saftey concerns burnout depression, etc. help me

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i work in an extremely fast paced infusion clinic. I started here as a new grad and quickly gained experience and was soon out working the other staff. We infuse Tons of remicade as well as Rituxan among others.... on our busiest days we have around 30+ patients between just two RN's and one medical assistant. The doctors are "on-site" but hardley available in case of reactions.

The reactions to medications have been more and more frequent, complex, and severe. It has gotten to the point where a patient has a bad reaction almost every shift i work. The nurse who I work with is abusive and has tons of issues. What makes matters worse is that since i have worked here, we have had problems getting other nurses to work here, so the clinic relies mainly on two nurses (me and captain insane).

I feel sick every time i go to work. I dont have the experience to get a job in the hospital, yet i feel like if i stay at this place im at something extremely bad will happen. I consider myself talented at what i do. I am very intuitive and a very hard worker. However i am willing to give it all up to feel normal again. sorry for the ********.....

i guess my question is this normal for this line of work? should i be in a situation where i have a 10:1 ratio of patients? should i stay at a place that only staffs two nurses? if one of us calls in sick we are screwed! Management could give two SH!ts about our safety concerns. Everything i say falls on deaf ears.

[Ratgirl]

If you don't "feel" comfortable with your assignments don't stay and risk the chance YOUR nursing license will be put on the line. Remember your manager is NOT out to safe guard your license, they protect the bottom line. You have enough experience to look elsewhere! Have confidence in your skills and knowledge! Go and have a good career where you feel good to go to work each day!

[iluvivt, BSN, RN]

So what problem are you concerned about the most? You are giving IV medications with a high probability of hypersensitivity reaction and side effects. A lot of times these can be managed with solid policies that address appropriate rates and special ramping up policies and also the use of premeds also helps immensely. Are the policies there good ? As far as captain insane goes that's a tougher problem to fix and deal with.

[mandomania]

Hey, I know this thread is a little dated, but I hope you don't mind me trying to encourage you in this stressful situation. I too have worked with my share of toxic personalities and weak management types. It definitely sounds like you realize that this work situation is having a negative effect on you. Be careful. It's a bummer when you are dreading going to work.

You described a situation that can have severe mental health consequences for you. This work environment will also have negative consequences in terms of patient outcomes too. Hang in there. It sounds like your moral compass is telling you to get the heck out of there. The tough part is learning to trust your instincts.

Leaving this toxic work environment will not make you a bad person. Plus, I would encourage you to find a good mentor. Is there anyone who's professional practice you admire? If you find one, stick to them like glue. It's okay to emulate good practice. These people can be a breath of fresh air.

Unfortunately, you cannot control what other people do. I totally get being an agent for change and all that, but maybe it's time to update your resume. It sounds like working part-time is not an option while you look for something else?

I have a lot of questions regarding why infusion reactions are on the increase and all that, but it sounds like the bottom line is your work environment is toxic to you. Short answer...get out, find a good (or more than one) mentor. Hope this helps. Take care.