Am I experiencing nurse burn out?

Taken from this website
Could I be experiencing job burnout?

Ask yourself the following questions:

Have you become cynical or critical at work? Yes, so much so that if something goes wrong I've gotten to the point where I laugh and say 'yeah, figures." Nothing surprises me anymore. Patient pulls their IV out. Figured that idiot would. Pt family has a complaint about something that happened on day shift? Yeah, well get over it. Nothing I can do about it. I wasn't here. I'm snappy, I'm mean. I'm not that nice nurse I was 12 months ago. Nursing is changing me. 

Do you drag yourself to work and have trouble getting started once you arrive? Yes, and almost throw up in the car before I get out. I used to be so quick to get started working. Now I can give two shits about starting on time. Pt will still complain that I haven't served them fast enough. Who really gives a fuck anymore.

Have you become irritable or impatient with co-workers, customers or clients? Yes, to the point when I vent when I get home. More about patients than co workers. I know my co workers are going through the same hell as me. Patients, not the really sick ones, need to grow a pair and go the fuck home.

Do you lack the energy to be consistently productive? Yes. I take mini breaks during my shift. It helps since I never take my full thirty min. one. Guess it adds up.

Do you lack satisfaction from your achievements? Yes, but then when I think I've done something right I get told I did something wrong. I don't see the point anymore.

Do you feel disillusioned about your job? Yes, by all the lies I was told when I was hired.

Are you using food, drugs or alcohol to feel better or to simply not feel? Yes, wine on my days off. Yay for that warm sleepy feeling. Food not so much. I don't eat as much as I should I think.

Have your sleep habits or appetite changed? Yes, I sleep okay, I guess, but I'm always tired no matter how much sleep I get.

Are you troubled by unexplained headaches, backaches or other physical complaints? Yes, reflux, head aches, muscle aches, pain, and dizziness. YES, YES YES

Switch to Royal Blue

So, my work place has decided to change all RN scrubs from navy to royal blue in an attempt to make us appear more professional and 'uniform.' Okay, so this wouldn't be such a huge pain in the ass if the higher ups actually fixed the 'real' problems within the hospital.

Patients do not care what nurses are wearing. They could care less that a nurse's outfit is off gray instead of a crisp navy blue. I've never heard a patient or their family complain that a nurse wasn't wearing the right color and that they didn't look 'professional' enough. They care more about the care they are receiving versus how fashionable their nurse's scrubs are.

In addition to scrub colors, my work place has spent thousands of dollars painting and redecorating the floors within the hospital. This money could have gone to hiring sitters to sit with hostile patients in the ED. This money could have been spent fixing the computers that nurses use and physicians use. They could have also hired techs for floors that are continuously short staffed or paying for another nurse or two to work on the floor so that our nurse to patient ratio could decrease to 5 like we were all promised when we were hired.

But no. Now our walls are blue instead of beige and the floors are fake wood instead of carpet. And nurses, and other professionals, are now being asked to buy new scrubs in an attempt to impress. I bet the people who are quitting left and right are so glad that their place of work is changing their scrub colors. THAT will make them want to stick around and work in a place so horribly managed that they can't even take a break to piss and eat within a 12 hr shift.

And I just love the pretty painted bathrooms. As if I get to see them at all during my entire, bloody shift.

The first thing you learn in nursing school is to prioritize your care. Did management skip this class or were they too busy deciding whether to wear a blue or black suit to class that day?

This is yet another reason why I'll be happy to leave this hospital. I'll be glad to work for a place that cares more about their workers than what they look like on the outside.

Sums up my hate of call lights

Oh in a perfect world.... (found on allnurses.com)

A selective call bell system..for example,when the call bell rings, they have an automated choice....

Enter 1 if you are calling to say you have to crap AGAIN.

Enter 2 if you are calling to say you have already s**t (this a totally different problem).

Enter 3 if you are a drug seeking a$hole and are requesting morphine.

Enter 4 if your crazy family is here and they want to speak with me.

Enter 5 if you feel like complaining and think I give a damn.

Enter 6 if you dropped your tissue box again and think I am coming in anytime soon to pick it up.

Enter 7 if you think I am a damn waitress and will get you the meal you actually ordered.

Enter 8 if your IV is beeping again because you just can't seem to remember to keep your ******* arm straight no matter how many times we tell you.

Enter 9 if you think Nurses walk on water, you haven't called since you have come in, you hate to bother me, your family is normal, you ARE having crushing chest pain and think you are going to die....I'll be right there.

Do not hit 9 when you meant to hit 2. You will wish you did die!

----

If only we really had this!

So....

Tonight was a good night. No real complaints.

Sometimes I wonder

If nursing is really for me. It's hard to remember the good days when the bad days stand out so prominently in my mind. I know I've grown as a nurse since I started working in August 2011. My confidence in my skills have far surpassed what I thought I could ever accomplish yet, each day I feel like I take one step forward and two steps back. Three steps back on those days where I do something that makes me question my future as a nurse. It's the tiny things that bog me down. Not calling the doctor about things that I probably should have. Not important things like blood sugars, elevated bp, critical labs, but small things that in retrospect I should have known to call about but didn't even think about. I feel incompetent sometimes. I've been doing this nursing thing for 15 months and yet I still feel like a newbie.

Everyone talks about this miracle 'ah ha' moment after your first year and I have to say I haven't had that moment yet. Sure, I know more about what's going on than the new GEMS on the floor. I know procedures, paperwork, who to call about what (sometimes...). I know how to handle family members to a degree. I've had my fair share of unruly patients and I think I've handled them to the best of my ability. Nursing school doesn't teach you about paperwork, mean doctors, the fact that if anything isn't done by another department it's the nurse's fault. They don't show you the 'mean side' of nursing. I wish they would. I very much doubt students would continue the course if they were repeatedly yelled at my doctors during preceptorship, had to deal with alcoholics hitting them spitting and cursing at them, rude family members who think they deserve all of your attention and who treat you like a waitress rather than a professional.

Had the rose colored glasses of nursing school been taken off prior to my senior year I would have changed majors. Yet, here I am. Stuck in a profession that I'm beginning to hate. I've spent more time looking for a job, any job, to take me away from the hospital or nursing in general. If I had more good days than bad I would like my job. I wouldn't mind waking up and going in to take care of patients. I'd actually enjoy my job. Thing is, I've had more bad days and those days have made me regret wasting 5 years of my life studying late into the night to pass an exam to get into nursing school. It has made me regret walking in the freezing cold to catch a bus to go to class to take classes that would ultimately lead me to where I am now.

Had I known what I know now about nursing I wouldn't have gone down this path. I'd be free of this gray cloud that hovers over my head an hour before I have to go to work. I wouldn't cry every day just thinking about how I absolutely hate taking care of people who don't appreciate it.

Nursing really isn't for me and I think I've finally figured that out. I may return to school to pursue something less stressful. The only thing that's keeping me at my current job is the pay and my coworkers. I didn't have any money before I started working and I'm sure I will find nice coworkers elsewhere.

Nursing isn't meant to for everyone. It's definitely not meant for me. I'm happy to finally admit that.

3 days in a row

I can quite honestly say, working 3 days in a row on nights is NOT gonna work. I feel like a zombie. THANK HEAVENS this is the third day. I'll be sure to let who ever makes the schedule know that I hate it. If they put me down for another  3 days in a row I'm seriously going to call out one of those days. 

Night shift. OMFG

I love it. Night shift is by far the shift from heaven. While it can still be very busy at times I didn't feel quite so overwhelmed as I did on day shift. The different sort of busy is in fact true. You don't have all the distractions like on day shift but you rarely have time to sit down and just chat. People don't stop hurting just because it's night time. I gave pain meds ALL NIGHT LONG along with Benadryl for itching q4. Patients wants snacks all night long. I really just wanted to say "go to sleep." Some of them did sleep for a moment but a few did not. I just don't know how you can stay up all night and stay up all day too. You wonder why your body is shot and worn out. You haven't slept in 24 hours. O_O.

There aren't nearly as many meds as on day shift. I had 2200 meds, one 0300 antibiotic and then I was done until 6am. I'm being very serious. I've never had that much down time between meds. I didn't know what to do with myself. Giving prns kept me busy but then those are q4 or 46 so I didn't have to give them quite as often.

The staff worked great together. I learned a lot and at the end of the shift I was really glad that I had chosen to go night shift. I know things will not always be like this, but for once I can say "I had an awesome night at work!!!!"

Go night shift!!

Me

Taking the leap

So a few weeks ago I asked my manager about switching to night shift. She was more than willing to allow me to try it out. I made it very clear that I would do 3 weeks to see if I liked it. If not I'd really prefer to stay on day shift. I have no other option other than to quit. -__-. Day shift is wayyy too hectic for me. Not to say that night shift will be any better, but at least I won't have to deal with all the crap that goes along with day shift. I.e. A gazillion doctors rounding and writing orders, changing orders and writing more orders, interns asking about things they could find out by simply looking in the chart, family members calling to see how a patient's night was (like I have any idea since I wasn't there.) admissions AND discharges, transfers, surgeries and the paper work that go along with it, physical therapy, occupational therapy, case management, managers, that guy who said he was gonna make our floor the best floor in the hospital but who spends all of his time in his office doing absolutely nothing worth talking about. Yeah, so night shift is looking pretty good right now.

All the night shift nurses seem to think that night shift is slower, easier and a different sort of busy. I don't know what they mean by a different sort of busy, but I hope it's not the same sort of busy that I'm used to. Days have sucked the life out of me. I dread going to work. I loathe knowing that in the morning I have to get up at 5 am to drive to work and deal with the same crap I had to deal with the previous day. At least now that I'm on night shift I know that day shift will deal with a large majority of the crap I've been dealing with for the last 9 months. Day shift nurses on a med surg floor have it hard. They deal with a lot of crap.  A LOT. I honestly can't take it anymore. I'm surprised that I handled it for 9 months...I guess I'm stronger than I thought I was.

Here's to hoping that night shift is a bit more tolerable. I really could use a change of pace.

Me

Typical Day Shift on Med Surg floor

I've been looking all over the place for blog posts about night shifts on med surg floors because I'm considering switching to nights. Days are just too busy and stressful. I know nights can be stressful too, but from what I've heard from the night shift nurses on my floor it's A LOT better on nights. Here's hoping!

My day shift (without any discharges or admissions...LMAO. Days like this are RARE.)

0500- Wake up and prepare for work.
0610- Out the door and driving to work
0645-Arrive at work, clock in, unpack and start getting report
00645-0730- Roughly I should be done with report (really depends on the night nurse and the amount of stuff to report).
0730-0735 I organize all my paper work (report sheets, braden scales, skin assessments etc) Check charts to assure that no new orders were written while I was in report. Docs round really early.
0735-0800- Assess all my patients to make sure that they are IN FACT alive and don't need anything (I. pain meds, help to the bathroom etc)
0800-1030- Med passes. Sometimes I'm done early if patients don't have many meds. Chart assessments and anything pertinent that happened.
1035 Check charts again. Help with blood sugars. Pain meds are given if needed.
1130-Give insulins if anyone on my team is diabetic. Gotta wait for lunch trays which come early some days.
1200- Chart again. Check on patients. Check charts again.
1330- Give 1400 meds if not given.
1530- Check blood sugars
1600- Give meds.
1800- Hopefully start working on report materials and prepare for report.
1900- Give report. Do anything I didn't have time to do before 7pm. Clock out hopefully before 2000...

This is a GOOD day. I've only had 3 days like this in the 8 months I've been working. You can usually throw in stat lab orders. This doesn't throw me off unless the patient has a PICC and I have to stop what I'm doing to draw the blood because the lab techs aren't allowed to draw blood from PICCs...I still don't know why this is. Physical therapy rounds around 9-11am so you have to wait for them to finish so you can pass meds if you're running behind.

Patients leave for test all day long. Thought you'd get those 1000 meds in at 10. Hahaha. Patient's going down for a CT. He'll be back at 1030. Think you'll be able to get those meds to him at 1030. Hahaha. No, another patient is complaining of SOB and you have to get in touch with the physician, monitor their O2 sat, get respiratory to come see them and write some verbal orders because the doctor is stuck in a trauma in ED and can't come up right now.

Case management (bless their hearts) likes to toss discharges/transfers on you at random times. I've been told a patient is being transferred as late as 1 hour before the ambulance service showed up. You'd think that would be enough time to call report to the receiving facility, take out IV, foleys, PICC lines if they aren't going with them before the ambulance gets there but not so when you have five other patients calling for pain meds, beeping pumps and a 100 other things. Some times report gets called after the patient leaves the unit...I know. I'm bad, but I honestly didn't have 10 minutes to sit down, organize report material, find the chart (which is being copied by the way...and the CM neglected to tell you and instead let you run around like a crazy person searching for it for a half hour.)

Blood orders may be written too so you have to go get that started. God forbid the blood order is written at 4pm and you can't get the type and cross done and blood hung by shift change...All hell will break loose.

Toss in $#%%&^* family members complaining that the patient in room 123 called for a stool softener 30 minutes ago and the patient in 456 called for pain meds 5 minutes ago and is now requesting to see the manager because the nurse hasn't come yet and you're in for a LONG day.

And if you get an admission thrown in there somewhere you better hope the patient is either an ICU roll out or an admit from the ED which had an admission nurse because if not you're stuck filling out admission paperwork, setting up IV pumps, getting all of their admission requirements done (SCD, O2, ted hose, trapeze for ortho patients etc). If the patient comes up alone you can get all of their needs met pretty easily, but if they come up with a demanding family member be prepared to spend 15 minutes answering 150000 questions about a patient who only just rolled up on the floor and who you know absolutely nothing about aside from what you got in report.


I'm lucky to make it out at 9pm on days like this. The latest I've stayed was 1030 to catch up on charting and chart checks.

I like my job on those 'good days' and I despise it on those bad, but hey...what can I say. It's nursing. No one said it would be easy!

Me 

Found a post on Allnurses that just sums it all up.

Mar 13 by Jennerizer here

"A lot of the hospitals here in Florida are getting rid of the patient care techs....so if you plan on being a nurse, you better make sure you're ok with doing a lot of what a typical CNA would do for the patients. I can understand why turn over is high for new grads....it is crazy out here. I've been a nurse for over 7 years & even I am getting fed up with the shortstaffing, poor pt to nurse ratios, the constant berating of HCAHP scores & how we (the nurses) need to do better.....even though the hospital chooses to keep us running with as few nurses as possible. Our poor new grads are started out on med/surg with 7 patients, no techs and no secretary. If I had started in an environment, I would have turned around & ran the other way.

I don't think it's so much that older nurses are eating their young......rather they are too overwhelmed themselves to help very much. I am not jaded towards nursing.....nursing is a fine career. It is when administration thinks because a nurse "can"...that they "should" do everyone's job. We put in our orders, we are doing respiratory treatments, now they are telling us to make sure we clean the rooms on a daily basis.....as well as emptying the trash and laundry. Cater to not only the patients, but their families also...because 60% of the patient satisfaction surveys are filled out by family members. Remind doctors to do this or that. Call doctors with results of tests....and in turn get yelled at by these doctors for bothering them with results.

Where is the nursing in all that? We are being turned into a jack of all trades & then blamed when something doesn't go right. Lab messes up a time or a order....well, the nurse should have caught the mistake & corrected it....or the nurse should have noticed no one from lab drew the blood at the exact time & the nurse should have made a call to remind lab to draw the blood. The doctor orders the wrong test or doesn't give a reason why a test is ordered....the nurse should figure it out or follow up with the md. MRI is ordered but the dept is taking awhile to get the patient...the nurse should call and find out why they are taking so long. Pharmacy is questioning medications, have the nurse call the MD to clarify & then call the pharmacist to follow thru on clarification. Pharmacist still doesn't agree? The nurse should keep calling until it is resolved. Why can't the doctor & pharmacist talk to one another? No one around to answer the phone, the nurse should drop everything to answer the random unit phone calls. It goes on & on & on. Put the nurse in the middle & then blame the nurse for everything that isn't perfect. That is not nursing!"

THIS. THIS. THIS in so many ways. Urgh! Thank heavens I'm not the only person who thinks this way.

And to add, why is it when a doctor comes on the floor to write orders for a patient they RARELY go in to see the actual patient? Patients expect us to stop what we are doing to call and inform the doctor of every question they have no matter how minimal it is (such as getting an excuse for work after they are discharged) and then get pissed when we don't take the time during our busy shift to stop and do said task....I'm sorry that passing pain meds, putting in orders, and drawing labs is more important that making sure you have an excuse for work!!!! All questions could have been resolved had the physician actually dropped in and SAW THEIR PATIENTS!!!! Then I wouldn't have to call them to get that order for tylenol for that patient who has a headache because they've been stressing out about not seeing their doctor for 3 days....

And patient families. Please do not get me started on you. Yes, I know that you want to visit your family member. I completely understand that. But please don't linger at the bedside and refuse to move when I ask you to so that I can get to said patient. And stop rolling your eyes at me because I don't have time to make YOU coffee or answer every bloody question you have. I can't tell you anything about the patient's condition. Stop asking! And no, this isn't a hotel or Burger King. You can't have it the way you want it. I'm not a waitress. I don't make coffee. I will if I have time, but I'm not going to stop in the middle of an assessment to make you a cup.

Lord. It feels like all I do these days is complain. I wish visiting hours didn't start until at least 11am. Then I could get my assessments and morning med passes completed before grandma, cousins and their best friends from high school show up and slow me down. -_-

The Road is Long

I've been working as a nurse for 6 months and 8 days and I must say...nursing isn't what I thought it would be. I've been yelled at my patients, threatened by family's, humiliated in front of every staff member on the floor by doctors. I've gotten in trouble for things I didn't know, things I was never taught and never thought to ask about. I've been made to feel little, unimportant, a waste of space in a hospital that can easily replace me. I do not feel important at all. Another name on a page. Another face in the crowd. I try and it doesn't seem to do any good.

I've been told that the first year of nursing will be your hardest. I've only been working for 6 months and 8 days and I'm already ready to quit.

In my short time as a nurse two nurses have already resigned. Neither of them have been on this floor for a year. This particular unit will chew you up and spit you out. Sure, there are nurses who will help you if they see you drowning, yet you're 10 feet under before they realize or care to help. And you hate to be a burden. Everyone's busy. No one has time to stop and answer every single question. They pile up, they suffocate you and before you know it you're head deep in chaos and no one, not even that sweet, even tempered charge nurse can help you.

I try. God how I try, but each day the light at the end of the tunnel grows dimmer. I can no longer see the glow as it fades. I try to keep my head up. It must get better eventually...right? Less than 6 months and I will be a year old nurse. Will I know everything? No. Will I feel comfortable in my own skin? I hope so.

Nursing for a new nurse is a difficult feat. I truly wish that patients, families, doctors and more experienced nurses realized how hard it really is. They expect you to know so much in such a small about of time. Six months is not very long. 3 days a week. 4 weeks in a month. 6 months. 96 days. That's barely 4 months of true experience and yet I'm required to have all of the answers or at least know where to find the answer which is easier said than done some days.

I'm ranting. I know. I've been having these horrible days a lot lately. A new nurse said something online that has stuck with me for weeks. I'll summarize it.

As a new nurse we need support and guidance. We need help even though we may not always ask for it. Please, when you see me drowning in piles of paperwork, calls, physician orders, family issues, do not ask me if I need help as you're one number away from clocking out. You do not wish to help. You only want to make yourself feel better, satisfy your conscience before you leave at the end of the day. Please do not, after asking if I need help, huff and pout when I ask you to do something for me. If you didn't want to help you shouldn't have asked. There's nothing more irritating.

Tomorrow I'll give it another try. I've yet to have 2 horrible days in a row. Tomorrow will be better. If it's not at least I get three days off before I have to plunge back into the despicable world of bedside nursing.