NightNerd

The ever increasing nurse to patient ratios. I had a med-surg job in 2021-22 where the norm was 6:1, frequently one or no techs for the 28-bed unit, and I hit a wall. I was no longer able to give the nursing care I felt good about, even some of the time; nor was I able to develop any solid closeness with the team because we were essentially all drowning all the time. In my area, most hospitals are now doing at least 7-8 at night and 6 during the day. I enjoyed med-surg and miss it terribly (sometimes, LOL), but I knew I wouldn't be doing a good job if I took a position knowing that this is the expectation. I'm now on a same day procedure unit, and while it's not a very compelling job (to me at least) I do have time to give my patients attention beyond throwing their meds at them and running off to the next room. Not being able to use what little PTO I accrue and the clearly warped priorities of all levels of management are runners-up. I really am so tempted to move on from nursing, but all the other careers I'm interested in also have high levels of burnout - and don't pay quite as well. I just want to do something I'm proud of, not spend my entire life at work, and not live paycheck to paycheck.

I think I could - but I'd also probably get plenty of questions "wrong" because NCLEX scenarios are so very different from the real world.

Don't quit. Unless there is something scary wrong with the job, don't quit. I can sympathize with the difficulties of adjusting to a new job, but you have to give yourself time to acclimate. If you don't, each new role will overwhelm you and you won't get the chance to become comfortable with it, keeping you stuck in this cycle for even longer. Stick it out for a few more months at least, and be patient with yourself in and out of work. I think it's pretty normal to be tired and even a little blue at the beginning of a new job, and if you have clinical depression that just adds to it. Don't expect yourself to be at your best just yet, try to sprinkle some calm and enjoyment in your days off, and just know that slowly and steadily, work will almost certainly get easier. Hang in there!

The only reason I don't like being called "Nurse" is that it means I'm at work and haven't become independently wealthy yet. Otherwise, as others have said, it's among the nicer things my patients have called me over the years!

To the first bold - that is extremely dependent on where you work. My benefits are not good at all, and still I am lucky to have them over some that I have heard others describe on this website. My pay is fine, not outstanding but livable where I am, but that of my coworkers, particularly nursing techs, is not; we should have a voice we can use to advocate for others as well as ourselves. Opportunities for professional and personal growth (as allowed by use of PTO, etc.) are few and far between for me and my colleagues. I am fortunately able to move and seek other opportunities; many of my coworkers can't. Just because things may be good somewhere, doesn't mean that everyone else shouldn't make some noise about what they need. Second bolded - you'll get no argument from me there. Teachers deserve improved working conditions and compensation as well! So do EMTs, firefighters, nursing techs, etc. These all need to be improved - it doesn't change that many nurses continue to work in unsafe, ineffective situations as well.

How many days off do you get during the week (I'm assuming four if it's still 12s)? Do you feel you have more energy on those days? If so, would making specific plans for quality time on those days be helpful? Working off-hours can make it more difficult to connect with a partner who works traditional hours - but it doesn't have to cause irreparable harm to the relationship. Takes a little more planning, is all, along with realistic expectations on both sides. I know after a 12-hour shift, I'm not participating in any meaningful activities beyond dinner and maybe a TV show together, and so does my boyfriend. Knowing that, I try to take PTO on big days, such as birthdays, anniversaries, etc., so that I can be fully present (I know that is not always possible, depending on unit needs and all that.) And we try to have at least preliminary plans in place for weekends we have off together so there's something to look forward to - that way I don't feel as bad falling asleep when we're just watching TV or whatever on a Wednesday night. I get why your fiance may be feeling a little lonely during these long shifts, but it sounds like you're making every effort to be present when you're spending time together, especially on his birthday. I hope you're able to reach a good compromise so you can spend meaningful time together without you having to be stretched so thin.

It's messed up that she would even think that's an acceptable thing to include in your review. If you're fulfilling your required hours, boom, that should be it for meeting expectations. Anything else is above and beyond. I agree with the suggestion to ask if that statement can be removed due to your good attendance record and the fact that you do pick up extra shifts when able. If you get resistence, I would definitely check with the next supervisor up, or a union rep as recommended. It seems crazy that she could include a subjective statement that you "could pick up more shifts" when I doubt that's even in the job description. This makes me especially mad for you. That doesn't matter! It doesn't matter how many things you have going for you that supposedly make it easier to pick up; your off-time is yours to use however you feel is most important. Don't ever feel guilty for being there for family and SO, having other interests, and taking a rest. Any short staffing is neither your fault nor your responsibility, and I sincerely hope your coworkers and manager come around to that understanding.

I regret the three year sign-on bonus I took every day. If you take that contract, you are already going to get far less than that $20,000 due to taxes. The interest thing is fishy as hell. And *every* weekend? You wouldn't even get two off per year or something? Is that an acceptable situation for you? Just read your most recent response. Glad you will be looking into other options! Good luck in the search!

@TryingtoThriveRN my non-bedside job before was in research nursing in a government setting. I think I wasn't prepared for something that much slower paced and calm, if you can believe it, and was more trying to get away from my (then) current job that no longer was healthy for me, rather than seeking something I was truly trying to move toward. (People here warned me about that possibility, but I chose to learn the hard way, LOL.) It also ended up being kind of cliquey, with not a lot of room for me to contribute any new thoughts and ideas, as the place was fairly set in their ways with the idea of "we already know what works best," so it ended up not being the nicest culture to try to break into. I was scared to apply for this job since last time went so poorly, but I was really invigorated reading the job description and researching the program, so I thought it might be worth it. It's also more along the lines of what I chose to study for my MSN, so I think my motivations for changing jobs is better this time too. Congrats on your new position! I love my 12s (and, more importantly, my days off), but I think for the right job, we will both do just fine with more traditional schedules. ?

You are not the only one annoyed by this. My facility is also cracking down on this and it's making me bananas. Bedside report on 6 patients takes a helluva long time, and I'm finding that when I come around at 7 AM to give report, they're not ready to be awake yet and don't acknowledge we're there, let alone participate. By all means, I'll verify code status and drips and bed alarms for everyone before I leave, but it's getting out of hand and I'm sick of hearing about it.

I got a call back to interview for a nurse coordinator position, which will coordinate treatments for outpatients with endovascular infections. It sounds like it's in a newer department within this hospital system, and I'm super excited for it based on my understanding of the role and program goals. At this point I'm pretty practiced in what questions to ask in bedside interviews, but I'm not sure how to evaluate the fit of this kind of job. Last time I worked a non-bedside position it ended up not being a great fit and I didn't last long, so I'm hoping to avoid that this time around. I think I have managed to choose something more aligned with my long-term personal interests this time, but beyond that I'm not sure what else to address when I get to talk with the director. What questions would you all recommend asking? So far I've got the standard, "What are the primary responsibilities?" and, "Who does this position report to?"

@dosamigos76 thanks, I didn't think about admissions at first, I'm sure that can be time consuming! @CrochetNurse154 thank you for all of the great details! That is a lot of good stuff to know and consider and will definitely be in mind for the second interview. I have enjoyed working inpatient hospice in the past and am interested to see what this new endeavor could bring.

Heyyyy all, I've got a second interview with a home hospice agency that I'm kind of jazzed about. Since I've only worked inpatient so far in my career, I have questions: 1) What is a reasonable case load? They quoted me 12-15 per nurse. 2) What kinds of tasks and challenges fill your typical workday/week? 3) Any tips for moving from inpatient to a home-based role? 4) Advice in general for evaluating an offer, should I be lucky enough to get one? Thanks, peeps!

Had a coworker get spoken to for using the term "died" (in hospice care! Not even to parents or family - to other staff members). He said he might as well start saying they crossed over with John Edwards.

We are getting to this point in my hospital with 1:6 ratios for nurses and sometimes just one tech for the floor. I don't blame our techs for moving on one bit, as they are not well compensated for the work they are doing, nor is their work valued by management. I'm counting my days here, as it sucks working in an environment that doesn't appreciate not only my work, but that of the nursing techs who are so crucial to providing good care.

Letting the IV pumps beep... and beep... and beep... Not only is it annoying to the patient *and* me, it means they're not getting what they're supposed to be getting! I'll go and fix the pumps when I hear them, but I have some coworkers who I swear don't check on their patients at all, so by the time I actually get there, they're pissed at *me* and have a list of demands ready. Ain't nobody got time for that! When there's an agitated and aggressive patient that we're all getting beaten up by, and the primary nurse won't do anything about it - like only won't they contact the MD or security, but also won't even help control their own patient. Seems to happen a weird amount on my unit. Also, having videos or music on with your volume up. I get it, sometimes we're just tryna stay awake, but I haaaaaate listening to other people's stuff. I'm realizing I just don't like noise. I think I picked the wrong profession.

These Skechers have been everything to me since I started med-surg: https://www.skechers.com/technologies/collections/womens/work-relaxed-fit-comfort-flex-sr---hc-pro-sr/77217_BKMT.html Not for everyone, but I love alternating these with my Danskos during stretches at work, and they work well for me. Comfy, easy to move in, durable, and easy to wipe down. I also remember having good luck with NurseMates shoes, but they stopped making the one I liked most and I haven't tried any since, so I can't vouch for any particular product of theirs right now.

As someone who lives to sleep in (not just love it but actually live for it!), I assert that night shift is a perfect situation. More money, less busy work (not that we're not busy, but when we are it's typically more meaningful and directly connected to something the patients truly need), and night shifters are fabulous company! (Day shifters are too, but I never got to know any of them when I worked days because everyone was drowning in their own assignment and not tryna go out after work.) I also am growing to appreciate holidays as a night shifter. It sucks no matter what if you have to travel to see loved ones, but I like that I can either work the night before or the night of and still participate a little bit, at least. Or in my case, I'll work either all of Christmas or all of New Years and get a stretch to really make the most of one or the other. I totally get that sometimes you physically just can't do nights, but it's a bummer when people get such a negative introduction to it and don't get to hear any of the good stuff.

To be honest, the unit I've worked on where I was by far the most invested and happiest was one where I *did* socialize with coworkers, including our manager and my shift's supervisor. It was mostly for unit holiday parties, an event for Nurses Week one year, and other things that everyone on the floor was invited to. I also hung out with a couple people individually that I was especially close to, or would grab breakfast with the crew after crazy shifts. I really liked feeling close to the people I worked with and having those fun shared memories, and I think by and large it was the reason I was more engaged in that unit than any I've worked at since. My manager and I even collaborated on a non work-related hobby we shared for a bit, and it honestly never felt weird. I would not have felt comfortable doing that with any manager since, but I knew from experience that she could tell me about myself if needed, so favoritism wasn't a huge concern I had. ? Things I learned...not the hard way, but more through near-misses: -Watch the booze and know your limits! Preferably, stay conservatively under those limits. -Be careful what you're texting to whom if you regularly communicate with people from work on your personal phone! ?

I got scissors, a flashlight, and a pen. All things I already had in versions I prefer, but it's always good to have backups. Tons of candy at the nurse's station. They did feed us all kinds of food every night for a week, which was a nice break from the sorry lunches I pack myself every shift. All in all, not too bad - at least it wasn't a rock!

Dang, and here I am with my two little extra strength Tylenols and a multivitamin like, "Nope...need another sip...maybe I should try applesauce?" ?

I am diplomatic and typically able to sympathize with others' viewpoints, even if not necessarily able to agree with them. It's extremely helpful in communicating with patients and their families; it is rare that I have a patient (at least in their right mind!) who doesn't have confidence that I will advocate for their goals of care. It also comes in handy when offering education or alternatives they hadn't previously considered, as they're more likely to give real thought to what I have to say. Being agreeable is not so great when I end up picking up or switching shifts with coworkers that end up destroying my schedule; I hate to tell people no. It also isn't great when dealing with those one or two people in every unit who are miserable in life and take it out on the rest of us. There are times when I wish I'd stuck up for myself and at least tried to interrupt a toxic pattern of interactions with certain coworkers, but I don't in the moment because I can't stomach the temporary discomfort of healthy conflict.

That is out of control! Wish I could say something helpful or constructive, but I got nothin. Definitely furious for you, though. ?

Hey guys, looking for advice/wording suggestions on telling my manager I would like to transfer internally - to a non-bedside position, if that matters. I'll have been here for six months next month (I cannot find a specific transfer policy but I'm guessing six months is the minimum), and this unit is not a great fit for me. Additionally, I finished my MSN last Spring, and while I had wanted to stay bedside for a little bit longer, there is an open position that would help me gain work experience in the area I'm hoping to move to at some point. It's a little sticky since I did accept a sign-on bonus, but I'm really struggling to get myself motivated for each shift, and I can see the quality of my work starting to dip. I'd rather move into something I can find some amount of energy for, rather than keep this up and feel like I'm doing less and less for my patients. How would you approach this with a manager? What would you focus on when explaining the decision to apply for another position? Thanks!

I want my patients to know as little as possible about me, but so much more about nursing and the hospital environment in general. For example, no, some of these labs can't wait until tomorrow, or yes, I really do need to wake you every two hours to look at your pupils. I like to think I'm good at educating people about these things, as well as clustering care when possible, but sometimes it just doesn't stick. For my coworkers, since I'm fairly new, I wish they knew that I haven't always been a crabby person and genuinely have nothing against them; I'm simply exhausted and, in all honesty, not a good fit on this unit. I think I can come off as a little short sometimes, which I am working on and have gotten better at - but even with the improvement I've made in that area, I'm still not always particularly friendly or open. But despite that, I am genuinely happy to help when they need it! In my humble experience, once I stopped expecting this of myself, it became easier to set the expectation for others. It's easy to fall into the trap of thinking, "Well, I *could* intervene," while not acknowledging our own limitations and our desires for a meaningful life outside of work. When you are frustrated and resentful of work for expecting so much of you, it's a sure sign that you need to set and hold a boundary - probably in a much earlier place than you thought.