This started out as an email to my nurse friends for advice. I'm casting this out for more than just two opinions. And my friends might not be brutally honest, which is what I'm looking for right now. To begin with, a SALT is like a write up in most cases. But it's mainly there for patient safety. We do them on falls, med errors, skin tears and pressure ulcers on admit, and sometimes just whatever the need.
I got an email from my mgr. I have 3 salts. I think they are all from last friday night when I totally wanted to quit. It was the night I wanted to claim safe harbor. Wish I had now. If your gut ever tells you to claim safe harbor, do it right then. It's totally worth it. Go to the bon website and print out the quick form for it. I did last night. Anyways, I get this email from mgr and it lists 3 medical record numbers and very brief description of what it was. I have no way to look it up to determine what the issue is or the patient. I'm supposed to stay late Monday morning for the mgr to come in early to have a meeting with me. In the email it says to come prepared with feedback. Huh? I had a patient pull out iv and refused to be resited, that morning I had a critical called the doc and day shift showed up and wanted report before I could even write the order. Well, I couldn't convince patient to resite, I am not going to force them, that falls under assault and battery. Horror. The other is about interval/profile not being done, I don't know. The last was patient who had sores on coccyx and back not documented. I want to scream. I think I know which patient that was, I remember the dressings were white and photographed on day shift and documented in progress notes. I missed more med orders last night. I reported it as soon as I noticed it. What am I gonna do? I feel thorough and ocd about doing my paperwork but this is blind-siding me. Even this morning when I got home I had to call because I forgot to note a med rec form. Sometimes the extra paperwork I'm doing is left over from day shift. I know it's my fault but how do I change this? Is it the patients? I make mistakes on the nights when I have one or two patients that call every 5 mins. I had one last night who needed to go to bathroom every 30 mins. Her first call was at 1906, no tech I went in to help her and did her assessment while on BSC. I just want to scream. I feel like it's all for nothing. I really regret going into med/surg now. I'm so frustrated I can't even think about what I've actually learned. Maybe I've learned that med/surg is not for me. I still want to cry every shift because I'm so overwhelmed and behind in everything and others are just laughing and having fun. I go in for 12 hours work my bottom off to try and get everything done, for what? To get salts? Salts are now the equivelent to write ups and everyone can do it. I never salt people, but I think that is about to change. But when would I have time to do a salt? I feel completely unappreciated by everyone. Also, I hate when day shift comes in for report and is hateful to me because they're getting my patients. Please, I had them all night, I don't make the assignments so take it up with someone else. I can't even give good reports because I'm sitting there getting the evil eye because of the patients. I forget what is important and should be telling them. I'm gonna quit giving them the details that suck and will tick them off. I hate it so much. I just don't know what to do. Is it like this because it's a corporate hospital? Found out last night we're not getting the bonuses for the KPIs because of budget. We met every KPI but we didn't make enough money. Is it like this everywhere? Will healthcare always be like this? Will it be different with computer charting? Am I really supposed to be a nurse? What about ER? Will I not like it there also? Will it be different? Is this just med/surg? I feel like having an anxiety attack at the thought of going to work and when I get there. I need advice, reassurance, something.
I guess I'm just overwhelmed right now. I hate making mistakes or getting in trouble. I try to do everything right so it doesn't happen. Thanks in advance.
Also, I am not complaining about day shift. I worked with the same day shift crew for 1 1/2 years before going to nights.
Specializes in Psych, ER, Resp/Med, LTC, Education.
I have to say that I worked on a medical/respiratory unity for about a year and a half and yes I had days here and there that went well--I felt confident and got things done on time and stayed organized--however MUCH of the time I was stressed and anxious and rusing all the time! Staying really late to finish up charting. Several of the nurses were just not very nice......I decided to try psych and I have to say.....that anxiety and constant stress and feeling like I missed something or made a mistake.... that was gone. I had been on meds actually for anxiety to deal with that job! lol no more meds. I learned a lot that I still use and am glad I sucked it up and did it but medical was not for me. I feel much more comfortable and confident in psych. And don't constantly worry that I screwed something up. Not saying that psych is what you need to drop you job and switch to....not to say that maybe you might like it but.....maybe its not for you, that's okay it's not for everyone. That's why there are lots of different areas you could go to-- a little lower stress and maybe just less stress cause it will just be a better match.....psych, mother/baby maternity (not necssasarily L&D as that can be high stress but a straight mother/baby post partum unit.....other things that might interest you. But it's a thought if you get to a point where you just feel like maybe all your efforts are not helping and you have given it a fair shot. No harm in exploring other areas/specialties.
Good luck to you and BTW-- you are nicer then me! lol ...I would have told that nurse..."Excuse me but I would really apprecite it if you would at least TRY to act like you are listening to my report...reading the paper while I give it to you is really pretty rude!" LOL
Update: Just had my meeting with my mgr. Over the phone. I'm working tonight, not on floor, watching tele. It's really hard to defend yourself or anything else for that matter when meeting is on phone. Bottom line was next time I'm supposed to restrain patient to restart IV. Don't think so. I've already had my quick cry and got it out of my system. Going back to work now.
Phone "meeting"? Restrain an a/o x3 patient to restart an IV? Not working as a licensed nurse? Ill-treatment when you've worked on that floor for over a year as a tech? FWIW, I'd seriously think about leaving. None of the things you did were so awful that you deserve to be treated like that. Almost all of those things fall under the category of being brand new to nursing. I sure wouldn't want to work there. I don't like units that don't like to "grow" new baby nurses.
As for working as a tech: Heck, it's their dime -- you still get a nurse's pay. And what they fail to understand is how much money they just cost the hospital by training you and then losing you. I think it's upwards of $50,000 to train a new nurse nowadays. Always remember, what you've learned, they cannot take away from you. You're a licensed nurse and you have a valuable skill set that they're throwing away because they don't know how to nuture you into excellence.
I'd go in with my 2 week notice prepared and ready to hand over and a realization that this is a toxic workplace and their loss. When you go for other job interviews, you'll really be telling the truth when you say, "It just wasn't a good fit for me," because who wants to fit into an environment like that?
I still help out with tele since they haven't hired anyone prn for nights. There used to be 2 nurses that we could do it, but now it's only me. I do receive my nurse's pay, but I have tele, answer call lights and play secretary. A bit of sensory overload. I have lined up a job interview for next week. It's a teaching hospital, so I'm hoping there will be more opportunity there. I wish I was able to stay here, but the few who make work unbearable don't outweigh the others. I guess I'm disappointed in how this has turned out. Hopefully I'll be able to find another place to work, and I'll go prn here for a month or so. Prn only requires one shift a month and April will be 2 years I've been here. I don't really want to cut it short that close. Thanks.
Phone "meeting"? Restrain an a/o x3 patient to restart an IV? Not working as a licensed nurse? Ill-treatment when you've worked on that floor for over a year as a tech? FWIW, I'd seriously think about leaving. None of the things you did were so awful that you deserve to be treated like that. Almost all of those things fall under the category of being brand new to nursing. I sure wouldn't want to work there. I don't like units that don't like to "grow" new baby nurses.
As for working as a tech: Heck, it's their dime -- you still get a nurse's pay. And what they fail to understand is how much money they just cost the hospital by training you and then losing you. I think it's upwards of $50,000 to train a new nurse nowadays. Always remember, what you've learned, they cannot take away from you. You're a licensed nurse and you have a valuable skill set that they're throwing away because they don't know how to nuture you into excellence.
I'd go in with my 2 week notice prepared and ready to hand over and a realization that this is a toxic workplace and their loss. When you go for other job interviews, you'll really be telling the truth when you say, "It just wasn't a good fit for me," because who wants to fit into an environment like that?
ICAM with this post. And I will add, that I am concerned for the patients at this hospital. It all trickles down to them in the long run.
update: just had my meeting with my mgr. over the phone. i'm working tonight, not on floor, watching tele. it's really hard to defend yourself or anything else for that matter when meeting is on phone. bottom line was next time i'm supposed to restrain patient to restart iv. don't think so. i've already had my quick cry and got it out of my system. going back to work now.
ICAM with this post. And I will add, that I am concerned for the patients at this hospital. It all trickles down to them in the long run.
Our Press Ganey results just came in, out patients are not happy. And we didn't meet all of our KPIs from last year.
There are quite a few pleasant and supportive people I work with, but they can't outweigh the toxic ones.
The comment about commiting battery on a patient is the last straw. I'm looking forward to my job interview next week and if I don't get it, I'll just keep applying until I find a better place to work or go back to EMS temporarily.
Thanks for all the advice and support. It sometimes hard to see the bigger picture when looking from the inside. I'm grateful to all of you.
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RochesterRN-BSN, BSN, RN
399 Posts
I have to say that I worked on a medical/respiratory unity for about a year and a half and yes I had days here and there that went well--I felt confident and got things done on time and stayed organized--however MUCH of the time I was stressed and anxious and rusing all the time! Staying really late to finish up charting. Several of the nurses were just not very nice......I decided to try psych and I have to say.....that anxiety and constant stress and feeling like I missed something or made a mistake.... that was gone. I had been on meds actually for anxiety to deal with that job! lol no more meds. I learned a lot that I still use and am glad I sucked it up and did it but medical was not for me. I feel much more comfortable and confident in psych. And don't constantly worry that I screwed something up. Not saying that psych is what you need to drop you job and switch to....not to say that maybe you might like it but.....maybe its not for you, that's okay it's not for everyone. That's why there are lots of different areas you could go to-- a little lower stress and maybe just less stress cause it will just be a better match.....psych, mother/baby maternity (not necssasarily L&D as that can be high stress but a straight mother/baby post partum unit.....other things that might interest you. But it's a thought if you get to a point where you just feel like maybe all your efforts are not helping and you have given it a fair shot. No harm in exploring other areas/specialties.
Good luck to you and BTW-- you are nicer then me! lol ...I would have told that nurse..."Excuse me but I would really apprecite it if you would at least TRY to act like you are listening to my report...reading the paper while I give it to you is really pretty rude!" LOL