MeganAK

I have to post to this one. Most of the time i just hop on and read and think, but this just screams for a reply. I have been a nurse for four years, the last year being at a small, rural hospital that was hit fairly hard by the recession. In the last few months they began laying people off- I work in the ER and we now have to be our own housekeeping, mop floors, take out trash, decontaminate for isolation patients, etc. They also are letting the Physician Assistants go- they see most of the lacerations, broken bones, coughs, colds, etc. It has gotten UGLY. I have complained several times about not being given any breaks or only one during a 12 hour shift. No one cares. Our work load is going up, our acuity is going up, our staffing level is going down. No one cares. Well, I take that back- WE care, but the manager doesn't, the administration doesn't. They are totally giving us this attitude that we are lucky to have a job, so....... It is absolutely horrible. My level of patient care is going down out of necessity because I just don't have enough time to do it all. We are all getting written up sometimes daily for lack of 'proper' care- and we just don't have time, or staff to make it all happen. We are tired, burned out, and everyone is getting apathetic. I am the LAST person I ever thought it would happen to. I love my patients, I love being a nurse, I will still do everything possible to take good care of my patient, but I am also getting apathetic about the organization. Why should I care when they don't give me breaks? When management responds to complaints with an attitude? When every where you look people are busting their tails and there is no end in sight? When more and more benefits are taken away? When we are already underpaid and don't get raises? I am not saying we are apathetic about taking care of sick people but we are definitely getting apathetic about the organization. I fear it is only going to get worse, and we are stuck in this weird vortex of feeling thankful to have a job and hating the job we have. I come home crying many days, exhausted all days, and dread going back the days that I am off. I do not think this is specific to my hospital, but a symptom of a greater epidemic. I, too, would like to hear more thoughts on the original post, because I am tired of it- the apathy- and really would like a way out without leaving nursing!

No - it is definitely not the promised land. I loved it when I was in the ER as a tech, but being there as a nurse is a whole new ballgame. I guess deep down, I feel like my gut is telling me that the level of stress really isn't healthy. I have always been a people person, I love helping, I am usually pretty social, and I feel like I have become a whole new person since being in the ER- and it isn't someone I really like. This discussion here, though, reminds me of one of the many reasons I chose nursing- because there are so many different options out there that I knew I would be able to find my niche. Still looking, but maybe LTC? We'll see. Good luck to the others out there making the switch. Keep us all posted on your experiences!

Oh my gosh, you are both wonderful! AManda3- your ideas are so helpful, and I appreciate the time you put in to writing. I will definitely take note of the things you mentioned when I go for an interview/tour! And Riegen, thank you so much as well. I am thinking I might cut and paste the list and think about for a bit- and figure out which ones I would want to ask, they are all great! Thank you SO much- you have been so helpful. I will keep you posted- am picking up applications on Tuesday at the facilities that have openings!

For those of you out there who have some experience under your belt, I need some advice. I am considering a move from ER/Inpt care to LTC. I have no experience with LTC and am hoping that you can give me some questions to ask at the interview that would help me solicit information about what the facility is like. For example, what is the RN//LPN/CNA staff to patient ratio? On days? ON nights? Please add your own questions. I would like to go into the interviews prepared, but also know what to ask so that I can make an adequate determination as to whether it is a place that I would be comfortable/safe working in.

I, too, for different circumstances, am considering a move from the ER to LTC. I am a little bit nervous. It sounds like things can get overwhelming and stressful in LTC, and this is already how I feel in the ER. TO the OP, have you made the switch yet? Keep us posted on how it turns out. I am just at the stage where I am considering some interviews at LTC facilities, but have my reservations. I just know that I cannot sustain my enthusiasm for life, work, or patient care in the ER that I am in. Keep us posted!

I know that the same theme has probably been posted many times on this forum, but I am posting again because I feel like I need your thoughts and we are all different! I have been an RN for four years, was an ER Tech for three, and an EMT for five. As an ER tech, I loved the ER- had a great team to work with, and just generally loved my job. As a nurse, I spent my first three years in an extremely rural hospital in an Alaska Native community. After moving back to 'the real world' outside of Alaska, I got my first job as an RN in the Emergency Room. I hate it, and I am absolutely torn up about it. I love my patients, most of the time. I love being a nurse, most of the time. But I feel burned out after 6 months. I feel that I need to be superhuman to complete all the tasks required of me. I feel grumpy about the lack of teamwork and backstabbing. Most of the days that I am working, I have no tech to help, I have too many high acuity patients for what I feel I can handle, and I come home tired and empty. What have any of you found in the ER- have you had to learn to love it- or did you just love it? Do you feel like the stress level is so unhealthy that you are shortening your life every time you walk in the door? Do you worry that one of your patients could die or be injured because you have way too much on your plate and no help? Thoughts, please! I wanted to make myself hang in for a year, just to see if it would get better, but I am running on empty and I am only half-way there!

I like the idea of just buying your own. I went in to work today and discussed the issue with my manager and she said that if I wanted to wear one, I could. Apparently the Infection Control Nurse is all bent out of shape and is coming to have a talk with me tomorrow about not following the hospital policy, which is surgical masks. I will by all means offer to her that I am happy to buy my own! Thanks for the idea!

So my next question would be, after reading the previous post about the respiratory transmission of the flu, what are we supposed to do about our hospitals not providing the proper protection? My hospital hasn't even fit tested me yet and I have been working there for three months. I have yet to actually see an N95 available in the ER. I can't afford to not work. Makes me think about the questions I might be asking when I go to work tomorrow.

Pretty much the same thing here- no N95, only surgical masks. We are doing the rapid flu test, but basically everyone who has flu-like symptoms is being treated as a positive with isolation, masks, etc. The problem I have is that it is already getting crazy with the amount of people that are coming in and wanting to be tested. Our hospital has no real plan to deal with the sheer numbers of people that are coming in and wanting to be tested.

Last night was ridiculous! I was working Fast Track and I only saw a few patients that did not get flu swabs. I am estimating that I probably took care of fourty or so patients in the twelve hour shift, and did about thirty flu swabs. Everyone was there for cough, cold, congestion, etc. We had ONE positive H1N1. I totally agree that people need to stay home unless they are truly sick- and DON'T keep spreading the love!

Thanks all- I know the shot is available Thimerosol free, but not at my hospital yet. That isn't my only concern about the shot. Good info from everyone, though, it is nice to see an adult discussion where everyone can give their opinions!

Anyone have any input on wages vs housing in rural areas? Many of the posts I saw were cities, where I think the pay is a bit higher. I was living in a rural town in Alaska, making $34/hr with median house prices being around $220,000 and now I live in a rural area of West Virginia and only make $22/hr with median prices around $120,000. I feel ripped off with the low pay, but I tend to think that might be normal for rural areas?

We are just being offered the H1N1 vaccine. I was not able to get the seasonal flu vaccine due to an allergy to Thimerisol and I am not really super interested in getting the H1N1 vaccine. I am currently working with my manager to educate the Infection Control nurse on an alternative medicine thereapy to the vaccine called MucoCoccinum. You can do your own research, I will not try to sell anyone on my ideas, but take a a look at some of the info: http://www.naturopathicfamilyclinic.com/images/Mucococcinum_ho.pdf http://www.vitalitymagazine.com/oct09_pg32feat http://www.allbusiness.com/medicine-health/diseases-disorders-infectious/12819420-1.html http://www.betterhealthproviders.com/documents/newsletters/2005betterHEALTHNewsletterOctober.pdf. I do not want the vaccine, but I am willing to do the research and attempt to explain to my manager why I do not want it and what I will do to make sure that I am not at risk of spreading the virus to people at risk. So far, she seems receptive because she recognizes that I am not being stubborn, I just don't want the other ingredients that are in the shot. As far as I can tell, the MucoCoccinum is just as effective as the vaccine without the side effects.

Wow! Thanks so much for your reply. I knew that travel nursing probably wasn't much of an option right now, which bums me out because it would give us a chance to explore the State to get a better idea of where we want to settle and apply for a permanent position, but now we will just have to do it the old fashioned way. We'll have to save up some more money, hit the road, and do some camping and exploring. Anyway, thanks so much for the help. We are getting super excited to head down there. And all the things you said about West Virginia sound great, especially the part about a slower pace- we are used to that up in Alaska, and want to stay with that nice pace! I have been here too long and can't wait to live in a place where we can grown food and have fuit and buy things at the store instead of on the INternet! Thanks so much for your help and I will write again when we are headed that way. Thanks!

Well, I know this is a tough time in a tough market, but we are headed to West Virginia in a couple months to relocate and really wanted to get a travel assignemnt there to get a feel for the place before I try to get a permanent job. I have been a nurse for three years and we really want to come to WV. Are there any travellers being used that you know of? Or temp agencies that are local to WV? I know it is a long shot, but we really wanted to try out the area before committing to stay. Any ideas? Thanks!