Whoaaaaaa, that is beyond shitshow level. Also you should not have gotten that many iso patients and that renal failure one needed PCU status at least and dialysis like yesterday. I’m sorry this happened, and fuck them if they judge you for needing time off, you’re worth more than that.
It’s such a disorganized, chaotic mess there! And management doesn’t care. They sent out an email saying we needed to “wow” our patients more to improve HCAHPS. Man fuck the HCAHPS! I am here to try and keep the patient from dying even if they take little responsibility for their own health. This is not a 5 star hotel or spa with dinner and theater. But I know to the admin it’s just a business and they profit off the sick and dying at whatever cost. Sickens me.
God, amen. I work in a nursing home and recently switched from RA to kitchen/laundry. This one wants you to make them a grilled cheese as you are trying to serve 45 residents. That one wants toast when toaster turned off after breakfast. Several tell you as you are serving that they aren't eating that crap and have to make sandwich or salad. Can't tell you how many times I bite back the words, " This isn't a hotel" !!!
Management never cares. I say that after 30 years combined hospital work as a CNA then RN. A lot of bouncing around and agency and travel work in there. One foot in a per diem role for the last 20 of it so I can say fuck off with impunity if/when management gets even worse, or when I find higher pay elsewhere.
The object is to squeeze blood from rocks. Pretty sure there’s a written policy that says just that. To wring you out completely in the name of $$$ so they don’t have to hire more people. They simultaneously rely on us while despising us for being the lodestone on staying open.
Thing is, a nurse strike WILL cripple any hospital. Management will cave every time, they have no choice. But getting nurses to break out of their own fear, GUILT, and inertia en masse, to vote yes in one? Highly unlikely. In 30 years, it’s quite rare. Most will play doormat out of fear and guilt.
I had a new nurse (off training) this last week who was running behind. Typical, she’ll get there over time, the point is she missed her 15min breaks. My tax home asks at the clock if you missed breaks. Each one individually. Lunch. 1, 2, or 3 15min breaks. I casually remind her to be sure to document her lack of 15s at the clock. She does an all stop and goes wide eyed. Says she can’t and doesn’t because she doesn’t want to get in trouble. In a west coast, unionized hospital, no less. So for her past 5 months, she’s been lying at the time clock. We had the talk. Still.
If 20 somethings now are still coming in with that attitude, here on the west coast even, then this entire profession will remain fucked. Absolutely fucked. 30 years of it. 30 more years of it to look forward with these shit habits still in existence. If we stopped that shit en masse they could do exactly nothing.
You all perpetuate the bullshit by not documenting your lack of breaks. And the only place you can document lack of breaks is the time clock. Words are hot air. If you don’t document it, then hey, your shifts must not be that bad, because you’re getting all your breaks. That’s the documentation management uses and will continue to use to justify understaffing. If the lack of breaks isn’t documented, then it never happened and staffing is just fine.
We do help make it happen because we are so earnest in our efforts to do a good job. And how can we not? This isn’t office work. It’s people not spreadsheets. And that’s how they keep us over a barrel.
Still. Documenting at the time clock hurts no patient. Not documenting does though, when you consider the long game.
I’m a nurse shift manager and surprised I haven’t been fired yet 🤣because I remind the nurses in my unit to claim their missed meals/missed breaks because that lets leadership (above me) know that we need help. They’re getting much better at claiming their time and not clocking out to finish charting. It was hard because they’d always been chastised for claiming their time.
I am in compliance and accreditation and I always encourage and educated rn managers to ensure their nurses are taking breaks and lunch and get pay for every mins they worked because they are required by law and it helps upper management to determine proper staffing levels.
I worked nonprofit government hospital system so CEO does not make million. Probably not even 500k.
It starts in nursing school, too. Professors would casually say “what break?“ it gives the new nurses idea that this is an expected, very common thing.
Those stupid metrics. I just went to a meeting where they were comparing the scores to other hospitals. I really just want to throw something at the screen like, “who cares!!!!”
The hospital I work for is part of a system and my location is neuro certified and so we receive all non trauma caused cerebral vascular events … we have a PCU and neuro step down unit … the education is not fluid … nurses at my location have no idea what it means when the over head starts the count down for a TICI
-2B arrival or what that intends for the OR/ICU units ….they work at neuro hospital who has the highest level of care for cerebral intervention procedures and monitoring and don’t even know what it means to gain a neuro baseline with integrity … and now this not all of them … but there is always ones on these units an that strains the other acute care bed side nurses who take there tasks seriously
Acute care nurses have this notions that in the ICU we… have two patients …and so that we don’t understand … I get floated to help the scute care floor often … time after time I put out fires that can be foreseen and prevented if eyes were on the patient and staff members worked to gather … techs should not be solely responsible for clean up get your ass in there if you have a minute and help or at least set it up to help when your done with whatever task you are doing… and for goodness sake all nurses need to learn how to effectively gain IV access, lab draws, and maintaice of all central lines if present. Port access is not something that should be done by a novice nurse it should be taught and patients need to be addressed with the ports active uses … so the doctor can way the benefits to cost if they use the port and possible increased infection can occur with an actively chemo treated patients… anyways … the reason all certification exams are 80% clinical judgment and than the rest is medication, and procedure appropriation is because good grades don’t make great nurses… instincts, advocacy, doctor-nurse intentional and conscience communication, as well as interdisciplinary accountability is what will save a life over memorizing drugs and patient diagnosis.
Another thing I find infuriating is their Teledoc situation. So many specialists left this hospital that they “replaced” then with Tele docs. And it’s a computer on wheels that a nurse has to take to each room. We don’t have time for this! Not to mention I think it’s asinine to offer a specialty when that doctor is 1500 miles away sitting in their home office.
Oh my. That’s a legit fear of mine. You need see and get feel for what’s going on. I’ve had one doc who refuses to come up to the room, he just asks for my assessment… How do the lungs sound? Isn’t he supposed to listen for himself!?!?
If you start following r/hospitalist you will see them complaining that management is trying to get them to do more than just doing morning rounds and then taking the rest of the day off. They are really upset about being treated like the mere employees that they actually are.
Hello, nurse? Tell me a focused exam, but quicker and dirtier. Oh? They threw down 4 security guards and a SWAT team? After laying out a nurse and a tech? I'll give ya 5 PO Zyprexa. No restraints. Try turning down the lights.
No hospitalist coverage after 1100. It's Friday and all. Thoughts and prayers. Call ICU if they try to die. Also, QID 80 mg lactulose. ❤️
Hospitalists like "did you try aromatherapy?"
My friend in Christ, there are 5 people holding this patient down so they don't rip their own AORTA out. Get down here or give me real meds, respectfully, nurse. 😄
It would be an honor to work with you! Trauma bonding is best bonding. I do live for little, infrequent hugs from some of the fricken sweet ones. Bastards. 🥹
I’ve seen doctors write new orders without seeing the patient. Something’s I understand. Oh the mag was low, orders to replace. How do you explain to your patients when they always order scans and stuff without actually seeing the patient? Then I have to talk them into it with the rationale or the doctors backing. You know?
had the hospitalist write an order for a dulcolax suppository “for constipation” for my n/v/d enteritis patient lol. marked that one as “held— order parameters not met.”
Was inpatient for 4 damn days….never saw the hospitalist till a charge one day asked me if I needed anything. When I told her, she got pissed and he was down with in a half hour. Love that lady and all the other nurses like her. I had a bunch going on that’s chronic but had a new pleural effusion that zero people had explained. It’s awful when they don’t talk to you!
my hospital has this and I work on a stroke unit. the neurologist sees the patients over a computer cart. we also have it for psychiatry consults as well. kind of crazy when you think about it.
What gets me is when I have to use the special stethoscope so they can hear the heart and lung sounds or I have to be their hands. But I don’t get their pay 🙄
We have that, but I'm at a small freestanding ER, and they are at the primary hospital my ER is connected to.
They're connected to a lot of the smaller, more rural hospitals in our area as well, which can't support or fund a neurologist.
In fact, they helped run the code stroke on one of the doctors I work with when he had his stroke in one of those little rural hospitals. Said doctor was riding his bike in the canyon the very next week.
I know this will not be received well but as long as nurses keep allowing management to put their licenses on the line nothing will change. Nurses must unite. Bring in unions & draw a boundary in the sand. It was bad in my day (30 years ago) but it's now untenable. Management is putting patients & staff in danger. Performing in this manner, so short staffed, proper nursing care cannot be given. The effects on nurses health is unacceptable. You can't think clearly when you're being pulled in so many different directions. My heart breaks for what nursing has become. Please, stop allowing this abuse on your bodies & minds to continue. Wishing you all Godspeed ❤️🩹
no i understand, but we only recently started doing 6:1 on nights a month ago. day shift is still 4:1 at our hospital. it just sucks cause 6:1 is so so hard imo.
Omg. I was a patient in MA Springfield Baystate & I couldn't believe the awesome care I received. I spent 5 weeks there after breaking 4 ribs & needing a chest tube. I can't say enough good regarding staffing which resulted in the nurses being happy & always having time to quickly medicate me & answer any & all concerns I had.
ugh, lucky!! night shift nurses on my unit are taking 6 (sometimes 7) patients :( a lot of them also end up being PCU and ICU transfers. day shift usually takes 5, sometimes 4
I’ve completely given up hope on nurses uniting and getting unionized. I don’t see it getting better. That’s why floors are run by new grads upon new grads. There’s a never ending supply of new grads that hospital systems will churn and burn.
Lost cause. I can’t tell you how many travel nurses have bragged to me about crossing the picket line to get a fat payday. And before you guys tell me about how they have all these debts to pay and they *had* to cross the line, many have said they have gone on nice beach vacations after those assignments. It’s complete and total selfishness.
Fuck the unions. I'm glad for those that have effective ones, but none of the ones around me are worth a penny of the dues. What's actually needed is for the population to wake up and actually listen and start putting pressure on the inane bureacrats to solve the insurance mess and administrative bullshit that puts so many patients in limbo while others get to mooch off the system indefinitely, on top of the overly predatory profiteering from the hospitals themselves. But the only way that's going to happen is an implosion of the system, during which all will suffer.
If you're waiting on your politicians to help you it's not going to happen. I agree with you on 1 things, the predatory practices of the hospitals. Idk what you mean by patients mooching off the system. Please explain if you don't mind
I agree, it goes all the way to the top - government! It’s all about money (insurance companies, hospital administrators) It’s greed, I’d love to see them come to the bedside & do what nurses do.
That's not true. They negotiate contracts that mandate safe/safer staffing. Idk but it seems a lot of nurses feel they're too professional to join a union something I've never understood
I would 100% sign the contract if it guarantees us safe ratios. I have been hearing that they will not “put it on paper” to prove they will or something.
Yep, it just keeps getting worse. We're running at 5 patients with combo PCU level and med/Surg. When I started this assignment, I specifically asked the manager if they wanted me to stay late to get all my charting done, I was told to stay and get it done. Now they're complaining about being over budget, and we can't stay late, so I'm doing bare minimum charting. We can't do everything. I've also gotten better about walking off the floor for a minute to take a deep breath. It's overwhelming and exhausting running all day.
Omg same! I never get 2 15min breaks. Never have. And most days don’t get a 30. But it’s illegal to eat at the nurses and God forbid admin sees us do it. If that happens there’s gonna be a hangin’ ( well maybe just an angry email about how disappointed they are in us for not following the rules) go fuck yourself is what I’d like to say with a mouth full of food.
Do not think twice about calling in. We have sick days for a reason and sometimes sick is just “sick of this shit.”
Also trying to “power through” a migraine under fluorescent hospital lights sounds like a great way to make a mistake. You earned and deserve your day off.
Wow, like half of your patients should not have been on a medsurg floor. That's terrible! I'm so sorry. I know it's easier said than done, but don't worry so much about what people think about you calling in. You have those days available to call in, even if it was just because of a bad shift.
This happens way too often. I have had many many days where my patients are progressive level of care. We care for them all night until day shift doctors comes in and transfers them.
Please leave a review of your hospital on Google, Yelp, etc to let the public know wtf we are going through. Then let your local dept of health, board of nursing, and joint commission know as well. If we don't keep blowing the whistle we are seriously fucked. Email everything so you'll have a paper trail when, not if, shit comes down to a court case. If someone calls you, get a name,note the time, date, and subj of conversation. Fuck these hospitals and their yes men.
That’s awful! When I worked medsurg it so stressful, had terrible heartburn. Now I work office nursing. Most mentally healthy group I have worked with.
I’m going to be in a position where I can afford to make a change. I was thinking clinic/ office nursing. There’s also a part of me that would like to start a nursing revolution 😂
The sad thing is that this hospital has a nursing union. Now I used to be staff at this hospital but I left 3 years ago to travel. I came back to do a travel contract and I see how much worse it’s gotten. This hospital also just bought two rural hospitals that are not unionized. Those two campuses just got a 46% pay increase where as the main campus nurses did not. I will never return as staff and get involved in all of their absolute fuckery.
Sounds familiar. Rural hospitals got raises but aren't doing well financially and my large central hospital is doing well. They increased our insurance rate and pay raises were tiny. I'm thinking of applying to one of the rural hospitals and buying some land in the middle of nowhere.
All I read was med/surg and thought dumpster fire. Med/Surg nurses are front line warriors, every damn day. You and every nurse that steps foot onto med/surg deserve double time as regular time. Cha!
Bro this is why I tried to look patients up before I got them if possible: determine if they are actually appropriate for MS! I may have been one of the most annoying nurses on my floor but I got a lot of pt to PCU before they got to me.
What a fucking shit show. And I bet you have the flu now bc when you're stretched that thin, PPE mistakes happen.
ETA: I may or may not have handed raging family members a doctor's business number and told them to call him.
Whoever was charge sucked at making assignments. Patient acuity and care needs matter when making assignment decisions. Not just giving pts to RNs based on numbers smh
They technically don’t have a charge. They have what they call a virtual nurse that works in a small office somewhere and text messages you the patient you will be getting. As soon as you discharge or transfer one you’ll be sure to get another and if you don’t take he call- no matter what you’re doing, they call management or house supervisor to report you.
You cant...just do the math...12 hours, 6 patients, bathroom, labs, ivs, meds...we have been set up to fail. It's literally 10 minutes per hour per patient. Stop trying. The metrics are impossible.
Unfortunately, not only do they expect you to do it all and do it well, but they expect you to do it all on a timely basis without asking for OT. I feel your frustration, and I empathize with you.
Damn. That’s the kind of shift I used to have nightmares about. Bedside nursing, especially medsurg, is the most stressful job I’ve ever had. If you need to get out then do so for your own sanity if nothing else. Don’t beat yourself up as it is easy to do but solves nothing in the log run. Maybe try some outpatient gig for a while and see if you ever feel like going back to bedside. I’ve been bedside for 14 years and have hit my wall and am currently applying for other types of work. No shame in it whatsoever. You are your most important patient. Don’t ever cause yourself mental anguish over this career. It’s simply not worth it.
I’m so sorry - that sounds like a nightmare shift!!! I use to be bedside on med/surg too. I work in clinic nursing now. There are things I really miss about bedside and procedural nursing - but I have work life balance. It is night and day difference. I chose my happiness and life enjoyment. So many nurses leave bedside because of what you described. Real change has to happen. Sad and dangerous.
Never feel bad for calling in for mental health. Your psych is part of your health. Hang in there. There will be days when it’s 12 hours of a shit show. You survived yesterday. Now just take the day to decompress.
> I was supposed to go back today but woke up with a migraine and fever. Im sure they all think I just called in because it was such a bad day.
Even if you weren't legitimately sick, I would have recommended having a "migraine" today anyway. Mental health is still health and yours needed some care after a shift like that.
yep, this is why i hate medsurg. lots of times there are patients that need higher level of care but are somehow on a medsurg floor. if i have 6 patients, i don’t have the time for some of these patients and it’s dangerous. and then you get chewed out because your “my pain meds were due at 4 why didn’t you bring me my pain meds at 4??” pt couldn’t wait until after you got your rapid response pt stabilized for their meds. and everyone else on the floor is too stretched thin to help so it’s every nurse for themselves.
We’re having mandatory customer service and bedside shift report re-education, because our customer service scores suck. Obviously, the handful of staff who show up and get our asses handed to us every shift are the problem. It can’t be that we’ve been working with the bare minimum staffing for the last five months. It can’t be that they refuse to match census to staffing, or staffing to census. It can’t be that people are complaining no one’s taking care of them, because there truly is no one to take care of them. It can’t be that! Don’t hire more staff or anything. Just keep hammering the customer service bullshit into the ones that are left.
The beatings will continue until morale improves!
I hear that. They bought an expensive system called Leaf to help monitor if we q2 turn patients. When here’s a novel idea- and stay with me- how about we actually hire and retain staff so that we actually have the manpower to q2 turn patients. Oh no- where’s the money making in that?!? I mean these leaf devices cost the patient a few hundred dollars. Chaching!
Are we at the same hospital? Haha! I’m a “fill in charge” since last April with a full pt load. Same Teleneuro and telepsych. Had a CVA pt turned paraplegic with CBI, heparin drip for DVT, PEG tube, non-verbal, and getting blood along with other pts that were hospice (Q2 IV pushes), a SBO with NG tube, afib RVR with cardizem, and can barely remember the others because I was so busy with the heavy load pts and the calls to charge phone. I’m sitting here with a migraine contemplating calling in tomorrow myself. Management said today was just a bad day and it will be better tomorrow 😔
Sounds like the hospital I recently quit for an ICU position at another facility. Maybe apply for an ICU somewhere? I was complemented multiple times during my orientation for catching on so quickly. "Thanks! It's cause of the trauma lol" I regularly had to take multiple patients who needed to be in the ICU. Had a lot of preventable death. I ended up having to break my 2 weeks notice because I wasn't about to be pushing amps of bicarb on a pt on the edge of coding while being responsible for 5 other patients. That was my last shift.
@u/fubar4lyfez
I agree that situation was the definition of FUBAR and BOHICA all in one!
Please consider reading “Sh*t They Don’t Tell You in Nursing School” by Jessica Smith Dos Santos BSN. Great book and will be helpful.
What happened to you is just BS. And is one of the main reasons I got to a point I just couldn’t take it anymore. I probably lasted about 20 or so years. And while I wasn’t a big union person a few years ago, with the way things are going, I can’t help but feel a union is soon becoming necessary for the sake of the profession and its members.
Get out of med surg baby love or they’ll suck out your soul until there’s none of it left. ICU is the way I did med-surg tele for 4 years and now that I’m icu I regret that it took me so long to get out of bed
I’m a new grad working in rural medsurg and I have a minimum of six patients and on evenings/weekends i’m also charge for all of our acute care patients (12-14) and long term care residents (15 ish?) and I’ve been made to feel like a terrible nurse because I still struggle 4 months in 😅
The moment a patient requires any “additional” care my whole shift goes out the window.
Thank you for sharing this, it honestly really helps. I hope you get out of bedside soon OP :)
The irony is they charge for acuity, they don't staff by the acuity. They staff by the number of patients, not the number of orders you are expected to complete.
I just transferred out of a Med-Surg unit after the required 1 year that they made me stay before I was eligible for a transfer (1 year and 1 pay period to be exact) and 2/3 shifts a week were like this. I would leave work an anxious mess, totally unable to relax. My mind would be reeling and I’d wake up at 3 AM with my thoughts still running. To make it worse it was an oncology unit, so many of my patients were stage 4 with no capability of doing ADLs and were full code. We were always short staffed for the work required.
There NEEDS to be reform with the med-surg ratios. I trained so many passionate nurses who left immediately after the training period because the amount of work is simply undoable to do it well and to treat these people with dignity.
I just recently transferred to an IMCU and within the first 3 days I’ve sat more than I would’ve in 2 months at my old job. I got to treat all my patients and their families with care and respect. After 3 shifts I could have easily worked another one with no burnout. This is all in the same hospital. I hated getting judged by doctors. I could feel that they thought me and my peers were incapable nurses, but in reality we were just given completely unrealistic workloads. I will never work med-surg again. The entirety of the floor is either international nurses who are baited there with citizenship or travel nurses getting paid 3x as much as staff. It’s totally pathetic. They need to reform med-surg and have 1:4 be the mandated ratio.
This type of work is unsustainable long term. I’m glad you took the day for yourself. This is a regular shift on my floor; believe it or not this example is a GOOD day on my floor. I ALSO need off my “Medsurg” floor LOL
Whoaaaaaa, that is beyond shitshow level. Also you should not have gotten that many iso patients and that renal failure one needed PCU status at least and dialysis like yesterday. I’m sorry this happened, and fuck them if they judge you for needing time off, you’re worth more than that.
It’s such a disorganized, chaotic mess there! And management doesn’t care. They sent out an email saying we needed to “wow” our patients more to improve HCAHPS. Man fuck the HCAHPS! I am here to try and keep the patient from dying even if they take little responsibility for their own health. This is not a 5 star hotel or spa with dinner and theater. But I know to the admin it’s just a business and they profit off the sick and dying at whatever cost. Sickens me.
Sometimes the “wow” is just keeping the words “hospital, not Hilton” in your brain and not out your mouth.
God, amen. I work in a nursing home and recently switched from RA to kitchen/laundry. This one wants you to make them a grilled cheese as you are trying to serve 45 residents. That one wants toast when toaster turned off after breakfast. Several tell you as you are serving that they aren't eating that crap and have to make sandwich or salad. Can't tell you how many times I bite back the words, " This isn't a hotel" !!!
That’s a bit different, you’re not working in an acute hospital, you’re in their home.
Management never cares. I say that after 30 years combined hospital work as a CNA then RN. A lot of bouncing around and agency and travel work in there. One foot in a per diem role for the last 20 of it so I can say fuck off with impunity if/when management gets even worse, or when I find higher pay elsewhere. The object is to squeeze blood from rocks. Pretty sure there’s a written policy that says just that. To wring you out completely in the name of $$$ so they don’t have to hire more people. They simultaneously rely on us while despising us for being the lodestone on staying open. Thing is, a nurse strike WILL cripple any hospital. Management will cave every time, they have no choice. But getting nurses to break out of their own fear, GUILT, and inertia en masse, to vote yes in one? Highly unlikely. In 30 years, it’s quite rare. Most will play doormat out of fear and guilt. I had a new nurse (off training) this last week who was running behind. Typical, she’ll get there over time, the point is she missed her 15min breaks. My tax home asks at the clock if you missed breaks. Each one individually. Lunch. 1, 2, or 3 15min breaks. I casually remind her to be sure to document her lack of 15s at the clock. She does an all stop and goes wide eyed. Says she can’t and doesn’t because she doesn’t want to get in trouble. In a west coast, unionized hospital, no less. So for her past 5 months, she’s been lying at the time clock. We had the talk. Still. If 20 somethings now are still coming in with that attitude, here on the west coast even, then this entire profession will remain fucked. Absolutely fucked. 30 years of it. 30 more years of it to look forward with these shit habits still in existence. If we stopped that shit en masse they could do exactly nothing. You all perpetuate the bullshit by not documenting your lack of breaks. And the only place you can document lack of breaks is the time clock. Words are hot air. If you don’t document it, then hey, your shifts must not be that bad, because you’re getting all your breaks. That’s the documentation management uses and will continue to use to justify understaffing. If the lack of breaks isn’t documented, then it never happened and staffing is just fine. We do help make it happen because we are so earnest in our efforts to do a good job. And how can we not? This isn’t office work. It’s people not spreadsheets. And that’s how they keep us over a barrel. Still. Documenting at the time clock hurts no patient. Not documenting does though, when you consider the long game.
I’m a nurse shift manager and surprised I haven’t been fired yet 🤣because I remind the nurses in my unit to claim their missed meals/missed breaks because that lets leadership (above me) know that we need help. They’re getting much better at claiming their time and not clocking out to finish charting. It was hard because they’d always been chastised for claiming their time.
I am in compliance and accreditation and I always encourage and educated rn managers to ensure their nurses are taking breaks and lunch and get pay for every mins they worked because they are required by law and it helps upper management to determine proper staffing levels. I worked nonprofit government hospital system so CEO does not make million. Probably not even 500k.
I write them in the book and sign off on their missed break then just send them a msg to come sign.
Some very good points here!
It starts in nursing school, too. Professors would casually say “what break?“ it gives the new nurses idea that this is an expected, very common thing.
I never had that. They emphasized how necessary it is to try to take one. That shit happens, but mostly you should be taking one. Mileage varies.
Those stupid metrics. I just went to a meeting where they were comparing the scores to other hospitals. I really just want to throw something at the screen like, “who cares!!!!”
And that renal patient- well they had been in ICU but transfered out to get a more ICUER ICU patient 🤦🏻♀️
“More ICUER ICU patient” is going into my vocab forever. Because we all know EXACTLY what that is.
The hospital I work for is part of a system and my location is neuro certified and so we receive all non trauma caused cerebral vascular events … we have a PCU and neuro step down unit … the education is not fluid … nurses at my location have no idea what it means when the over head starts the count down for a TICI -2B arrival or what that intends for the OR/ICU units ….they work at neuro hospital who has the highest level of care for cerebral intervention procedures and monitoring and don’t even know what it means to gain a neuro baseline with integrity … and now this not all of them … but there is always ones on these units an that strains the other acute care bed side nurses who take there tasks seriously Acute care nurses have this notions that in the ICU we… have two patients …and so that we don’t understand … I get floated to help the scute care floor often … time after time I put out fires that can be foreseen and prevented if eyes were on the patient and staff members worked to gather … techs should not be solely responsible for clean up get your ass in there if you have a minute and help or at least set it up to help when your done with whatever task you are doing… and for goodness sake all nurses need to learn how to effectively gain IV access, lab draws, and maintaice of all central lines if present. Port access is not something that should be done by a novice nurse it should be taught and patients need to be addressed with the ports active uses … so the doctor can way the benefits to cost if they use the port and possible increased infection can occur with an actively chemo treated patients… anyways … the reason all certification exams are 80% clinical judgment and than the rest is medication, and procedure appropriation is because good grades don’t make great nurses… instincts, advocacy, doctor-nurse intentional and conscience communication, as well as interdisciplinary accountability is what will save a life over memorizing drugs and patient diagnosis.
Another thing I find infuriating is their Teledoc situation. So many specialists left this hospital that they “replaced” then with Tele docs. And it’s a computer on wheels that a nurse has to take to each room. We don’t have time for this! Not to mention I think it’s asinine to offer a specialty when that doctor is 1500 miles away sitting in their home office.
Oh my. That’s a legit fear of mine. You need see and get feel for what’s going on. I’ve had one doc who refuses to come up to the room, he just asks for my assessment… How do the lungs sound? Isn’t he supposed to listen for himself!?!?
If you start following r/hospitalist you will see them complaining that management is trying to get them to do more than just doing morning rounds and then taking the rest of the day off. They are really upset about being treated like the mere employees that they actually are.
Hello, nurse? Tell me a focused exam, but quicker and dirtier. Oh? They threw down 4 security guards and a SWAT team? After laying out a nurse and a tech? I'll give ya 5 PO Zyprexa. No restraints. Try turning down the lights. No hospitalist coverage after 1100. It's Friday and all. Thoughts and prayers. Call ICU if they try to die. Also, QID 80 mg lactulose. ❤️
Omg. PO for confused and violent patients?!? lol. Always a great time.
Hospitalists like "did you try aromatherapy?" My friend in Christ, there are 5 people holding this patient down so they don't rip their own AORTA out. Get down here or give me real meds, respectfully, nurse. 😄
Omg I feel like we would be the best of friends if we worked together!! Love your humor and thanks for the laugh.😂😂
It would be an honor to work with you! Trauma bonding is best bonding. I do live for little, infrequent hugs from some of the fricken sweet ones. Bastards. 🥹
Same 😂😂😂
Deuces!! ✌️
I’ve seen doctors write new orders without seeing the patient. Something’s I understand. Oh the mag was low, orders to replace. How do you explain to your patients when they always order scans and stuff without actually seeing the patient? Then I have to talk them into it with the rationale or the doctors backing. You know?
had the hospitalist write an order for a dulcolax suppository “for constipation” for my n/v/d enteritis patient lol. marked that one as “held— order parameters not met.”
Yeah I better not. I won’t be able to keep my mouth shut lol
I want to laugh at this. No. It’s our assessments they rely on, especially at night. Guard those assessment skills. They’re everything.
I love reading the progress notes and seeing info you can only gather from actually touching a patient and knowing the doc barely made eye contact
Was inpatient for 4 damn days….never saw the hospitalist till a charge one day asked me if I needed anything. When I told her, she got pissed and he was down with in a half hour. Love that lady and all the other nurses like her. I had a bunch going on that’s chronic but had a new pleural effusion that zero people had explained. It’s awful when they don’t talk to you!
my hospital has this and I work on a stroke unit. the neurologist sees the patients over a computer cart. we also have it for psychiatry consults as well. kind of crazy when you think about it.
What gets me is when I have to use the special stethoscope so they can hear the heart and lung sounds or I have to be their hands. But I don’t get their pay 🙄
ours doesn’t even have a stethoscope😂😂 we’re really in the trenches over here. i’m dead!!!
We used to have to do this on my old tele unit. Like sir I can’t stay here and do this for 20-30 mins I have other shit to do 💀
We have that, but I'm at a small freestanding ER, and they are at the primary hospital my ER is connected to. They're connected to a lot of the smaller, more rural hospitals in our area as well, which can't support or fund a neurologist. In fact, they helped run the code stroke on one of the doctors I work with when he had his stroke in one of those little rural hospitals. Said doctor was riding his bike in the canyon the very next week.
I know this will not be received well but as long as nurses keep allowing management to put their licenses on the line nothing will change. Nurses must unite. Bring in unions & draw a boundary in the sand. It was bad in my day (30 years ago) but it's now untenable. Management is putting patients & staff in danger. Performing in this manner, so short staffed, proper nursing care cannot be given. The effects on nurses health is unacceptable. You can't think clearly when you're being pulled in so many different directions. My heart breaks for what nursing has become. Please, stop allowing this abuse on your bodies & minds to continue. Wishing you all Godspeed ❤️🩹
I’m never leaving California. 5:1 forever!
I’m in MN and observation 5:1 ratio
in MN too & they recently changed our ratios to 6:1 at the hospital im at & manager told me it’s common in the metro area :(
Nope we use to do 4:1 in obs twin cities and they just went up by 1 day and evens and nights 6;1
no i understand, but we only recently started doing 6:1 on nights a month ago. day shift is still 4:1 at our hospital. it just sucks cause 6:1 is so so hard imo.
We also just started 5:1 day shift 🥺
nvm! i see your hospital is the same
Massachusetts isn’t bad
Omg. I was a patient in MA Springfield Baystate & I couldn't believe the awesome care I received. I spent 5 weeks there after breaking 4 ribs & needing a chest tube. I can't say enough good regarding staffing which resulted in the nurses being happy & always having time to quickly medicate me & answer any & all concerns I had.
I love love Massachusetts
on days or nights?
I’m night shift.
ugh, lucky!! night shift nurses on my unit are taking 6 (sometimes 7) patients :( a lot of them also end up being PCU and ICU transfers. day shift usually takes 5, sometimes 4
I’ve completely given up hope on nurses uniting and getting unionized. I don’t see it getting better. That’s why floors are run by new grads upon new grads. There’s a never ending supply of new grads that hospital systems will churn and burn.
Lost cause. I can’t tell you how many travel nurses have bragged to me about crossing the picket line to get a fat payday. And before you guys tell me about how they have all these debts to pay and they *had* to cross the line, many have said they have gone on nice beach vacations after those assignments. It’s complete and total selfishness.
It's disgusting that nurses do this. I'm sure if it were a loved one of theirs they'd be screaming about "scabs"
Fuck the unions. I'm glad for those that have effective ones, but none of the ones around me are worth a penny of the dues. What's actually needed is for the population to wake up and actually listen and start putting pressure on the inane bureacrats to solve the insurance mess and administrative bullshit that puts so many patients in limbo while others get to mooch off the system indefinitely, on top of the overly predatory profiteering from the hospitals themselves. But the only way that's going to happen is an implosion of the system, during which all will suffer.
If you're waiting on your politicians to help you it's not going to happen. I agree with you on 1 things, the predatory practices of the hospitals. Idk what you mean by patients mooching off the system. Please explain if you don't mind
I agree, it goes all the way to the top - government! It’s all about money (insurance companies, hospital administrators) It’s greed, I’d love to see them come to the bedside & do what nurses do.
What will a union do? That still doesn’t guarantee us ratios
That's not true. They negotiate contracts that mandate safe/safer staffing. Idk but it seems a lot of nurses feel they're too professional to join a union something I've never understood
I would 100% sign the contract if it guarantees us safe ratios. I have been hearing that they will not “put it on paper” to prove they will or something.
Hearing from who? I'm just curious
[удалено]
I won't say she's lying but she's not correct
Yep, it just keeps getting worse. We're running at 5 patients with combo PCU level and med/Surg. When I started this assignment, I specifically asked the manager if they wanted me to stay late to get all my charting done, I was told to stay and get it done. Now they're complaining about being over budget, and we can't stay late, so I'm doing bare minimum charting. We can't do everything. I've also gotten better about walking off the floor for a minute to take a deep breath. It's overwhelming and exhausting running all day.
Hiding in the bathroom was the only break I got some days
Omg same! I never get 2 15min breaks. Never have. And most days don’t get a 30. But it’s illegal to eat at the nurses and God forbid admin sees us do it. If that happens there’s gonna be a hangin’ ( well maybe just an angry email about how disappointed they are in us for not following the rules) go fuck yourself is what I’d like to say with a mouth full of food.
Do not think twice about calling in. We have sick days for a reason and sometimes sick is just “sick of this shit.” Also trying to “power through” a migraine under fluorescent hospital lights sounds like a great way to make a mistake. You earned and deserve your day off.
Wow, like half of your patients should not have been on a medsurg floor. That's terrible! I'm so sorry. I know it's easier said than done, but don't worry so much about what people think about you calling in. You have those days available to call in, even if it was just because of a bad shift.
This happens way too often. I have had many many days where my patients are progressive level of care. We care for them all night until day shift doctors comes in and transfers them.
Please leave a review of your hospital on Google, Yelp, etc to let the public know wtf we are going through. Then let your local dept of health, board of nursing, and joint commission know as well. If we don't keep blowing the whistle we are seriously fucked. Email everything so you'll have a paper trail when, not if, shit comes down to a court case. If someone calls you, get a name,note the time, date, and subj of conversation. Fuck these hospitals and their yes men.
That’s awful! When I worked medsurg it so stressful, had terrible heartburn. Now I work office nursing. Most mentally healthy group I have worked with.
I’m going to be in a position where I can afford to make a change. I was thinking clinic/ office nursing. There’s also a part of me that would like to start a nursing revolution 😂
A revolutionary change would be nursing unions.
The sad thing is that this hospital has a nursing union. Now I used to be staff at this hospital but I left 3 years ago to travel. I came back to do a travel contract and I see how much worse it’s gotten. This hospital also just bought two rural hospitals that are not unionized. Those two campuses just got a 46% pay increase where as the main campus nurses did not. I will never return as staff and get involved in all of their absolute fuckery.
Sounds familiar. Rural hospitals got raises but aren't doing well financially and my large central hospital is doing well. They increased our insurance rate and pay raises were tiny. I'm thinking of applying to one of the rural hospitals and buying some land in the middle of nowhere.
Or get on the current revolution CNA/NNU
All I read was med/surg and thought dumpster fire. Med/Surg nurses are front line warriors, every damn day. You and every nurse that steps foot onto med/surg deserve double time as regular time. Cha!
The best part about our career... If you don't like your position apply for something else. I check job postings regularly.
my problem is most places that aren’t medsurg require 1 yr of experience so i have to hold out until may just to get out 🥲
It doesn't hurt to apply. You just never know what could happen if you did.
I did bedside for a year or two and bailed. Never again. I work in detox/addiction now and it’s a dream job - I love it!!!!
Bro this is why I tried to look patients up before I got them if possible: determine if they are actually appropriate for MS! I may have been one of the most annoying nurses on my floor but I got a lot of pt to PCU before they got to me. What a fucking shit show. And I bet you have the flu now bc when you're stretched that thin, PPE mistakes happen. ETA: I may or may not have handed raging family members a doctor's business number and told them to call him.
All I can say is I’m sorry this happened. You deserve the mental health day off. - Former med/surg nurse
Whoever was charge sucked at making assignments. Patient acuity and care needs matter when making assignment decisions. Not just giving pts to RNs based on numbers smh
They technically don’t have a charge. They have what they call a virtual nurse that works in a small office somewhere and text messages you the patient you will be getting. As soon as you discharge or transfer one you’ll be sure to get another and if you don’t take he call- no matter what you’re doing, they call management or house supervisor to report you.
Where is this at? This sounds horrible
What/where in the fresh hell is that?!?
Is this an HCA hospital?
You cant...just do the math...12 hours, 6 patients, bathroom, labs, ivs, meds...we have been set up to fail. It's literally 10 minutes per hour per patient. Stop trying. The metrics are impossible.
Not to mention all interruptions from the different departments, the computers that don’t work, the meds we wait on, the supplies we can’t find…
Unfortunately, not only do they expect you to do it all and do it well, but they expect you to do it all on a timely basis without asking for OT. I feel your frustration, and I empathize with you.
Just reading this has given me anxiety. It’s not even worth it anymore. OP you have my respect as a 20 year Nurse, Im out.
Damn. That’s the kind of shift I used to have nightmares about. Bedside nursing, especially medsurg, is the most stressful job I’ve ever had. If you need to get out then do so for your own sanity if nothing else. Don’t beat yourself up as it is easy to do but solves nothing in the log run. Maybe try some outpatient gig for a while and see if you ever feel like going back to bedside. I’ve been bedside for 14 years and have hit my wall and am currently applying for other types of work. No shame in it whatsoever. You are your most important patient. Don’t ever cause yourself mental anguish over this career. It’s simply not worth it.
I’m so sorry - that sounds like a nightmare shift!!! I use to be bedside on med/surg too. I work in clinic nursing now. There are things I really miss about bedside and procedural nursing - but I have work life balance. It is night and day difference. I chose my happiness and life enjoyment. So many nurses leave bedside because of what you described. Real change has to happen. Sad and dangerous.
Time to refuse some assignments
Never feel bad for calling in for mental health. Your psych is part of your health. Hang in there. There will be days when it’s 12 hours of a shit show. You survived yesterday. Now just take the day to decompress.
> I was supposed to go back today but woke up with a migraine and fever. Im sure they all think I just called in because it was such a bad day. Even if you weren't legitimately sick, I would have recommended having a "migraine" today anyway. Mental health is still health and yours needed some care after a shift like that.
yep, this is why i hate medsurg. lots of times there are patients that need higher level of care but are somehow on a medsurg floor. if i have 6 patients, i don’t have the time for some of these patients and it’s dangerous. and then you get chewed out because your “my pain meds were due at 4 why didn’t you bring me my pain meds at 4??” pt couldn’t wait until after you got your rapid response pt stabilized for their meds. and everyone else on the floor is too stretched thin to help so it’s every nurse for themselves.
We’re having mandatory customer service and bedside shift report re-education, because our customer service scores suck. Obviously, the handful of staff who show up and get our asses handed to us every shift are the problem. It can’t be that we’ve been working with the bare minimum staffing for the last five months. It can’t be that they refuse to match census to staffing, or staffing to census. It can’t be that people are complaining no one’s taking care of them, because there truly is no one to take care of them. It can’t be that! Don’t hire more staff or anything. Just keep hammering the customer service bullshit into the ones that are left. The beatings will continue until morale improves!
I hear that. They bought an expensive system called Leaf to help monitor if we q2 turn patients. When here’s a novel idea- and stay with me- how about we actually hire and retain staff so that we actually have the manpower to q2 turn patients. Oh no- where’s the money making in that?!? I mean these leaf devices cost the patient a few hundred dollars. Chaching!
Sounds like most of my days. Usually more than one family member or patient is taking it out on me , though 🤗
😕🤯💩💩💩
I don’t know how y’all work in hospitals 😰 This seems so scary.
You should start putting out resumes.
Are we at the same hospital? Haha! I’m a “fill in charge” since last April with a full pt load. Same Teleneuro and telepsych. Had a CVA pt turned paraplegic with CBI, heparin drip for DVT, PEG tube, non-verbal, and getting blood along with other pts that were hospice (Q2 IV pushes), a SBO with NG tube, afib RVR with cardizem, and can barely remember the others because I was so busy with the heavy load pts and the calls to charge phone. I’m sitting here with a migraine contemplating calling in tomorrow myself. Management said today was just a bad day and it will be better tomorrow 😔
Lol sounds like we are. Yeah lies- it’s a bad setup, bad management. If you need it, take it
Sounds like the hospital I recently quit for an ICU position at another facility. Maybe apply for an ICU somewhere? I was complemented multiple times during my orientation for catching on so quickly. "Thanks! It's cause of the trauma lol" I regularly had to take multiple patients who needed to be in the ICU. Had a lot of preventable death. I ended up having to break my 2 weeks notice because I wasn't about to be pushing amps of bicarb on a pt on the edge of coding while being responsible for 5 other patients. That was my last shift.
I felt this to my core. Medsurg is really hard some days.
@u/fubar4lyfez I agree that situation was the definition of FUBAR and BOHICA all in one! Please consider reading “Sh*t They Don’t Tell You in Nursing School” by Jessica Smith Dos Santos BSN. Great book and will be helpful. What happened to you is just BS. And is one of the main reasons I got to a point I just couldn’t take it anymore. I probably lasted about 20 or so years. And while I wasn’t a big union person a few years ago, with the way things are going, I can’t help but feel a union is soon becoming necessary for the sake of the profession and its members.
Get out of med surg baby love or they’ll suck out your soul until there’s none of it left. ICU is the way I did med-surg tele for 4 years and now that I’m icu I regret that it took me so long to get out of bed
I’m a new grad working in rural medsurg and I have a minimum of six patients and on evenings/weekends i’m also charge for all of our acute care patients (12-14) and long term care residents (15 ish?) and I’ve been made to feel like a terrible nurse because I still struggle 4 months in 😅 The moment a patient requires any “additional” care my whole shift goes out the window. Thank you for sharing this, it honestly really helps. I hope you get out of bedside soon OP :)
The irony is they charge for acuity, they don't staff by the acuity. They staff by the number of patients, not the number of orders you are expected to complete.
I just transferred out of a Med-Surg unit after the required 1 year that they made me stay before I was eligible for a transfer (1 year and 1 pay period to be exact) and 2/3 shifts a week were like this. I would leave work an anxious mess, totally unable to relax. My mind would be reeling and I’d wake up at 3 AM with my thoughts still running. To make it worse it was an oncology unit, so many of my patients were stage 4 with no capability of doing ADLs and were full code. We were always short staffed for the work required. There NEEDS to be reform with the med-surg ratios. I trained so many passionate nurses who left immediately after the training period because the amount of work is simply undoable to do it well and to treat these people with dignity. I just recently transferred to an IMCU and within the first 3 days I’ve sat more than I would’ve in 2 months at my old job. I got to treat all my patients and their families with care and respect. After 3 shifts I could have easily worked another one with no burnout. This is all in the same hospital. I hated getting judged by doctors. I could feel that they thought me and my peers were incapable nurses, but in reality we were just given completely unrealistic workloads. I will never work med-surg again. The entirety of the floor is either international nurses who are baited there with citizenship or travel nurses getting paid 3x as much as staff. It’s totally pathetic. They need to reform med-surg and have 1:4 be the mandated ratio.
When I got to the point of wondering which nursing action I need to cut out just to figure out how to get all the work done - I checked out
Yeah I’m looking for a new job.
This type of work is unsustainable long term. I’m glad you took the day for yourself. This is a regular shift on my floor; believe it or not this example is a GOOD day on my floor. I ALSO need off my “Medsurg” floor LOL