MrsChiefofControl

When I started everyone had PRN orders, but now not so much. It makes sense to me to start day 2 in the morning when the primary providers are there, but then it is "passing the buck".

The floor I work on is pushing to start bowel regiment on day 2... and for the overnight crew that really means day 1 and I think its just crazy! I don't really think it appropriate to call the covering MD about poop meds in the middle of the night, since : 1. They cover the entire hospital for the night. 2. People do not usually have a BM in the middle of the night. 3. We are trying to promote rest 4. Some people just plain do not have a BM every day. I realize it is important to make sure our patients our having regular BMs and there needs to be some sort of accountability, but really? Am I crazy or is it the protocol?

The struggle is real! I work in a medium sized hospital that has other resources and is connected with a large hospital for select specialties, but we are in the never ending cycle. We are the only local ER, the beds are constantly full, which makes our ratios high. We higher new staff, usually new grads, who need a lot of mentoring and guidance. Usually at about a year the new hires are fully functional and I no longer have to worry about them when I am charge, but during that year our experience ratio is way out of balance. We don't have enough experienced nurses and those that are there usually have 2 or 3 new nurses coming to them all shift because the charge is busy with patients or audits or meetings, and it wears the experienced nurses down. They have 6 patients and are trying to juggle all the questions, so they leave because they are burnt out. The other scenario is that many of the new people hired to not want to work med-surg. As soon as they get an offer in a field they would prefer they leave. And now we need to hire more nurses and aides. ?

In the perfect world everyone would get the positions they wanted, but that can't be the way it is. You need to take care of your finances because they have a major impact on the rest of your life. My philosophy is apply to any and all positions in your area. If you get an offer for more than one, then you can be a little more picky. I am also in your position. I feel the time slipping away, adding more pressure everyday to get a job.