Why do we put up with it? (sorry, longish)

Nurses General Nursing

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Okay, so I had kind of a rotten shift the other night. One bad shift wouldn't be so awful if it wasn't for the fact that we had nothing but bad shifts for most of December and January. Then we had a couple of nice weeks, and it seems we are back to unmanageable again. Why do we as nurses, in a field with a huge amount of liability (in a very litigious society), allow this to be the norm?

I was so busy last night (3 - 1130), I did not have time to check my charts until 11pm. Upon doing this, I found 2 med orders that were never taken off. We have been having problems for weeks now with our computer MARs - one time orders that are in our pyxis are not showing up on our to do list on the computer. In the "olden days", I would have had the order transcribed onto a paper MAR by the UC, so I would have seen it. Anyway, this pt had a K+ of 3.0 and was supposed to recieve K-Dur "now" at 1400. He never got it. Then, at 1500, another pt was supposed to get dulcolax suppositories x2 "now". Keep in mind that I am in report until 1530. So I guess that's why I didn't know about the orders till late. I took care of them, but I was pissed. What if that had been something important? Another nurse I work with said that, if it was something important, I would probably have known about it, but maybe not. And the nurse I followed must just not have seen the orders, because she is usally very good.

The main reason that I was so busy was my little houdini. She was in a posey and bilat wrist restarints, and she screamed bloody murder all night long. She managed to get out of the restraints at least once and hour, and even though the ANM could hear her, and knew that I was drowning, she would not go into that room. I flat out said, "I'm dying here." She said, "so is everyone else." Yeah, that's a good way to deal with the situation. I repeatedly asked for a siiter. I had given this little tiny lady 4 of haldol IM, seroquel, 2 prn doses of zyprexa, and a mg of ativan per PEG. It didn't touch her! But she did wear herself out...she was starting to nod off about 2345 - 15 minutes after I was supposed to be gone.

Are your hospitals like this? Where you have to take pt loads that you can't handle alone, or you have nobody to help you, or you constantly stay late every day (most of the time I am finished on time, but I have to wait for the next shift to get out of report)? I work for a good hospital. We keep winning all kinds of awards. It's insane. We aren't union, and it all feels very hopeless right now. I'm sure I'll get over it, but I still think that bad shifts should be the exception, not the norm. I didn't get my BSN to be constantly worried that I don't have enough time to provide adequate care to my patients, and be run off my feet and miserable every night. It jsut feels like there is nothing I can do about it! I like my job! I like my pts! I like (most of) my coworkers! I just feel that we are all being abused by the system now, and it doesn't feel like it's going to get any better.

Aaaaahhhhhhh okay, vent over!

Specializes in ER/Trauma.

Sounds like my last three weeks! :(

Specializes in ER,Neurology, Endocrinology, Pulmonology.

Yea! my day as you know it. Hang in there!

Natasha

Specializes in NICU.

yup sounds like my hospital to. I work days where i usually have 6-7 patients.. .and the acuity is very high.. I had 2 patients yesterday that I was debating sending to the unit... And our night shift is even worse.. We are a 36 bed unit.. almost always full and many times they only have 4 nurses on nights.... We have a call in problem.... I dunno it is quite discouraging.. So you are not alone... And I don't know why we put up with it.. We just do what we gotta do

Specializes in ER.

I can appreciate every word of your rant. I work in ER and it is the same, too much work, too many patients, too few resources, and management who says....deal with it, you knew nursing was going to be tough!

I hate to say it, but I don't think it will ever get any better. Computers, I have found usually cause more problems than they solve. I am working to pay off bills, looking into alternative work situations.

I have loved nursing and have done it a long time, but it is killing me. Good luck.

what could we do to make it get better?

are computers helpful or not (as you mention above that computers cause more problems)?

Specializes in LTC.

I feel for you guys!!!! That's kinda sounds like my shift last night. I work in a LTC and last night was hellish... We have 4 residents that are wonderful on dayshift and when 4 pm hits they go nuts.

1 of them is extremly abusive and punched me in the face, bite a CNA and then put one of our orderlies in a headlock!!!!! He had 3 doses of seroquel and a dose of ativan!!!!!

While we're dealing with this saint the other nurse is down the hall with another abusive pt getting her arm twisted and the orderly down there is getting hit with a phone...

And our supervisor was no where to be found....

And the sad thing is I'm going back for more tonight.... I must be a sadist or something!!!!!

Everyone has my sympathy!!!!!! At times like this I wouldn't mind having velcro suits and sticking people to the wall..... I know I'm mean but I think we all wish it once in a while

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
what could we do to make it get better?

are computers helpful or not (as you mention above that computers cause more problems)?

computers usually cause as much work as they save us. but that's a matter for another thread.

Specializes in ER.
computers usually cause as much work as they save us. but that's a matter for another thread.

100% agreement!

These are all the reasons I left hospital nursing. I took a major cut in pay, but for me it was worth it.

Specializes in ED, PACU, OB, Education.

This is the way nursing is because it is a predominately female occupation and we 'care giver' moms won't ever stand up for ourselves. God forbid our little patients should be left unattended while we organize and get better conditions for all. And god forbid we should actually stand behind and support those few souls who are gutsy enough to put it on the line and start the process for organization. WE DO IT TO OURSELVES, LADIES!!!!

Specializes in ICU, Research, Corrections.

I think one of the biggest problems is that the public DOES NOT HAVE A CLUE on how short staffed nurses are and what patient ratios are in place. The normal patient probably thinks we have all the time in the world to schmooze around at the bedside, get me a blanket, get me some ice, ad nauseum.

I know at my facility, we are not allowed to say we are short staffed. It would probably cause the patient, and the patient's family to have safety concerns......and they should have safety concerns! :angryfire

The key would be to have staffing ratio laws like CA does....that would be a big help. Hey, and while you are at it, give me a unit clerk ALL THE TIME so I don't have 500 more interruptions by having to answer the phone :idea:

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