RN's who were PCAs/UAPs/Techs, did you burn out prior to becoming an RN and how is it different the change in job positions?

[happerhiker44]

So a little background. I am currently an unlicensed nursing assistant, (PCA at my hospital) on a trauma floor--have been for two years. The hospital is a level 1 trauma center so I can assure you it's extremely busy. 95% of the patients consist of elderly who have fallen and have dimentia, GSW victims in gangs, car accidents that have patients with xfixes, ORIF, traction, etc. We get bariatric patients that have been up to 800 lb with unstageable pressure ulcers, patients with severe TBIs that are out of control, as well accidents either MCA or MVA related to drug overdose and dealing with them detoxing) and we have plenty of total care patients, and it's rare an assignment even has one independent patient.

In my first year of working on this floor I did three 12s on overnights, and we'd constantly be understaffed--where it'd be just two of us (18 patients each) or just me (36 patients total), and even on night shift there would be plenty of nights where the call bells are going on the entire night and you don't get to sit down for even a minute.

Anyway, since I've been in my nursing program I switched to days because night shift really interfered with my pre-reqs. However, it's been a year now since I've been on days and nurses are very uptight about everything. I assure though I am not discrediting them that they are busy. They most definitely are. On day shift the standard staffing is 4 PCAs, however, many times there's 3 of us with 12 patients.

Now this isn't saying nurses are being lazy or anything. Just want to clarify. They can have 3/4 or out of 5 patients be total care patients, and they are always busy charting and all that.

I feel burnt out, majority of our patients are 2-3 assist/hoyer out of bed and require a lot of additional care, a lot of the day nurses won't help with any of the "PCA work" as some actually say which I know will always happen everywhere of course, and I know a lot of the nurses are burnt out themselves, however, it's gotten to the point where it's interfering with patient safety; nurses don't even help each other out--, one nurse has a rapid response and is in the room for two hours, three of her patients need medications--no one will help her other patients meanwhile the people at the nursing station are looking at youtube videos.. All four PCAs could be in rooms with patients and bed alarm goes off, nurses ignore it, nurses try to tell us two assist patients are a one assist and won't help, meanwhile they're texting at the nurses station. If one nurse's patients IV is beeping and the nurse is in with another patient (who is heavy and will take a while to get out of the room) other nurses generally ignore it and roll their eyes if they get asked to fix it.

Some nurses even press the patient's call bell and walk out of the room with the bathroom or emptying a urinal. Nurses will ignore bathroom bells, and complain that they can't find the PCA or think we're "ignoring" them even though we're generally busy other patient rooms, or can't answer because we're cleaning poop in a C.Diff room.

I don't want this to sound like a rant against the nurses, there are a lot who don't want to do anything besides "nurse duties", and then there are very burnt out ones, and very helpful ones of course, and on the flip side I know there are a lot of lazy PCAs/Techs/Aides that hide or talk in addition to not getting any of their work done, but most of us are very hard working--I do 40 hours a week when I'm not in school, and majority of the time I don't get time to drink water, pee, take a break, or even sit down. (I think a lot of the stress too is because I picked up a lot of overtime for the entire month of July) .

I've felt burnt out for awhile, and I've been so negative-I don't want to have this attitude, I want to be the way I was in the beginning-wanting to help people, being quick at responding, etc. (I still do all aspects of my job, but I don't go as fast because I'm always exhausted). An even bigger fear of mine is that I'll hate nursing. Can any of you tell me what your experiences were like and what it was like transition from PCA to RN?

For me the main thing about being a PCA that's made me feel this way is the amount of patients we get and the amount of physical labor, and in addition it's so hard to get time off. My manager approved a 10 day vacation in March, and then less than two weeks before my trip (in June) she told me I couldn't take it because I didn't have enough CLT even though I paid for $2000 already and the floor had the coverage--I had another trip after that I planned which i switched shifts with people to get so I could do it, however, she made me work all the time for my original trip plus extra hours so I could do my other trip because apparently I couldn't use an oz of CLT. I am aware that it is my responsibility to be aware of our CLT, but it doesn't accumulate at all, it takes two months to be able to get one 12 hour shift covered and on top of that, unpaid time off isn't against hospital policy--it's manager's discretion.

In my two years there, I've only taken one whole week off for vacation, but even with that, whenever we request time off they make us work a ton more hours in the days before and after our time off, so it just seems we can't even get a real break. I would like your feedback. I really hope this is just burn out, because I don't like how I've been lately.

Thank you!

[Queen Tiye, RN]

Wow, sounds like a hectic floor. I’ve burned out several times before becoming a nurse. The floor you work on sounds like it has poor management, and non-existent team ethic because it’s so overwhelming, everyone seems to have taken on the “every man for himself” mentality.

Is changing units or facilities and option for you? It doesn’t seem like the culture of your unit is going to change anytime soon.

[J.Adderton, BSN, MSN]

I transitioned, albeit years ago, for PCA to RN. The responsibilities and job role are so different, I don't think burn-out as tech should keep you from continuing to nursing. However, both jobs provide patient centered care- including both personal and medical. I do think you owe it to yourself to explore other work options for a better environment. It is easy to feel "trapped" and scared when thinking about leaving a job.... but there are better jobs.

[J.Adderton, BSN, MSN]

I transitioned, albeit years ago, for PCA to RN. The responsibilities and job role are so different, I don't think burn-out as tech should keep you from continuing to nursing. However, both jobs provide patient centered care- including both personal and medical. I do think you owe it to yourself to explore other work options for a better environment. It is easy to feel "trapped" and scared when thinking about leaving a job.... but there are better jobs.

[RNNPICU, BSN, RN]

From your description of the unit, it just sounds like poor team ethics. There probably is some element of burnout, and some lack of support from leadership. Unit leaders can set the tone for how to deal with hectic shifts. Based off of your description, it seems that the norm is to let others drown, that doesn't just come from one or two people , it comes from what behavior is tolerated. This is not the norm in every unit.

In nursing you will have days like you described, however, that should not be happening every day. While there is no perfect unit where everyone helps, most do not let others drown or struggle. Nursing in general will always have ups and downs, but many are able to truly enjoy their career. Working with the general public is always hard, especially when something such as a trauma, illness, etc disrupt the norm.

Being in school and working is tough, it probably also contributes to your feelings of burnout. Although your are busy, please make sure to take time each day, even if it is just 15 minutes, to allow your self to just be. Unplug and do something you enjoy, seriously, 15 minutes, longer if you can. Cook, walk, run, bike, workout, watch a tv show, etc. Something that you enjoy.

Good luck and keep up your great work.

[smartace]

On 9/16/2019 at 10:32 PM, J.Adderton said:

I transitioned, albeit years ago, for PCA to RN.

I think a lot of nurses that worked as techs many years ago dont appreciate how much physically heavier patient's have gotten. I routinely take care of 12-16 patient's as a tech. It's virtually guaranteed you are always going to have some back breakers mixed in, usually multiple. So physically you never get a break. Even mentally its rough because with that many you are always gonna have some patient with behavioral issues or some demanding family that sees you as the hired help, but that probably hasnt changed from years ago.

Years ago nearly every bed bound patient got a foley. Now you have bedbound bariatric patients getting diaretics with no foley. That takes a serious toll on techs.

The physical toll is rough. Some units at our hospital have been wiped out by injuries or techs quitting because they've had enough.