[Cammer]

Okay, it's my turn to gripe.

I've never been one to complain about an assignment. I take what is given to me and make the best of it. I've mentioned on this forum that on my unit (ICU) it's not uncommon to be assigned 3 patients, and it's not uncommon to not have an aide, or a secretary, but the last shift that I worked was absolutely... just unbelievable.

I was given an assignment that was not doable. Three patients, all three vented in various stages of weaning, all three were very sick and on pressors. Two were on Levophed, one was on Neosynephrine, one was on Diprivan, the other two had orders for no sedation. One was on an insulin gtt with hourly blood sugar checks. The other two had Q4 hour blood sugar checks. CVP Q2H on one of them, sky high ammonia level on another so we were giving lactulose, unfortunately she was the one without the rectal tube. One spiked a temp of 104.6 at noon. Major family dynamic issues on 2 of the 3. All three patients had nonstop IVPB infusions for electrolyte coverage and antibiotics. Q8h potassium levels. Hung 2 units of blood on one of them.

All of this and we had no aide, no secretary, and, get this - NO CHARGE NURSE. The clinical manager was in meetings all day so we got no help. The area I was in was staffed with a traveler RN and an LPN that was floated over from telemetry. I was responsible for taking off written orders, answering the phones, watching the monitors -even when I had to be in a patient's room, dealing with family, turning and bathing patients, basically everything, and it all didn't get done. I'm just damn glad that one of my other patient's didn't code while I was in a room. I didn't have time to eat or drink except for a container of yogurt I had to swipe from the patient's fridge.

Things have been bad in this unit before, but I have never actually felt like the assignment was impossible. I was unable to properly care for my patients. They did not get turned, they did not get adequately cleaned up, the phone was not answered all day, the family members were upset with me, the doctors were upset with me, and I am upset with me.

I have spent today updating my resume and I have spoken with the manage of our PACU about a possible opening she has there. It's time for me to get the hell out before I lose my license. Within the last few weeks we have had two traveling nurses quit their contracts because of similar conditions. I've been in this unit for over two years, I love the people I work with and I try to maintain a very positive attitude, but what else can I do???

[wsustud08]

Hearing this story scares me. I'm just a student now, and having a heavy patient load (like yours), and not being able to properly take care of all my patients is one of my biggest fears.
You have every right to complain, and I think you're right about getting out of that hospital as soon as you can. Many more assignments like that are going to run you down emotionally too.
I wish you the best of luck in finding a better place to work

[NavyJim58]

Cammer, if you have made up your mind to leave than you have nothing to lose by taking these issues to your clinical manager or to your director or even to the chief nursing officer. I assume you have made your concerns known to them in the past? What was their response? Do they expect you to be able to accomplish the work or have they made promises they have not kept?

Very rarely is the decision to quit the only one or even best one. If you are happy in your job and just need a change of some kind like fewer patients or more help or additional equipment or training then that would be the avenue to pursue. I know nurses who are always moving around from job to job looking for the perfect assignment. It's not out there. thanks for listening

[MagRedC5]

"Things have been bad in this unit before, but I have never actually felt like the assignment was impossible." - Cammer

Cammer, have you used your civilian chain-of-command to voice your concerns about these same issues in the past? Plus, this current event you shared, did you voice same to others higher up the totem-pole?

[Maddie]

...hence, the nursing shortage. This is why our very best are leaving the profession by the droves. I truly feel for you; they have put you in a situation that is dangerous for your patients and for you. Assuming that you have shouted at admin's door until you're cyanotic, they don't leave you much choice but to move on, don't they? Please write and give us the aftermath.

[Cammer]

I did speak with the ICU clinical manager on this subject. She gave me a Thank You card and a free cafeteria meal ticket to show that she appreciated all my hard work, then she apologized profusely and restated the same line that she told me a few months back when the staffing crisis became a common topic of conversation during the few minutes each day that we'd have for lunch. She just said that they are aware of the problem and to have some patience. It should resolve in a few weeks. The weeks have turned into months and I feel that I can't do this anymore. It's time for me to move on.

My wife and I have had lengthy discussions on this topic. She is an incredibly astute person and comes up with some pretty good stuff now and then. From my description of the working environment, and using her university background in sociology, she made the comparison to an abusive domestic relationship. When times are good in an abusive domestic situation they are really good, when times are bad they are almost intolerably bad. Every once in a while flowers are brought home and promises are made. Things are said, like "I'm so sorry, this will never happen again," but it always does, and the promises are always broken. But, you think, maybe this time the promise won't be broken and we can go back to the good times, yet the cycle of abuse continues.

Her comparison made a lot of sense to me. Suddenly my situation had been made crystal clear. It is time to move on and leave this abusive relationship.

After considering the many options that are available to me, such as going full time agency, travel RN, becoming employed at another hospital, moving to a caribbean isle and living in the jungle, and so on, I have made the tentative decision to remain at this facility and just transfer to another area. Specifically the PACU. The PACU isn't quite as critical of an environment as I enjoy, but the environment should be better. I haven't finalized anything so I may consider another option if I think of something else.

I have a good friend who is a county deputy. He has been trying to get me to work in the county jail. They pay REALLY well (about like ICU agency) and it's a low stress job, but in all the jailbreak movies I've seen the nurses always get shot first. Still not sure about that idea. Hmmm.

[NavyJim58]

"I have a good friend who is a county deputy. He has been trying to get me to work in the county jail. They pay REALLY well (about like ICU agency) and it's a low stress job, but in all the jailbreak movies I've seen the nurses always get shot first. Still not sure about that idea. Hmmm." quote

Whoaa.....Cammer......don't know if you were joking or not about working in a county jail but I can state that I worked part time (yes, I have had a lot of "part time" jobs outside the Navy) in a state prison (not county jail) and it was the worst job I have ever had as a nurse. Worse than working in a nursing home. It was both scary and sad working around those inmates and talk about manipulation.

Good luck in PCU.....I think you made the right choice

[Cammer]

Originally Posted by NavyJim58

Good luck in PCU.....I think you made the right choice

PACU - Post Anesthesia Care Unit, some call it Post-Op. In our hospital PCU is the telemetry unit.

[mpicray]

Hi, Cammer!

I believe you've made the best choice - probably for your patients as well as yourself. Sometimes we are left no rational options except to vote with our feet and let administration know that the current working conditions are unacceptable.

I have been in your unenviable shoes at least twice in my 30+ year nursing career. In one instance, my leaving forced the hospital to close some beds and pull 3 RN's from the closed area to help relieve the crisis. As long as I was willing to risk my license, my health (physical & mental) and my patients' well-being and safety, they did nothing. I tried a grievance procedure that went all the way to the VP level and got words about how their long-term goal was to "teach nurses how to deal with more stress" and in the short-term encourage us to "hang in there".

When I left, (one of the hardest career decisions I've ever made) it forced them to act to provide better care for the patients. It hurt but it felt good to know things got better after I was gone.

Do what is going to keep you sane and keep you in the nursing profession. There are not enough nurses out there to lose even one to abusive management.

Good Luck with your new PACU experience!

Melodee P.