kek

Hi mom and nurse, I always have a nurse tech working with me, every shift. It is only the odd day I have eight patients, it is often nine and sometimes even ten. I work the 7am to 3pm shift and also work the 7am to 7pm shift. It is hard going even with the lowest - eight patients - but it is worse first thing in the morning when I have to rush to get the meds passed and assesments done before patients leave for therapy. That is the time I feel the tightness across my chest! I'm getting used the routine and the system so it's not as hard as it was at first but I don't like it. It's just too much to do in too little time and therapy rules and nurses drool it seems. I honestly think if I had six patients then I could quite enjoy my job .... that is not going to happen though. I am just doing my best in the system - trying to hang in there and do what I can do. I really just think I can't be a nurse for much longer if this is what it's like. thanks for asking how I'm getting on. I hope everyone elses nursing shifts are better than mine.

OK - time for an update I think. I accepted the job and have since found out that eight patients is the minimum I (with a nurse's aid) would have. It can often be 9 patients and it's not that unusual to have 10 patients. I don't want to go on too much but basically it's not what I was hoping for. Obviously it is still early days and I do have to give it some more time before I make any hasty decisions. I mean new jobs in new areas are always stressful at first so I want that to ease and then I will know ..... That said - right now .... I want to quit nursing all together

OK - time for an update I think. I accepted the job and have since found out that eight patients is the minimum I (with a nurse's aid) would have. It can often be 9 patients and it's not that unusual to have 10 patients. I don't want to go on too much but basically it's not what I was hoping for. Obviously it is still early days and I do have to give it some more time before I make any hasty decisions. I mean new jobs in new areas are always stressful at first so I want that to ease and then I will know ..... That said - right now .... I want to quit nursing all together

crackles and rhales sp? are the same thing as far as I know too. they can sound like - rub a few strands of your hair next to your ear - crackling/mid to high pithed popping. Rhonchi can also change or clear almost if you ask your patient to cough - as this is basically thick junky/green yukky stuff that would come up IF a person could cough a big enough cough to get it up through their nose or mouth. I also used to ask the resp. therapist to listen to what I thought I had heard and to learn that way. What I was told once though is - people, nurses and even resp. therapists often don't agree on what they have heard on the same patient. So don't beat yourself up about it - but do take the whole patient history into account as this will/can guide you with what you are hearing.

Hi there . My initial response would be not to recomend nursing as a career. However, that said - I think it depends on WHERE you work as a nurse. I mean in which area of nursing and which part of the county. Med/surg is tough! There again I hear that in California or Oregon for example - they have much better patient nurse ratios so it's not as bad there. I did burn out working on med/surg for over five years straight and that's what has made me bitter about nursing. Nursing itself is a great job but it's the working short staffed that gets you down the most I think. Shift after shift after shift... working short staffed takes its toll after a while because you can't do the job the way you feel and know it should be done - in the end it's like you can't make anyone happy, including yourself. BUT .... find the right area of nursing for you (area = geography and type of nursing) and you sound like the type of person that would enjoy it. I'm still in it right now because like the post above - I took a break and tried a calmer less acute area of nursing so I could recover. If you do ever feel yourself starting to burn out then get out then and there, don't wait like I did because it will eat away at you and you can become bitter about nursing. There are so many avenues in nursing that if you choose wisely where you work you should be okay. Good luck to you

Hello again rngreenhorn and thanks again for your reply. It is actually good to read that some nurses do have it 'fair' in some places. I don't mind being busy, in fact I prefer it - what I don't like is feeling overwhelmed and that is how I did feel pratically every night on that med/surg floor. In the end it burned me out - I was admitted to my own hospital with chest pain and when I was discharged (all things cardiac were ruled out) I never went back. I worked out patient for a while and now I'm looking at other options. To tell the truth I'm seriously considering leaving nursing now. I think if I had found places to work like you are describing I might have wanted to stay. I had heard that Oregon has some pretty decent nurse patient ratios a long time ago. I live in Florida right now and I can't move right now because of children in school etc etc. If I could move though - Oregon is one of the main places I would love to see. I don't know why - it just has been for years. Once again though - thanks for letting me (and others) know that some nurses somewhere in the country are getting a fair deal - that is really good to hear. I'm still waiting to hear from other nurses that have these same ratios that I'm considering and are able to do it okay. Can anyone out there do this withOUT feeling OVERWHELMED? If I don't do this then it will have to be home health and that's got its downsides too.

thanks rngreenhorn for your reply. I would love to find a job around here where the ratio was more like 1:5 or like you said - 1:8 but with two CNAs then. I don't think that is going to happen around here though. I used to work med/surg and was often charge for the 44 bed floor while having my own 8 patient load and no CNAs at all - this was on nights - I guess patients are supposed to sleep then right ? On days the nurses would have 6 patients each - sometimes up to 7 and on odd occasions 8 if a nurse had called in. Also on days they would only have 1 CNA for the whole 44 bed floor. I guess I'm wondering then if 1:8 with a CNA might seem okay to me after those days? I don't know though - I've never done rehab. Also, this is a rehab hospital to which patients are discharged to following their stay in a hospital. I'm wondering if these patients will be as sick as the ones I cared for on med/surg. These nurse patient ratios are what's bothering me the most - I really really really don't want to go back to a place that was as hell to work at as that med/surg floor was - now that was crazy! Are there ANY nurses out there that think these ratios are do-able????? I am wondering how two people can get 8 people dressed before 8am ..........especially when one of the people doing the dressing is also supposed to get all the meds given and the docs orders noted etc etc etc.... hoping - begining to feel panicy - 'where is the HELP ME button' ? :confused: :confused: :confused: :confused: :confused: :confused: :confused: :confused: :confused: :confused:

WOW! one nurse AND one CNA for five patients ???? and in Florida too ! That's great - where abouts in Florida are you? What type of rehab patients do you care for mainly? I would be jumping into the job off with those ratios. Good for you! ( unless of course they all have a very high acuity)Or - is that CNA for the whole floor ? or as I read it first - just with you for your 5 patients? Thanks

It would be 7am to 7pm shift and it would be me, the RN, and one aid for eight patients.

Hi all, I am possibly considering a job change into rehab. It is a 60 bed free standing rehab hospital that is all over the country. I've never done rehab before but I have done med/surg. I was told during an interview that the patient nurse ratio is - one nurse and one aid for eight patients. The patients are mainly strokes and joint replacments. Is this good, bad or just right? ANY suggestions, advice, warnings etc would be very much appreciated. Thank you in advance and Happy Thanksgiving to you all.

This is very scarey stuff indeed but it happens and we just hope and pray the consequences are not dire. The mistake that sticks in my mind happened on a busy med/surg floor when I had 4 years under my belt. I was giving Heperin IV - I don't remember all the details but I had to work it out per the patient's weight. When I had worked out the dosage I thought "wow that is a lot!!" so I checked my math again and I got the same dose. So then I asked another nurse to check my sums and he agreed with my dosage too. We then checked the drug book to see if such a large amount of Heparin was sometimes given and it was in there - although it was at the highest point of the range given. So I went ahead and gave the patient the Heparin. The patient was in because of blood clots and was scheduled for a Greenfield filter. I can't remember when or how I came to the realisation of what I had done ...... but oh my God was I scared to death when I did realise .... I had done all my sums using the patients weight in pounds when it should have been kilograms!! *ARGHHHHHH PANIC* I had to call everyone, supervisor for the hospital and then the surgeon. It was nights too so you can imagine the fear of calling a surgeon to wake him and tell him that. What did he say to this very scared RN ? - he said " well I guess we don't need to worry about him throwing any clots tonight do we ..... keep an eye on him and call me in the morning" The patient did fine. PHew! That's not the only one but it sure is my scariest.

I've been in nursing as an RN for eight years. I worked med/surg for nearly six of them and it burned me out fast. I looked around the hospital to see who had a the best job. Ie. similar opportunities, similar pay but much less agro and much less stress and much less BS thrown at them from every direction. I narrowed it down to the imaging department and from there I further narrowed it down to ultrasound. So - I'm currently at school working towards getting into an accredited program for sonography. I will work prn as a nurse and then quit for good. I'm sorry to say but most of the people I know that are nurses have had enough too. It's very sad and scarey. Who will be left to look after me when I need nursing care ??