I'm sooo irritated!

[Cinderelley]

I've been a nurse for 5 years, all at the same hospital, and things just keep getting worse and worse. They started with revamping our assessment paperwork, which wouldn't have been too bad except they had the head of security do it. The head of security!!!! What does he know about assessing a patient? Then they increased our patient to nurse ratio. It used to be that we all had a maximum of 5 patients. Then it went to 6 patients for everyone except the team leader. Now the team leader has to have 6 patients too. (To all of you who aren't nurses, one patient doesn't sound like a lot, but it really is.)
I told my boss that it was too much with all the extra paperwork/jobs that the team leader has to do. So, she makes an appointment with her boss for me to talk to her about it. I presented her with all my arguments logically and concisely. She agreed with me, and then said she wouldn't do anything about it. :confused:
At the meeting this morning, they presented us with more paperwork that we are supposed to be doing, which really isn't my job. It's not my job to diagnose a patient with severe sepsis or myeloproliferative diseases. They say it's because our rates of venous thromboembolism are too high. Okay, take this "assessment" paperwork to the doctors and have them "assess" their own patients like they should do. It's their job to order things to prevent it - not mine. I don't have that authority. I don't have that kind of schooling, and I don't have that kind of paycheck. This is just one more thing the hospital administration is shoving on the nurses, because the doctors won't do their job.

So basically, I've had it with the doctors not doing their jobs and administration "enabling" this behavior. Last month for example, there was a code on the floor and the staff was paging the doctor over and over again for 20 minutes without any response. Another doctor happened to be coming onto the floor and told them that the doctor was in the stairwell right outside of that floor talking on his cell phone. :mad: Another day I had a patient who couldn't breathe. I had two ICU nurses and two respiratory therapists at the bedside with me because we all knew this patient wasn't going to last forever. It took me 45 minutes to get a doctor to call back. When he did, all he did was order a sedative for her. No matter what I tried to tell him, he would cut me off. I guess he wanted her to relax as she suffocated. Thankfully, one of the ICU nurses ran across the physician's assistant on their way back to their unit. The physician's assistant ordered her transfer to ICU, and they were preparing to intubate her when I left. This morning a third doctor discharged a patient without even going in and looking at her. He just asked me a bunch of stuff to write down. What if I lied to him? What if I got her confused with another patient? What if I really don't know what I'm talking about since I can't diagnose a patient with a myeloproliferative disease?

Thanks for listening. I really can't wait until I'm at WDW in 3 weeks.

[bleukarma]

Wow, I'm sorry you have to go through all that, it sounds really stressfull!

And it makes me wonder about going to the hospital!!

[SBETigg]

Sounds so frustrating! Hugs, Cinderelley, you need a vacation. Three weeks! :thumbsup:

[Rileylightyear]

My wife is a nurse here in Alabama at a hospital and I hear alot of the same stuff from her. It's so bad that she is thinking about getting out of nursing in the future. The good thing is that we will be in WDW in 3 and a half weeks.:thumbsup:

[kaliepooh]

I'm sorry to hear of your frustration. Sounds like my job. I have four more days until vacation. Your vacation is needed.

[DisneyDudet]

Seems like this type of stuff is happening all over the country.

One patient is indeed a HUGE step, no matter what people say. We try to stay at 4, but we can't have any more than 5. Most of the time, 4 is crazy, much less 5!

Not only are you giving medications to the patients, but you have to assess them and keep watch over them, doing things not done on the previous shift, making sure everyone is comfortable, give baths, feed them, call drs, move patients, turn patients, help them to the bathroom... You can't add diagnosing to that.

Honestly, I would say that it is not in my scope of practice to diagnose patients. We have the Texas Nurse Practice Act. If I were you, I'd hand it to the director and have him read it and show you where we are to diagnose patients. We can't. We can make nursing diagnoses, such as "impaired skin integrity" or "risk of spiritual distress" but we can't say, oh, you have lupus or whatever. We don't have the schooling, credentials, or license to do so. I would not feel comfortable doing things like that.

I sure hope things get better for you. Our unit got a new manager and she's run off at least 6 day nurses. Thats not good AT ALL, especially since we're opening up a brand new unit that will be staffed with our nurses and aides. She's also found one nurse that they've made a charge nurse, and this nurse has been charging for about 3 weeks and because she's best friends w/ the new boss, she now outranks the other charge nurses, even though they've been doing it for years. Not cool. She's also training a nurse that is as new as I am (we graduated nursing school in December) to be charge nurse for days!! I just can't believe it! This girl doesn't do her job now, how can she be watching over others and being a resource!? She piggybacked antibiotics through blood!!!! That's the worst I've heard about, but I spent 2 hours at the beginning of my shift last week doing what she didn't and redoing what she did wrong. I'm just as new as she is, but I feel as if I'm a better nurse.

Ok.. sorry about my ranting! I think we should start a nurse rant thread... it would make me happy!!!

Here's some :pixie: for you to help you with this stuff. Healthcare is turning from helping the patients to helping make money. So sad. That's not why I'm a nurse....

[kakn7294]

Ah Cinderelly, I've been there - just this morning in fact. Most of the time I can't say I really like it where I work and most of that is due to administration and hospital policy. However, it's hard to give up 16 years and go elsewhere when it's close to home, pays well, is familiar, and you know that the grass isn't going to be greener and you'll just be trading sets of problems. We have a union but the only thing they do for us is take our dues. I filed a grievance just this week because I work on an adult telemetry unit but Mon night I admitted a 14 yo girl with anorexia and bradycardia (slow heart rate for you laypeople). I fought it because I wasn't comfortable caring for a 14 yo girl but we were told that we had to take her because the peds nurses weren't trained for telemetry even though they are required to be PALS certified. Huh? How can you take an advanced life support class but not be trained in basic heart rhythms? I was also told that at 14 yo she's considered an adult because of her body mass - wait a minute, she's anorexic therefore she doesn't have a normal body weight! I also got sent to Peds about 8 mo ago to work a shift and the union filed a class-action suit against the hospital because I'm not PALS or peds trained and we are a hospital of closed units (not that it matters, we work wherever they choose to send us). My arguments fell on deaf ears and she was still on my unit this morning. I tried to ask questions as far as what normal vitals are for a 14 yo and nobody knew, including the Peds supervisor. As her mother, I would not want her on a unit where the nurses felt unqualified to care for her but all that matters for the hospital is that there is a body occupying that bed and paying the bill. Administration is putting more and more work on us, RN's are responsible for every aspect of the patient's care - including making sure that everyone else has done their job (my friend was chastised because her aide didn't weight a patient one morning). We even get in trouble if the garbage cans are full in the patient rooms. Just a year ago, we went from wearing whatever scrubs we wanted, prints included to wearing navy and white, still including prints. Fine, I needed new uniforms so when we had to make the switch, I bought some. Now, 1 year later, we have to now wear hunter green and white and no prints whatsoever. We are not allowed to wear a t-shirt under a scrub jacket, we have to wear v-neck scrub shirts at all times, including under a jacket. However, management and shift supervisors can still wear a t-shirt under their jackets and I now have a closet full of uniforms (probably close to $1000 worth) that I can't wear because they are not the right color and many are less than 1 year old. I'm afraid to get rid of them because who knows when we might be forced to change colors again! I could go on and on but this post is huge. Just know that you are not alone. Unfortunately, I just don't know what we can do about it. We have a union and it does no good.

[January-2007]

That stinks. I couldn't even imagine having that much stress, I would not last a day in your shoes. Here's some :pixie: hoping something changes, and soon.

[Cinderelley]

Thanks for all the encouragement everyone. I showed the new form to one of the doctors tonight. Her comment was "You guys can't do this stuff. Each one of these is a whole lecture that I give by itself!" Hopefully, the docs who care will be able to do something about it.

[pianobabe]

It sounds like we have a club going. Although we have different problems, it sounds like administration has stopped listening to what the floor people are saying. I am suppose to be training to do charge on our floor (surgical). I have done it before, but when I did OB (it is a different world all on its own). Earlier this week on one of my training days, I had to take patients and "train". Because I was doing hands on care, I wasn't up at the desk learning. The preceptor was doing all the paperwork, etc. that I was suppose to be learning how to do. I complained to our Supervisor and she said there was nothing she could do about it. What she did do, was go up to the desk and help get the paperwork/orders done. That irritated me, because THAT is what I'm suppose to be LEARNING!!!! It would have been a GREAT learning day, because we had several things going on that weren't the "norm". After next week, I am on my own doing charge. I'm not going to be ready, because I haven't had the chance. My training was going to be less than what they normally do for others, because I had done it before. ALL of the paperwork is different from when I did charge on OB. The whole set up is different. I made a comment to my preceptor about having to take patients. Her only comment was, that a couple of weeks ago, she had to take patients and do charge all without a Ward Clerk or a CNA. That made me angry because she has been doing this for 9 years (and that is just counting her experience at our hospital). I am suppose to be learning. When we got our fourth new admission, I finally asked her if she would take it, so I could put the chart together from start to finish. She did, but only after her attempts to pawn the admission off on another trainee failed. I am just so frustrated with the whole thing. I have a couple of Resume's/applications out in our area. One of the jobs I put in for I don't particularly want, but it would get my foot in the door for a place that I am impressed with. The other one sounds exactly like what I have been looking for. I have never been one to use "connections", but if I have to this time I am. I know the grass isn't always greener, but at least it would put me in a situation where the benefits would out weigh the risks.
Thanks for letting me vent.

[kakn7294]

Thanks for letting me vent.
Sometimes that's all we need to get a new perspective on things. Unfortunately when nurses complain, vent, and try to achieve change we are seen as being whining and uncaring and just looking for a way to make our jobs easier instead of the true result - better patient care. Let's face it, wouldn't we all be better off being cared for by nurses who are happy in their job and have administration's support?

[gueli]

Hey, all you nurses out there...
Thanks.
this is an amazing thread.
I have always known it was hard work, and stressful too...
But I just wanted to say THANKS.
Keep doing the right thing...keep complaining when things arent right...we (the laypeople) need you to do the rigt thing...so thanks for caring/helping/just doing your best
gueli
:mickey:

[Cinderelley]

pianobabe- I can totally understand where you're coming from. It would be nice if our training was as complete as they said it will be. I switched shifts and was supposed to be trained as the team leader by following someone in a few months. The second week, as I was still trying to be awake in the morning instead of getting ready for bed, I was tossed into the role of TL all by myself.

[Cinderelley]

Gueli,
Thanks for the comments. It always helps when someone reminds me of why I'm doing this.

[DisneyDudet]

Our new director is rolling a lot of things that require time and effort, and could sacrifice patient care. She came in from a hospital where she improved patient satisfaction by 70% or something. Well, our thing is, if a nurse is happy, or even content about being at work, then that will reflect in the patient care, thus improving it. If a nurse dreads coming in, they could negatively affect patient care.

The new thing I heard about is a Physician Notification Worksheet. We are to fill out this worksheet before calling a physician. We are then supposed to give it to the charge nurse for him/her to "consolidate" calls. Sorry, you can't consolidate all calls, because issues arise at different times. Anyway, it says at the bottom that its not part of the patient's permanent record, so why have it? She wants it in the chart, and for what purpose? If she wants to see it, she should have a box for it.

We have lost so many nurses because of this woman. She claims to have given us a lot of travel and contract nurses, but she wants to do away w/ agency.... huh? That makes zero sense. The travel nurses are here for a few months, unless they like it, which, at this hospital, is unlikely. So, in a few months, we'll be right back where we started.

She says she's here for us, but I have never met the woman, and she's been here since June 4.

This seems to have become a thread for venting for nurses, and frankly, I need this thread. People at work know about the issues, so we're all complaining, and nothing is getting done. I sent an email to the new big boss lady, with no response. Everyone says when they email her she responds. Well, I went to the asst director (the one who hired me, she was interim director, and now is going to be interim educator) whom I trust and get along with. She had received it, and assumed the director was addressing it. NOPE. She knew that she got it, but no response. Not a good image to me.

Now, I am off to work my second shift of the week. I'm half way there. I hope tonight is like last night, pretty smooth.

I love my job. I love taking care of patients, and giving them dignity and independence. I love the families (for the most part) and helping them cope with a possible long term hospital stay or a new diagnosis. To me, this is a rewarding job, but I hate that this director is making it really hard to want to be there and makes it more difficult to give the care I like to give.

Thanks for listening/reading. I have to leave for work now. :sick:

[Cinderelley]

Hope your shift went well DisneyDudet.

[Marilyn Michetti]

DD works at Desert Banner in Mesa, in the Cardiac Telemetry unit, and she could have written your post word for word.

I'm her sounding board, and don't understand a word she's talking about except for the frustration of wanting to be a great nurse, and having her hands tied.:mad:

[Magic Smiles]

It's nice to hear that there are still Nurses who care. After reading this thread, I can kind of understand what has happened to the nurses who no longer care, maybe they still do care, but have given up on the system.
Either way, we appreciate all that nurses do for us. Without them, where would we be.
Thanks for the great job!

[pianobabe]

Thanks for all the support from everyone. When you pour your heart into something day after day and you have done everything you can humanly do and you still don't get it all done; it takes a toll on you. People/management/patient families only see what wasn't done. They don't care that you have had 6 or more other patients that you have had to do the same things for. Time runs out. I don't like feeling like someone hasn't gotten the care they need because I have been involved with other patient's and other help is not available. To me it is heart breaking. What does make it worth it is when someone comes up to you and says thank you. It doesn't make it easier, but it lets you know everything you have done hasn't been in vain.

[DisneyDudet]

Thanks for all the support from everyone. When you pour your heart into something day after day and you have done everything you can humanly do and you still don't get it all done; it takes a toll on you. People/management/patient families only see what wasn't done. They don't care that you have had 6 or more other patients that you have had to do the same things for. Time runs out. I don't like feeling like someone hasn't gotten the care they need because I have been involved with other patient's and other help is not available. To me it is heart breaking. What does make it worth it is when someone comes up to you and says thank you. It doesn't make it easier, but it lets you know everything you have done hasn't been in vain.

I feel the same way. Its hard when you're doing so much paperwork (well most of ours is on computers) and things required of us, its hard to actually deliver our patient care.

We got another email from Big Boss Lady saying that we really need to be doing pain assessments every 4 hours and before and after giving pain medication. If people are not doing it, it will turn into every two hours. Ok.. let me get this straight... you are giving us an ultimatum? Well, if they aren't doing it every 4 hours, they won't do it every 2, thats just fact. I started doing it to appease her. It won't last long. Its hard to take care of a max of 5 patients (for us), most of the time no aide on nights, assessing at the beginning, doing reassessments and vital signs every 4 hours, along with pain assessments, plus document telemetry strips, pass millions of medications (yes, I can easily give 600 medications a month, only working 3 shifts a week). If we have no aides, I'm cleaning up patients, giving baths, changing linens, getting patients to the potty and back, getting drinks and other needs. In addition to all that, I must chart all this stuff and make nurses notes, plus do 24 hour chart checks to make sure things weren't missed during day shift, plus get everything done. Not only this, but I could get an admission if I have 4 patients.

When I'm not doing that, I have to take care of myself, like go to the bathroom (yes, there are times I don't go to the bathroom for over 12 hours), plus I need to eat at some point.

How am I supposed to give GOOD patient care if I'm doing so much bull that is required of me? Me sitting down, talking to a patient doesn't happen. It did in nursing school. Real life nursing is full of rules and micromanaging, that real good nursing is hard to come by. I hate that my patients and families have to be on the backburner at times. I want to be able and sit down with a patient whose family doesn't live around and has no one to talk to, but with all I have to do, its not possible, if I want to leave in time to get rest for the next shift.

All I want is to be a good nurse...

[gueli]

DisneyDudet-
Don't doubt yourself. You are a good nurse. You care. The paperwork/micromanaging might be a pain, please remember- we need you to care.
Again
Thank You
:mickey:
:beer::marg: (no driving)

[Cinderelley]

All I want is to be a good nurse...

This is what everyone seems to be saying these days, but no one in management will support this. It's all about $. My solution is simple, cut the paycheck of the higher-ups and give us a lower nurse to patient ratio. I bet they never do that though.

[DisneyDudet]

This is what everyone seems to be saying these days, but no one in management will support this. It's all about $. My solution is simple, cut the paycheck of the higher-ups and give us a lower nurse to patient ratio. I bet they never do that though.

I bet you're right.

We do the work so they can make the money. Its business... heck.. its America.

My hospital is part of HCA... which is a corporation...

Therein lies our problem...

[Cinderelley]

I bet you're right.

We do the work so they can make the money. Its business... heck.. its America.

My hospital is part of HCA... which is a corporation...

Therein lies our problem...

I work for a non-profit hospital and it's not any better.

[DisneyDudet]

I work for a non-profit hospital and it's not any better.

The Joint Commission?

All I know is that healthcare is changing, and I don't like it.

There's a reason I became a nurse, and I'm afraid that, after not even a year, I'm burned out.

[rnin02]

I used to work in a horribly busy, understaffed unit and it seemed like every day there was more and more paperwork. Med recs, screening for vaccines, etc, etc. I can't remember them all, but I know you guys know all about them! Plus the difficult patients who needed restraints (but god forbid we restrain anyone, lets just make all the patient care techs sit with the combative confused people and make the rest of the unit suffer even more), the isolation patients, the unstable patients, it was just too much. And I hate those sheets on what to do before you can page a doctor...I guess they are good while you are still early in nursing, but after a few months you know how to page an MD!! Anyway...I work in mother/baby now and it couldn't be better. And I just laugh when the nurses complain there about having 6 or more moms to take care of...they have no idea what its like to take care of 6 truly sick people, after them, 6 post-partum moms are nothing!!

DisneyDudet, just hang in there...I know how you feel, I remember spending most of my nights cleaning up the mess left behind, plus trying to get everything else done...you will make it! And maybe after your first year is done look at making a move to a different unit or different hospital. I hated my first year on my first unit (telemetry), then I found my rhythm there and I started enjoying it...then the bad manager left and we got a great one so that was awesome, but by the end I was sick and tired of working there, I dreaded going to work. I would have such headaches and while I didn't call in sick a lot, I know I called in sick somedays when I could have actually managed to work physically, but mentally I was drained. My new unit was a huge jump (adults to babies!) but so worth it. It took a while to get settled, but its awesome to enjoy going to work again. And I've missed maybe 2 days in the past year? Compared to 6 or 7 in the years before. I won't ever again work anywhere that I hate going to like I hated going to my Tele unit. Its just not worth it. I loved my coworkers (well, mostly) but still, its not worth it. I did learn a bunch of stuff, I did learn how to be organized, which I'm very grateful for (many of the nurses I work with now have horrible organizational skills and are always falling behind and leaving late), and I really learned time management. So, stick in there, you are a great nurse, and you will find a unit to love someday! Maybe it will even be this one.;)

[DisneyDudet]

I want to love my unit, but I just like it, for now.

I have a staff meeting tomorrow, so we'll see how this is all going to impact us.

[Cinderelley]

I hope your staff meeting went better than our last one did.

I love the crew I work with. I just hate the politics.

[DisneyDudet]

I hope your staff meeting went better than our last one did.

I love the crew I work with. I just hate the politics.

Well, its 0841 and the meeting was at 0730. That right there will tell you how it went. It didn't.

This is the second meeting that this woman has had. Well, her first one she canceled and I was planning on going. That time it was an evening meeting and someone called me knowing I was going because he found out that it was canceled.

Well, I figured that wouldn't happen again, so I woke up at 0530 this morning (I work night shift so yeah...) and got ready and got there, and saw someone in the elevator and asked about it, and it was CANCELED! I can't believe it. Her second month and she's already canceled two meetings. I'm not going to make an effort again. We have to go to 9 out of 12. Well, sorry. Not my job to call before I come in to see if she's doing her job and having the meeting. I have lost all respect for this woman. I can't go to the rescheduled meetings because its my one day off next week. I work for then off one then work one. Sorry. Not going to happen. She has yet to come to night shift and see the staff. She says she's here for us... that bull. If she were, she'd come up there and actually introduce herself.

I don't know what to do. I like the people I work with, but I don't like her. She's going to lose a night shift nurse soon if she doesn't start acting like a director. She makes me so mad! I sad bad words that I never say!! My blood pressure is indeed up, I can feel it. I'm so angry!

I'm going to put myself down for an hour and a half travel time to the meeting that was canceled. I sat in traffic to meet this woman. You won't see me doing that again unless she absolutely makes me.

I'm so mad! I've already vented to my mother and grandmother and I'm still mad! I haven't been this mad in a VERY long time. I can't even remember when I was this mad last.

Gosh... really. What do I do? I've heard that everyone above her just LOVES her and thinks she's going such great things. I know if I send an email today I will get in trouble because I'm so mad and rude. I'll have to wait a few days to calm down to even begin to tell people who matter about this.

Any suggestions?

[Cinderelley]

DisneyDudet- any word from your boss about why she was cancelling the meetings?

Just got home from my shift. At 0430 this morning, we had a patient become unresponsive. We were doing everything we could, called Rapid Response, etc., etc. Our house supervisor calls the Team Leader to give her a patient. The Team Leader tells her that we cannot take the patient because of the critical status of the patient we are working on. (BTW, the house supervisor should have been at there with the rapid resonse team and she wasn't.) So, then the house supervisor comes up to the floor, pulls the team leader out of the room, and tells her that she has to take the patient. :huh: There's some real concern for our patients. Thankfully, that patient was fairly stable. Then to top it off, as we're rolling the critical patient down the hall to ICU, the house supervisor comes up and tells our Team Leader that she has to take a stat transfer. :mad: Can't we even breathe while we're at work? That stat transfer was getting sent to ICU as I left work (an hour and a half after my shift was supposed to be over).

I saw the house supervisor in the hall & said "That was not a good time for an admit." She didn't say anything, and there were other people in the hall so I couldn't tell her what I really thought.

5 more shifts and I'm on my way to see Mickey!!!!

[DisneyDudet]

DisneyDudet- any word from your boss about why she was cancelling the meetings?


The first one she canceled is still a mystery. She canceled this one due to "prior commitments". Not sure what that means, but it was the day before the meeting. I looked at the email once I got to work on Thursday. She rescheduled it for today in about an hour. You see that I'm rushing to go. Nope. I'm not going on my only day off.

Rumor has it her "prior commitment" was her kid getting sick. She has not come to work many times because one of her 4 children were sick. She lives 5 min away, and I do believe she has older children (at least one who can stay and watch the younger ones while she comes 5 min for a meeting). One of our night aides called in and said that she couldn't work one day because her daughter was sick and needed to take her to the dr. She told her to find someone else to take her!!! Can you believe that?

Cinderelly- we have two house supervisors like that, that demand people take patients, even though you really can't. Our Charge Nurses really can't take patients, as we are a large unit -38 beds. A charge nurse is in charge of all that, plus the 7-9 nurses and 2 aides caring for the patients. There's paperwork and other things they do as well. They can only do patient care when a nurse is struggling (like take a transfer or admit and watch them while the nurse catches up). We have only one house supervisor who cares and is considerate of both ER, transferring units, and receiving units. She works with everyone to get things straightened out. Most of us would go out of our way to help her out in a sticky situation.

The big thing this week at work was my first night. I come in and was given my assignment. The day nurse told me that I'm getting a transfer/admit but that one of my patients has discharge orders and the day nurse is working on them, so just watch them until they have a ride home. So I go get report from the nurse with that patient and I have to ask if she was doing the discharge. She said no that she just got it. So I go find the discharge orders and everything in her box and tell the day charge that she wasn't going to do it. The day charge nurse tells me that the nurse told her she was going to do it. So as I tell her, the nurse makes it an even bigger deal, by making a scene with the charge nurse saying that she just got it and doesn't have time. Well, she would have if she hadn't been talking and I had to find her for report. Plus, I look at the time, and it was written at 5:50pm!!!!!!!!!! That is MORE than enough time to do our discharges. She claims she was waiting on a transfer. Sorry, it takes 5 min to settle a transfer when you get it that late. A note and a set of vital signs.. thats it. Then, she was mad at me because I expected it to be done that she's going to write me up!!! All I said to her about the discharge was after she was telling me he is going home and has orders:
Me: "Is the discharge done?"
Her: "No"
Me: "Are you going to do it?"
Her: "No"
Me: "Ok"
And I get up and get the papers so I can start it and not have it back up my whole day, seeing as the orders were an hour old, and he's been waiting all day. You can't write me up because I EXPECTED it to be done. If we had something written at 550, she would throw a HUGE fit that it wasn't done. I wrote an email about it to the director, because she's done this before. She didn't even take the tele box off him or take out his IV. NOTHING was done for the discharge. She could have at least done that. To top it off, I'm supposed to give instructions and tell the patient about everything when I've never even seen him. She had him all day!!! Whatever...

Then, ER faxes my report sheet for my admit up at 7pm. They call for report at 720. I tell the secretary that I can't accept report at this time because I'm discharging a patient and that I would call them back and get report as soon as I'm done with this patient. Well, they take that as I'm refusing the patient and call the house supervisor on me. They call the charge nurse and he stands up for us. We can't accept report while we're already getting it and they'll have to wait. The claimed they were having a code and needed to get the patient up. They were NOT full, and really, why would you send up a patient during a code? Isn't that a little more important?

I sent an email about that as well, as its not MY fault I couldn't take report. I hadn't even gotten report on my other patients either.

Then the same nurse as the whole discharge debacle came in yesterday and was mad she had 5 patients. I'm sorry lady, you have two aides and you are NEVER guaranteed only 4 patients. We were full. She asks, "Are we short staffed?" I reply, "You have 5 patients don't you? Then yes, we're short staffed". If we are staffed correctly, we all will have 4 patients. She is just very lazy and expects things to go her way. I heard she's been in trouble lately for not doing her job, so hopefully she won't be coming back (she's agency) but since Big Boss Lady is running off a ton of day nurses, she probably won't leave. Hopefully she gets talked to. I'll send an email to her every time she messes with me.

Sorry that was so long, but I was too mad to type it after it happened!

Thanks for listening guys!

52 days til Disney!

[hoop de do]

Texas, North Carolina, Pennsylvania, Arizona, Alabama, I'd say that is a pretty good cross-section of our great country. Seems to be a countrywide problem doesn't it. Quick history of myself. I was an EMS/Prehospital Care Coordinator for a very busy Emergency Department (ED)in Western PA fo 25 years before retiring 2 years ago. I was supervisor for a Paramedic staff that responded from the hospital in a fully equipped Advanced Life Support Unit when there was an emergency in the area. When not on a run our paramedics would assist the ED nurses in patient care (I.V.s, blood draws, intubations, actually anything that fell into their job descriptions.)
That being said I can attest to all that you say. Our greatest asset was that we had a GREAT nursing supervisor who got into more trouble than any other supervisor for missing meetings because she was helping out in her busy department.
It is very important that you never forget that you are truly worthy of your titles. I have the utmost respect for a Critical Care nurse. You all care for your fellow man or you wouldn't being doing what you are doing. I better slow down here: I truly believe that healthcare as we are doing it today MUST change and I do think that change is coming (it has to come) because we can no longer ask our nurses to work the way we are asking them to. Sad to say it is a political/monetary decision - a decision that has to be made at a lot higher level than ours.
Let your Patients/patience be your guide and remember your patients and their families do appreciate what you do.

Why does our breed like Disney - because everyone is smiling and in a good mood, courteous and in good health. I could never get to Disney soon enough when I was working and now go as often as my budget allows.
Hang in there you guys/gals are the best. :thumbsup::thumbsup:

[mouseaddict]

Ahhh..finally..people who relaize that a 5 pt assignment is heavy! My non-nursing friends and family don't get it. They all say "well, at least you only worek 3 days a week"...yeah..I do 7 days worth of work in those 3 days.
The pain assessment thing...grrrr. We have to reassess pain within an hour of giving the pain med or we get written up....
I work on what is supposed to be a cardio-thoracic surgery "step-down" unit. Yeah...sure...they extubate the hearts in the unit and send them up within a few hours..to a 5 patient assignment???? We usually wind up sending them back the same day. We tend to get the heaviest patients because we have strong nurses on our floor..but now we are all burned out!
I am starting as weekend charge in the next month..and I am not looking forward to it..we are losing nurses and they are being replaced with travellers!
I love being a nurse..but there are days when I wonder if I made the right choice!

[murphy1]

I am still thinking about nursing school, if I truly want it. I know when I go back to work in a couple years after my youngest is in school that I do want to work, but just PT, so if I do nursing will either be in a dr. office or PRN.I worked in a hospital in Occupational Health unit and did Medical Transcription for two years, so I really need the patient aspect more even though I was a nurse aide in high school. I just know I can't be all of it full time. Here in GA they are begging nurses to come out of early retirement (some of my friends are nurses and they tell me the good and bad). I see some of them getting burnt out in their 30's. I am also thinking of teaching or subbing, so I'm really learning a lot from the conversations around here. My previous job was insurance so I'm used to massive paperwork and crossing t's, dotting i's.

[Cinderelley]

It would be great to have a supervisor who could work well with ER & the floors. Our ER is so babied. They get everything done their way, no matter what. The admit we got during our rapid response situation was from ER. Apparently, when our team leader told the supervisor that we couldn't take that patient at the moment, the supervisor said the ER doctor was throwing a fit about getting the patient up there right away. My response to that was to have the ER doctor come up, intubate the patient, and transfer the patient to ICU. Then we could take the patient. (It took us between 1-2 hours to get the patient's doc to call us back for the transfer order). Which, in the end, is what wound up happening, except they decided to get her to the unit before intubating her. While he was on our floor, he didn't strike me as the type to throw a fit. Plus, two of the nurses on the rapid response team had just been in the ER, and said that there were only 3 patients down there. 3! I think they could've handled watching one of them while we took care of our critical patient.

I too have had situations where they told me they had to get the patient up to the floor right then because their other patient was coding. My response was "well, why are you giving me report instead of attending to your code?". I didn't get much of an answer.

[Ed]

Wow! This thread has really opened my eyes and my mind to the present state of the entire health care system. It's absolutely no wonder that there's such a huge demand for more nurses (and docs) all over the country.

I know that it's entirely futile to expect people like the doc who ignored emergency pages because he was hiding in a stairwell chatting on his cell phone, or the supervisor who expected a nurse to basically walk away from a patient who had coded to handle a more-or-less routine admission. Those folks are the ones who should seriously consider a change of professions. In fact, if I had it my way, I'd suggest to them that they get used to asking "You want fries with that?" :mad:

One other theme stuck out in a few of the posts, and that is the apparent absolute lack of activity on the part of your unions. As one of you stated, the only thing they do for you is take your money. Sounds to me like it's time to dump those unions, or at the very least to very actively and strongly campaign for new union leaders who understand what you all go through and will stand up for what's right for you, the membership, and what's in the best interest of the patients as well.

I truly sympathize with you. Nurses are among my favorite people, and it's depressing to see so many well-intentioned professionals being treated so shabbily.

I know it's difficult, but please never forget that your patients are cared for much, much more by the nursing staff than they are by the docs, and they really depend on you to help them get through their illnesses and injuries.

God bless you all!

[DisneyDudet]

Ahhh..finally..people who relaize that a 5 pt assignment is heavy! My non-nursing friends and family don't get it. They all say "well, at least you only worek 3 days a week"...yeah..I do 7 days worth of work in those 3 days.
The pain assessment thing...grrrr. We have to reassess pain within an hour of giving the pain med or we get written up....
I work on what is supposed to be a cardio-thoracic surgery "step-down" unit. Yeah...sure...they extubate the hearts in the unit and send them up within a few hours..to a 5 patient assignment???? We usually wind up sending them back the same day. We tend to get the heaviest patients because we have strong nurses on our floor..but now we are all burned out!
I am starting as weekend charge in the next month..and I am not looking forward to it..we are losing nurses and they are being replaced with travellers!
I love being a nurse..but there are days when I wonder if I made the right choice!

You sound like our unit!

5 patients are a lot of work! Especially since we're nights, they tend to not give us aides. Sorry, that is when most people are getting prepped for colonoscopies and have large BMs that we can't handle. Its difficult to do everything with little help.

I often don't have a lunch break. I eat while I'm charting or checking charts. Its very hard on you to care for so many other people and not for yourself.

Well, off to work now. Luckily I have a week off!

[TiggeRia]

It would be great to have a supervisor who could work well with ER & the floors. Our ER is so babied. They get everything done their way, no matter what. The admit we got during our rapid response situation was from ER. Apparently, when our team leader told the supervisor that we couldn't take that patient at the moment, the supervisor said the ER doctor was throwing a fit about getting the patient up there right away. My response to that was to have the ER doctor come up, intubate the patient, and transfer the patient to ICU. Then we could take the patient. (It took us between 1-2 hours to get the patient's doc to call us back for the transfer order). Which, in the end, is what wound up happening, except they decided to get her to the unit before intubating her. While he was on our floor, he didn't strike me as the type to throw a fit. Plus, two of the nurses on the rapid response team had just been in the ER, and said that there were only 3 patients down there. 3! I think they could've handled watching one of them while we took care of our critical patient.

I too have had situations where they told me they had to get the patient up to the floor right then because their other patient was coding. My response was "well, why are you giving me report instead of attending to your code?". I didn't get much of an answer.

I'm joining in this conversation a bit late, but I thought I'd throw in my two cents. I am on the other side of this--I am the evil ER nurse (as we are often viewed, at least in my hospital anyway). I have worked on the floor--I did telemetry when I first started nursing six years ago. I've been on the other side and I know that getting admits around shift change and when you are busy are quite a drag and really put you behind in your work. I've been there.

Working in an ER, I also see the other side. When we first start our shift in the morning, I have anywhere from 6-8 rooms assigned to me, and yes, they have all been full at one time. As the day goes on, our room numbers generally decrease down to 4 per nurse by 1 in the afternoon, as long as we are properly staffed. Unfortunately, there is no point where we are capped off. I can't refuse any more patients. The ambulances keep coming and they keep coming through the doors. The other morning I walked into work and had two ICU admissions and three medical patients. Both ICU patients were holds because they didn't have enough staffing to take them. Needless to say, it was an extremely busy morning, and I'm sure my medical patients didn't get the attention from me that they needed.

If I know that we're getting a critical patient in, I do try and push some patients off to the floor. That critical patient may not be assigned to me, but I will be expected to be in that room assisting other nurses out, which pulls me away from my patients. That is one of the reasons I need them to go to their rooms as soon as they can. On the other hand, if we only have three patients, no, I will not push off to the floor if I know that they are swamped. However, I will not hold that patient for hours. Just because the ER is not busy at the moment does not mean that it won't be full to the brim in just 10 minutes. Anything can happen there.

I admire you nurses who work on the floors...you couldn't pay me enough to do it. Every floor has their own problems, and it is certainly not greener on the other side. That goes from hospital to hospital, too. The whole health system needs to be "torn apart" and pieced back together...I'm just not sure how they are going to do it.