I'm a new nurse, in my job for just a year now working on a med/surg floor. Being older than my co-workers and having previous work history, I tend to be more adamant about some of the rules and ways things should run.
My most experienced co-worker ( on this shift) has 20 months experience due to the high turnover here: 100% at 2 years is the current according to recruitment.
Anyway, I was made charge a couple nights ago and things were just insane as usual. We were running short 1 nurse and we were getting slammed with admits. 5 in the first hour plus an AMA and an irate family to deal with because day shift had neglected to tell them they could'nt leave until the pt urinated - pulled their cath @ 1900.
I had 5 patients: one with SaO2 @ 63%, one getting 2 units PRBC's with Lasix and fluid overload and one with 9/10 pain and we were out of meds as usual.
My co-workers were in a similar bind with their crazy night.
The Unit secretary calls and says I'm getting an admit. I said it was wrong and the assignment sheet was made up differently, she told me that too bad I was getting it anyway the House Supervisor wanted that room.
I called the House Sup and refused saying we were completely overwhelmed and would not accept the pt. His response was to tell ER to put the pt in the room and I would call later for report.
In other words they dumped the pt and left! Further they never even told me the pt was there. I got really pissed and I even called the NM at home. Understand, Admin is only on duty here 0730- 1530 , we have NO admin here on nights weekends or holidays.
The NM's answer was I don't have enough time management and everybody runs short and we all have to deal with it.
As to having no meds from pharmacy - a regular issue here - she said that I need to address the issue and I should also confront the Unit Secretary to tell them they don't assign duties.
It's always the answer here: Deal with it & You do something about it.
The last year has been entirely like this: 5 & 6 hours to get meds from pharmacy, no stock of different doses so we have to give 6 or 12 pills for a dose, we spent two days over memorial days with no tylenol because we were out of stock and the always standard answer from Admin that we need to deal with it.
Anyway, I'm bad, I got really mad and threw a chart at the desk and was rude to the house supervisor.
Now I'm not afraid of firing, after all they've had staffers threaten homicide and they don't get dismissed, but I am afraid for my licence and the likelihood of bad references for a new job.
Recently they gave poor reviews to two staffers to keep them here and they were very blunt to them saying that they didn't need to leave so they would not get positive evals.
I do have a foot in the door at an agency for various PRN & contract work. Should I cut and run? Give notice and go?
Is it like this everywhere? The hospitals I did clinicals at in school sure seemed better.
oh, please don't tell me you are giving them tylenol that has been on the floor.
this issue has already been addressed by the person that mentioned this incident, by stating that the tylenol is still in it's unopened blister pack, and therefore not contaminated. the poster also stated that pills that are already out of the packs that fall on the floor, are considered contaminated.
Wow. That must be tough. Politics are so difficult. Sounds like you have already inadvertantly burned your bridges with the NM and house sup. Maybe you could comtinue to work there for awhile and try to find a new job. Don't forget to take what you have learned from this job to your new one, should that happen.
this issue has already been addressed by the person that mentioned this incident, by stating that the tylenol is still in it's unopened blister pack, and therefore not contaminated. the poster also stated that pills that are already out of the packs that fall on the floor, are considered contaminated.
i didn't see the other comments before i posted mine.
I have to agree with the another poster, I don't see where or how you really "lost it". I've seen my charge nurses throw phones before, while dealing with far less crap, I think you held it together pretty well! I would at least transfer to a different unit if you don't want (or can't) to leave your hospital entirely. Its not worth what you are going thru, totally not worth it. If your administration could care less about fixing things...I'm sure the state would care, and maybe JCAHO would like to pay a visit to your facility as well! As far as running out things....we've run out of the most unbelieveable things: 10cc saline vials, urinals, Newborn diapers, infant formula, and much, much more. To whoever's in charge of ordering for hospitals: the expiration dates are that short! trust me, we will use up the tylenol, dilaudid, saline etc before it goes bad!!!
Thanks to all for the great replies and really confirmation that things can be better.
In the last couple of nights the sharps containers have really been overflowing and we're always told we're out. As of today they were putting sharps containers out without lids in some rooms. The rooms I had I just took them out of and tossed them.
As to reporting things to risk or higher up, THAT is an absolute no-no. It is a sure fire way to get swift retribution. Reporting things like sexual harassment, staff breaking things fooling around or poor behavior means in the next several days or weeks you will be singled out for reprimand. I reported the Male NM of another unit for asking one of our floor's staff if she was a "natural" red head and how she trimmed herself and took care of personal grooming and that was blown off as "joking". In turn, I got a written reprimand for being off the floor on my lunch break. My NM response was that when you're here at work you will be here at all times. Except of course for the smokers that are off the floor every hour.
If you report an issue here, be prepared for your name to go with the report and for managemtn to cut you down.
I'm just going to take everybody's advice and Monday start the fast track to departure. Things are getting too scary and too stressful. I am very afraid for my patients, unfortunately all I can do is leave.
Run away now! Seriously, no one should have to put up with that on a consistent basis. We all need to stand up together and say "enough is enough"; for both our sanity and for the patient's safety.
Also, the ED shouldn't have dumped the patient - I'm in the ED and I refuse to send up a patient until I give report. But, please forgive us in the ED! I get so frustrated when I try to call report and they are too "busy" to take report from me even though a bed is ready and clean (busy being "I'm on break, call back"). Meanwhile, we'll be running a code in the ED, and I'll have a patient with runs of v.tach with his pacer firing, and another patient whose labs just came back with an elevated troponin...and the EMS radio just won't stop beeping! I don't know how many patient's roll through your ED, but we're often close to splitting at the seams, and if we have ICU holds (grrrr) we need to ideally have 1:1 to 1:2 nursing care. The safest thing I can do for my patients under these circumstances is get them upstairs ASAP, but only if their nursing care can be continued...
Your nursing license is with the state, not the hospital...and don't let them bully you any longer. Good luck.
I understand what ER goes thru and I try to accomodate. Usually I get along fine with ER staff because I don't do the constant delay crap and they know that several on my floor are the same way.
The problem here is that admin doesn't care what happens and the answer is always that somehow we as staff are lacking ability. I could go on but I might get mad or depressed instaed of just determined to leave.
I reported the Male NM of another unit for asking one of our floor's staff if she was a "natural" red head and how she trimmed herself and took care of personal grooming and that was blown off as "joking". In turn, I got a written reprimand for being off the floor on my lunch break. My NM response was that when you're here at work you will be here at all times.
That is 1) a totally inappropriate and 2) if you are on a break you should be actually taking the break- which means being off the floor.
So glad to hear you're going to be finding a way out, and onto a better place!
PLEASE inform JCAHO about everything you've told us .... about the insufficient use of pain meds, the sharps containers, etc, etc. PLEASE get them involved.
Good luck to you! Please keep us updated on how things go.
So glad to hear you're going to be finding a way out, and onto a better place!
PLEASE inform JCAHO about everything you've told us .... about the insufficient use of pain meds, the sharps containers, etc, etc. PLEASE get them involved.
Good luck to you! Please keep us updated on how things go.
I agree 100% Document as well as you can dates times, etc. of all you can remember and get JCAHO involved ASAP. That kind of negligence is a serious incident waiting to happen. Also there are protections in place for those who report sexual harrassment. document your c/o to management and your subsequent write up and get that to your BON. Also, to the best of my knowledge you can not be prevented from going on break off your unit. I would check w/ your state BON or labor board to see what if anything you can do about that.
I'm sure given the chronic shortages that plague some hospitals in poor nations no, they don't. And don't you find it telling that his friend has been pocketing and keeping the "wasted" Tylenol?
Actually the given tylenol wasnt pocketed..it's heartily given by my friend's patients ( as an act of gratitude ) because my friend is really on heck of a loving, caring, skilled and compassionate nurse in one of IL's biggest hosp. in the Tele area.
Oh, please don't tell me you are giving them Tylenol that has been on the floor.
We dont...Its sealed and clean and it's the excess of the patients' stock that they gave to my friend because of her great job for them...We nurses value the principle of asepsis, so dont worry...We dont give naked pills from the floor.
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I don't know how many patient's roll through your ED, but we're often close to splitting at the seams, and if we have ICU holds (grrrr) we need to ideally have 1:1 to 1:2 nursing care. The safest thing I can do for my patients under these circumstances is get them upstairs ASAP, 
We dont...Its sealed and clean and it's the excess of the patients' stock that they gave to my friend because of her great job for them...We nurses value the principle of asepsis, so dont worry...We dont give naked pills from the floor. 
missdeevah, NP
318 Posts
this issue has already been addressed by the person that mentioned this incident, by stating that the tylenol is still in it's unopened blister pack, and therefore not contaminated. the poster also stated that pills that are already out of the packs that fall on the floor, are considered contaminated.