What would you do?

[Simply Complicated]

Ok, so I thought I had things figured out, but now I'm really not sure. I have been at my job in the ICU for about 8 months. Although it's such a low acuity, that it really isn't an ICU. I'm not really gaining any critical care experience. We float constantly, even to the medical rehab unit. I've debated on trying to switch to either ICU or ER (assuming I could get hired somewhere).

The issue is we are trying to get pregnant. I've had 2 MC's this year, and now will have to take Lovenox while pregnant. I had hyperemesis with my daughter, and am terrified of having it again. So I've planned on staying at my current position through a pregnancy, and then looking to switch after.

But I'm really starting to dislike the job I am at. There's some really negative people, and I find myself starting to become one of them. I go to work in a good mood, and try to stay that way, but I leave in a terrible mood most days. It's a small hospital, very top heavy. The other day, I had a very confused pt, ETOH s/p fall, who has been in our facility for over a month. Most of that in 4 point restraints. After having been out of them for a couple days, he got very violent again. After dodging a punch, and him telling me he was going to throw me through the F'ing window, I had the bed alarm going off, and was yelling for help, as I'm trying to keep him from falling off the bed as he's trying to get up, and keep him from swinging at me again. There was only 2 of us in the unit and the other nurse was cleaning another CDiff pt, so it took her literally like 2 or 3 minutes to get to me. I put him back in restraints and got the order. I went to break a little later, come back to find my NM has taken him out of his restraints, saying she had just been in there with him for like 30 minutes (giving me my break) and that he really doesn't need them. Well sure, because he's fine sometimes, then freaks out again.

Fast forward a little while, he's again climbing out of bed. This time I was literally holding him up to keep him from falling. He was basically laying on his stomach on the edge of the bed. He literally pooped all over the side of the bed and the floor. (C Diff) Again, yelling for help. I changed this man 11 times, 4 complete bed changes. Finally got a rectal tube in him at like 4pm. When the other nurse told our NM we really needed an aid, she resonds with "So just because you have 2 patients pooping all the time you think you need an aide?"

I feel like I need to stay here, because getting pregnant, possibly being sick, and trying to handle learning a new job seems not the smartest move. But I'm really getting frusturated here. Most people have worked here for years, so I think they just are used to it. I did travel nursing, so I have worked the good, the bad and the ugly. I know not all facilites are this bad.

We don't want to put off having another baby, I'm in my 30's, among other reasons we don't want to wait. Would you just stay and deal with it for the next year or so? Some days seem not so bad, then others I just want to quit right then (I never would)

Sorry this came out so long!

[anonymurse]

What's your OB say? Bedrest? Can you afford to stay at home through the pregnancy? Will they hold your job?

[kaliRN]

Along with what the above poster mentioned, I just wonder, would the stress of learning a new job be greater or less than the stress you are currently experiencing? It sounds as though you feel you are getting no support, have fears about patient safety and your own, and are unhappy with the overall culture of the workplace. Is that the best environment to carry a pregnancy to term?

From what I have seen (anecdotal not medical), stress can reek havoc on the ability to conceive and make conditions such as hyperemesis even graver. If you can not get an aide when you so clearly need one, have a NM undermining a direct threat to your safety, how much more when you need additional support during pregnancy? You emotional well-being is very valuable at all times, even more so while you carry your unborn.

If you cannot afford to take time off during the pregnancy should it become necessary, then I value the dilemma. However, the environment seems so toxic to you, I would be searching for every out under your circumstances.

All the best in whatever you decide.

[Mona77]

You have gone through 2 MC`s you`ll have to be very careful during your

future pregnancy!

But it doesn`t seem that you will get the needed support at work!

A stressful job situation and dissatisfaction will have a deep impact on your pregnancy particularly facing violent pts without immediate help from your co-workers and an ignorant NM!

If you can afford, protect your unborn child and start your career after maternity leave!

Best wishes!

[GHGoonette, BSN, RN]

Pregnancy or no pregnancy, sounds like you should be getting danger pay.

[brownbook]

I agree with the above comments, but also think you had a bad time with a crazy poopy patient. It can, and will, happen in any nursing job where ever you work. More support would have been nice, a nurses aide, your manager sounds like an idiot. But again I just keep thinking you might find similar conditions if you change jobs? If your current job is low acuity ICU it sounds like most of the time it would be a less stressful place to work. Getting a new job in a higher acuity critical care unit or busy ER is going to crank up your stress level no matter how much support you get and how wonderful you new co-workers may be.

As for negative co-workers try to keep busy, stay away from them. If there is down time keep busy stocking bedsides, organizing file cabinets, organizing supplies, etc. keep busy and away from the negative people. Smile at them and keep your mouth shut.

I think I'm trying to say the grass is always greener on the other side of the fence!

[SaltyNurse]

Yes, there are going to be bad days and stressful situations in nursing no matter where you go. However, there are healthy environments and toxic ones. I actually have left a bad unit while I was 6 mos. pregnant and it saved my sanity and nursing career. Do I still have some bad days at work? Uhhhm, yeahhh, but thanks be to God, it isn't everyday like it used to be. I have no regrets.

[Simply Complicated]

Thanks everybody. I think I am just going to tough it out for a while, and see. I'm going to do everything in my power to keep a positive attitute, and not let the crap get to me. I'm only 2 days a week, so if I can keep the power of positive thinking, lol.

Not all days are that bad, some are better than others. It's best for me to stay here, as I will have short term disability, and FMLA. You guys are right, there's no telling that the next place I go won't be just as bad. I really didn't want to start over while pregnant.

Sometimes it helps to just be able to come and vent, and get some advice/support to help you deal!

[GHGoonette, BSN, RN]

Just try not to let yourself get into any more dangerous situations. I work in recovery (PACU) so I know how hairy it can get when patients start throwing punches. Please, if you DO fall pregnant, and if you can afford it, take long leave and nurture that baby!

[Simply Complicated]

Just try not to let yourself get into any more dangerous situations. I work in recovery (PACU) so I know how hairy it can get when patients start throwing punches. Please, if you DO fall pregnant, and if you can afford it, take long leave and nurture that baby!

I will get short term disability, and my FMLA will allow me 12 weeks. But if I need to go out early or anything, being that I really don't care if I return to that specific job, then I'm sure I can make it work. The short term disability will help, and my hubby just got a promotion to manager. By that point he will be running his own store, so taking longer off may be an option.

Otherwise, I think I will just have to work hard at not getting so frusturated and letting the job get to me. I'm sure I make it worse on myself, I start focusing on the negative, which can be an easy thing to do.Thanks again!!