What are your biggest pains/ problems as a nurse?

Nurses General Nursing

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What are some of your biggest pains or problems you encounter in your day-to-day work as a nurse? What are some of the annoying/ tedious/ redundant parts of your job you wish you could change? It could be anything, whatever makes you tick and wish would be improved/ made better. It could also be non-work related as well.

thanks for your time, your input is much appreciated!

Specializes in Infusion Nursing, Home Health Infusion.

Use a toothbrush to clean stool under fingernails.Soak the hand in warm soapy water first.If in a rush you can put lotion on the toothbrush and just scrub under the nails

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Specializes in Cardiovascular recovery unit/ICU.
Clients who care less about their health than I do.

Like, you came to me for wound care in the hopes of healing your disgusting gigantic lower leg ulcer, right? And we agree that I'm not a fairy godmother? So you might actually have to do things like wear the compression I put you in (yes even though you can't wear your favourite shoes with it) and control your diabetes and show up to your appointments on time. God forbid, right?

And then somehow clients are mad at ME when they don't do anything I tell them to do and SHOCKER their wounds don't heal. Really?

and somehow when these "clients" who don't care about their health for the last 30+ years and completely abuse their bodie suddenly want to know why we can't make them well and are the ones most likely to sue.

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Specializes in Cardiovascular recovery unit/ICU.
In addition to the above

1. Physicians who deny/refuse to acknowledge when a patient is declining until they actually crump/code/require intubation, etc. Often interns/residents who are too scared to call their attending. And I'll go over their head and call the attending myself, but I have to notify them first, let them see patient, formulate a plan. These things all take time. I had a patient with new onset symptomatic bradycardia to the 20's and no IV access. I told the intern and resident that she needed a central line before she coded. They wasted over half an hour asking me to repeatedly page IV therapy, asking if we could get IO access, etc. I'm pretty sure because they weren't comfortable with the procedure of putting a central line in and didn't want to call the fellow. The patient VT arrested. She lived and was fine, but COME ON. This happens to a lesser degree fairly often, this happens to be an extreme example, I'll admit.

2. 'Informed Consent'. People consenting 95 year old patients for open heart surgery and brushing over the risks and complications. I have had countless patients who end up circling the drain and slowly dying over the course of months postop. I don't care if she's a 'good 95'. All lives end in death. The elderly, especially those with co-morbid conditions DO NOT bounce back from open heart surgery like a 60 year old. They have CVAs, their kidneys fail, they get septic, they get delirious, they get ischemic gut and end up with an ostomy, they can't wean from the vent and end up trached and pegged. We spend millions of dollars on their care and they spend the last weeks or months of their lives miserable and much worse off than they were pre-op.

3. Patients who think that the best way to tell if they moved their bowels is to stick a hand into their butt and see if it comes up wet. I'll never trust a handshake again. A side question, anyone have any magic tricks for scrubbing fecal matter from underneath someone's fingernails?

"Trach and PEG" over and over again.

Why would a surgeon schedule an open heart surgery for a pt in ESRD, Malignant HTN, low EF requiring IABP post op (which the pt never comes off of) and COPD??!!!!! They will spend weeks in ICU then on to LTAC if they survive the transport. The costs are enormous and the family wants to know why we can't make them "better"and they remain a FULL CODE on top of that.

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Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
"Trach and PEG" over and over again.

Why would a surgeon schedule an open heart surgery for a pt in ESRD, Malignant HTN, low EF requiring IABP post op (which the pt never comes off of) and COPD??!!!!! They will spend weeks in ICU then on to LTAC if they survive the transport. The costs are enormous and the family wants to know why we can't make them "better"and they remain a FULL CODE on top of that.

The surgeon gets paid for the surgery even if the patient never makes it off the ventilator. I sometimes think that there should be ethics panels to evaluate cases Pre-op. Or that there should be someone in the surgeon's office to advise patients that yes, the surgery itself is a proven treatment and very effective for THIS complaint, but it won't do anything at all for THESE complaints, and it will actually exacerbate THOSE complaints. Furthermore, the recovery period will be at least a few months, and may be the rest of your life.

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Specializes in orthopedic/trauma, Informatics, diabetes.

I work weekend option and we have a great group. I also work one weekday to get my three shifts. The two groups are SO different. We are a bonded team on the weekends. I find the weekday people change so much (not many work the same days every week) that there isn't the bond that we weekenders have.

The down side of weekends is that we miss a lot of communication about weekday activities, in-services, etc.

Biggest pet peeve is when we have off-service patients (I work on ortho floor) and the covering teams don't answer pages.

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Specializes in PICU, Pediatrics, Trauma.
In addition to the above

1. Physicians who deny/refuse to acknowledge when a patient is declining until they actually crump/code/require intubation, etc. Often interns/residents who are too scared to call their attending. And I'll go over their head and call the attending myself, but I have to notify them first, let them see patient, formulate a plan. These things all take time. I had a patient with new onset symptomatic bradycardia to the 20's and no IV access. I told the intern and resident that she needed a central line before she coded. They wasted over half an hour asking me to repeatedly page IV therapy, asking if we could get IO access, etc. I'm pretty sure because they weren't comfortable with the procedure of putting a central line in and didn't want to call the fellow. The patient VT arrested. She lived and was fine, but COME ON. This happens to a lesser degree fairly often, this happens to be an extreme example, I'll admit.

2. 'Informed Consent'. People consenting 95 year old patients for open heart surgery and brushing over the risks and complications. I have had countless patients who end up circling the drain and slowly dying over the course of months postop. I don't care if she's a 'good 95'. All lives end in death. The elderly, especially those with co-morbid conditions DO NOT bounce back from open heart surgery like a 60 year old. They have CVAs, their kidneys fail, they get septic, they get delirious, they get ischemic gut and end up with an ostomy, they can't wean from the vent and end up trached and pegged. We spend millions of dollars on their care and they spend the last weeks or months of their lives miserable and much worse off than they were pre-op.

3. Patients who think that the best way to tell if they moved their bowels is to stick a hand into their butt and see if it comes up wet. I'll never trust a handshake again. A side question, anyone have any magic tricks for scrubbing fecal matter from underneath someone's fingernails?

Yes but time consumimg...1) Soak hands in very warm soapy water. 2)Put an emolient/greasy cream, then wrap a warm moist towel around the hands. Let sit for 5 minutes and then use a toothbrush with warm, soapy water over a basin.

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Specializes in PICU, Pediatrics, Trauma.
Use a toothbrush to clean stool under fingernails.Soak the hand in warm soapy water first.If in a rush you can put lotion on the toothbrush and just scrub under the nails

I just responded with the exact advice. Then I continued reading and saw your post!

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Specializes in PICU, Pediatrics, Trauma.

Like most have said...Poor staffing, lack of supplies, redundant Charting, impatient co-workers rushing thru report or not paying attention as you give report.

I can also add:

Who the heck designs these units? Supply/linen carts/equipment rooms/ med.rooms spread all over the place. Having to go to 3 or 4 places to get basic supplies needed for any generic admission. Traveling all over to find a working IV pump or whatever piece of equipment needed. Frequently used items are not kept in a convenient location, and then nurses end up grabbing handfuls of things that end up wasted because they are trying to avoid running back and forth for things they need to save time. Alcohol wipes, 2X2 gauzes, flush syringes, and tape come to mind as examples. And for that matter, nurses ending up using "work-arounds", for any number of things to save time, which often can become a safety issue. WHY? Staffing and unreasonable expectations and workloads...once again.

When you need to ask a question, communicate something , or need help with something, and you have to stand around waiting for the person (like a unit clerk for example) to finish a non work related conversation while they ignore you as you obviously are waiting for their attention. AND THEN, when you politely say, " Im sorry to interrupt you, but ...(fill in the blank)....and they give you that annoyed attitude.

People who aren't busy, sitting around the nurses station chatting or surfing the internet, while others are running around super busy and not offer to help. When it's OBVIOUS that others are working very hard, and these same people have helped when the opposite occurred. In other words, when it's not personal...Why not jump in and at least offer to help?

Examples:. Answer the freaking phone when the unit clerk is busy.

Answer a call light when it's been going off for a long time and you know the nurse assigned to that room is busy somewhere else. There is ALWAYS something you can do around the unit.

( I guess I simply could have said lack of "Work Ethic".)

I could go on...

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Specializes in Neuro ICU and Med Surg.

1. Staffing well the lack of staffing in some units.

2. Supplies not always being there. Or there are 3 different rooms with different sets of supplies on some units. Being rapid response I should be able to find supplies quick and some floors I just can't find stuff.

3. Supplies being constantly moved to different locations.

4. Out of touch managers. Ones who do not help out on the unit.

5. Out of touch educators. They never take assignments on the units they are educator for. How do you know where education is lacking if you are not working with the staff ever? Take one day a week and work the floor for Pete's sake.

6. Staff who treat the rapid nurse as a physician. I am not an MD I have the same RN license you do.

7. Lack of education to bedside staff.

8. Difficulty to find nursing policy online when needed as a reference. If you do not know the number or the "key word" good luck finding it.

9. House supervisors that are less than helpful. Ones that refuse to speak to a patient or family that is having an issue and you have done all you can to solve it.

10. Customer service mentality is an issue of course.

11. Press Ganey and HCAPS.

I could go on forever.

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Specializes in PICU, Pediatrics, Trauma.
1. Staffing well the lack of staffing in some units.

2. Supplies not always being there. Or there are 3 different rooms with different sets of supplies on some units. Being rapid response I should be able to find supplies quick and some floors I just can't find stuff.

3. Supplies being constantly moved to different locations.

4. Out of touch managers. Ones who do not help out on the unit.

5. Out of touch educators. They never take assignments on the units they are educator for. How do you know where education is lacking if you are not working with the staff ever? Take one day a week and work the floor for Pete's sake.

6. Staff who treat the rapid nurse as a physician. I am not an MD I have the same RN license you do.

7. Lack of education to bedside staff.

8. Difficulty to find nursing policy online when needed as a reference. If you do not know the number or the "key word" good luck finding it.

9. House supervisors that are less than helpful. Ones that refuse to speak to a patient or family that is having an issue and you have done all you can to solve it.

10. Customer service mentality is an issue of course.

11. Press Ganey and HCAPS.

I could go on forever.

Yes, me too! But #8 is a big one. I've had the same problem and this is NOT safe. Bringing up this issue, which is very important, to managers who simply say, "Yeah, I know." but no one does anything to correct it or provide an alternative. Since we all MUST perform using the organization's policies and procedures, how are we expected to do so when we can't find the damned things.

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Yes but time consumimg...1) Soak hands in very warm soapy water. 2)Put an emolient/greasy cream, then wrap a warm moist towel around the hands. Let sit for 5 minutes and then use a toothbrush with warm, soapy water over a basin.

And if I may - wear a mask, because those toothbrush bristles flick all over the place and the last thing you need is soapy fecal matter on your face.

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I know I already mentioned this in earlier replies to this thread but, here is my latest nurse vs PT scenario: Today at work PT wanted to know why we could not place an indwelling catheter in a patient just because she was incontinent and in a brief. Kept expressing concern about her getting a UTI because her brief was wet when he entered the room. When asked why he was extremely concerned about a UTI for this specific patient, answered "because a UTI would be detrimental to her recovery." When I explained that incontinence is not a dx to support indwelling catheter, he asked what were the diagnoses for it then? And finally, when I stated that I would be more concerned about UTIs with a patient who was incontinent of bowel than bladder, he wanted to know why.

I really dont don't understand why therapy is always trying to interfere and argue with nursing judgment. It just grinds my gears!

Edited to add: Not to mention that an indwelling Foley catheter puts a patient at risk for a UTI, does not prevent it. *facepalm*

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