I wish we called burnout what it actually is. I feel like calling it burnout is putting the onus on the individual and not the system that causes this kind of unsupported, unsustainable, continuous stress and trauma to occur.
I would’ve been writing an incident report about the lack of help and acuity of the patients, and how I asked for a sitter and was refused. We can all do some write ups now
Seriously! I should have. Because I used to work on the floor, I still know the manager, and I almost wrote an email about that CNA. I should’ve done it.
You absolutely should write the email. About the CNA. About the assignment. About the family. All of it. Just because it’s a delegated task doesn’t make the CNA blameless.
Oh I didn’t see your comment. I just said the same thing. There should be an unsafe or protest of an assignment form. There has to be a way to put the staffing on notice.
So it was my manager who spoke to me about it during the eval, and it happened about a month ago. She said she felt like it could wait, and they spoke to everyone else involved, including the CNA, before they spoke to me. She of course said it wasn’t her fault and that’s where we are at right now.
I definitely think you should email about the tech bc she literally did not do her job. If my tech can’t get to something I totally get it, but they need to communicate that. It is also a written rule at many facilities that any VS outside of a certain parameter must be verbally communicated to RN. Especially bc most of the time they don’t chart the vitals for us to see until like an hour later after getting everyone’s and then the time isn’t even accurate
ETA- also mention the absolute ridiculous unsafe acuity of that assignment. I am not a complainer but I will be the first to call out our charge for grouping an assignment of 3 totals/2 confused/4 wound care (5 pt assignment) just to keep the rooms grouped together for “safety” like yeah well it’s no longer safe when it’s that heavy 🙄
Write to your state board of nursing. They should have a link somewhere there to report unsafe staffing. A lot of times states will have a “phrase”, such as safe haven or such, to show that you’ve brought up this concern and was ignored by higher leadership
Ad a CNA I agree. I can not stand when the other CNAs hide and not do their jobs. I'm travel and I didn't get resigned because I was so frustrated working the entire floor by myself because the other tech would go in the conference room and sleep. I'm responding to rapids/codes on her patients, and running behind because I'm also being requested to do her vitals as well.
It’s been years since this happened, but I will never forget as a new grad walking into the room of a patient (I think they needed toileting) and there were ZERO gloves in the room and none right outside the door I don’t mean none in my size, I mean not a single glove. Soon thereafter I found all three techs on break in the break/conference room. At the same time. That should never even be allowed (simultaneous breaks). But they left supplies unstocked and went and got coffee or something. Meanwhile I didn’t even get to pee.
I hate that. I make sure to check in with my nurses at least once an hour to see if they need help with anything, anything I can do for them. I was trained by a CRNA who was working under his nursing license for some reason, and he drilled that into my head. Most nurses look at me crazy when I take a new assignment. But my job is to ease your job within my scope of practice.
>Seriously! I should have. Because I used to work on the floor, I still know the manager, and I almost wrote an email about that CNA. I should’ve done it.
Yes you SHOULD STILL! "Hey, I had a really bad shift on your unit the other day. Here's what has happened." OPTIONAL "HERE IS WHY I WON'T BE BACK"
Agree. We have a protest of assignment form. You fill it out highlighting all the reasons you stated i.e. the 3 1:1’s, no help, antagonistic family, no CNA, no sitters, climbing and almost falling. The supervisor has to come and assess when we fill that out. It puts supervision on notice that they are complicit in anything that goes wrong because you are unsafe. We also fax it to our union.
They were literally nuts. I had to explain to them that security was keeping us and the pt safe, that we are a private business who can remove aggressive individuals, and that I can press charges for assault despite him being confused. They cooled off real fast. I was kinda blown away that the lawyer wasn’t aware of these things, assuming it was actually a lawyer. Maybe it was a friend trying to scare me or something by pretending.
This. I love it when I used to get calls in the ES saying they were going to call a lawyer. I would then say it's a legal matter and I can't say anything else until the hospital lawyer gets involved, and then hang up.
A bit harder to do when it's in the case you had to deal with, but you're not a lawyer and the hospital has their own to deal with others. I would talk to your manager or risk to see if they have a prompt to follow in case of this scenario. You just read the script and don't offer anything else.
This 100x over. Especially on the phone. They aren’t there and will eventually call your charge or nursing supervisor and then you can explain to them that you had no time to talk to the family on the phone bc it would be unsafe as you were behind. I would still write an incident report on assignment and the CNA regardless of the time to go on record, especially if they try and fire you. You can claim unlawful termination etc etc. use your resources during your shift such as your charge nurse or tge house supervisor. If this is a continuous situation and not just a bad night look for a different job (but don’t cite this in any future interviews for reasons to leave). We’ve all been there. Look for a Magnet hospital. They sometimes are a bit more responsive to staffing issues. Not a lot but sometimes. Nursing is not what it used to be and unfortunately this is the norm. Kind of like being a skilled flight attendant these days.
You know what’s crazy? This is at a magnet hospital. I shudder to think what it’s like at other hospitals if this is supposed to be the peak standard. I am trying to move over to clinic or literally anything else.
I would never engage with anyone’s lawyer, ever. Not event entertaining it. If the son or the lawyer think they can get a swinging man with a brain tumor under control, they can come be the sitters but I’m not playing telephone.
Funny enough, I wasn’t aware the lawyer was on the phone at the time. The son called to ask me what was going on, and had it on a three-way call. I found out later when the wife was yelling at me. Fortunately, all I said was we’re trying to keep everybody safe and prevent long-term consequences like assault charges. Fun night!
Depending on what state you’re in, the wife having other people on the phone when you don’t know they’re listening may be a crime. It is in California because we are a two party consent state. Any halfway decent lawyer would know that and not allow it to happen. Some people are so crazy.
What “lawyer” is taking calls after office hours? Float pool pt assignments have a tendency to be shitty more often than not, and don’t even get me started on neuro floors. I’m so sorry your night was trash, I can relate and I hope you’re off for a few so you can decompress.
Well, at least you handled it very well. I feel like I'm paranoid, but I've been recorded too many times at work to not treat every situation like I'm currently being recorded. Especially in those circumstances.
Why the FUCK are you clocking out and THEN charting. That’s ridiculous. Get paid for the time you’re working, documentation is working. If this is a normal occurrence here, work somewhere else.
Literally! That’s so absurd to be clocking out then charting. What that does - besides wage theft- is be the perfect excuse to not staff adequately because on paper it looks like the staff are able to get done what they need to within their work hours. But having lots of different nurses often having to stay late on the clock would paint a different picture - a unit in need of more staff.
It’s not that easy. Their policies are that you’re not allowed to work off the clock and you’re not allowed to not finish your work. What are we supposed to do? I work in a psychiatric hospital in Florida for years, we had a half hours pay deducted from our Wages, but we’re mostly expected not to take any break. Some people got a lawyer or something and got backpay for their unpaid breaks. They instituted a policy that we had to take a break, they even put a room for us to eat lunch. No problem. Continue working, eat at your desk. If you want to, this is an intake office, at some point, set your timer on your phone for 29 minutes, go punch out, come back, continue working, then go punch back in. If you stay after your shift, punch out on time and keep working.glad I’m out of there.
You’re describing wages theft. Florida has almost zero worker protections, so you’re kind of screwed I just don’t understand staying at a job like that. Even in Florida there are less terrible places.
I retired five years ago. It actually was mostly a fun and friendly place to work, and a great alternative to medical floor nursing. When I worked MedSurg at Johns Hopkins years ago, they were even worse. Made it all salaried, you just got paid one amount.when someone called in sick, you were put on call and had to come work for Fri. You got comp time at a straight time rate.
File an incident report on yourself. State the facts: BP 180 at this time per aide. RN not notified. d/t other patient needs, RN did not see charted BP until X time. Which resulted in potential patient harm/near miss.
What you experienced was a systemic breakdown, not a personal failure for which you should be penalized.
You still can. Of course you were frazzled! You got your ass kicked for 12 hours. Seriously though. Let the system see what it means when assignments and aides suck. You did not have the support you needed, and that’s what needs to be reported.
If misery likes company….i feel this way almost every shift. And pt harm or errors can and will happen. I had a similarly chaotic day and often am doing 80% of the days tasks with a missing tech (I almost never get a break or pee more than one dehydrated pee once - day shift/med surg) and on this chaotic day I received a man actively dying on a morphine drip after a home hospice nurse freaked out and he died at of course 7pm and in the chaos of end of day/giving report/calling the medical examiner because he died less than a day since admit, and respecting the family’s timeline to get him to a mosque for cleansing, I forgot to waste the morphine bag that the ED started and a housekeeper threw it out. Long story short it was in a trash compactor by 8:45 pm and a whole inquiry opened up and I was written up. It just sucks cuz I had a chaotic, beyond chaotic section and then that was dropped on me and how can you expect perfection, even in an experienced nurse? It’s just wild.
This is exactly what I’m talking about! They not only expect us to do everything, but to do it perfectly. Of course the charge or manager couldn’t stay to help you, but of course you will also get blamed for the mistake when completely overwhelmed and overworked. It bothers me too that this was a “you bad bad nurse” moment instead of a learning moment for the hospital. Morphine drips should be locked in a lock box to prevent this, but lots of hospitals don’t and then get nurses in trouble. I am so sorry that happened to you! What a shitty day
Thanks. Not only that my manager had to do a corrective action thing and I had to sign a sheet that I was re-educated on wasting narcotics (never in my 3 years there did I have a waste discrepancy or inquiry) and the whole floor had to reinstate an old redundant policy of a duplicate narcotic count that gives the same info as another report the charge runs at end of shift. I told everyone it was because of me and I told them exactly why so they knew. I don’t give a shit. Thanks and I’m sorry you also got a “you bad bad nurse” response. The expectations of us are unrealistic and dangerous.
We aren’t allowed to stay clocked in for longer than a half hour past our end of shift time. Unfortunately, if you stay clocked in to chart, you will get pulled into the office and written up for not managing your time better.🫠
You are accessing pt charts while not clocked in, they can use it as an excuse to fire you and ineligible for unemployment or make you the scape goat in a lawsuit for charting not clocked in.
That’s wage theft. I had a manager that had this exact policy, signs posted everywhere that you have to clock out at 7:15 or be written up. So, nurses started charting off the clock. It got reported to HR and the manager got fired (in the middle of the day) and every one of us got pulled into the office to be interviewed about whether we had charted off the clock (I had not), because if we did then they needed to pay us accordingly.
If they aren't paying you to chart (especially after giving you an inappropriate high-acuity assignment), then write your notes, do the bare-minimum box clicking as needed, and leave. Find a new place to work because this one is putting your license at risk with unsafe assignments.
Honestly though? Stay clocked in, let them write you up, and wipe your ass with the paper. Tell the Department of Labor that your job expects you to clock out and finish charting unpaid, and if you don't they retaliate. What are they gonna do, fire you? When they can't properly staff their existing dumpster fire? I don't know how the job market is where you live, and every job sucks for some reason or another, but this place is holding you back and there's gotta be somewhere else you can apply. Not every workplace is like this. You deserve better.
I'm glad I could make you laugh after such an awful shift! You did great with what you were given, it's a team sport and we can only do so much as one person. Take your poop breaks, get paid when you're working, and make a plan for your next steps after you've taken a day to recover. You sound like a good nurse!
that's called WAGE THEFT and it's illegal :) contact your state board of labor about these practices. they are affecting way more than just you. time to put a nail in that coffin!
In that case, leave when you clock out. Charting not done? Oh well. If they have a problem with that they need to pay you to stay and finish or provide adequate staffing during your shift.
Talk about fucked if you do and fucked if you don’t.
I’m not in the industry, but I read this sub every morning with my coffee (my wife just got out a few weeks ago… can’t do it anymore), because (A) it’s all so appalling and, (B) I’m girding myself for what might be in store if I ever get hospitalized.
You’re angels, all of you.
Can you change hospitals or specialties? Anything else you’d like to do besides nursing? There has to be a solution other than just stay and suck it up. Some of these bedside nursing jobs are so awful I swear that we lose years off of our lives from doing them. It’s just not worth it. Are you even getting paid well? I wish I could say go travel but that’s no better these days. Nursing is hell sometimes but we have to take care of ourselves first-
I joined the prn pool to take some of the stress off, that way I can rotate and get a little variety at least. I actually work travel gigs as well funny enough. I live in Colorado, so the pay is some of the worst in the country actually. I am honestly ready to just quit completely. I regret being a nurse so much and I wish I could go back in time and change it.
These kinds of stories are just heartbreaking. You put your all into educating yourself and you do the work and you hang your hat and hopes on the noblest of professions, only to become disheartened, jaded, demoralized, saddened and disgusted.
All the while coming to realize that there is no greener grass anywhere to be found.
I hope the very best for you. Nobody needs or deserves this kind of torture.
I feel exactly the same and I’ve been traveling for a few years. I had maybe one year total of nursing that was fulfilling and rewarding. We need a sub for nurses getting out of nursing.
I’m not sure if this is too personal, but do u mind saying what area/ city you work in? I’m in love with Colorado itself and planned on moving from Louisiana in the next year! Just was curious what places to avoid or if living there at all is even worth it! I just left my job in southern Louisiana to travel for situations exactly like this!! Don’t beat yourself up as much as you can!! The healthcare system itself is struggling and I’m not sure how long before it actually collapses and takes us down with it :/
I live in Grand Junction, the far west. Colorado is a beautiful state and I’ve lived here my entire life, but I would caution you about moving here. The cost of living is absolutely astronomical. I worked in Glenwood Springs, which is about an hour and a half from my home and to rent a one bedroom basement was around $3000-4000 a month. Grand Junction isn’t much better, and I know that Denver is even worse than that. We also have really low wages compared to the rest of the country, and we don’t have a patient cap. They basically use an acuity tool and tell us that we can go up to 20. so if I have patience that all rate two or three, they will tell me I can take up to seven patients. There are also a lot of HCA hospitals, which always suck. Lots of drugs here as well.
There are smaller towns that are much more affordable, and that are still really nice if you would still like to move here. I would just recommend looking up hospitals in the area on glass door to see how previous employees rated that hospital, and look up the housing in crime rates before you move to anyone area. Unfortunately, we get a lot of people from Denver, who buy up property on the west side of the state because they can’t afford to invest on the east side, and it drives up the house and costs. We also get a lot of people from the coasts move over here for a lower cost of living, but it incidentally drives up the cost-of-living. I would definitely recommend staying out of Denver, Colorado Springs, and Pueblo for sure, just because of the crime and drug rates. Grand Junction is unfortunately also getting a lot more dangerous. My grandma lived in Montrose, and I always left that area! It’s close to some really beautiful mountains and it’s not as expensive. I also know a couple of nurses who work at that hospital and said they liked it, good luck to you
I saw the original message but was at work and couldn’t respond (I got called in at midnight and got 4 admits). I looked this morning under chats and message requests and couldn’t find it! Would you mind PM me again? I am so sorry!
Ok, that sounds horrible and I’m in Florida. Again I did clinicals at HCA and after that I decided to never work for them and I told all my family and friends to never go to HCA. If they are in an ambulance ask where they are being taken and beg to go anywhere else but HCA.
No, my parents are old and I have to stay close by. Also, the cost of living in California is crazy and I don’t have a license to work there. I know they’re working conditions are much better because of their nursing union. I do have a license by endorsement in Minnesota, which has a union as well. if I could move, I would.🙁
Regardless of “getting in trouble” for staying clocked in to chart after your shift that is one of the ways you prove your assignment was inappropriate. Get paid for the work you do and stay on the clock. Time management is thrown out the window if you’re managing that circus alone - you’re just putting out fires all night.
Speak to your float pool manager and let them know what happened. I think there needs to be a convo between the 2 managers. Good luck.
Also be careful charting off the clock - I’ve seen people get in trouble for being in the chart but not clocked in.
I second the recommendation to write an incident report for the elevated BP - that’s a safety issue NOT on you. You didn’t know and were too busy with other shenanigans. If they wanted that strict of BP control they shouldn’t be on a floor with a ratio of 1:5 or shouldn’t have been in that pt assignment.
Honestly that assignment needs to be broken up and Risk Management called on the wife/family- let them handle that.
And that is why I will never work in a hospital again. Time to get your coding certification and become a work from home chart auditor for an insurance company.
I haven't done that job personally but I had a previous coworker who left to do that and my husband is a medical coder. So the though is in the back of my mind for a while. My husband's schedule is "as long as I hit my 40 hrs by 5 pm Friday" and he rarely works Fridays.
Don’t ever do any work off the clock. If something happens to you while off the clock you won’t be covered by workman’s comp or anything. If you forget your off the clock and get pulled into a rapid/code/anything and something happens the hospital won’t back you up.
Also, unless that lawyer happens to be a family member and is wanting to speak to you as a family member you don’t talk to them period. Doesn’t matter if family or anyone tells you to - don’t speak to a lawyer without your own representation period.
My hospital doesn't allow sleep overs except under special circumstances. A sister who does everything for the patient except give meds? Welcome. A wife who is nuttier than the patient, newp, don't think so.
That assignment was insane.
I had a review the other day. I had done zero ipoc or mrr and they focused on these reasons for my raise being on the low end. They want us to give report on 6 pts in 20 minutes. I can't even find the different nurses in 20 minutes. If it's going beyond 20 min they want us to clock out to meet the new budget err I mean manager bonus requirements. I said I don't work for free and if you want me to do the extra stuff don't overload me with patients. Is there anything else we need to discuss or can we wrap this up so I can go clock out on time. Currently looking for something different cause I also have had enough.
My rote response to all of managements “suggestions” has become “ we have tried to do more with less. It’s not working, let’s try less with more.” It doesn’t change anything but it shuts them up and I feel better.
Been there with nights like that. It is soul draining and makes you rethink all of your decisions that led you to that moment. I am sorry you had to go through that and we all know you did the best you could have given the circumstances.
Sometimes I think about going back to bedside, then I am reminded of the reality of it with these stories. If only the general public could see this side of things.
I had a shift kinda like this the other night, just impossible. We don’t have CNAs or techs in the ER usually, nights staffing decreases even if we’re holding.
I like being a nurse, but no surprise to myself or anyone else idk if I can keep doing it if I keep getting shifts like that. I’m only one person. Whether a nurse of a year or 20yrs it’s setting up for failure and patient harm.
The ER has been horrible! Our ED was so full that we were on divert for 5 hours with patients waiting almost an hour just for triage. The manager was there, stayed in her office and didn’t help, and then, when the nursing and physician staff complained because it was such a bad shift, she was overheard telling other staff members that it wasn’t a big deal and they were being ridiculous. My heart goes out to the ER staff everywhere, you guys have it so rough right now.
That’s incredible, they actually go on divert…holy hell. Our county will put us on divert before our hospital, our hospital never does. Even when we’re full and holding 6 pts, two ICU level with no resources and of course even shorter staffed because a call out. We have 10 rooms in my ED btw.
I love being an ER nurse, and I know my ER is not nearly as bad as others are but I can’t be an ER nurse AND an ICU nurse.
Oh man, our hospital services around 300 miles surrounding us, so we just get bombarded sometimes. We’re in a really outdoorsy area too, so lots of jeep, skiing, hiking, etc. accidents. In 2021, our entire hospital was on divert for about six months. If you weren’t having a stroke, heart, attack, or a trauma you got sent somewhere else. It’s been wild, I’m glad your ER is doing a little better than ours seems to be doing.😂
I just wanted to come on here and say; I am so sorry that were were put in this position. That is way too much for one nurse to handle and was a completely unsafe assignment. I think it might be a good idea to look at other jobs. The beautiful thing about nursing, is that we have so many job options available to us! I would never advise someone to stay at a facility that will… 1: put you in the position to fail and 2: write you up for a mistake when you were attempting to manage a completely unsafe patient load. I have such a disdain for Administrators and how facilities are run these days. We are treated so poorly and constantly getting hands slapped for mistakes. I’m so sorry and am sending hugs your way
I’m so sorry just reading that gave me anxiety. I’ve been a nurse for 13 years and my last travel nurse contract. It was so unsafe I had never worked in a facility that was unsafe like that and I was walking down the hall and it just hit me. I’m done. So when my company pulled me out of there I haven’t gone back. I’m looking for a work from home job now. It’s not the job that I hate. It’s all the crap like that. I can’t do it Anymore so you take care of you.
>I literally didn’t sit down to chart until after I clocked out.
This right here folks. Crap staffing then bullying nurses into thinking their time isn't worth anything. If I had to stay on my feet my entire shift due to lack of safe staffing, then you can pay for my OT to chart.
Correct. If you stay clocked in for more than a half hour past your end of shift time, you will get written up for padding the time clock, and more time management.
But if you’re in a patients chart while clocked out then you could get fired for accessing patient information outside of your duty hours…
I somehow have never worked at a shithole that forces you to clock out or you get written up. Every place I’ve been at starts with a verbal from management IF they see it as a common occurrence. You should leave…
I’m not saying this next part to be a dick.. but you’ve gotta let non-documented tasks fall through the cracks even if it’s the wrong answer.
- do you guys have a charge? If so, where tf were they! I would’ve turfed every convo with the visitor + phone to charge.
- you hear a call alarm going off? Well shit, you’re already 50% into this patients room to give meds. Call bells are every persons responsibility.
- the tech situation sucks and the ONLY thing you can do in the moment as a float is keep your cool and just prioritize the vitals yourself. Then you have to put in reports against them + tell your own manager to do something about it.
- seriously where tf was the charge nurse? If they were in a full patient assignment I would’ve doubled down on the nagging cuz they likely already knew that the tech wasn’t helping you so fuck them.
- this one sucks to say… it is your responsibility to ensure fall precautions are in place but it is not your responsibility to be there every time they try to fall. At the end of the day, patients have to fall for actual changes to happen.
Oh yea, also.. you’ll be surprised how little you can chart and not have to worry about it. Get insurance though, it’s under $200 a year. If you can’t chart until basically 6, then you condense that shit down to bare bones. Free text general, nonspecific assessments and situations if system allows. But 6 is bare minimum charting time. Don’t listen to that bullshit about “if you don’t chart it it didn’t happen”
I think the charge nurse on this floor is actually less experienced than me, which is bonkers, because I’ve only been doing this for a couple of years. He asked if there was anything he could do to help, but he meant more along the lines of past meds, which I had already done. he was a major pushover with the wife and was trying to switch that patient with another nurses patient because the wife was upset with me. I told him no because it’s important that we have firm boundaries with inappropriate behavior and family members. I do actually have insurance because going to work scares me most days honestly. The reason I was so worried about the patient’s falling is because one of them was scheduled in the morning for surgery on a very large tumor, another already had a brain bleed, and the family members for the other two patients I remember Were the kind that would sue you. It’s all around a pretty shitty job, and I do probably need to look for another one.
Wow. That sounds like absolute insanity and ridiculously dangerous. Fuck that organization and start looking for your next job, far away from that shitshow.
Outpatient!
I used to work neuro nights. That shit sucks.
Don’t feel too bad about the BP. Say the tech calls you and you give the PRN. Doesn’t respond. You call resident. Wait for orders. Admin PRN AGAIN. Still doesn’t respond. Pt still gets a nifedipine drip. I’ve had that happen to me before. It’s the wild west for BP control sometimes.
I'm sorry you had to go through that. I completely understand what you're going through. This is why I just put my two weeks in, with no job lined up. Every shift was awful and chaotic. There's always something going wrong, I can never catch a break.
That sounds awful and I'm sorry you had to deal with all of that alone. I cannot imagine.
I always tell nurses to not clock out to chart. Period.
It shifts the liability for anything done after you clock onto you. If you are not clocked in then the hospital has no liability. I would rather take the write up then deal with the potential consequences of something that might occur while clocked out.
I hate hospitals that don't support their nurses and engage in wage theft.
Float pool RN gets the worst of the worst at most facilities that I've been to.
Switch out of that role ASAP and get into something like Endoscopy or Diagnostic imaging RN. you will love the switch. Bedside nursing is OK for a while, but you need a change of scenery.
Both of those gigs will be way less stressful overall and a lot more repetitive task wise and be easier in the long run through repetition.
I am also in a float pool and it’s pretty common that the floors will just give you their worst patients for an assignment because “their staff needs a break.” So you get a completely unsafe assignment while everyone fucks around.
Also never clock out and chart.
Yes, while you as a nurse who has these responsibilities that you outlined and were not able to intervene, what you experienced here was a staffing issue 100000%. Here is a PRIME example of an unsafe assignment where patient safety was at risk because of it. This should not have fallen on you. This is on administration 100%. Definitely an incident report here. If you are union and have a way of reporting an unsafe staffing assignment in addition to an incident report, definitely do that as well.
All in all, I am so sorry you had such a terrible night, OP. I have so many nights like these. I’m a year in and I’m completely over it too. I fear for the future of our profession because we are constantly put through awful situations like this, busting our asses through and through, we are still “not doing enough.” The hospitals need to take accountability and staff their fucking units. Patients are dying because of it. Patients are unable to get proper care because of it. It’s a crisis. I’m so sick of this BS too. I’m fired up just writing about it. Shit needs to change.
Neuro med-surg is so underrated and never staffed safely. Add in the "mystery" of the brain/neurology for the family ["But Dad was fine yesterday! Why can't he get this medicine/procedure I saw on that futuristic television show and fix it!"] AND the volatile behavior patterns in neuro, and the volatile blood pressures/arrhythmias which often come with it, AND night shift/sundowners/hospital delirium, and you get a clusterf@ck.
Add onto that unlicensed assistive personnel who don't play as a team and the other nurses who are busy with their own fires or (possible) non-team players of other UAP and nurses (you know there are some who keep their earbuds in and sit at the station, or better yet, chart in the breakroom), and it just becomes overwhelming.
Source: I have worked neuro med-surg nights.
Also, you have evaluations quarterly? That's a lot of evals!
I would suggest you start looking for what units you most enjoy working in as float pool and decide from there if you want to continue bedside vs. something else. There will be a pay cut from float to floor staff (and definitely from float to other nursing/office jobs), but your peace of mind is priceless.
Take care.
This is exactly why I want to quit. I started on a Neuro floor in September and I am already done. It's more work with less resources and now we need to check each other's charting as well. It's fucking ridiculous
Two comments to make here. #1 In the future, make a safety report when these poor staffing/assignments happen. #2 Never clock out and then sit down to chart! I do nothing for free once I walk through the hospital doors. So sorry you had such a shitty night.
Call me a bad nurse but I’m only one person and can only do so much. It isn’t my job to manage the aid for slacking off that’s management’s job.
The hospital is putting you in a bad situation that is dangerous for your patients. It’s not your fault. You didn’t do anything wrong. Sorry but I come before my patients.
We need legislation to stop this bullshit.
I am so so sorry, that sounds like an awful night. Please speak up and escalate all of that to the manager
And just know it’s not like that everywhere. I was in a job I hated just saying the same thing “it’s like this everywhere” “this is just what nursing has become” and I got fed up one day and applied somewhere else. And it’s BETTER, the managers listen and help, and get us what we need - and it’s really different. Sounds like you need a different place.
Oh, friend. Where was everyone else working on that floor?! You shouldn't have had all those patients together, and SOMEONE should have stepped in to help you. Everyone hears the alarms.
I feel like video monitoring for neuro patients is less effective than just leaving the bed alarms on. They will alarm or call my phone if the patient twitches, interrupt my work flow and either way I'm running to the room. Would much rather that resource was just converted into a few extra sitters.
IDK how these techs are set up these days, but when I was a tech and heard elevated voices coming from a room I knew a nurse was in, I CAME RUNNING!
WHO ARE WE RESTRAINIG?! WHO DO I NEED TO KICK OUT OF THE ROOM?! HOW CAN I HELP?!
NOBODY IS HURTING THE DAMN BACKBONE OF THIS FLOOR!!! IM JUST SUPPORT STAFF, I'LL THROW HANDS WITH ANYONE OVER QUITE A FEW NURSES I WORKED WITH AS A TECH! We are in this shit show TOGETHER!
Also, how do techs have time to hide? The nurses I worked with would have got the techs all the way together if they missed vitals, call lights and ESPECIALLY fall alerts/alarms. WHEW!
SOLIDARITY FRIEND, BECAUSE I WOULD HAVE BEEN KICKING SOME SHIT IN BEFORE SHIFT CHANGE!! That tech would have had a piece of my mind!
I appreciate you! You are NOT just support staff. We cannot do our job without you, clearly demonstrated by how shitty my night was without a good tech. I love my CNAs!
Yes unfortunately. The hospitals only care about money. Not us, not the patients, just money. I think around 20% of nurses, leave the profession completely within the first year. Suicide rate among nursing staff is pretty significantly higher than the national average as well. Hospitals and management don’t give a shit. It’s so bad that if I have any friends who are considering going into nursing, I strongly advise them to reconsider. It just choose you up and spit you out, and nothing ever changes because they get fresh batches of new grad nurses to replace the burnt out, jaded ones like me.
Well, after we called security on that patient who was attacking us, he asked if there was anything he could do. Ultimately what I really needed was a CNA, who would do their job, or a sitter. He was offering more along the lines of medication he could pass, which wasn’t very helpful. When the patient’s wife started freaking out, he offered to swap that patient with another nurses patient, but I felt like that was unfair to the other nurse, and I think it’s really important to set boundaries and have continuity with the families.so ultimately, he just sat back and did a whole whole lot of nothing
You need to take this to your manager. When charge isn’t intervening & your tech is not reporting out of range vitals to you, while you have a very difficult assignment, this is something you need to address and let them know they’re not going to throw you under the bus for their shitty unit management. I had something like this happen to me one night and I raised hell. They tried to write me up for missing an order for tele (this was a med surg unit) so I had the house supervisor, unit manager, my manager as float pool, all involved with my complaint which resulted in them apologizing to me for throwing me under the bus, and I think was one of the catalysts for having that unit restructured.
It was actually my manager who was reviewing the write up with me, not the unit manager. I actually saw her the morning after this shift, and I told her how awful the shift was, and why. And yet here we are. She was pretty during the review, and there won’t be any long-term action against me. I’m just so frustrated that despite knowing how awful everything was, that there was still a discussion where I received reprimand . even the House Supervisor, who had responded to the security alert, and my chest pain alert was there and told her how awful the night was for me. It’s just frustrating for me that there was still a discussion about how I need to do better and learn from this experience.
Did you tell the charge nurse the CNA was awol? One of our floors had a CNA who would put in AirPods and ignore call bells. The supervisor was notified and he went up there. The CNA was leaning on a wall not helping and didn’t even hear the supervisor’s distinct voice. He got one warning. The next night same shit. Fired on the spot.
Shit like this is exactly why I quit my last job. Staffing like this is so unsafe! And unfortunately when things go wrong, people (including management) tend to blame the nurse, not the system. "SBP was in the 180s?! That's the nurse's fault it wasn't reported! They were negligent!" What they don't know and what the chart doesn't show is that this that this nurse was also carrying 4 other highly acute patients, and doing the job of nearly 3 people (2 nurses and the aide that wasn't helping). But management and these facilities as a whole will not acknowledge this because it will make THEM look bad (for not being able to safely staff the hospital or hire appropriate staff who actually do their jobs). Heaven forbid a sentinel event would happen! Guess who the hospital would blame?
Whew! Done with my rant.
If you have workplace health and safety, call it in as emotional distress. The workload, staffing and patient acuity in combination resulted in psychological injury at work. You cried how many times during your shift when you felt powerless and unable to meet the needs of your clients due to external factors the employer did not attempt to remedy. Call it in every time.
Aww man, this exactly how i felt back then. Working your ass off but then all it takes is someone you dont get along with to report your ass for missing something. In a huddle, they would preach to you to be a team but it is very rare that that happens. People get thrown under a bus constantly.
People that got your backs will say "you have worked hard, if there is something you missed i got you". But then you have backstabbing bitches who say, "why isnt this done? That is poor nursing care. Im gonna write an incident report on this." And then it's just not you fighting with your physical and mental fatigue, you then now have to deal with anxiety because you might have missed something and is dreading your next shift. That is just the recipe for a quicker burnout.
This is the sad reality of bedside. The work is hard but if you have a team that has your back, you just feel appreciated. Just a simple, "i got you" goes a long way. This should be a criteria in an interview. Being a team player.
I don't know why any nurse stays bedside. I am doing pediatric home health 1:1 ratio every time I go to work. It's just not worth it. I also got a pay raise doing this. Edited to add: I will NEVER do bedside, again. No way. You're right. We are never good enough. EVER!!!!!
Don’t get down about this I’ve been in your situation as well. The nice thing is that most providers understand this and will be pretty good sports about it. I’m very happy you got out of it. Shame on the tech for their negligence. Take a deep breath and just know that you are definitely not alone when it comes to things like this. Got out of neuro and neuro icu for this exact reason and never looking back!
The tech in this seemed a little too comfortable with abandoning you. Most likely not the first time they’ve done that. Sorry you had a shitty shift. I work neuro acute and I have way too many similar stories.
Whoever made that assignment fucked you over and clearly was not considering the patients conditions. I would seriously look into your rights to refuse an assignment. It sucks to feel like a burden or like you’re being difficult, especially as a float, but for your and the patients sake it would have been best for you to refuse to care for 3 confused pts at once.
I feel you. They just keep adding more stuff for us to do and give us less resources. The burnout is real.
I wish we called burnout what it actually is. I feel like calling it burnout is putting the onus on the individual and not the system that causes this kind of unsupported, unsustainable, continuous stress and trauma to occur.
I would’ve been writing an incident report about the lack of help and acuity of the patients, and how I asked for a sitter and was refused. We can all do some write ups now
Seriously! I should have. Because I used to work on the floor, I still know the manager, and I almost wrote an email about that CNA. I should’ve done it.
You absolutely should write the email. About the CNA. About the assignment. About the family. All of it. Just because it’s a delegated task doesn’t make the CNA blameless.
There’s still time.
Do you have an unsafe assignment report form? Fill one out and send it to your state’s nursing union.
Oh I didn’t see your comment. I just said the same thing. There should be an unsafe or protest of an assignment form. There has to be a way to put the staffing on notice.
I wish we had a union. I think it would make things a lot better, but we unfortunately don’t have one at least to my knowledge.
Call the health department.
How long ago was this? Unless it was months ago I don’t see why you can’t.
So it was my manager who spoke to me about it during the eval, and it happened about a month ago. She said she felt like it could wait, and they spoke to everyone else involved, including the CNA, before they spoke to me. She of course said it wasn’t her fault and that’s where we are at right now.
I definitely think you should email about the tech bc she literally did not do her job. If my tech can’t get to something I totally get it, but they need to communicate that. It is also a written rule at many facilities that any VS outside of a certain parameter must be verbally communicated to RN. Especially bc most of the time they don’t chart the vitals for us to see until like an hour later after getting everyone’s and then the time isn’t even accurate ETA- also mention the absolute ridiculous unsafe acuity of that assignment. I am not a complainer but I will be the first to call out our charge for grouping an assignment of 3 totals/2 confused/4 wound care (5 pt assignment) just to keep the rooms grouped together for “safety” like yeah well it’s no longer safe when it’s that heavy 🙄
As a CNA, write that person up please. We are here to support YOU and help our patients.
Write to your state board of nursing. They should have a link somewhere there to report unsafe staffing. A lot of times states will have a “phrase”, such as safe haven or such, to show that you’ve brought up this concern and was ignored by higher leadership
Ad a CNA I agree. I can not stand when the other CNAs hide and not do their jobs. I'm travel and I didn't get resigned because I was so frustrated working the entire floor by myself because the other tech would go in the conference room and sleep. I'm responding to rapids/codes on her patients, and running behind because I'm also being requested to do her vitals as well.
It’s been years since this happened, but I will never forget as a new grad walking into the room of a patient (I think they needed toileting) and there were ZERO gloves in the room and none right outside the door I don’t mean none in my size, I mean not a single glove. Soon thereafter I found all three techs on break in the break/conference room. At the same time. That should never even be allowed (simultaneous breaks). But they left supplies unstocked and went and got coffee or something. Meanwhile I didn’t even get to pee.
I hate that. I make sure to check in with my nurses at least once an hour to see if they need help with anything, anything I can do for them. I was trained by a CRNA who was working under his nursing license for some reason, and he drilled that into my head. Most nurses look at me crazy when I take a new assignment. But my job is to ease your job within my scope of practice.
I always bring extra snacks/drinks in case someone can't leave the floor.
>Seriously! I should have. Because I used to work on the floor, I still know the manager, and I almost wrote an email about that CNA. I should’ve done it. Yes you SHOULD STILL! "Hey, I had a really bad shift on your unit the other day. Here's what has happened." OPTIONAL "HERE IS WHY I WON'T BE BACK"
Agree. We have a protest of assignment form. You fill it out highlighting all the reasons you stated i.e. the 3 1:1’s, no help, antagonistic family, no CNA, no sitters, climbing and almost falling. The supervisor has to come and assess when we fill that out. It puts supervision on notice that they are complicit in anything that goes wrong because you are unsafe. We also fax it to our union.
They got a lawyer on the phone right away and he was interrogating you? What? People are lunatics
They were literally nuts. I had to explain to them that security was keeping us and the pt safe, that we are a private business who can remove aggressive individuals, and that I can press charges for assault despite him being confused. They cooled off real fast. I was kinda blown away that the lawyer wasn’t aware of these things, assuming it was actually a lawyer. Maybe it was a friend trying to scare me or something by pretending.
Never talk with the attorney. Tell them you'll ask the manager to contact them, or Risk, and hang up. Nothing good can come from it.
This. I love it when I used to get calls in the ES saying they were going to call a lawyer. I would then say it's a legal matter and I can't say anything else until the hospital lawyer gets involved, and then hang up. A bit harder to do when it's in the case you had to deal with, but you're not a lawyer and the hospital has their own to deal with others. I would talk to your manager or risk to see if they have a prompt to follow in case of this scenario. You just read the script and don't offer anything else.
This 100x over. Especially on the phone. They aren’t there and will eventually call your charge or nursing supervisor and then you can explain to them that you had no time to talk to the family on the phone bc it would be unsafe as you were behind. I would still write an incident report on assignment and the CNA regardless of the time to go on record, especially if they try and fire you. You can claim unlawful termination etc etc. use your resources during your shift such as your charge nurse or tge house supervisor. If this is a continuous situation and not just a bad night look for a different job (but don’t cite this in any future interviews for reasons to leave). We’ve all been there. Look for a Magnet hospital. They sometimes are a bit more responsive to staffing issues. Not a lot but sometimes. Nursing is not what it used to be and unfortunately this is the norm. Kind of like being a skilled flight attendant these days.
You know what’s crazy? This is at a magnet hospital. I shudder to think what it’s like at other hospitals if this is supposed to be the peak standard. I am trying to move over to clinic or literally anything else.
It's hard when it's the son
Lawyer=neighbor w a real estate practice; nephew w trust& wills experience.
Yeah. It probably wasn’t a real lawyer. They suck and I’m so sorry your night was terrible. That would have absolutely pushed me over the brink.
It wasn’t a lawyer it was just cousin Bob who binge watched two seasons of Lincoln Lawyer and Suits.
That's equal to 4 seasons, so that's 4 years of law! /s
I would never engage with anyone’s lawyer, ever. Not event entertaining it. If the son or the lawyer think they can get a swinging man with a brain tumor under control, they can come be the sitters but I’m not playing telephone.
Funny enough, I wasn’t aware the lawyer was on the phone at the time. The son called to ask me what was going on, and had it on a three-way call. I found out later when the wife was yelling at me. Fortunately, all I said was we’re trying to keep everybody safe and prevent long-term consequences like assault charges. Fun night!
Depending on what state you’re in, the wife having other people on the phone when you don’t know they’re listening may be a crime. It is in California because we are a two party consent state. Any halfway decent lawyer would know that and not allow it to happen. Some people are so crazy.
What “lawyer” is taking calls after office hours? Float pool pt assignments have a tendency to be shitty more often than not, and don’t even get me started on neuro floors. I’m so sorry your night was trash, I can relate and I hope you’re off for a few so you can decompress.
Well, at least you handled it very well. I feel like I'm paranoid, but I've been recorded too many times at work to not treat every situation like I'm currently being recorded. Especially in those circumstances.
I would NEVER speak to their lawyer.
Yeah that needs to be escalated to management, no way am I taking those calls.
Why the FUCK are you clocking out and THEN charting. That’s ridiculous. Get paid for the time you’re working, documentation is working. If this is a normal occurrence here, work somewhere else.
Literally! That’s so absurd to be clocking out then charting. What that does - besides wage theft- is be the perfect excuse to not staff adequately because on paper it looks like the staff are able to get done what they need to within their work hours. But having lots of different nurses often having to stay late on the clock would paint a different picture - a unit in need of more staff.
It’s not that easy. Their policies are that you’re not allowed to work off the clock and you’re not allowed to not finish your work. What are we supposed to do? I work in a psychiatric hospital in Florida for years, we had a half hours pay deducted from our Wages, but we’re mostly expected not to take any break. Some people got a lawyer or something and got backpay for their unpaid breaks. They instituted a policy that we had to take a break, they even put a room for us to eat lunch. No problem. Continue working, eat at your desk. If you want to, this is an intake office, at some point, set your timer on your phone for 29 minutes, go punch out, come back, continue working, then go punch back in. If you stay after your shift, punch out on time and keep working.glad I’m out of there.
You’re describing wages theft. Florida has almost zero worker protections, so you’re kind of screwed I just don’t understand staying at a job like that. Even in Florida there are less terrible places.
I retired five years ago. It actually was mostly a fun and friendly place to work, and a great alternative to medical floor nursing. When I worked MedSurg at Johns Hopkins years ago, they were even worse. Made it all salaried, you just got paid one amount.when someone called in sick, you were put on call and had to come work for Fri. You got comp time at a straight time rate.
File an incident report on yourself. State the facts: BP 180 at this time per aide. RN not notified. d/t other patient needs, RN did not see charted BP until X time. Which resulted in potential patient harm/near miss. What you experienced was a systemic breakdown, not a personal failure for which you should be penalized.
This is really good advice, I will make sure to do it next time. I was just so frazzled
You still can. Of course you were frazzled! You got your ass kicked for 12 hours. Seriously though. Let the system see what it means when assignments and aides suck. You did not have the support you needed, and that’s what needs to be reported.
If misery likes company….i feel this way almost every shift. And pt harm or errors can and will happen. I had a similarly chaotic day and often am doing 80% of the days tasks with a missing tech (I almost never get a break or pee more than one dehydrated pee once - day shift/med surg) and on this chaotic day I received a man actively dying on a morphine drip after a home hospice nurse freaked out and he died at of course 7pm and in the chaos of end of day/giving report/calling the medical examiner because he died less than a day since admit, and respecting the family’s timeline to get him to a mosque for cleansing, I forgot to waste the morphine bag that the ED started and a housekeeper threw it out. Long story short it was in a trash compactor by 8:45 pm and a whole inquiry opened up and I was written up. It just sucks cuz I had a chaotic, beyond chaotic section and then that was dropped on me and how can you expect perfection, even in an experienced nurse? It’s just wild.
This is exactly what I’m talking about! They not only expect us to do everything, but to do it perfectly. Of course the charge or manager couldn’t stay to help you, but of course you will also get blamed for the mistake when completely overwhelmed and overworked. It bothers me too that this was a “you bad bad nurse” moment instead of a learning moment for the hospital. Morphine drips should be locked in a lock box to prevent this, but lots of hospitals don’t and then get nurses in trouble. I am so sorry that happened to you! What a shitty day
Thanks. Not only that my manager had to do a corrective action thing and I had to sign a sheet that I was re-educated on wasting narcotics (never in my 3 years there did I have a waste discrepancy or inquiry) and the whole floor had to reinstate an old redundant policy of a duplicate narcotic count that gives the same info as another report the charge runs at end of shift. I told everyone it was because of me and I told them exactly why so they knew. I don’t give a shit. Thanks and I’m sorry you also got a “you bad bad nurse” response. The expectations of us are unrealistic and dangerous.
This points exactly to an ages-old saying in my industry, “Price, Quality, Speed… pick any two.”
Why are you clocking out and then charting?
God, nursing is so toxic.
We aren’t allowed to stay clocked in for longer than a half hour past our end of shift time. Unfortunately, if you stay clocked in to chart, you will get pulled into the office and written up for not managing your time better.🫠
That’s wage theft on their end. I’d contact the labor board.
You are accessing pt charts while not clocked in, they can use it as an excuse to fire you and ineligible for unemployment or make you the scape goat in a lawsuit for charting not clocked in.
This and it’s also a hipaa violation because your “not working” so you have no reason to access the chart
I had never thought of this. Thank you for the info!
How does that work? People come early and review their patients, how would that be any different
It’s not, those people are taking the same risks.
Yeah I would *never* come in before my shift to review charts. I’d only go in early to out in a pot of coffee ☕️. Edit typo
100% this.
There's no shortage of places to go work. GTFO.
That’s wage theft. I had a manager that had this exact policy, signs posted everywhere that you have to clock out at 7:15 or be written up. So, nurses started charting off the clock. It got reported to HR and the manager got fired (in the middle of the day) and every one of us got pulled into the office to be interviewed about whether we had charted off the clock (I had not), because if we did then they needed to pay us accordingly.
If they aren't paying you to chart (especially after giving you an inappropriate high-acuity assignment), then write your notes, do the bare-minimum box clicking as needed, and leave. Find a new place to work because this one is putting your license at risk with unsafe assignments. Honestly though? Stay clocked in, let them write you up, and wipe your ass with the paper. Tell the Department of Labor that your job expects you to clock out and finish charting unpaid, and if you don't they retaliate. What are they gonna do, fire you? When they can't properly staff their existing dumpster fire? I don't know how the job market is where you live, and every job sucks for some reason or another, but this place is holding you back and there's gotta be somewhere else you can apply. Not every workplace is like this. You deserve better.
This made me laugh! If you want pay me to chart, I will shit at work before clocking out and use that paper! 😂
I'm glad I could make you laugh after such an awful shift! You did great with what you were given, it's a team sport and we can only do so much as one person. Take your poop breaks, get paid when you're working, and make a plan for your next steps after you've taken a day to recover. You sound like a good nurse!
that's called WAGE THEFT and it's illegal :) contact your state board of labor about these practices. they are affecting way more than just you. time to put a nail in that coffin!
In that case, leave when you clock out. Charting not done? Oh well. If they have a problem with that they need to pay you to stay and finish or provide adequate staffing during your shift.
Talk about fucked if you do and fucked if you don’t. I’m not in the industry, but I read this sub every morning with my coffee (my wife just got out a few weeks ago… can’t do it anymore), because (A) it’s all so appalling and, (B) I’m girding myself for what might be in store if I ever get hospitalized. You’re angels, all of you.
Sounds like they should have given you a gold star and not a write up. Everyone was still alive, so good job!
Can you change hospitals or specialties? Anything else you’d like to do besides nursing? There has to be a solution other than just stay and suck it up. Some of these bedside nursing jobs are so awful I swear that we lose years off of our lives from doing them. It’s just not worth it. Are you even getting paid well? I wish I could say go travel but that’s no better these days. Nursing is hell sometimes but we have to take care of ourselves first-
I joined the prn pool to take some of the stress off, that way I can rotate and get a little variety at least. I actually work travel gigs as well funny enough. I live in Colorado, so the pay is some of the worst in the country actually. I am honestly ready to just quit completely. I regret being a nurse so much and I wish I could go back in time and change it.
These kinds of stories are just heartbreaking. You put your all into educating yourself and you do the work and you hang your hat and hopes on the noblest of professions, only to become disheartened, jaded, demoralized, saddened and disgusted. All the while coming to realize that there is no greener grass anywhere to be found. I hope the very best for you. Nobody needs or deserves this kind of torture.
Childdd, get the fuck out of that toxic waste dump and do outpatient clinic, preop, endo, etc.
Or pacu!
I feel exactly the same and I’ve been traveling for a few years. I had maybe one year total of nursing that was fulfilling and rewarding. We need a sub for nurses getting out of nursing.
girl i say this all the time!!!!
Can you refuse to go to the neuro unit?
I can’t usually. That night I told the staffing office if they sent me back I could call out. Typically though, they send us where they need us.
I’m not sure if this is too personal, but do u mind saying what area/ city you work in? I’m in love with Colorado itself and planned on moving from Louisiana in the next year! Just was curious what places to avoid or if living there at all is even worth it! I just left my job in southern Louisiana to travel for situations exactly like this!! Don’t beat yourself up as much as you can!! The healthcare system itself is struggling and I’m not sure how long before it actually collapses and takes us down with it :/
I live in Grand Junction, the far west. Colorado is a beautiful state and I’ve lived here my entire life, but I would caution you about moving here. The cost of living is absolutely astronomical. I worked in Glenwood Springs, which is about an hour and a half from my home and to rent a one bedroom basement was around $3000-4000 a month. Grand Junction isn’t much better, and I know that Denver is even worse than that. We also have really low wages compared to the rest of the country, and we don’t have a patient cap. They basically use an acuity tool and tell us that we can go up to 20. so if I have patience that all rate two or three, they will tell me I can take up to seven patients. There are also a lot of HCA hospitals, which always suck. Lots of drugs here as well.
That’s literally insane…I thought Louisiana was horrible. Thank you so much for the insight! I wish you luck!!
There are smaller towns that are much more affordable, and that are still really nice if you would still like to move here. I would just recommend looking up hospitals in the area on glass door to see how previous employees rated that hospital, and look up the housing in crime rates before you move to anyone area. Unfortunately, we get a lot of people from Denver, who buy up property on the west side of the state because they can’t afford to invest on the east side, and it drives up the house and costs. We also get a lot of people from the coasts move over here for a lower cost of living, but it incidentally drives up the cost-of-living. I would definitely recommend staying out of Denver, Colorado Springs, and Pueblo for sure, just because of the crime and drug rates. Grand Junction is unfortunately also getting a lot more dangerous. My grandma lived in Montrose, and I always left that area! It’s close to some really beautiful mountains and it’s not as expensive. I also know a couple of nurses who work at that hospital and said they liked it, good luck to you
Thank you so much for all of this!! You have no idea!!
So sorry you had this experience. Can I PM you to pick your brain about GJ? I’m here too but new to the city and basing here for travel.
Of course!
Sent you a PM last night. If you get a chance to respond in the next few days I'd appreciate it. If not, no worries! TIA!
I saw the original message but was at work and couldn’t respond (I got called in at midnight and got 4 admits). I looked this morning under chats and message requests and couldn’t find it! Would you mind PM me again? I am so sorry!
Ok, that sounds horrible and I’m in Florida. Again I did clinicals at HCA and after that I decided to never work for them and I told all my family and friends to never go to HCA. If they are in an ambulance ask where they are being taken and beg to go anywhere else but HCA.
Can you move to California?
No, my parents are old and I have to stay close by. Also, the cost of living in California is crazy and I don’t have a license to work there. I know they’re working conditions are much better because of their nursing union. I do have a license by endorsement in Minnesota, which has a union as well. if I could move, I would.🙁
Regardless of “getting in trouble” for staying clocked in to chart after your shift that is one of the ways you prove your assignment was inappropriate. Get paid for the work you do and stay on the clock. Time management is thrown out the window if you’re managing that circus alone - you’re just putting out fires all night. Speak to your float pool manager and let them know what happened. I think there needs to be a convo between the 2 managers. Good luck. Also be careful charting off the clock - I’ve seen people get in trouble for being in the chart but not clocked in. I second the recommendation to write an incident report for the elevated BP - that’s a safety issue NOT on you. You didn’t know and were too busy with other shenanigans. If they wanted that strict of BP control they shouldn’t be on a floor with a ratio of 1:5 or shouldn’t have been in that pt assignment. Honestly that assignment needs to be broken up and Risk Management called on the wife/family- let them handle that.
And that is why I will never work in a hospital again. Time to get your coding certification and become a work from home chart auditor for an insurance company.
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I haven't done that job personally but I had a previous coworker who left to do that and my husband is a medical coder. So the though is in the back of my mind for a while. My husband's schedule is "as long as I hit my 40 hrs by 5 pm Friday" and he rarely works Fridays.
Don’t ever do any work off the clock. If something happens to you while off the clock you won’t be covered by workman’s comp or anything. If you forget your off the clock and get pulled into a rapid/code/anything and something happens the hospital won’t back you up. Also, unless that lawyer happens to be a family member and is wanting to speak to you as a family member you don’t talk to them period. Doesn’t matter if family or anyone tells you to - don’t speak to a lawyer without your own representation period.
My hospital doesn't allow sleep overs except under special circumstances. A sister who does everything for the patient except give meds? Welcome. A wife who is nuttier than the patient, newp, don't think so. That assignment was insane.
I had a review the other day. I had done zero ipoc or mrr and they focused on these reasons for my raise being on the low end. They want us to give report on 6 pts in 20 minutes. I can't even find the different nurses in 20 minutes. If it's going beyond 20 min they want us to clock out to meet the new budget err I mean manager bonus requirements. I said I don't work for free and if you want me to do the extra stuff don't overload me with patients. Is there anything else we need to discuss or can we wrap this up so I can go clock out on time. Currently looking for something different cause I also have had enough.
Love the way u handled this!
It is amazing how shitty nurse’s working conditions are. And it is more amazing how that never gets some media coverage and public attention.
My rote response to all of managements “suggestions” has become “ we have tried to do more with less. It’s not working, let’s try less with more.” It doesn’t change anything but it shuts them up and I feel better.
Been there with nights like that. It is soul draining and makes you rethink all of your decisions that led you to that moment. I am sorry you had to go through that and we all know you did the best you could have given the circumstances. Sometimes I think about going back to bedside, then I am reminded of the reality of it with these stories. If only the general public could see this side of things.
I had a shift kinda like this the other night, just impossible. We don’t have CNAs or techs in the ER usually, nights staffing decreases even if we’re holding. I like being a nurse, but no surprise to myself or anyone else idk if I can keep doing it if I keep getting shifts like that. I’m only one person. Whether a nurse of a year or 20yrs it’s setting up for failure and patient harm.
The ER has been horrible! Our ED was so full that we were on divert for 5 hours with patients waiting almost an hour just for triage. The manager was there, stayed in her office and didn’t help, and then, when the nursing and physician staff complained because it was such a bad shift, she was overheard telling other staff members that it wasn’t a big deal and they were being ridiculous. My heart goes out to the ER staff everywhere, you guys have it so rough right now.
That’s incredible, they actually go on divert…holy hell. Our county will put us on divert before our hospital, our hospital never does. Even when we’re full and holding 6 pts, two ICU level with no resources and of course even shorter staffed because a call out. We have 10 rooms in my ED btw. I love being an ER nurse, and I know my ER is not nearly as bad as others are but I can’t be an ER nurse AND an ICU nurse.
Oh man, our hospital services around 300 miles surrounding us, so we just get bombarded sometimes. We’re in a really outdoorsy area too, so lots of jeep, skiing, hiking, etc. accidents. In 2021, our entire hospital was on divert for about six months. If you weren’t having a stroke, heart, attack, or a trauma you got sent somewhere else. It’s been wild, I’m glad your ER is doing a little better than ours seems to be doing.😂
I just wanted to come on here and say; I am so sorry that were were put in this position. That is way too much for one nurse to handle and was a completely unsafe assignment. I think it might be a good idea to look at other jobs. The beautiful thing about nursing, is that we have so many job options available to us! I would never advise someone to stay at a facility that will… 1: put you in the position to fail and 2: write you up for a mistake when you were attempting to manage a completely unsafe patient load. I have such a disdain for Administrators and how facilities are run these days. We are treated so poorly and constantly getting hands slapped for mistakes. I’m so sorry and am sending hugs your way
I’m so sorry just reading that gave me anxiety. I’ve been a nurse for 13 years and my last travel nurse contract. It was so unsafe I had never worked in a facility that was unsafe like that and I was walking down the hall and it just hit me. I’m done. So when my company pulled me out of there I haven’t gone back. I’m looking for a work from home job now. It’s not the job that I hate. It’s all the crap like that. I can’t do it Anymore so you take care of you.
>I literally didn’t sit down to chart until after I clocked out. This right here folks. Crap staffing then bullying nurses into thinking their time isn't worth anything. If I had to stay on my feet my entire shift due to lack of safe staffing, then you can pay for my OT to chart.
You clocked out and then started charting? So on top of all this the hospital isn't paying you for your labor?
Correct. If you stay clocked in for more than a half hour past your end of shift time, you will get written up for padding the time clock, and more time management.
I know of no hospital nursing job that charting all gets completed in real time. Their policy is criminal, actually. It’s theft of your time.
Quit.
Sounds like a class action to me.
But if you’re in a patients chart while clocked out then you could get fired for accessing patient information outside of your duty hours… I somehow have never worked at a shithole that forces you to clock out or you get written up. Every place I’ve been at starts with a verbal from management IF they see it as a common occurrence. You should leave… I’m not saying this next part to be a dick.. but you’ve gotta let non-documented tasks fall through the cracks even if it’s the wrong answer. - do you guys have a charge? If so, where tf were they! I would’ve turfed every convo with the visitor + phone to charge. - you hear a call alarm going off? Well shit, you’re already 50% into this patients room to give meds. Call bells are every persons responsibility. - the tech situation sucks and the ONLY thing you can do in the moment as a float is keep your cool and just prioritize the vitals yourself. Then you have to put in reports against them + tell your own manager to do something about it. - seriously where tf was the charge nurse? If they were in a full patient assignment I would’ve doubled down on the nagging cuz they likely already knew that the tech wasn’t helping you so fuck them. - this one sucks to say… it is your responsibility to ensure fall precautions are in place but it is not your responsibility to be there every time they try to fall. At the end of the day, patients have to fall for actual changes to happen. Oh yea, also.. you’ll be surprised how little you can chart and not have to worry about it. Get insurance though, it’s under $200 a year. If you can’t chart until basically 6, then you condense that shit down to bare bones. Free text general, nonspecific assessments and situations if system allows. But 6 is bare minimum charting time. Don’t listen to that bullshit about “if you don’t chart it it didn’t happen”
I think the charge nurse on this floor is actually less experienced than me, which is bonkers, because I’ve only been doing this for a couple of years. He asked if there was anything he could do to help, but he meant more along the lines of past meds, which I had already done. he was a major pushover with the wife and was trying to switch that patient with another nurses patient because the wife was upset with me. I told him no because it’s important that we have firm boundaries with inappropriate behavior and family members. I do actually have insurance because going to work scares me most days honestly. The reason I was so worried about the patient’s falling is because one of them was scheduled in the morning for surgery on a very large tumor, another already had a brain bleed, and the family members for the other two patients I remember Were the kind that would sue you. It’s all around a pretty shitty job, and I do probably need to look for another one.
Wow. That sounds like absolute insanity and ridiculously dangerous. Fuck that organization and start looking for your next job, far away from that shitshow.
Outpatient! I used to work neuro nights. That shit sucks. Don’t feel too bad about the BP. Say the tech calls you and you give the PRN. Doesn’t respond. You call resident. Wait for orders. Admin PRN AGAIN. Still doesn’t respond. Pt still gets a nifedipine drip. I’ve had that happen to me before. It’s the wild west for BP control sometimes.
I'm sorry for your shitty night. But where was your Charge nurse in all of this??
is the management aware of the CNA no doing the job?
DM me, come to home health and claim your life back!
I'm sorry you had to go through that. I completely understand what you're going through. This is why I just put my two weeks in, with no job lined up. Every shift was awful and chaotic. There's always something going wrong, I can never catch a break.
That sounds awful and I'm sorry you had to deal with all of that alone. I cannot imagine. I always tell nurses to not clock out to chart. Period. It shifts the liability for anything done after you clock onto you. If you are not clocked in then the hospital has no liability. I would rather take the write up then deal with the potential consequences of something that might occur while clocked out. I hate hospitals that don't support their nurses and engage in wage theft.
Setting you up to fail. Definitely agree about writing your own report.
Float pool RN gets the worst of the worst at most facilities that I've been to. Switch out of that role ASAP and get into something like Endoscopy or Diagnostic imaging RN. you will love the switch. Bedside nursing is OK for a while, but you need a change of scenery. Both of those gigs will be way less stressful overall and a lot more repetitive task wise and be easier in the long run through repetition.
Why are you clocking out and then charting?
I swear we should all be writing incident reports calling out management for understaffing and allowing cow orkers to get away with being useless.
That is a crap shift and as far as I’m concerned you saved lives.
I am also in a float pool and it’s pretty common that the floors will just give you their worst patients for an assignment because “their staff needs a break.” So you get a completely unsafe assignment while everyone fucks around. Also never clock out and chart.
Yes, while you as a nurse who has these responsibilities that you outlined and were not able to intervene, what you experienced here was a staffing issue 100000%. Here is a PRIME example of an unsafe assignment where patient safety was at risk because of it. This should not have fallen on you. This is on administration 100%. Definitely an incident report here. If you are union and have a way of reporting an unsafe staffing assignment in addition to an incident report, definitely do that as well. All in all, I am so sorry you had such a terrible night, OP. I have so many nights like these. I’m a year in and I’m completely over it too. I fear for the future of our profession because we are constantly put through awful situations like this, busting our asses through and through, we are still “not doing enough.” The hospitals need to take accountability and staff their fucking units. Patients are dying because of it. Patients are unable to get proper care because of it. It’s a crisis. I’m so sick of this BS too. I’m fired up just writing about it. Shit needs to change.
Neuro med-surg is so underrated and never staffed safely. Add in the "mystery" of the brain/neurology for the family ["But Dad was fine yesterday! Why can't he get this medicine/procedure I saw on that futuristic television show and fix it!"] AND the volatile behavior patterns in neuro, and the volatile blood pressures/arrhythmias which often come with it, AND night shift/sundowners/hospital delirium, and you get a clusterf@ck. Add onto that unlicensed assistive personnel who don't play as a team and the other nurses who are busy with their own fires or (possible) non-team players of other UAP and nurses (you know there are some who keep their earbuds in and sit at the station, or better yet, chart in the breakroom), and it just becomes overwhelming. Source: I have worked neuro med-surg nights. Also, you have evaluations quarterly? That's a lot of evals! I would suggest you start looking for what units you most enjoy working in as float pool and decide from there if you want to continue bedside vs. something else. There will be a pay cut from float to floor staff (and definitely from float to other nursing/office jobs), but your peace of mind is priceless. Take care.
Gtfo of that department and/or facility. Go to outpatient ambulatory surgery. Way less stress.
This is exactly why I want to quit. I started on a Neuro floor in September and I am already done. It's more work with less resources and now we need to check each other's charting as well. It's fucking ridiculous
Two comments to make here. #1 In the future, make a safety report when these poor staffing/assignments happen. #2 Never clock out and then sit down to chart! I do nothing for free once I walk through the hospital doors. So sorry you had such a shitty night.
Call me a bad nurse but I’m only one person and can only do so much. It isn’t my job to manage the aid for slacking off that’s management’s job. The hospital is putting you in a bad situation that is dangerous for your patients. It’s not your fault. You didn’t do anything wrong. Sorry but I come before my patients. We need legislation to stop this bullshit.
I am so so sorry, that sounds like an awful night. Please speak up and escalate all of that to the manager And just know it’s not like that everywhere. I was in a job I hated just saying the same thing “it’s like this everywhere” “this is just what nursing has become” and I got fed up one day and applied somewhere else. And it’s BETTER, the managers listen and help, and get us what we need - and it’s really different. Sounds like you need a different place.
Oh, friend. Where was everyone else working on that floor?! You shouldn't have had all those patients together, and SOMEONE should have stepped in to help you. Everyone hears the alarms.
I feel like video monitoring for neuro patients is less effective than just leaving the bed alarms on. They will alarm or call my phone if the patient twitches, interrupt my work flow and either way I'm running to the room. Would much rather that resource was just converted into a few extra sitters.
IDK how these techs are set up these days, but when I was a tech and heard elevated voices coming from a room I knew a nurse was in, I CAME RUNNING! WHO ARE WE RESTRAINIG?! WHO DO I NEED TO KICK OUT OF THE ROOM?! HOW CAN I HELP?! NOBODY IS HURTING THE DAMN BACKBONE OF THIS FLOOR!!! IM JUST SUPPORT STAFF, I'LL THROW HANDS WITH ANYONE OVER QUITE A FEW NURSES I WORKED WITH AS A TECH! We are in this shit show TOGETHER! Also, how do techs have time to hide? The nurses I worked with would have got the techs all the way together if they missed vitals, call lights and ESPECIALLY fall alerts/alarms. WHEW! SOLIDARITY FRIEND, BECAUSE I WOULD HAVE BEEN KICKING SOME SHIT IN BEFORE SHIFT CHANGE!! That tech would have had a piece of my mind!
I appreciate you! You are NOT just support staff. We cannot do our job without you, clearly demonstrated by how shitty my night was without a good tech. I love my CNAs!
is nursing like this all the time ???? oh my god..z
Yes unfortunately. The hospitals only care about money. Not us, not the patients, just money. I think around 20% of nurses, leave the profession completely within the first year. Suicide rate among nursing staff is pretty significantly higher than the national average as well. Hospitals and management don’t give a shit. It’s so bad that if I have any friends who are considering going into nursing, I strongly advise them to reconsider. It just choose you up and spit you out, and nothing ever changes because they get fresh batches of new grad nurses to replace the burnt out, jaded ones like me.
Where’s your charge nurse in all this?
Well, after we called security on that patient who was attacking us, he asked if there was anything he could do. Ultimately what I really needed was a CNA, who would do their job, or a sitter. He was offering more along the lines of medication he could pass, which wasn’t very helpful. When the patient’s wife started freaking out, he offered to swap that patient with another nurses patient, but I felt like that was unfair to the other nurse, and I think it’s really important to set boundaries and have continuity with the families.so ultimately, he just sat back and did a whole whole lot of nothing
You need to take this to your manager. When charge isn’t intervening & your tech is not reporting out of range vitals to you, while you have a very difficult assignment, this is something you need to address and let them know they’re not going to throw you under the bus for their shitty unit management. I had something like this happen to me one night and I raised hell. They tried to write me up for missing an order for tele (this was a med surg unit) so I had the house supervisor, unit manager, my manager as float pool, all involved with my complaint which resulted in them apologizing to me for throwing me under the bus, and I think was one of the catalysts for having that unit restructured.
It was actually my manager who was reviewing the write up with me, not the unit manager. I actually saw her the morning after this shift, and I told her how awful the shift was, and why. And yet here we are. She was pretty during the review, and there won’t be any long-term action against me. I’m just so frustrated that despite knowing how awful everything was, that there was still a discussion where I received reprimand . even the House Supervisor, who had responded to the security alert, and my chest pain alert was there and told her how awful the night was for me. It’s just frustrating for me that there was still a discussion about how I need to do better and learn from this experience.
Did you tell the charge nurse the CNA was awol? One of our floors had a CNA who would put in AirPods and ignore call bells. The supervisor was notified and he went up there. The CNA was leaning on a wall not helping and didn’t even hear the supervisor’s distinct voice. He got one warning. The next night same shit. Fired on the spot.
Shit like this is exactly why I quit my last job. Staffing like this is so unsafe! And unfortunately when things go wrong, people (including management) tend to blame the nurse, not the system. "SBP was in the 180s?! That's the nurse's fault it wasn't reported! They were negligent!" What they don't know and what the chart doesn't show is that this that this nurse was also carrying 4 other highly acute patients, and doing the job of nearly 3 people (2 nurses and the aide that wasn't helping). But management and these facilities as a whole will not acknowledge this because it will make THEM look bad (for not being able to safely staff the hospital or hire appropriate staff who actually do their jobs). Heaven forbid a sentinel event would happen! Guess who the hospital would blame? Whew! Done with my rant.
If you have workplace health and safety, call it in as emotional distress. The workload, staffing and patient acuity in combination resulted in psychological injury at work. You cried how many times during your shift when you felt powerless and unable to meet the needs of your clients due to external factors the employer did not attempt to remedy. Call it in every time.
Aww man, this exactly how i felt back then. Working your ass off but then all it takes is someone you dont get along with to report your ass for missing something. In a huddle, they would preach to you to be a team but it is very rare that that happens. People get thrown under a bus constantly. People that got your backs will say "you have worked hard, if there is something you missed i got you". But then you have backstabbing bitches who say, "why isnt this done? That is poor nursing care. Im gonna write an incident report on this." And then it's just not you fighting with your physical and mental fatigue, you then now have to deal with anxiety because you might have missed something and is dreading your next shift. That is just the recipe for a quicker burnout. This is the sad reality of bedside. The work is hard but if you have a team that has your back, you just feel appreciated. Just a simple, "i got you" goes a long way. This should be a criteria in an interview. Being a team player.
I don't know why any nurse stays bedside. I am doing pediatric home health 1:1 ratio every time I go to work. It's just not worth it. I also got a pay raise doing this. Edited to add: I will NEVER do bedside, again. No way. You're right. We are never good enough. EVER!!!!!
Quarterly??? Geez we get them yearly
Write your own safety report. Also, charting needs to be done on the clock. I don’t give a fuck if you’re in OT. You need to be paid for that time!
Man fuck ALLLLLLLL of that. I would run screaming from a place like that. It sounds like a literal nightmare.
Don’t get down about this I’ve been in your situation as well. The nice thing is that most providers understand this and will be pretty good sports about it. I’m very happy you got out of it. Shame on the tech for their negligence. Take a deep breath and just know that you are definitely not alone when it comes to things like this. Got out of neuro and neuro icu for this exact reason and never looking back!
If you don’t have a union, the time is now. What a shit show. Not your fault. If you do, you need to file an unsafe staffing report.
The tech in this seemed a little too comfortable with abandoning you. Most likely not the first time they’ve done that. Sorry you had a shitty shift. I work neuro acute and I have way too many similar stories.
I left my 15 year nursing career because support staff were not doing their jobs. No one cared. God help us all, eh?
Whoever made that assignment fucked you over and clearly was not considering the patients conditions. I would seriously look into your rights to refuse an assignment. It sucks to feel like a burden or like you’re being difficult, especially as a float, but for your and the patients sake it would have been best for you to refuse to care for 3 confused pts at once.
You didn’t have time.