When you literally can't keep up.

Maybe JACHO citing them is what it is going to take to get them to fix things and hire more staff, but yeah you are probably going to be in the crossfire.  On the other hand, when you are the only RN, they still need you.   Hope things getter better for you.  Sadly, it sounds like they will only fix things if something drastic happens like a citation.  In reality, it is really only a slap on the wrist anyway.  Hope it is enough to improve things for you.  Either way, I'm sure you will survive, be able to find another job if need be, and I think you are doing the right thing to only do what can be done in your 8 hours.  If you keep working above and beyond things will never get better and it will just be expected of you.  Your manager telling you to get the Dr's to do "their" job is above your pay grade!  That is between her and their manager.  Do what is right for you.  Keep your resume up to date just in case.  Good Luck!

Anything that you are doing that doesn't require the skills and/or license of an RN is a very bad use of your time and is money being wasted, just like (IMO) anything that the providers are doing that doesn't require their knowledge/skill/license is a very bad use of their time and is money down the drain. You mentioned the extra work the docs think you should be doing--my guess is at least some of that isn't that they think *you* should be doing it, just that it is something they rightfully should not strictly need to do because it doesn't require their skill/license. But leave it to management to set things up as physicians against nurses - tactic as old as time/they aren't particularly creative with their excuse-making, are they?

It sounds as though there is just not enough ancillary help around there. You don't need an MD/DO/PA/NP *or* an RN to check fridge temps and keep track of staff education and set up means by which staff can do competency check-offs etc. And so much more that does not require a professional degree to plan out an accomplish. Focus on the care that the patients need.

All the things that constitute pie-in-the-sky fantasies of administration would automatically go to the bottom of my list. Next time there is a comment about what needs to get done, say "I'm sorry, I don't know what to tell you other than that I *had* to prioritize in order to do this job any justice, and I chose the needs of patients and the things that must be done by an RN." Granted that could bring some wrath down upon you, but at some point if you're going to burn out anyway it becomes more of a risk worth taking.

If it is a unmanageable workload... then you must move on.

JKL33 said:

Anything that you are doing that doesn't require the skills and/or license of an RN is a very bad use of your time and is money being wasted, just like (IMO) anything that the providers are doing that doesn't require their knowledge/skill/license is a very bad use of their time and is money down the drain. You mentioned the extra work the docs think you should be doing--my guess is at least some of that isn't that they think *you* should be doing it, just that it is something they rightfully should not strictly need to do because it doesn't require their skill/license. But leave it to management to set things up as physicians against nurses - tactic as old as time/they aren't particularly creative with their excuse-making, are they?

It sounds as though there is just not enough ancillary help around there. You don't need an MD/DO/PA/NP *or* an RN to check fridge temps and keep track of staff education and set up means by which staff can do competency check-offs etc. And so much more that does not require a professional degree to plan out an accomplish. Focus on the care that the patients need.

All the things that constitute pie-in-the-sky fantasies of administration would automatically go to the bottom of my list. Next time there is a comment about what needs to get done, say "I'm sorry, I don't know what to tell you other than that I *had* to prioritize in order to do this job any justice, and I chose the needs of patients and the things that must be done by an RN." Granted that could bring some wrath down upon you, but at some point if you're going to burn out anyway it becomes more of a risk worth taking.

 

I'm okay with wrath. The next job is always a few days away if necessary. Thanks for this.