Really? Why so Negative

[Crew2Nursing]

Hello,

I am an older student and have been accepted into and accepted a BSN program. I have all ready finished my pre-req's at a community college in order to save money. I currently work on a Neuro/Telly/Stroke floor with the RN's having around 6-8 patients a piece with NIH scales to do on these patients every 4 hours or more.

The New Nurses are burnt out due to the stress of 6/8 patients and always talking about how stressful it is and really putting these new grads in very bad situations.

The atomsphere is really bad about nursing because my Unit seems to have a turn over every six months.

The Manager of the Unit along with the Main Unit leader of 4 floors tells these Nurses to suck it up and deal with it. The atmosphere is really nasty because its not safe for the patients, staff, etc...

How do I get over the negativity over Nursing when even the brand new nurses are burnt out and upset.

All I hear is "WHY am I in Nursing? I hate this job! Don't do this, find something else"

Is it the stress and are other floors a better match? or is all of Nursing like this?

P.S. I want to be in ICU/Trauma or ER/Trauma right out of school. :) I love fast pace action due to my EMT/Paramedic degree.

[WookieeRN, BSN, MSN, RN]

I have a strong feeling that the reasons why many nurses ask themselves 'WHY did I choose nursing?" or genuinely feeling burnt out really has to do with the employer, more so than the actual job of nursing. I think new grads, especially get this feeling because it is a brand new world to them. They most likely went in with some expectation of what it would be like, and are getting a little bit of a dose of reality. Some facilities just are not run efficiently and safe. Some just have a really bad culture.

I want to say, the overwhelming majority of nurses I know and work with genuinely like (or love) their jobs. We all have bad days, but when I ask them if they ever regret going into nursing, I rarely, if ever, get a "yes."

[TheCommuter, BSN, RN]

6 to 8 patients per nurse is a downright crappy ratio for a neuro/stroke telemetry floor. 4 to 6 patients per nurse is a much more breathable ratio for that type of nursing care. The ratios, in my humble opinion, are a major part of the problem at your workplace. You are working with nurses who are (drum-roll, please!):

1. overworked

2. poorly managed

3. unsafe

4. probably underpaid

5. stressed out

6. treated like poo

7. accountable to many people, but lack any real authority

[HouTx, BSN, MSN, EdD]

Totally agree with Commuter ^^^^^

There is an astounding amount of information in the literature that has really not changed over the years. Evidence that nurses LOVE their profession, but HATE their jobs. That inherent conflict - inability to fulfill expectations of the profession they love due to the harsh requirements of their jobs (workload, politics, hierarchy, poor managers, etc) - is guaranteed to produce burnout. And this is normally expressed as either anger/hostility (overt) or apathy (covert).

The solution is pretty simple - competent managers can create and maintain an environment that supports professional practice. But very few organizations provide adequate training for managers or hold them accountable for 'soft' metrics such as staff turnover, job satisfaction of their staffs, etc. Unfortunately, most organizations only pay attention to the financial bottom line - so their only criteria for evaluating managers is budget performance.

[Here.I.Stand, BSN, RN]

The Manager of the Unit along with the Main Unit leader of 4 floors tells these Nurses to suck it up and deal with it.

This fearless leadership is poisoning the atmosphere from the top down.

When you are being worked to the bone and don't even have any empathy, support, or helpful suggestions from management--plus are expected to provide Excellent Customer Service--that's going to affect the attitude. And yes, 6-8 pts on a neuro floor is an insane ratio. I started my career in neuro on the floor, have worked in an LTACH with TBI/stroke pts trying to wean from the vent, and in two high-level ICUs with neuro pts. Neuro pts are tough to take care of because they need so much help physically, and there can be confusion and impulsiveness, depression, family stress, etc. on top of it. That sounds like an unhealthy environment all around.

[RunBabyRN]

I would venture to guess that this type of organization has difficulty holding onto competent management, as lower management gets little support for staffing from upper management, and the poo, of course, rolls downhill.

I don't think it's about the specialty or even the unit, but rather, most likely the organization itself. Each one has its own reputation within the healthcare community. I've been in healthcare for many years, so although I am a new grad RN, I know which hospital is known for what, as far as patient care and treatment of staff/nurses, in my area. It makes a big difference. Even in the 15 or so years I've been in healthcare, little has changed, as far as the overall reports from nurses within these establishments. Of course things change, new companies come in and buy up hospitals, etc., but I hear the same complaints I've been hearing for years (that match up with my own observations from having spent time in these places in other roles). There's a BIG difference between one and another. Many nurses leave the middle-paying one once they have some experience to go to the lowest paying one because they treat nurses better there.

[Baubo516, RN]

This definitely sounds like a unit culture/organization culture problem. I think with the changes in healthcare law that have happened in the last 20 years, all facilities are asking nurses to do more with less, but not all units have nurses who are that stressed. I have worked as a CNA on a Rehab/Skilled Unit at a Magnet Hospital for 3 years, and as soon as I pass my boards in January, I will be working as an RN on full time nights. My unit has a pretty good culture and good teamwork attitude, and while there are a few burnt out nurses, the majority are happy there. There are some other units at my hospital where I would NOT want to work due to the personality and management style of the unit directors, which affect the total atmosphere. I am happy to start on nights because I do NOT crave a fast-paced environment! My advice to you is pay attention to the atmosphere/culture on each unit where you get to do clinicals. You will see that the morale of the staff varies greatly from unit to unit. Notice which ones have good atmospheres and managers, and apply there. Sounds like the unit you are on is one to avoid as a nurse.

[Nibbles1]

This is why I am doing private duty nursing right now. I was sick of having a huge work load with no support. I needed a break from it. Hang in there! And good with BSN school.

[Crew2Nursing]

Thanks, I'm glad to hear that it is probably just my unit.

[Baubo516, RN]

Another thought - I have heard that ICU's and ER's don't always hire new grads... although a local ER I went to for clinical said they have done so. Anyway...consider working at a small hospital first. Nurses at small hospitals are often trained to multiple units and this will increase your chances of working in ICU or ER as a new graduate. (Or do they have ICUs?) I'm sure your EMT experience will help you get hired in ER as well.

[Shorty11, BSN, RN]

6-8 patients seems like too many for one nurse to manage. At my hospital, even our least acute floors only have a 4:1 ratio. I graduated from nursing school (BSN-RN) in May 2014 and became an RN in June 2014. I started my job working in a Medical ICU/CCU in June 2014. It is possible to start in an ICU right out of school (I am proof). We have a 2:1 patient to nurse ratio. I love my job. I received 5 months of preceptorship before being on my own. Seems like the problem here is the environment (heavy patient to nurse ratio, management, environment, etc). I would personally look elsewhere to work... A safer, more nurse friendly environment!