I am an RN and charge nurse for a small rural hospital. I work 7A-7P. Our hospital staffs 1 RN, 2 or 3 LVN's, and 1 nursing assistant pershift depending on the number of patients in our facility. If the patient load is small an LVN or assistant is called off and sometimes both. We have 1 LVN who is assigned med nurse, and 1 assigned patient care on the floor.
The RN does assessments, makes rounds with Docs, notes all orders, orders all lab and radiology, puts all ordered meds on MARS, covers ER and is responsible for the floor as well.
On a slow day I feel like I do a really good job of taking care of all of my responsibilities. But on a busy day I get out late and feel like I have flown by the seat of my pants all day long. I don't feel good about the care my patients got because I rarely see them except for assessments and if there is a problem. I don't have time to address their emotional and spiritual concerns and probably feel as helpless as they do. Needless to say my shift change report isn't what I would like it to be either. And my patients continued care depends alot on the information relayed to the oncoming nurses in report.
Yesterday was one of those days.In addition to the 9 patients we had on the floor, we saw 8-10 in the ER, had 5 transfers (4 ground and 1 air transport), and admitted 4. I got slammed as you can see. Then in the middle of noting orders, transposing meds to the MARs, ordering lab and xray, assessing ER patients, doing transfers and admissions, one of my patients is going bad on the floor. We eventually had to transfer him out. So that was 6 transfers in all.
While waiting for the Doc on call to secure a physician to accept the patient, we were already into the 7P shift and I rounded up the oncoming nurses for report. During report, the on call Doc sent someone in and told them to tell me to get back out there and finish the transfer so she could go home. So I headed back out to the floor, now that she had secured an accepting physician, and wrapped up the transfer.
Me, and my 2 LVN's spent about another hour and half finishing our documentation, and making sure everything was in order from our shift. I found meds that were not given as the med nurse was tied up with patient care while my other LVN was assisting with patients in ER so that I could take on the more serious patients we were preparing for transfer. One was especially of concern having been involved in a one car roll-over. My med nurse was in tears because she felt so helpless and overwhelmed. I felt like crying a number of times throughout the shift but I didn't have time.
It was a nightmare. I thank the Lord that it is behind me but I pray that I never have another day like that.
I was wondering how many of you work in a small hospital like ours and have days like this. Sometimes I wonder if working in a larger hospital would be better if they have more staff, or at least a ward clerk to take on the task of ordering lab and radiolgy, etc.
I'd say stay in at least with one toe, but definetly get other skills. Nursing is like a blind fold to our lives/selves. The best thing I have done is to have gone out of nursing learned new skills and met different people. It is as if the career made you co-dependent on itself. Then you find that all the years have passed and you stand there looking into the mirror and saying, "should I stay or should I go"?
Oh yeah! I've sid it also; "if I had to do it over..." I would have picked engineering. I also am a LVN (CA) and it would not benefit me to be an RN. More money they would take from me, but I am looking to get into, patient services/admission etc. I see LVN's filling those types of slots.
My God, are we all like this? I say and have said the very same words.
I have been a nurse for only 1 1/2 years but have already said the very same thing more times than I can count! Most of my complaints are due to constant policy changes, problems with stafing, pharmacy and the computer system. I do have to say I am lucky to have an excellent unit clerk on my floor who knows how to order anything I need and is very efficient. I was a dental assistant for 14 years before becoming a nurse. During my "nightmare" days I have found myself saying "I can always go back to dentistry" which nothing more than blowing off steam because I love nursing! That's why I'm continuing my education, to increase my options. Nursing can offer so many opportunities that I wouldn't give up on it completely. Hang in there!
There are other advantages to nursing....we have lateral transfers....I have had a total of 8 state licenses in my 27 years..we can work where ever we go! I usually interview for a job and they ask if I brought a uniform...what other job can do that?
We also have the advantage of various shifts for our needs. I worked nights for 15 years while my son grew up and he was never home alone...no latch key kids for me.
We can work 3 days/we and it's full time. That way we have plenty of time off for the other things in our lives.
So there are plenty of positives to offset the negatives.
Hope this helps.
Hang in there.Being a nurse is one of the most rewarding experience's I know of.I am retired but I miss it very much. Yes nursing has changed over the years. for the worse but I still loved taking care of my patients.Seeing them recover ,go home feeling much better.I think my most rewarding experience was careing for the dying.If you ever have a dying pt. tell the family to talk to them.I do not know how many times I have had family's tell me "Thank you so much for telling me to talk to Mother and to tell her I love her but I will be ok .It is ok.Their dying relative,a many time closed their eyes w/ an appearence of a grin and go on.I can name 1000;s of people who have been blessed by talking to MOM ,Dad,Sister, daughter or what ever relation to thank me over the years. Even today when they meet me still say thanks.I have never saw or heard a nurse tell a family this before.Even with me tellling them they should.The world needs good nurses .Do not quit now.
A very good example was a fellow employee 's mother was in her dying stage.There were 10 adult children there with her in the Hospital.Well , no they were in the waiting room.I and one family member was with the pt. She had ask me to stay with her.Knowing I needed to go check all the pt's as I was charge nurse, I could not leave so ask a fellow nurse to ck. on all pt's and I stayed.She was about gone .I went to the waiting room.Told all 9 kids ther ,i they wanted to see her one more time they better go now.All 9 went in some w/ spouses and made more than 9.They stood and looked at her for about 10 min.I could not stand that.I said in a whisper to them each of you need to talk to her tell her you will be fine it is OK. Tell her you love her.Anything you want to say.They ,two at a time went up to her huged and kissed her talked to her then each followed until they had all said their goodbys.This mother who had not said a word the whole time we were there.Smiled and very low voice said, I love you all. and closed her eyes.and passed away.They all were in smiles said she was waiting on us to talk to her to see if we would be ok and then she went on home to be with dad.They still thank me today.Their time with mother still is deep in theit hearts.This is my calling to help the dying and sick.I will never regret it.I only wish I had two lives to redo it again.
JaneBSRN I think I moonlighted at that small rural hospital you work at a few years ago. If not your hospital it had to be its clone! Actually, they staffed yours better than the one I experienced come to think of it.
This place had a 40 bed floor & 5 room ER. It would mostly get elderly patients- some from the area's nursing homes, some from the community- many cardiac cases, too many dementia, medical issues, post surgery patients, and because it was in a dry county located on the border of a wet state too many alcohol related MVA's into the ER along with chest pain - and attrocious staffing!
12 hour shifts, 1 RN on PM shifts to handle the entire floor, the ER, and also be the pharmacist. 1 LPN - and if lucky we'd have 1 CNA. 1 shift supervisor as well but she doubled as assistant DON and literally spent her working hours hiding in the DON's office and only coming out to the floor just before morning shift change so the actual DON would see her "working in the hospital" when she arrived for work. Ha!
Sorry, but there isn't enough pay in the world for me to want to do that as an extra job again- and never as a full time job! Talk about putting patients at risk and yourt license on the line eh?
1 RN can not safely (or even marginally safely) deliver good care to 40 patients, adequately even assess all patients, do neuro checks on time, monitor changes in patient condition well enough, etc - especially while also being stuck in a trauma room with an acute ER patient, and have to be the hospital's pharmacist as well all at the same time.
If I were you, I'd seriously consider changing where I worked before something happens where you're at. If it's like the place I worked a while at that one summer it's probably the only hospital around & does what it does because they think all of you nurses don't want to drive a ways to work someplace else. Well- I strongly suggest you all band together & demand better staffing or else really do drive someplace else & quit that hospital.
Would I be a nurse again if I had it all to do over again? No- I'd become a PA instead. Same number of years education but more autonomy, more pay, more professional practice ability instantly. I am a nurse however and I LOVE running a trauma case. Bring me your gun shot wounds, your stabbings, the multiple patient MVA's, the OD's all day long... the more serious the presentation the more I love it...
But gawd I admire the floor nurses because I sure couldn't handle what they do. The patient overload, inadequate staffing, higher patient acuity levels, and overwelming paperwork....
STUDENT NURSE
You've made a step and you should be proud.
You've lifted yourself out from the crowd.
You've set a goal that few can do:
Some drift along...they're not like you.
It matters not from where you came.
It matters, your worthy aim:
To become a nurse: You've received the nod:
What inspired you? Was it God?
You'll parallel the Great Healer in some tiny ways,
and blessings will follow you all of your days.
Nothing is easy that's really worthwhile:
and many times there will be no smile.
Your field will be basic: Dealing in life and in death.
You'll view the new-born and the final of breath.
Your days will be hard and you'll want to quit!
But you'll think for a moment: WHAT can match "IT"?
You'll be tired and grouchy and your strength really sapped:
But the day will dawn when you will be "capped."
It's a mighty long way or at least it all seems;
To the day when your grad pin, in the sun, gleams.
The duty's so hard it will seem like a curse:
But it's a mighty big statement when you say:
"I'm a nurse."
By Frank Gillespie
1964
Dear Aspiring Nurses,
As you probably have perceived, Mr. Gillespie spent some time in the hospital as a patient. He was no doubt an observant people watcher. His poem tells it like it is.
I want to add to his words my own best wishes and my own sincere prayer for your career. I hope something written here will give you encouragement to hang in there & reach that goal. If I can help you, I will be glad to. God knows we need your help.
As you have read in all the current magazines, there is trouble; yes, there is corruption; the burn out rate is high. I would be a statistic myself if I'd not gone to work at St. Rita's Medical Center and read the Mission Statement: Among other beautiful words were these, "...to carry on the healing ministry of Christ..." I was inspired at Saint Rita's; I hope this prayer will inspire you.
A Nurse’s Prayer
Oh, Great Physician,
As we attempt to deliver care,
We know our limitations,
Please make us fully aware.
Send your angels to guard
Over those who have come for healing.
Make us alert, give us wisdom,
Your will, never stop revealing.
We trust in You for guidance.
This job is too big for mortals.
We must depend on your mercy and grace,
Please open Heaven’s portals!
Let Your Love rain down,
Help us to do our best,
Give us strength and protection,
Help us to pass each test.
Only You know how to cause healing.
We can only do our part.
Only You can give the increase.
Only You can we trust with our heart.
So, be our Great Physician.
Reign in our hearts and minds.
Help us always give You the praise,
Please remove the blinds!
By Eva Linda Hays
June 10, 2002
Best Wishes In Your Studies,
Sincerely,
Eva Linda Hays
PS: If you wish to write to Mr. Gillespie:
Frank M. Gillespie
806 Bolling Avenue
Charlottesville, Virginia 22901
Thanks for your reply to my post. I am in contract with this rural hospital until February. I just bought twenty acres back home and plan to move there as soon as I can. Hopefully I will land a better job in a larger hospital with better staffing. I hope I am not dreaming too big.
I did get slammed again last weekend but I picked up the phone and sent out a mayday to the DON and she tried everything, including telling me to call other nurses to come in, and I told her staffing was not my job and I would leave it up to her to round up the help. You won't believe it but she came in and helped out.
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