I took a job as a traveling nurse 6 weeks ago, half days, half nights. This has been the most stress I have ever had in my life and I'm afraid it is affecting my health. I need some advice. I am under contract with a nationwide company. I am on a surgical unit, 15 bed. General surgicals, bariatric surgeries, many very complex patients, lots of TPN, open wounds, all the wound flap surgeries on quads, paras, etc. You get the picture. I have had 7 patients on day shift which I felt is too much. There is no time for real care, just get in, get out, the less you talk to the patient, the better kind of environment. So I contacted my recruiter and got permission to go straight nocs and the hospital gladly accomodated my request. I start my 3 nocs in a row tomorrow. It is not uncommon for there to be 1 RN, 1 LPN, and 1 CNA for 15 patients. I feel this is so unsafe and I"m scared to death to be responsible for that many surgical patients. The LPN can only pass meds, take vitals, I/0. No assessments, charts, MD calls. How can one nurse keep track of this many patients and do an adequate, safe job? Am I being a wimpy nurse? I want to get the heck out of this contract. I am so stressed out during the whole shift because I fear for my licence. What should I do? Also, just wanted to say this is my first travel assignment...i didn't ask any questions. Just didn't think it could be this bad.
Hi Panda,
First organize and prioritize. Make as good help of your LPN as you can.
I worked post surgical for years and had 6-10 patients it is not ideal ...but you have a LPN also.
I do not think you are being wimpy for justified complaints.
For years Nurses have been overworked. in regard to fear for your license,follow policy for that is all you have that stands behind you,and most companies are only interested in the income generated.
Group your calls to Doctors together.....take a team approach. And start with your treatments first you can probably have 3-4 done in first couple of hours.
If admissions come get basics in asap and then in most places you have 24 hours to get full Care plan in place. 22N
Thanks your your advice. Using an LPN in this capacity is very new to me so sometimes I don't remember that they are there to help me out in other ways besides passing meds. And then I feel really bad if I ask them something and they are already overwhelmed by what they already have to do. My worry is the extreme number of patients to keep track of as far as assessments, labs, histories etc go. Everything is documented on a computer so these nurses rarely write anything down. Well, I am still in the dark ages on paper and feel like I have to have my hard copy in hand at all times so I'm doing double duty (computer and hard copy) to keep it all straight. 15 is a lot of patients to keep situated in my mind. At least on nights, there are not nearly as many meds to be given so this may free the LPN up enough to do some other things. I'm heading out for my 3 nights so wish me luck. Thanks again.
Panda,
If you are tethered to hard copy put the abnormal labs on your shift sheet...so that you can report them when reporting off(chances are that at least 2 other Nurses have seen them also.
I would use red pen to circle them if just slightly abnormal.
Grossly abnormal recieved a red star and a check mark when i called doctor.
Of course luck! Moreover high skills@ our craft!.....22N
Panda,
What facility are you working at? Which State?
Good luck to you......be well!
Judi
Well, I'm convinced that I don't want to work here. 70 nurses have quit this facility in the past 2 to 3 months due to some changes the hospital made that these nurses were not willing to accept (not a union hospital). I hurt my back because I tried to do something as I had no help so I did it by myself. Now I have no idea if I even have work comp in case it gets worse. This is not stated anywhere in my contract. It happened on saturday so I'm not sure who to report it to. This is a bad situation and I would not be a patient at this facility. I go back Tuesday and not sure I can do it. Way too scary. The other traveler that I started with, walked out last week, she had had enough.
sunnijudi wrote:Panda,
What facility are you working at? Which State?
Good luck to you......be well!
Judi
I will send it to you privately if you want it.
Thanks I would appreciate the info!
jschmitt@centurytel.net
Hope things are better! :-)
judi
Hello,
I am sorry to hear about the dreadful conditions under which you are working. I use to work at a hospital that had a 4-1 bariatric patient to nurse ratio because they are such tough patients. The management of that hospital should be ashamed of themselves and it is likely that they will get into serious trouble before long with their calloused attitudes and flawed decision making. Please share with us the name and location of this dreadful hospital so that others of us out here will not be subject to the same horrendous conditions as you have been. Best of luck and all I can say is that this to will pass. Tim :(
panda60 wrote:I took a job as a traveling nurse 6 weeks ago, half days, half nights. This has been the most stress I have ever had in my life and I'm afraid it is affecting my health. I need some advice. I am under contract with a nationwide company. I am on a surgical unit, 15 bed. General surgicals, bariatric surgeries, many very complex patients, lots of TPN, open wounds, all the wound flap surgeries on quads, paras, etc. You get the picture. I have had 7 patients on day shift which I felt is too much. There is no time for real care, just get in, get out, the less you talk to the patient, the better kind of environment. So I contacted my recruiter and got permission to go straight nocs and the hospital gladly accomodated my request. I start my 3 nocs in a row tomorrow. It is not uncommon for there to be 1 RN, 1 LPN, and 1 CNA for 15 patients. I feel this is so unsafe and I"m scared to death to be responsible for that many surgical patients. The LPN can only pass meds, take vitals, I/0. No assessments, charts, MD calls. How can one nurse keep track of this many patients and do an adequate, safe job? Am I being a wimpy nurse? I want to get the heck out of this contract. I am so stressed out during the whole shift because I fear for my licence. What should I do? Also, just wanted to say this is my first travel assignment...i didn't ask any questions. Just didn't think it could be this bad.
I don't think you are a "whimpy nurse". Just covering your butt. Sounds like a form of neglect going on in there.
panda60 wrote:I took a job as a traveling nurse 6 weeks ago, half days, half nights. This has been the most stress I have ever had in my life and I'm afraid it is affecting my health. I need some advice. I am under contract with a nationwide company. I am on a surgical unit, 15 bed. General surgicals, bariatric surgeries, many very complex patients, lots of TPN, open wounds, all the wound flap surgeries on quads, paras, etc. You get the picture. I have had 7 patients on day shift which I felt is too much. There is no time for real care, just get in, get out, the less you talk to the patient, the better kind of environment. So I contacted my recruiter and got permission to go straight nocs and the hospital gladly accomodated my request. I start my 3 nocs in a row tomorrow. It is not uncommon for there to be 1 RN, 1 LPN, and 1 CNA for 15 patients. I feel this is so unsafe and I"m scared to death to be responsible for that many surgical patients. The LPN can only pass meds, take vitals, I/0. No assessments, charts, MD calls. How can one nurse keep track of this many patients and do an adequate, safe job? Am I being a wimpy nurse? I want to get the heck out of this contract. I am so stressed out during the whole shift because I fear for my licence. What should I do? Also, just wanted to say this is my first travel assignment...i didn't ask any questions. Just didn't think it could be this bad.
I've traveled to 9 hospitals in 4 years. My 8th hospital was in Miss. 15 minutes from the arkansas line. It was suppose to be 13 weeks it ended in 5 weeks. It was unbearable. The hospital was very unsafe plus we were being cursed at the nursing station by other nurses. If the job is really unsafe then you need to contact you agency. The CNO at the hospital said that the hospital was a system failure. A supervisor told us about getting sugar in her gas tank. An example of safety was we had a bleeding hep. pt. and only small gloves was in the room . think safety or help a pt from bleeding out a diaysis port that had gone bad . no b/p in room to help a pt that was coding. the only onces working went backwards. you worked really hard for your license. Our agency tns took up for us even showed up at the hospital . they pulled us off the job and we owed nothing. Good luck. this is the only probelm I have ever had with a hospital 1 out of 9 isn't bad. The goal is to investigate the area and hospital more than the money. Its better to make 34.00 and be able to do a safe job that to make 38.00 and fell at the job.
Update. I quit this assignment on week 9. I admitted a patient one night, he came in with seizures. Ativan or Valium were ordered prn, seizure. We were not allowed to override anything on the omnicell. So, 10 minutes after getting him into bed, he went into a bad clonic tonic seizure. We ran to the Omnicell to get the Ativan, thinking pharmacy had programed it in by then...couldn't get it out, called pharmacy and no answer, put it on speaker phone and it rang for 12 minutes before they answered. meanwhile, we ran to the omnicell and scanned every patient on the unit to see if anyone had ativan, which no one did, so had to run to another unit and do the same thing. Finally found someone who we could take from. By this time, the patient had quit having the seizure and had started into another one. There were 2 nurses on, no aide and 15 patients. This was the tipping point. I called my recruiter and they told me NO PROBLEM. I got all my pay, didn't have to pay anything back and they were really good about it. The hospital was very mad at me but I do not care. I never saw management step in and help these nurses out. I will never travel again because of this assignment. I'm glad to be back at my old hospital where my ratio is 6 to 1 on nights. The past four nights I've had 4 patients, tops. What a change. Thanks for all your advice.
I have a list of questions on my website for Travelers which I print out and use on every interview with the hiring manager and the recruiter. You may even think of others specific to your specialty. I've turned down plenty of assignments because I found things out in the interview, from other Travelers and searches on the Internet. That said no assignment will be perfect or else they probably wouldn't need travelers but it defintely helps to minimize the risks. Another thing get NSO liability coverage (NSO.com) which also covers you very well if you ever were investigated by any Board of Nursing. Thank God I haven't had to use it for that but it happens to even the best of Nurses. I just renewed mine and it was $98/yr and tax deductable and a must for Travelers. Covers all states and Puerto Rico. Good luck to you and get plenty of rest and relaxation in between shifts. Maybe you could ask to spread the shifts out if not already to give you more down time. Sounds like they are working with you which is a good sign. I've heard of situations and have been in situations where the workload increases and the back-stabbing atmosphere increases. That's why I left my perm position to go Traveling and so far all my Travel assignments have been great. There are a lot of great assignment out there evn in my specialty Psych...you just have to do your research and ask the questions.
CJ
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