The Breaking Point

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Hello all. So, I am 10 months in to being an RN on a med/surg floor in a small hospital. The job seemed overwhelming at first (totally normal) with the fear of not being able to do good assessments, not knowing how to do certain things, lack of confidence etc., but then I got more comfortable. The problem is now, I still feel totally overwhelmed but for a different reason.

Now, I have just had it with the short staffing and the crazy demands. Even without the short staffing, any med/surg floor job is going to be stressful. You are dealing with numerous diagnoses, patient's going downhill, tons of meds and treatments, admissions, families, etc etc etc! Ok, this is part of the job, which I get and would be okay with. The issue is, I can not stand having 8 to 10 patients anymore. Often times, I can never find the 1 or 2 aides who are working to help me with little things. And there are many times that we have one aide for 20+ patients (it's like that every Saturday and Sunday that I work). Tonight I started with 6 patients, then had 3 admissions within 3 hours of each other. I had 4 patients on FSBS (nurses do all FSBS and vitals here), and I work 3-11 and have med passes at 1600, 1800, 2000, 2200. I am to the point where I have to literally stop and settle myself down before I start crying because I am so overwhelmed. Then I come home and I feel like a terrible nurse because I feel it's impossible to be a good nurse with so much to do and so little time! I want to start applying for new jobs, but I am just so afraid it will be like this anywhere I go. I just wish it could be better here because I want to stay but it's making me very depressed. I also want to talk to management, but I feel they just don't get it. They leave at 4pm and all their troubles are behind as we deal with being short staffed and non-stop admissions.

I work part time (thank goodness) and I have NO IDEA how anyone can do this full time. I could probably count the amount of times I have actually had a more than 15 minute lunch on one hand. And of course we all got in trouble for signing for "no lunch". We lost 6 nurses within 4 months from the 3-11 shift alone. How is that not an indicator that there is a problem?

Do any of you deal with or have dealt with such conditions? What did you do? Is it like this everywhere? I can not see doing this for much longer. It's so physically and emotionally exhausting. And it's TERRIBLE for the patients too. More falls, more things that should be noticed left unnoticed, more mistakes, less time to teach and talk, worse patient satisfaction and outcomes.

Is there any hope? How do you other nurses deal with this?!?? Thank you for listening. And you can vent here if you had a bad night/10 months/10 years as well :)

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Specializes in Going to Peds!.

BTDT. While I didn't end up leaving my facility, I did switch to nights, which was much better for me all the way around. I am naturally a night owl. There's (usually) fewer admissions. Half the time 3-7 gets screwed because they start with too few patients to get an aide or a third nurse, but they end up admitting a bunch. I found myself getting very resentful that I was busting my butt to admit 2-4 patients & ending up with a heavy load. Night shift would stroll in & we'd have all the admitting done & they'd get the extra help. So, I moved to nights. Oh & nights is paid higher.

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I work nights sometimes and I agree that it is a better shift. They often times have 10 to 11 on nights and as annoying as that is, they have a super easy and quick med pass, and usually fewer admissions. There was a part time nights position open recently, but it was on a floor that is incredibly disorganized and the night workers there basically eat each other alive. At this point though, I wish I would have went for that over continuing to deal with this. Are med passes in all hospitals on 3-11 designed like this? (1600, 1800, 2000, 2200) ? It seems way overkill and is uber time consuming on top of everything else we are expected to do.

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Specializes in Going to Peds!.

Pretty much. We even have some 1700 & 1900 & 2100 meds. However, our eMAR system will allow us to give meds up to an hour before/after. So, an 0600 med could be given anytime from 0501-0659. Most of us use that to our advantage to consolidate passes. Our shifts are 12 hours though. So, night shift is 1900-0730. We're responsible for meds/treatments due between 1930-0700.

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8 to 10 in med surg? That is awful. I would run far away!!

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HA! Trust me, I want to sprint away! Oh, we also use the old school DOS based Meditech (F keys, probably should have died in the 90's....), and pharmacy closes at 7p on weekdays and 3p on the weekends. Let's just say nightmare since new admissions and tons of new orders come in after those times. I wonder if there is anything not going against us here LOL.

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Specializes in Acute Care.

8-10 on evenings, and 10-11 on nights!?!?! I have NEVER heard of those ratios... even at a "smaller hospital". I wouldn't ever sign on for those ratios. I work in a "smaller hospital" too on a telemetry floor (but it's more like a med-srug)... I'm on days and we're usually at 5, and I am totally exhausted with just that! Like I said, I'd never sign on the dotted line for that- sounds very unsafe. Good luck! I hope things get better for you!!

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Oh, believe me, I did not sign up for this. I was told "5 to 6 on days and eves and 7 to 8 on nights". Last night I went in and although census was low, it was just me and the charge nurse. So I had all 7 on the floor then had two admissions. They went from having 4 and 3 each on days to me with 9. And today, they are leaving me alone again. I am having panic attacks and my stomach isn't keeping anything in. So sick of this.

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Specializes in PACU, pre/postoperative, ortho.

Charge assigning all 9 pts to one nurse while taking no pts would never fly on my floor. More like 6 & 3 if eve or 5 & 4 on nights. Giving all pts to one nurse during low census might happen with 5 pts.

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Specializes in Cardiac.

I work nights and how I handle my 8 & 10 PM meds is I give them both at 9 (so med pass is 8:30-9:30) since I have an hour leway in each direction. That is as long as they can be safely given together. Saves tons of time and helps me get everyone's mostly on time instead of mostly late!

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Update: Just got a Urology Outpatient Surgery position. No more weekends, holidays, or going absolutely nuts trying to care for 8, 10 patients. It's been a year and half of med surg craziness (I have to say though, sometimes I did really like it). I am going to ask to stay per diem at the hospital though. I think having control over when I work there will ease the burden a bit as well.

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