So tired of bedside nursing

[FutureNurse0201]

So, I had a “situation” with my manager the other day and that was it for me. I work on a busy floor where we usually get 4 patients (vs 6 that I had in previous hospital) and I thought that would be awesome. Was I wrong? By 7pm, I am still not done with everything despite not taking a break, not stopping for a second and not charting and this is not just me. This is same for everyone. 
 

Anyway, the other day, my manager runs to me as I am discharging a patient and while trying to hide her anger asks who put my other pt on bedside commode. I had no idea what she was talking about so I said “probably got up by himself, and you know he refuses alarms. He said he will sign whatever necessary just not to have the alarm.” 
she responded “I know, and no alarm is fine but he cant have a bedside commode by his bed and get up on his own. Is that clear.” 

Now, I was left feeling completely stupid like I did something wrong. pt is alert and oriented, he was educated to call for help and was given a call light. However, he decided he didn't want to bother everyone and got up on his own. I understand why maybe he shouldn’t be getting up on his own (he gets dizzy) but I cant see what I could have done differently. 
Btw the manager yelled at the poor man and he was visibly shaken when I got into the room, apologizing for “getting me in trouble”. 
I am so over it. We are given so many tasks, so much of unnecessary charting, in services... etc and still expected to do amazing work when I am able to do bare minimum to satisfy their criteria. 
 

Any thoughts on this brief conversation I had with the manager that left me feeling like “it is just not fair.”

 

[JBMmom, MSN, NP]

The manager was saying what needs to be said on her end to cover her butt. Unfortunately he does fall into the category of a fall risk patient if he gets dizzy and therefore even if he can get up on his own he shouldn't. You educated him, gave him the call bell and did everything right, but if he has the commode there he's probably going to ignore the education so he doesn't bother anyone. If he does end up falling, it could come back on you that he had access to the commode at the bedside so was much more likely to fall. It's so hard because we're trying to treat alert and oriented people as such, but there are liabilities and that limits our ability to do so. I would say that you could move the commode to the bathroom or the hallway so he can't see it, and then he'll have to call (unless he decides to ambulate to the bathroom which could be worse), and the commode could be brought to his bedside. Or, moving him to a room closer to the nurses station, having a PCT intentionally round more frequently, etc. to keep him from falling.

Sorry things have been rough for you! I don't think you did anything wrong, but unfortunately we have to be aware of situations that could get us into trouble. 

[speedynurse, ADN, BSN, RN, EMT-P]

Yep and that’s why I left the ER. I got tired and fed of never seeming to do anything right when I was well aware of priorities. I feel bad for the patient because there are some that are very independent and want to keep that while in the hospital. I would be one of those patients! You fulfilled your responsibility. That’s all you can do. 

[JKL33]

Sounds like a completely inappropriate interaction on your manager's part, if I understand correctly that you were attending to the care of another patient, along with her "is that clear" bs and her chastisement of the patient.

Your other main option would have been to not leave the commode at the bedside, in which case he may have just decided to take himself all the way to the bathroom without bothering anyone.

5 hours ago, FutureNurse0201 said:

I was left feeling completely stupid

There's a good lesson here: Don't decide to feel stupid based on what other people do (such as your manager). If other people are inappropriate, they own that all by themselves.

5 hours ago, FutureNurse0201 said:

“it is just not fair.”

No, it isn't.  What are you going to do about it? Things that can help are working on being pleasantly assertive, work on controlling own emotions, work on prioritizing appropriately. For example, redundant charting will never be a priority. Also learn that the things that have been piled on top of excellent patient care cannot all be accomplished by one person. That is not your problem, that is administration's problem.

Lastly: I am completely biased here because of how disgusted I am at changes in hospitals and large healthcare systems in recent years, but my advice would be to start thinking about your future now, and whether you want all of this malarkey to be a long-term part of your future.

Sorry this happened; I say let it go other than the above.

 

[mtmkjr, BSN]

If there is corrective action needed and you are left feeling stupid, that  is not on you, but on the manager.

In a healthy work environment there are clear expectations and an incident like you describe is treated as a learning opportunity with a goal of  improved delivery of patient care - not leaving you confused and frustrated.

Your manager needs some work.