codes for tonight!" Jamie L. Beeley

Thank you all for sharing your experiences...I also feel like a slacker now (LOL). It's very encouraging to know that other new nurses are dealing with heavier patient teams and they're surviving. I was talking with a traveler and he said that in some states he's had 8 patients! Happy Holidays to all!

I'm just curious as to how many patients other nurses have. In my last semester of nursing school, during preceptorship, I had 5 patients, which would be reasonable except that these patients were difficult. Because I have chosen to work in a community hospital, most patients are very sick when they finally get care (because sadly they're uninsured) and have additional health issues other than the reason for admission. Here, in the southwest, we have ALOT of diabetic patients (fingersticks, insulin, dialysis and wound care, especailly on their feet). Often, I'll have an isolation patient. A couple of patients usually have critical morning lab values (that means calls to the MD's before I can even start assessments). And often I'll get one of those patients whom you can set your watch by because they're on their call light wanting their pain meds. And in the afternoon, I usually get a fresh post-op or an admission from the ED. Also we don't have computer charting (all paper!). I love nursing and I love the hospital I'm at because everyone (from the doctors to the housekeepers) is wonderful. We really feel we're being of service to God. But, as a new nurse, I always feel I'm so far behind in my work. I often eat while I chart or skip lunch all together (and eat a protein bar on the fly). It's not usual for me to stay until 8 pm to catch up on charting. When I was in clinicals (at a different hospital where I got plastic surgery patients and "easy" patients), I had all my assessments done and charted and morning meds passed by 0930 Am I whining or are my patient teams as heavy as they seem? What kind of patient ratios do you all work with? Thanks for your feedback.

I was born in Tucson and have lived here for all 30 years of my life..... I like it, personally..... the weather is beautiful (69 degrees was the high today) , however it can be brutal during the summer (110 degrees is normal)and all my family and friends are here, so perhaps I'm biased.... Yes, I suppose there's as much crime as there is any other fairly big town, but I personally have never been of a victim of crime (Thank God). As far as education of children goes, well, Arizona cames in almost last in the nation (but there are charter schools and magnet schools and if you've got the money for it, private schools). RN's generally make about $20 an hour (+ overtime, time'n'half,etc) from what I hear.... I'm only a first semester nursing student. Hospitals...well, I prefer St. Mary's or St. Joseph's because they are more patient-focused, however University Medical Center brags a 1:4 ratio (because they won't admit anyone else and let patients spend a day or two in emergency). I'm doing my clinicals at Northwest Hospital and while they've got the latest in technology, there's a "coldness" about it and while I know that healthcare is a business, they really seem to focus on the "bottom line". The other hospitals I don't know about. Hope this has been helpful!