Well, I've only been an RN for a little over 6 months now and I am not sure I made the right choice by atarting this career. I work night shift on a PCU/tele unit, generally we have 5-7 patients each.... I feel like from the moment I walk in, I am constantly running to keep caught up, passing and pushing meds like a robot, no real time to spend with my patients other than the quick assessment. I went in to nursing to help people but most days I don't feel like I am. I still feel like I don't know what I'm doing.
Every day is worse than the next it seems. For example: last night I walked in and this was my assignment: Patient 1:had been on the unit for 3 hours (admission not yet done) all they had done on the patient was take vital signs Patient 2: Confused elderly woman in posey vest with angry family that want pt discharged NOW Patient 3: Pancreatitis with uncontrolled pain/ nausea/ vomiting whose BP had been over 200/100 all day not addressed by doctor Patient 4: Gross hematuria with q 2 hour bladder irrigation Patient 5: Isolation for c-diff Patient 6: New onset Afib on cardizem drip. So how do I even prioritize here. I call on the BP/pain first. Orders to start a PCA. Do that. Come back, family of pt 2 at desk yelling. I calm them down, call MD, he agrees to discharge. I do her paperwork remove iv, tele, etc. Walk her out. Come back in to do admission that has not been completed by days. Call from desk that patient 5 has pulled her IV out. Gown and glove up to start new IV. Back to admission. Finally finish admission. It is now 9 pm and I have not seen any of my other patients other than to pop my head in and say hi i'm your nurse, i'll be back. So my charge nurse comes up and tells me theres a transfer from ICE coming and -lucky me- he will be my patient becuase I am down to 5 patients now. Just after I get my transfer in and settled, I get an admission from the ER. I finished my assessments and 10 pm med pass by midnight. Patient 3's pain is better but BP still uncontrolled so I call on that again. Irrigate that foley cath again. Midnight meds get passed. Finally start charting by 1 am. Chart checks were done by 3 am. MARS done by 4. Then it was time for I and Os and daily weights, IV tubing changes, Check AM vitals and lab results. Then 6 am meds. Then the MDs start coming in and then the day shift comes in.... I didn't have time to take even a ten minute break off the floor, didnt have time to eat....
I don't know if it's the hospital I work at, the floor I work on, or the charge nurse I work with, but I am heading for burnout fast. I practically jump for joy when I get called off (although I desperately need the money). And now with only 7 months experience I am a precepter for new employees and nursing students (scary) and they have started floating me to ICU. When I told them I wasnt comfortable floating to ICU they said "well nobody is, but we all have to take turns." I am honestly scared that I am going to lose either my licsense or my sanity... maybe both LOL.
This isn't the specialty I wanted to work in, it was what was offered and I took it. I wanted L&D, Mother/Baby, NICU/Nursery, or Peds, but I wonder if it is just as crazy on those type of units... I knew nursing would be fast-paced job, but I wasn't prepared for this...
I have suffered job burnout a few times and my only advise here is you might need to take some time off for the sake of your mental health. If your workload is that bad that your not able get a meal break, maybe you should speak to your occupational health and safety department. I don't know how a nurse is supposed to provide care safely without adequate food intake. I know i would be either demand a safer working environment or be looking for work elsewhere.
One of the things i experienced when i was new to nursing was being given a bigger load than the more experienced nurses and all the new admissions and discharges. This happens in a lot of places i have noticed because your so new and eager that you don't realise it's happening and when you do catch on, you feel powerless to act. I realized what the other nurses were doing and made it very clear to them that if i'm not given a fair workload, the nurses union would become involved and i would start writing incident reports about unsafe work practices that were compromising patient care. I was unpopular for a while but my workload was more reasonable.
And at the end of the day as a Registered Nurse we are patient advocates and we should speak up about unsafe patient ratios and staffing levels.
Specializes in CTICU, Interventional Cardiology, CCU.
I opened my mouth tonight and it worked...I had a pt. that needed the ICU badly and they were ready to give me another and I said NO...amd it worked what a relief!! thanks for the advice all!!!
Oh my goodness! I think I would want to quit!! The people you work with (the majority of them) sound horrible and lazy. What an aweful situation. Is/are there other good places to apply for a position?
Have you ever read the books by Echo heron? She worte books on when she was a student nurse and then after she graduated and she cracks me up! She has gone through similiar situations and she dealt with it in funny ways. Sometimes she just wanted to strangle people (including the doctors) These books are true but the names are changed. She writes them in such a way that I just can't put the books down. Condition critical, is the first one I think. They are so worth the time to read. They are easy too. I think you will gte a lot of insight from her experiences.
all i have to say is wow to ur nights........ i feel like for me day to day its different one min i hate it the next min i have an awesome day where i really feel like i made a difference.... but i willt ell u that as a new nurse 8 mos they tend to kind of like "haze" the new nurses.... which seems like u get the harders pts and admits etc etc..... of course i want to learn and see different things but now while i have 5 pts goin on 6 and u have 3 no way.... i used ot be nice i really did haha but now i stick up for myself and ask why am i gettin them im at 5 they ahve 2 d/c and will be at 3. it usually works they dont expect u to speak up and when u do they dont know what to say hahah..... so if they kniow that u know what the floor is like and it IS possible for someone else to take the pts then say it....sometimes i have awesome nurses aides that can orient the pt to the room while i get caught up most of the time we dont tho its suposed to be team nursing truthfully but it seems like u know who u can ask for help and who will sit on their ass while ur runnin ur ass off... i dunno if its nursing or jus every job, when ur in it for u go to work and do u ......dont take on other things u cant handle say NOOO in the nicest way possible haha good luck!!
one more piece of advice....... its really helped me VOLUNTEER to take the enxt pt early in ur shift that way ur full:) then u have things done early and ahve all day to do it so that when someone comes in postop an our bf u leave ur already full :) plus they love love when someone takes initiative and volunteers good luck
GET OUT NOW! I worked on a tele unit 5-6 patients no monitor techs etc. IT WAS HELL. I did 3 years there, and left because I was burned out, and felt that every time I was there I was jeopardizing my license. I love what I do now, not that you cant get crazy busy, but it isn't like that day after day. Good luck, you sound like an efficient, good nurse. Don't give up your career, just that job.
I wanted to write an update on this. I did not go back back in 2008. I was accepted but I was asked by hubby to wait a bit. Then in Nov of 2008 I found out I was pregnant! I was so excited. I had my precious little boy in July of 2009 and I could not even go back now til he is older. I still have the fever for nursing and I study still to not lose any knowledge but I will wait to go back so I do not get burnt out again and take it out on my family My baby needs me and my other kiddos too.
november17, ASN, RN
1 Article; 980 Posts
I don't know what advice to offer...
but,
I feel your pain.