gorjos

Yeah, it is the 3 to 11 shift. Super busy. We don't have a charge on evenings. I did get some help this time, which doesnt always happen, but there was a tone of "you will get there and be able to handle this when you become a more experienced nurse." Yes, I will become more self reliant, but with so much going on, care becomes diluted. I don't want to miss the little things that make a good nurse a good nurse. I am only human, yet I feel like that whiny nurse who complains or doesn't like being busy. Not true, I just hate the anxiety of trying to manage a circus safely.

Alright, I have already had a blurb about a crazy shift I have experienced recently. This evening was another one. It started by sending 2 patients to surgery; one went and the other stayed b/c of new onset chest pain and O2 sats in the 70s. Meanwhile, I receive another patient back from surgery and then begin admitting/prepping a direct admit for surgery that evening. Then another patient gets an order for 2 units of blood. New admit goes to surgery, other guy I sent to surgery comes back. New admit comes back from surgery. So in one shift that is an admission who goes to surgery, sending another one to surgery, getting 3 back, giving 2 units of blood and intervening/monitoring for an mi/whatever could be going on. Lots of details left out. Is this normal? Should I be able to handle this? I seem to get the idea that I am supposed to be able to pull this off. One thing is for sure, I sure hate evenings like this.

Give yourself a break. You mentioned the word hectic; that's when I have made most of my errors. During times of chaos with stuff flying at you from all directions you are vulnerable to that kind of thing. Too bad nurses have to be human, but we are.

Well I am a nurse because my passion wouldn't allow me to provide for my family, be around my kids, nor put a dent in my school loans. Nursing works because it is a job that enables me to take care of my top priority--my kids. If you think I was psyched to follow in the footsteps of florence nightingale, well, you are mistaken. Nursing isn't a bad profession I have found. I would actually like it if I didn't have to deal with the nurses who think they are gods gift to nursing or be in the position of catching everything that comes down hill. But that's part of it, and I deal with it because my kids need me to. The bottom line is that I care, and while all things nursing don't add up to being with my kids or coaching, my patients get my best.

I am an advocate of barbell exercises. My favorite for back strength is the deadlift. Basically you are picking a bar up off the floor while isometrically holding your spine in neutral position while lifting the bar with your legs. If done properly you really work the thoracic and lumbar extensors, as well as your scapular retractors. Good technique is a must, and I would probably wait until the back settles down. Youtube probably is not a good place to go as you will not see great technique in most videos.

Yeah, because the only cause of lethargy is a low blood sugar, right?I would go with neuro assessment and cardiac assessment. Also would consider what medications the patient is on. By showing the MD that you are thinking critically it may flip a switch in them to think critically as well and consider that something deeper may be going on. Good work advocating for your patient; better to over react than to under react. Experience will help you to discern, but really I am always paranoid of the worst case scenario.

Unfortunately, I am getting the vibe that you are right. I asked about what I can and cannot do in regard to asking PACU to hold a patient. What I was told is that we cannot do that because patients are charged for the amount of time they spend in PACU. Therefore, it is allegedly frowned upon to practice in such a way. Basically I get the impression that the higher ups are just listening and don't care. They have to listen, but don't have anything to offer other than to say tough luck.So, the next time this happens its me against the world I guess. I will be long gone the next opportunity I get, but I can't count on that happening too soon. Two kids, loans, guess I gotta grin and bear it.

I will be having discussions with my supervisor. I am obviously newer to the game and will learn from my experiences. However, I did precisely what I was told to do the last time I was in an overwhelming situation. Asked coworkers for help and called the supervisor. We all know how that went. Now you tell me...if you have done what you have been instructed to do and no help comes...is it me or the system? I can learn to play the game better, but why are we playing a game in the first place? I am mad. It all seems to fall back on me.

Cathy, you are right. That is not the norm where I work. I should have not accepted, though I am not sure they wouldn't have sent the patient anyway. Just going by what I have witnessed. Experience is a cruel teacher sometimes. Unique situation, but not unique in that I was left to dry when I needed help. Hence the anxiety.

Going to work always makes me anxious. You know, when you can't sleep, eat, or enjoy life. When your brain is consumed by what will happen and how you will handle it all.Granted, some days go well, and it actually feels like I enjoy my job; there are far too many days like a few days ago. Maybe this is nothing and I just need to find a new line of work, or maybe it is just nursing. I work ortho. Started the evening with 4 patients; gave 3 to the LPN on my team in anticipation of landing 3 surgical. Easy start, no doubt.Turns out, all 3 patients returned from PACU within one hour; the last 2 within 5 minutes of each other. The floor was getting other surgicals as well, and I was the only core RN on the floor, so the help on the floor was minimal. Paged the nursing supervisor to ask for some help. That page was not answered until 2 hours later; im quite sure the HUC made repeated attempts. Not throwing the sup under the bus; I know the entire hospital was chaos.One PACU nurse reported that one of the patients came out of anesthesia quite lethargic and received 20 of morphine, but his resps were 12-16 and he was improving. Needless to say, when the patient got to the floor, his resps were 8-10, and was barely responsive.Long story short, he got narcan twice and had rapid response called when his sats hit the 60s after receiving narcan once, while on 6 liters. I can manage this patient, but not with 2 other fresh surgicals, plus another fresh surgical from day shift and 3 other patients in my team to be responsible for.I am not throwing my coworkers under the bus, but honestly I called for help in all the right places and got almost nothing. The level of responsibility I had was too much. It was a very vulnerable situation and my team and I were left out to dry; but ultimately everything was on my shoulders.I guess this is nursing, and I guess we all have days like this. My question is, how the heck does being placed in these situations allow anyone to enjoy work? Avoid anxiety? I am in the process of dealing with all of these issues in terms of reporting and filing unsafe staffing. I just feel like this is a bad deal, and am curious to know if I am over reacting or if this is just nursing as we know it.

Yeah, I suppose part of my frustration is the fact that I worked in a place where I didn't have to encounter this stuff and now I do. I guess I thought everything would be the same when I changed jobs in terms of attitudes. The culture isn't ideal; guess I'll have to pack away the tampons and kleenex and deal with it, right? I'm not as much worried about how I feel as much as I am that I'm not 100% sure I can trust everyone I work with. I can deal with people being people, except when they have the potential and perhaps motive to damage my future. My work stands beside itself; it is solid. However, I'd be dumb and naive to think that I shoulnd't watch my back (contributes to anxiety).

This probably is not a unique situation for many male nurses out there. I worked my first 7 months as a nurse at a small hospital on a med-surg floor. Almost all of my female co-workers/supervisors were always very helpful and non-stereotypical in regard to gender. It never seemed to occur to any of them that I was a male; I was almost always treated with respect and as a peer--there was great camraderie. When I left this position to accept another position much closer to home (my commute was 1.5 hours one way), I left on good terms and was highly regarded (at least that is what I was told). The experience so far with my new job has been a rude awakening to say the least. I am not going to get into the circumstances of everything that has occured nor try to fester a pity party; just rather provide one example of a phrase that has been uttered to me by someone in a leadership position (a woman) as a summation of what the culture is like where I work: "Men are not good at multi-tasking. You will have to work extra hard to develop those skills." There is obviously more that goes into me forming my opinion of the nursing culture--you will just have to take my word for it. I know I have strengths and weaknesses, and I am open to criticism. I need to grow as a nurse to become all that my patient's deserve, but...it has nothing to do with being a male or female. I'm not into pity parties, nor am I on the I'm a male nurse and everyone is out to discriminate against me train. But...this feels like a work culture that is really annoying to work in. Ultimately it adds to my anxieties, is a strain on my confidence, and makes me paranoid. I can deal with it, but ultimately, I wonder if it is worth it. I'm not a suck up; won't play that game. I just show up, smile, don't complain, and do everything I can to carry my load and be a good team player. I'm as introspective as they come, and am as hard on myself as anyone. I'm really ready to work where that is appreciated. I guess this more of a vent than anything, but common experiences, advice, and encouragement are helpful to anyone this rings true with.