Is it just me , or does it seem that soooo many new nurses are posting questions about being stressed and overworked ? I understand that nursing is a stressful job but my goodness. I'm not complaining about them I'm just concerned about why their stress level seems to be to the point many of them want to leave nursing. Is it that they are not getting the proper training for what the job entails.(4 year and 2 year) I know that the nurses I precept come to the unit with little experience with pt care. It seems the little things stress them out because they have never done them. Therefore, somehting like a critical pt, completley discombobulates them. Many times they can't get past a simple procedure let alone critical thinking. I've done ER /ICU/OHRU for almost 30 years now. I'm " Old", and many days I feel busy and overworked but, I can still keep up with the best of them. Nursing is no more stressful now than it was in the 80's. Sometimes I just want to say , put your " I'm a nurse now, panties on" , stop whining and start learning. If you didn't learn it before you got to the hospital, you need to learn it sometime.
I believe the solution to this problem is assigning new nurses an increasing patient load over time (months) until they reach the same patient loads as experienced nurses. Allow new nurses time to accomodate, learn, and hone their time management skills. When they reach the full patient load, they will have improved on many of the basic skills they'll need to juggle tasks and will be more prepared to spend more time on critical thinking, etc..
I agree with this. When I started working a desk job some years back, I wasn't expected to fulfill all of the same responsibilities as those with experience for up to six months. Six weeks of orientation with 12 hour shifts comes out to less than 20 shifts total! I think having something like a 3/4 load for newbies (and for more than just 2-3 weeks) makes sense so they have the extra time to look things up and ask questions and take opportunities to learn from colleagues' patients as well. The new nurse in this case is working independently and not "sharing" patients with a preceptor but still has more time to collaborate & double check things than if they had a full load.
Personally, I don't care how well nursing pays, in many places it's not worth it for *me* for the stress it involves. So many places have bare bones staffing, which creates a miserable work environment where the quality of health care suffers and one is risking their license daily. If it were an option, I'd accept *relatively* less pay in order to have a lighter workload. For example, if the hospital offered $30/hr for taking 6 patients or $25/hr for taking 5 patients, I'd willingly accept the latter because I wouldn't last long with the higher workload and would end up burned out and looking for other work anyway. But I do see the threat of such a system. Many people would opt for the higher workload just for the money regardless of whether or not they could truly and safely handle it. And facilities might pressure staff to make choices that benefit their bottom line. However, as it is, the only choice is to take whatever ratio the facility demands or to not work there. Take it or leave it. I've left it.
Sometimes I just want to say , put your " I'm a nurse now, panties on" , stop whining and start learning. If you didn't learn it before you got to the hospital, you need to learn it sometime.
I'm glad I am learning to deal with stress while I'm still a student. I whine in private out of the eye/earshot of others
Specializes in Community Health, Med-Surg, Home Health.
I believe that there is not enough clinical time in nursing programs, and that the clinical time is not progressive. Years ago, vocational/practical nurse training was one week of class, the other week on the units, and midway through the program, the students had a full patient load. By the time they graduated, they had more experience back then, then they do now. I see the same things with the BSN training in my area...they get two patients (maybe) and they are usually the easier ones. I noticed that much of this comes from the fact that it is hard to obtain clinical space in the hospitals and also, the clinical instructors are not paid enough, so, many of them are holding two jobs. They are late many times due to the previous job's commitments and then, are too tired to really interact with their students (by the way, this was the same thing I experienced in my LPN program two years ago).
With the additional pressures of trying to learn policy, correlate the shock between textbook and real world nursing, no wonder they get stressed out.
When I graduated last year I felt like nursing school did not adequately prepare me for the "real world". We read thousands of pages in textbooks but rarely got the opportunity to apply it. We were in the hospital setting 2nd year (which consisted of morning care and 1 med pass) and 4th year, during that time there were so many things you weren't allowed to do because you were not certified. So we observed. Observing is totally different from doing.
I have learned more in 1 year of work than 4 years of school, seriously. In nursing school they give you the perfect scenario. In the real world you have to deal with management, time constraints, staffing issues, higher pt loads (8:1 on nights and 5:1 on days) and acuity (pt. who are actively dying), legalities, etc. And the training doesn't really prepare you either, I had 5 days in class and less than 10 days on the floor. And I didn't really learn much during that time except a general idea of what the floor is like. I do the bulk on the learning when I am thrown in there with the sharks basically. Of course I ask for help as needed, which is very often at this early stage of my new job, but I can keep up with the best of them as well. It just takes time and persistence. Some people cant handle and some people can. Its the same with everything in life. Nursing is tough. It is a lot of responsibility on your shoulders. Peoples lives are in your hands, how many people can say that? I love nursing, but there are days I wish I had an office job. Although it wouldn't be as fulfilling.
The stress level is hard I have been a nurse for only a little over 3 years and work on a busy tele floor. Yesterday I started with 4 patients, I was team lead we had an admission nurse in the afternoon, but she can only do so much I ended up taking two ER patients that I admitted myself and a transfer from ICU who luckily came right before shift change, so I didnt do much with her. My phone was ringing off the hook we had so many admits it was crazy. There were only 4 nurses on so everybody had to take admits. We had a dirrect that came an hour before shift change the admission nurse was in there to start the IV do the admit and make sure the patient was stable.. So essentially that patient was assigned to an admission nurse for the hour. Everybody else was running around crazy with only one tech.. That was very stressful and I dont know how you get used to that. The supervisior was not supportive, told me I had to take the ICU transfer because, the ICU was getting a code.. It goes on and on. I try to put on a happy calm face in front of the patients. We are not allowed to say no to admits. because there were patients on the board to go well we couldnt have another nurse. Thats the stress that gets to me oh and when a family member is up my a## and yelling at me for something that usually isnt my fault. I dont understand who makes these ratios and why they are acceptable. My thought is we are dealing with human beings not cans of baked beans! Sorry for the rant...
Just out of curiosity what was nursing school like 30 years ago? I had 12 hours of hands on clinical a week for 4 semesters. I had Holidays off and summers off.
I was not allowed to even start an IV until I had a lic. I was not allowed to draw blood till I had a lic. I was not allowed to do an IVP till my last semester. I never put in an NG or a Cath because none of my patients during clinical ever needed them.
I can write a near perfect APA paper!!!
I had 6 weeks of orientation.With in 3 weeks the mgr was saying "oh your doing great, I think you can work alone today, just hollar if you need anything"
As soon as I had those two magic letters behind my name mgmt looked at me to fill holes on the sched.
I have learned more in my 1st year of nursing than I learned all through school. Heck I learned more in 3-6 months than I did in 4 years!!!
I am not whinging that I have it harder than you did. I am just stating we are not as prepared leaving school than nurses once were.
Our schools are teaching us to pass the Nclex, because they want a near perfect pass rate, so they can recruit more nursing students in thier doors and collect higher and higher tuition.
Another point that was brought up is this is a message board. I only have a few friends that are nurses that can relate to the stress of being a new nurse~~~as I surley dont want the Sr nursing staff I work with to hear me whining and griping about how stressfull this is, as they would only make it harder on me~~so by having an anonymous forum to spill your guts from time to time and to get many mini pep talks is very cathargic to those that are struggeling.
I have been sitting reading this thread and trying to decide if I wanted to respond.
I have worked as a nurse since almost the beginning of time, it seems. I came out of an ADN program with all the problems still encountered by new grads: Too little clinical time, too few patients, not enough experience, no opportunities to take off orders. I had almost no support from other nurses in the beginning. The idea of a preceptor did not exist. I doubt if management would have paid to have 2 nurses caring for same pts.
I remember well taking care of 8 patients on eve. shifts. No CNAs, no techs, etc. What we did was that one LPN and I worked together. We did all care together on 16 patients. I had all the IV meds and assessments to do. We had more codes on that unit than any other place in the hosp.
We had copious charting to do by hand. We had to write long narrative charting each shift. Pay was terrible.
What I am getting at is that we have always worked hard. Nurses have a physical job. Some days it is more like a ditch digger than the professionals we really are.
Nursing has changed. Our patients on the regular floors are more like the old ICU. People who would have died now live. The stresses I had as a new nurse were no less than what new nurses face now. They have more support than I had. They also have 12 hour shifts that sap the strength of even the most able nurse. Since there are "so many days off" more nurses choose to do OT or maintain other jobs.
This country has become filled with "I want, I want it now" people. Scott Peck MD wrote about delayed gratification. I believe this is one of the greatest issues that we have to face.
I love new nurses. I learn so much from them. I expect respect and I will get it. In return I give respect. But new nurses know to not whine to me. In the past we dealt with whining in a different way. Not better, different. Don't believe it, read the article I wrote this month. We learned to laugh rather than fuss continuously. I agree there are big nurse panties available, put them on.
Im not a nurse yet-- still waiting to hear if I've been accepted to nursing school even-- But I know, knowing myself and who I am, I can handle the hectic, but my stress will come from a general fear of screwing up-- Epecially if it's screwing up SO bad that it's not "fixable" or, worse, the patient dies because of me. I know that will go away, but I also know it will inevitably have to freak me out for a while.
Wow, this gives me a much different mental picture than what I was expecting. I guess I should have known this because I've read Echo Heron's books and I think they were mostly set in the 80s. The conditions and patients she describes in her books are downright frightening. Good thing I read them after I started nursing school or I might have been completely turned off to the idea of nursing altogether. I actually have heard that before about the codes. One of my more experienced coworkers told me that they used to code people all the time all the telemetry units.
You ought to read Peggy Anderson's book "Nurse", which came out in the late 1970s and was the very loose basis for a short-lived TV series. I considered becoming a nurse because of that book.
Back then, nurses had to deal with things like doctors pressing nurses against a wall IN THE CAFETERIA and saying, "Thanks! Now I have two holes in my back!" . I understand things like this went on in the corporate world too. And this nurse said that a few years before she started nursing school in the late 1960s, the hospital where she was working used senior nursing students as "night nurses" - i.e. slave labor.
I have known plenty of pharmacists who had no job experience in their field until they graduated, and it was NOT what they thought it would be at all. Hello, life has a way of doing that.
Clinical experience in school was very poor. We were on a different unit every day and so we were always lost and never got the feel for the continuity of a day. Staff nurses that had students were so overloaded they barely had time to teach and also you were rarely with the same nurse each day so they didn't know what our abilities and limitations were.
i am a new LPN......and i love it.......46 yrs old too.....do i feel my clinicals were enough....not really........i couldnt wait to graduate to really pull up my sleeves and dig in and learn! and since july,when i started my new job,i have learned and grown.....
is my job stressfull....yup!...I work for the state in a house with 12 very medically frail mentally retarded individulas....i love each one of them with my whole heart......we have no aids that work with us...we are all LPNs....one RN during the day and one RN 3-11 shift.....but they are in the office doing office work.....i do it all....from ADL's to neb treatments.....to gtubes,trach care,etc.......passing meds takes a whole shift......the turn over at this house is wicked.......they cannot keep the staff....it is hard work......i took a tour of this place while a student and i just knew this is where i wanted to work.......i got the job and LOVE it.......i only work PT,thats all i want and need....but the extra hours are there.....they are always calling people in.....i let the ones who need and want the money go before i say yes.....
i ask tons of questions...stupid ones at times.....everyone is so willing to help and answer and show me how to do something.....there is alot to learn....stuff i never even got close to doing in clinicals.....
If you didn't learn it before you got to the hospital, you need to learn it sometime.
. I understand things like this went on in the corporate world too. And this nurse said that a few years before she started nursing school in the late 1960s, the hospital where she was working used senior nursing students as "night nurses" - i.e. slave labor.
jjjoy, LPN
2,801 Posts
I agree with this. When I started working a desk job some years back, I wasn't expected to fulfill all of the same responsibilities as those with experience for up to six months. Six weeks of orientation with 12 hour shifts comes out to less than 20 shifts total! I think having something like a 3/4 load for newbies (and for more than just 2-3 weeks) makes sense so they have the extra time to look things up and ask questions and take opportunities to learn from colleagues' patients as well. The new nurse in this case is working independently and not "sharing" patients with a preceptor but still has more time to collaborate & double check things than if they had a full load.
Personally, I don't care how well nursing pays, in many places it's not worth it for *me* for the stress it involves. So many places have bare bones staffing, which creates a miserable work environment where the quality of health care suffers and one is risking their license daily. If it were an option, I'd accept *relatively* less pay in order to have a lighter workload. For example, if the hospital offered $30/hr for taking 6 patients or $25/hr for taking 5 patients, I'd willingly accept the latter because I wouldn't last long with the higher workload and would end up burned out and looking for other work anyway. But I do see the threat of such a system. Many people would opt for the higher workload just for the money regardless of whether or not they could truly and safely handle it. And facilities might pressure staff to make choices that benefit their bottom line. However, as it is, the only choice is to take whatever ratio the facility demands or to not work there. Take it or leave it. I've left it.