Really, is this real?!?!

[FlossyRN]

Hi, I am a new nurse who graduated in May. I graduated with honors (this was not easy, I had to work for it) and did well in clinicals. I have been working day shift on a cardiac step down unit since July. I truly love nursing...I am just not sure I love where I am at. I feel like I am being run over but when I mention something casually to other nurses all I hear is "this is day shift" or "it is what it is" or my favorite "Management doesn't care". I also fear some of these feelings may be because I went to school and did clinicals in a large city with a very up to date hospital who treated their employees excellent. It was a CHI and magnet facility. Now, I know most may say well, go somewhere else, however, I live in a rural area with only two hospitals where everyone knows everyone so word of mouth travels faster than the speed of light around here. I am just unsure if this is what nursing is really about, will it get easier, or am I being taken advantage of as a new nurse???

I started working in July with a preceptor. First issue, I was told I would get 12 weeks of training. Immediately, management started balking until I went to higher management and demanded my full training. This didn't set well with me. Second issue, I was told I would have one dedicated preceptor...the forth day of having someone different I balked again and demanded what I was told. Another flag. From there things did seem to improve but were always hectic. However, I must mention that the hospital says they are a cardiac step down unit but will not make that official because they do not want to lower nurse to patient ratios. We also are a catch all floor as well. Basically, everyone on our floor is not sick enough for the unit but too sick for a med surg floor. It is standard, every day, without fail, I have at least 6 patients if not 8!! WHAT!?!?! This is insane. I had one patient the other day on Cdiff precautions, had a rectal tube, chest tube, stage four pressure ulcer, suprapubic catheter, peg tube, tube feeding, as well as non speaking and confused, who went to dialysis 3 days a week, plus 6 other patients just as complicated. It is nothing for each patient to have 10 to 20 meds due at nine am, 3x a day dressing changes, etc. We as nurses here are also responsible for getting our on blood sugars and passing those food trays!!! EVERYONE is a blood sugar check!!! These are all scheduled for 11 am...but they will schedule my lunch at 11 am and then get mad because I'm late going to my scheduled lunch. It is not uncommon for them to give me four patients who know they are being discharged at 6am and then give me 4 direct admits back to back who all have to have UA's, IV's, Cultures, etc and all of their information enter!! Again, when I complain I am told to "buck up" or "this is the big leagues" or some other smart comment that just completely defeats me. At this point I am ready to quit! This is so overwhelming to me. I get to work early, write down my meds, my labs, etc and none of this helps with me with my time management. I try to delegate to my CNA's but there is absolutely no team work. They are always busy or will ask you very rudely, "Wasn't you just in there, why didn't you do it!" And telling management is a joke. For instance the other day I had a patient who didn't receive her 11 oclock tray because I had an emergency in another room. With 7 other nurses and four techs and two secretaries not one person took her the food tray! When I asked two hours later why this patient wasn't taken a tray, I was told "she's not our patient!" Financially, I can't quit, I have to work but I hate this..I dread work every time I'm scheduled. Because I know it's going to be hell. Hoping for some insight.

[Anna Flaxis, BSN, RN]

Nursing isn't for the faint of heart, for sure.

The working conditions you describe don't sound out of the realm of normal reality. The one thing that stands out, though, is the lack of teamwork. It's one thing to be overwhelmed with too much to do and too little time to do it, but when you have a good team, you can work together and help each other out. When you don't have a cohesive team mentality, then things can seem more dismal.

One thing I dislike is the "not my patient" mentality. Something you could try is, whenever (if ever) you feel caught up, or have a less demanding assignment, offer to help others out by doing little things for them, such as answering their call lights, delivering meal trays, etc. Set an example of being a team player. Never say "That's not my patient". Instead, say something like "Suzy is assigned to that patient, but is there something I can help with?". Some will respond to this and you'll figure out which co-workers you can rely on to jump in and help, and cultivate those relationships as much as you can.

[icuRNmaggie, BSN, RN]

Yes it's real. Nightshift would be better for you in the this facility . Did you sign a contract?

[FlossyRN]

No, I didn't sign a contract however due to child care and my husband's job I am not able to work night shift.

[FlossyRN]

I am flabbergasted by the lack of team work. I mean, it is horrendous. Nurses are almost hateful to each other, very cliquish. I do hope to be able to catch up one day and lead by example...at this rate though I am not sure when this day will ever come.

[RNsRWe, ASN, RN]

Well, here's my thoughts: you described what is not unusual for many (most?) med-surg day shifts in most areas. It is not "normal", but it isn't flippin-out-crazy either. It happens.

But teamwork SHOULD be able to help the situation, not make it worse. Doesn't seem like that's really happening. So I'm going to broach this question as someone who is reading only one side of one story, and ask if there is anything you might be doing, saying, how you're behaving, ANYTHING that might give the impression that YOU are not a team player?

I am not saying this is what's going on, obviously I can't know....I'm not there. But sometimes, when someone describes a perfectly awful situation (like yours), my antennae kind of perk up looking for the "why" of the situation. Sometimes, the new grad who is complaining to management at every turn (go with it, it's an impression) is NOT the one other nurses or aides are likely to help. They sometimes want to keep as far from the **** storm as possible, if you know what I mean.

It's not fair to your patients, even if that IS why it's happening, so you do need to do something to address it. Is there a chance the other staff is reacting to you...and not just overwhelmed themselves? Or, maybe....they are in the same boat?

Give it some time to chew over, and see what you think.

[icuRNmaggie, BSN, RN]

These places will hire and keep any warm body. It sounds like you are stuck until your children are older.

Is it feasible to work where you did your clini als?

[FlossyRN]

Well, I was hoping by saying that I graduated with honors and did well at clinicals showed that I was a team player and worked hard toward my goals. I understand you are stating how you see it and only hearing my side. However, I would also like to state that my preceptor suggested I demand my 12 weeks of training and, frankly, I do not regret it or the fact that I demanded to have some consistency to my training. I am caring for peoples lives as well as putting my license on the lines! To be adequately trained should be a requirement not a request! And, Yes, I am blunt, I am straight to the point and I am forward! However, I am a team player, I am friendly, I love to chat and laugh, I pitch in when I can, I ask for learning opportunities, I ask why, I pull my weight! So, yeah, maybe they don't like that I complain that it appears I am being treated unfairly...tough. I mean, I would hope they would want to foster me and help make me great not shut me down. Even, if they are not the training type or standoffish that doesn't excuse not feeding a patient because it wasn't there's to handle. Sorry, if it seems I am defending myself harshly...I am not trying to do such. However, I was always taught to speak up, ask questions, and demand fair treatment.

[FlossyRN]

I wish..it was an amazing facility..however, it is five hours away. We moved to be closer to my husband's family which also happens to be a town over from Hillbilly Hell and Good Ol' Boy junction it appears.

[Anna Flaxis, BSN, RN]

Just for a little perspective, I'm going to lay it out on the table.

I got two weeks' orientation on a busy cardiopulmonary tele (unofficially also complex medical/ICU stepdown) unit with three different preceptors for my first job out of nursing school. Yep, you read that right. Two weeks as a brand-spanking-new-wet-behind-the-ears-fresh-outta-nursing-school-RN.

Sink or swim, baby. Pull up those hip waders and wade on in. On your drive home from work, be glad you didn't kill anybody, turn up your car stereo full blast, and let yourself have a therapeutic, full body cry. Get up the next day and do it all again.

I'm telling you - know who your resources are, cultivate good relationships, model teamwork. It's the only way you're going to survive. Dorothy, you are not in nursing school any more.

Is it right? Should it be considered "normal"? Those are good questions, but in reality they are questions you don't have the luxury of ruminating over if you want to keep this job.

via Imgflip Meme Maker

[Horseshoe, BSN, RN]

Cardiac step down at my hospital was 3:1. Six or eight patients?!?!? If the acuity is the same as at my facility, that's just beyond dangerous.

Frankly, if you can't or won't move, sounds like you are stuck.

[MarySnov]

Is that the only hospital in your area? It sounds like this place is going to burn you out very soon and is very poorly managed. I feel sorry for the patients, but you do have to take care of yourself as well. I'd suggest looking for another job, but don't quit your current position until you have one.

About all these posts saying that this is the reality and you're not in nursing school anymore, etc. Seriously-that is the reality of the facility she is talking about. 6-8 patients for a new nurse on a step down unit isn't something that would happen in the hospital where I work and it isn't something that the nurses I graduated with have talked about.