Working for M/S ward at an IHS in NM, closing thoughts

[Arizonaaa]

Just some things I have come across at the IHS I worked at...

please excuse my grammar/punctuation - I just wanted to lay this all out quickly

I work for the federal government on the medsurg floor of a reservation hospital out in New Mexico. The MS floor patient load is based off of nurse staffing for the night- each nurse can have up to 5 patients and 6 if they want to push it.

I have found a number of people always call in and every night is a surprise as to who shows up. We are always severely understaffed and have high acuity patients in the sense that patients will require one to one sitter's. Sometimes we have no NA's on the floor because the supervisor will let everyone call off for the night. We aren't suppose to admit psychiatric patient but get some on a regular basis. OB, Ped's, and ICU will send patients they don't want to handle (even though they're trained and able to).

The ward supervisor has no experience and is never on the floor and is so forgetful. meetings are held but never provide any change to the problems the ward has. Along with that the director of nursing is never around and expects all nurses to carry a six patient load. New graduates are placed with patients after 12 weeks and sometimes are pushed to be charge nurse after because there is no staffing available.

This IHS tries to keep up with some of the more newer equipment available or just some equipment we don't have in general. We just now own a bladder scanner. A lot of the items are older then private hospitals. This IHS hospital is also very wasteful with all it's supplies. The supplies sit in a closet and people and take whatever they please and nothing is recorded. The hospital it's good medicine and lots of things run our of stock quickly and just disappear. This is not concerning for the hospital and is really inventoried.

I had a frustrating time with this facility after I've realized how things are done around here. I feel if they let all the unreliable staff go, do some decent interviews, watch there inventory closely, hire a supervisor with some years under her belt, and a director of nursing who cares I think this place could be a great place to work. Or if they at least try and set a goal up to work towards something remotely close to this I think this place would shape up well.

I've brought up the short staffing, call-in's, low inventory on supplies with e-mails and one on one meetings with the supervisor. She told me she can't do anything about it and that the director is concerned with trying to have more open beds. Also I was told it's like this no matter where you and you just have to get use to it. I thought this was shocking and I found my self just trying to finish my two years and head to another department.

I tried using the chain of command and was ultimately send back to my supervisor and her assistance because I was told that's where the issue lies.

I stay with IHS because they are included in the loan forgiveness services, along with IHS loan repayment, and offer great benefits along with good pay. I am originally from this area also and can't see myself moving away from my home.

These are just some things I have found myself very frustrated with and ultimately choose to move to another department after 2 years. I like the patients and the care I do here but the structure and set up is horrible and I see no changes happening anytime soon.

I am now headed to public health with the same facility, but I have run into the problem of not getting paid what I am suppose to. IHS goes pay a pay scale called grades and steps. after working for a GS 7 for a full year and meeting minimum requirements to be promoted to a GS 9, I was told I'd have to star a GS 7 another year. I may even have my MSN by September (my official promotion review date) and she said IHS does not reward degrees earned. I know I am eligible to a promotion so I will not take no for an answer.

[cleback]

5-6 patients on nights and 12 weeks of orientation with everyone supposed to take charge sounds good to me. I get that's not the full story but maybe focus on the positives since you need to stay?