You Guessed It! Coworker Probs...

[Nursing_Mamacita]

This is about to be long...

So let me start with a disclaimer. I, of course, do not consider myself lazy nor do I feel like anyone should absolutely bend over backwards to make my job easy. I accept my responsibilities and I can say I work my orifice off for my patients.

Let me describe my unit for you...

So I work on an IMCU at a local hospital that is decent in size. We are a 3 part unit- 32 beds. 12 beds are basic tele (which we usually staff with float nurses/resource)- ratio 6:1, 12 beds are PCU/IMCU/stepdown (whatever you want to call it) ratio 4:1/5:1, and 8 beds are the same as the latter but are usually reserved for patients who need ever closer monitoring with bedside monitors plus we can take vents, hi-flos, BiPAP, and further intensive drips- ratio 4:1 strict. We are ridiculously understaffed at times. Barely ever CNAs, etc etc. You can imagine, we get BUSY.

That being said...

I am sick and tired of minimal support from some charge nurses/team leaders/whatever you call yours. Some are GREAT, don't get me wrong. Some are...eh...which I can deal with. But there are a couple who just don't help 90% of the time. Like I said, I don't expect anyone to just take over and do my job, but if I am 5:1 with a cardizem drip, nitro drip, and insulin drip (qh BG checks) and no CNA?? Sorry not sorry, but I do expect help. If you are TL and you are not in staffing, you can't walk around and grab vitals on 12 pts? You can't check my pts BG? You can't help me turn my 400lb patient in isolation? That is the kind of situation that grinds my gears. EVEN WORSE, are the team leaders who leave the floor for hours upon hours to do paperwork in the office. I totally get that the paperwork is insane. Floor nurses, like myself, often help out with this. But WHY oh WHY does it seem paperwork has become higher priority than the well being of the patient?? Then we get fussed at when we are on the clock past 7:30 charting. Its a vicious cycle.

It just seems that these "leaders" have no problem shoving write ups in nurses faces, notes on what hasnt been done yet for the pt (i.e no nurse written label on an already pharmacy labeled abx that infuses for 30 minutes) but aren't there to help when help is so desperately needed. I am forced to prioritize these things. If I JUST walk out of a room of a pt who had active chest pain and was diaphoretic and had just solved that issue, please dont come to me talking about a label and not ask me if I need help. Or, omg, there was even a situation where a isolation pt was in bilat soft wrist restraints and had gotten out of one and ripped of her IJ dsg. The 2 charge nurses discovered this during CVL rounds. The solution for them? Ungown, walk out of the patients room, and call the nurse on her phone to come now and re-tie the restraint and apply a new dsg. I watched them just walk into the next pt's room like nothing had happened. WHAT?! :eek::eek:

I could go on and on. It just infuriates me. I am a newer nurse. I LOVE what I do and I like to think I am good at it. I am looking at working towards being a TL, myself, for reasons that are obvious. But sometimes, this is just SO discouraging. That is not what I want to be. Is this normal? Is this what nursing is? I feel like a hamster in a wheel

Share your input, my nursing brothers and sisters. Any opinions, input, or encouragement is more than welcome.

EDIT: I would LOVE input from team leaders/charge nurses! What is it like from your perspective? Am I being unreasonable? Be honest with me ya'll!

/rant.

[Nola009]

While she may be an exception, the neighbor I was speaking of is in fact an RN.

[exp626]

I look at it this way: when I'm a bedside nurse, I work for the patient. When I'm a charge nurse, I work for my coworkers...my job is to help them take care of their patients. Obviously I have other duties as a charge nurse, but patient care and safety have to come first. I work with with a couple other charge nurses who don't share that philosophy.

It is a harder day when I work with a charge nurse who doesn't help as much, so I try to lead by example. Ideally, we'd all work in an environment where this role is rotated, which helps our leadership remember what it's like to be a bedside nurse!

No matter what, I never complain or say anything (except in a safe place like AN!), as I don't want to start a war. Some charge nurses or team leaders are favored or friends with management, and you have no idea until it's too late!

[icuRNmaggie, BSN, RN]

Depending on the drip, we typically don't titrate. It's just that, well our IMC is like purgatory. Our patient care supervisors who assign beds don't do a very good job sometimes, so we get the patients who are super simple and need to be downgraded, or we get the silent train wrecks who code 15 minutes after rolling onto the floor. But the drips arent that bad; my bigger concern for the drips are the fact that they take them on the side where we do not have bedside monitors. The side with them is fine, I can cycle the BPs from the desk with no issue. But omg I get nervous to take a dobutamine drip with no bedside monitors. That, to me, is unsafe- even if BPs were stable for the last 24hrs in ICU. As for drips with little to no help...Insulin drips are the worst. QH-Q20m BG checks is insane.

With the turns, luckily we have about 5 rooms with ceiling lifts...but do they consider that when placing the biggies? NO. Ugh. So yeah, sadly, a lot of my people get turned q4-q5, unless I have them on a bed with turn assist- WHICH IS LOVELY.

Ugh. We're supposed to get renovations soon. And we are downgrading and getting rid of our 12 tele beds. SO, no more 6:1 nights on that side. Plus with not having to staff for 6:1 our IMCU ratios will improve...hopefully. Because a LOT of people have/are quitting this year.

I always just try to smile and tell myself, one day when I move on to greener pastures, I will be a time efficient super nurse. LOL

to nursing mamacita,

(Off topic, sorry, )

Please tell me what monitoring system ( Phillips Spacelabs Nihon Maquette GE etc) has a function to cycle the NIBP from the central monitor.

Thanks a lot!

Maggie

[icuRNmaggie, BSN, RN]

It is impossible to change a management culture like the OP has described. The charge people were most likely picked based on favoritism not ability other than their lack of ethics and morals and willingness to be stepford wives and stick it to other nurses. I have seen this over and over. Does this sound like your situation?

No one in their right mind wants to work under these conditions, I wouldn't, people are leaving and you will be perpetually short staffed.

If you write a safety report you may experience illegal retaliation.. They may give you the worst possible schedule and assignment etc. So not worth it.

It is time to gracefully part ways with this institution with good references or at least leave the unit, as soon as you possibly can.

I'm assuming there is no union at this facility.

[Mikey31079]

to nursing mamacita,

(Off topic, sorry, )

Please tell me what monitoring system ( Phillips Spacelabs Nihon Maquette GE etc) has a function to cycle the NIBP from the central monitor.

Thanks a lot!

Maggie

Hey guys,

Sorry to take this off topic, but I just wanted to respond to this quote since ICU RN Maggie asked...I work as a unit clerk/monitor tech and we have Fukuda Denshi monitors that let us cycle BPs from the station...I'm almost certain our old system Nihon Kohden had it too.

We now return to our regularly scheduled thread :-)

[Nursing_Mamacita]

to nursing mamacita,

(Off topic, sorry, )

Please tell me what monitoring system ( Phillips Spacelabs Nihon Maquette GE etc) has a function to cycle the NIBP from the central monitor.

Thanks a lot!

Maggie

Oh man! I'll have to let you know for sure but I'm pretty sure all of our monitoring systems are phillips! I will definitely get back with you to confirm that!

[Nursing_Mamacita]

I look at it this way: when I'm a bedside nurse, I work for the patient. When I'm a charge nurse, I work for my coworkers...my job is to help them take care of their patients. Obviously I have other duties as a charge nurse, but patient care and safety have to come first. I work with with a couple other charge nurses who don't share that philosophy.

It is a harder day when I work with a charge nurse who doesn't help as much, so I try to lead by example. Ideally, we'd all work in an environment where this role is rotated, which helps our leadership remember what it's like to be a bedside nurse!

No matter what, I never complain or say anything (except in a safe place like AN!), as I don't want to start a war. Some charge nurses or team leaders are favored or friends with management, and you have no idea until it's too late!

Come be my charge nurse!! LOL

[Nursing_Mamacita]

It is impossible to change a management culture like the OP has described. The charge people were most likely picked based on favoritism not ability other than their lack of ethics and morals and willingness to be stepford wives and stick it to other nurses. I have seen this over and over. Does this sound like your situation?

No one in their right mind wants to work under these conditions, I wouldn't, people are leaving and you will be perpetually short staffed.

If you write a safety report you may experience illegal retaliation.. They may give you the worst possible schedule and assignment etc. So not worth it.

It is time to gracefully part ways with this institution with good references or at least leave the unit, as soon as you possibly can.

I'm assuming there is no union at this facility.

No there isn't. And I agree. We are in critical staffing maybe 3 days out of the week every week. We are about to be in an even worse spot as 5 RNs are leaving by the end of this month. We're trying to hire people but eh...hasn't worked out well before. Our floor is a hard floor to work on. It has 3 very different cultures to it because of the tri-unit aspect. We had hired two new grads, one quite like 2 weeks before she came off of orientation and took a position as an RN supervisor at an LTC facility. And the other quit after 3 nights on orientation because she had a night where 3 different patients had 3 separate MRT's (medical repsonse team) called. Its rough.

BUT a friend and I have plans to leave in April, once she hits 18 months experience. We are going to do cross country travel nursing together!