New Nurses Stressed by Workplace

“Starting my first RD job as a NICU RD. Any and ALL resources help! Also any advice on creating excel sheets for calculations (I’ve heard it’s a great idea but I’m not really sure where to start, which calculations I’ll even need, etc). Honestly a master list of all calculations that NICU RDs need to know would be amazing😊 submitted by /u/New-Bet4097 [link] [comments]”

this is what i was gonna say - sounds like it could be cultural!

“My hospital recently dissolved our float pool because the nurses were "unsafe" aka too expensive. This has left our ICUs extremely understaffed and unsafe. Normally, it's a max of two patient for one nurse. If there is a critical patient, such as ECMO, it's a standard two nurses for the one patient. When our patients have a cardiac device, the patient they're paired with should have no devices. We don't pair POD 1 patients with others who are also higher acuity. Every s”

“Are these the same patients who can’t tell the difference among a nurse, a PCA, a physical therapist, and a doctor?”

“they're basically handing you the blueprint for why the last person quit and hoping you'll sign up for it anyway”

“More Admin BS - they are never in the direct “Line of fire” of an upset patient! And certainly never “available” to deal directly with the fallout of short staffing, equipment shortages or any thing else that they can dodge!”

“I want to become a nurse. I'm lurking in this subreddit for that reason. If I ever get hospitalized. How would the best way be to tell management to fuck off and let nurses do their job? Also have any tips on dealing with this bs? Because I WILL get sassy with people that stop me from doing the best care I can. (Currently working in a group home and management makes dumb choices all the time too and will only listen to guardians.)”

“I was just thinking the same thing. A surgeon being nice is bizarre? That is so freaking sad.”

“Every single time I’ve tried to give push back about a patient being inappropriate for our floor as charge, I get attitude from the nursing supervisor, admitting doctor, the ED nurse, or all 3. And then the patient comes up anyways. Also, if the bed is clean, sometimes the patient can arrive within 5 minutes or less of it being assigned, making it impossible to look up the patient (I take a full patient load as charge). Our ER stopped calling report - I’ve walked past rooms that I thought were e”

“With the way OP described their pt load. Probably more than likely a struggle. Sickle cell pts tend to be needy, and rightfully so. But I can still give praise to med surge. As a nurse who’s only ever worked ICU I would not survive a simple med surge assignment.”

“I don't blame you for feeling that way. I definitely would've gotten heated. The most stern I've had to get in a situation somewhat like that was when a patient of mine was complaining about me not immediately addressing her IV pump beeping. I then explained that one of my patients had bad chest pain, so I had to address that first with a 12-lead EKG and a spot dose of IV morphine (and it was, thankfully, not a heart attack, just severe musculoskeletal pain in this patient's ches”

“Wait do you have to give care to a patient who willingly and knowingly did drugs? Is that a burden on the nurses?”

“My heart’s with you on this. I went through the exact same thing at a busy ICU. Took me way too long to realize I’d basically made my job my whole identity and forgot I’m a person who happens to be a nurse, not the other way around. Honestly what got me through was just journaling , getting it out of my head and onto paper (kind of like what you just did with this post) helped more than I expected. Therapy too, once I actually let myself cry. For me the way out ended up being leaving that toxic”

I walked in knowing i knew absolutely nothing and own it too

““note to self: charge nurse had time for me to speak two sentences. Staffing seems adequate, could even cut down some.” —CNO”

“Hi everyone. I’m going to be as vague as possible here. I made a med error, and because of that my patient had to go for a stat c-section. I’ve been a nurse for over 2 years; 2 on a med surg unit, and I’m currently at the end of my orientation on a level 4 maternal care labor and delivery unit. By the grace of whatever god exists out there, mom and baby are okay. I was literally hyperventilating in the OR waiting for baby’s first cry, who was miraculously just fine. I did everything that I knew”

“I work at a busy inner-city, academic center with residents. How are you all managing seeing the patients and managing their documentation? Do you repeat everything they do and thoroughly lay hands on every patient or are you hands-off? Are you sitting at the chair and working on documentation a bunch or are you on your feet having everyone looking for you in the unit or in a patient room? submitted by /u/MoreThanMD [link] [comments]”

“Yeah that sounds like a normal first day. Practically all nurses go through that for a while. You've just spent years in school having people observe and micromanage everything you did. Now suddenly you've been handed a license, thrust out into the world, and they tell you you're a grown up nurse with professional responsibilities. Anxiety is the normal response. It gets a lot better, slowly. It should get much less over the next weeks as your orientation progresses and you learn how”

“I felt dumb my entire first year of nursing and I was on a post-surgical unit. I can’t imagine the ER, even 4 years in. Give yourself some grace. Spend some time outside of work reviewing things you’re struggling with. You’ll get there if you don’t give up. Hang in there!!”

“The health and safety of staff and patients IN THAT ORDER should be the top priority. I👏 DID👏 NOT👏 STUTTER 👏”

“I am an adult hospice RN working for an agency with a small pediatric program. I work on-call with a small team and for one reason or another, all the peds patients live in a 2 mile radius from my house. I keep getting sent on peds visits. Every one of them sticks with me like a tattoo on my mind. I got sent to a elementary aged girl yesterday and when I saw her lying in her four poster bed in her hot pink room I totally lost it. I had to excuse myself and ask the parents for a tissue. I was abl”

“I just got a job on a mixed acuity unit in a hospital with no ICU and only two mixed acuity unit floors. It is my first nursing position and I have made my own report sheets in the past but I am not really sure what to expect. I know it's one of those things where you have to go and work on the unit and tweak your report sheets as you progress and work, but I would like to have some ideas for when that time comes. Here are the ones that I have already made for previous units so I can add to”

“13 years in ICU and I learned to start my days like this as well. Completely understated just how important this is to building rapport with your patients/families. Just sit down with them and touch base, open the conversation. If you want to have a good day at work, this is one of the best ways to do it.”

I don’t think the post was meant to be that deep

“Some patients will just complain about everything. The next one will love you.”

“Higher ups at my job with no bedside experience are the ones that post jobs for my unit. We are already so overstaffed and don't need more nurses, but yet there are 5 positions posted. My unit director does interviews, but doesn't hire anyone. I've also heard of there being hire freezes, but still having jobs posted. I don't get it.”

Noooo! I’d almost forgotten that story!

“Med surg commiseration my friend. Yesterday I got a patient from ER that had a HS trop of 3600. During report from ER I told her do not send this patient until after the repeat and it better be lower. She never grabbed the repeat and sent her up to me. I got the repeat and it was over 6K. Glorious days!”

“Got a patient last night that arrived right before shift change. I was reviewing his labs from ER while waiting on the day nurse and saw the critical K/BG/pH and abnormal AGAP and immediately just felt this heavy dread and knew he’d be transferred almost immediately. He had hyperkalemia protocol meds and labs that were late and asked the day nurse if she’d grab a new BG on him at least since his last one was from hours ago just to get told she was only getting his vitals because she didn’t know”

“I’m a CNA, and only been on my hospital MedSurg unit for 5 months. I don’t do well with wounds. For some reason I can handle basically everything else. This patient had a wound down to the bone. The nurse asked me around 6:30 to help her change the bandage (although I asked her around 11pm if she wanted to change it bc I was in there with her already) and I was supposed to give report at 6:45. Fuck. I agreed bc I’m agreeable, and after I told her “remember when I asked you earlier if you wanted”

“Had two today that I've been thinking about on the way home. One, a teenager with abdominal pain that examined like an appy, otherwise stable, but dad seemed to be in a rush to get home and was pushing to refuse workup (which showed an appy). The other, a younger girl with a possible mastoiditis, septic vitals, but otherwise nontoxic, parents wanting to leave and see how she does at home without labs/CT When do you override the parent? Obviously both of these had conditions requiring further”

“It's not your license on the line, with the CNAs, what a bizarre threat. They already got an IJ tag so are under scrutiny and if the same issues keep happening State knows exactly who is responsible. I can't tell you how many times I've seen new administration teams sweep in to clean things up only to piss everyone off and work themselves out of a job.”

“New intern here. Needed to do a physical exam that was actually important and nurse yelled at me for waking patient up at 7:30 AM. Absolutely insane. submitted by /u/k0alaty [link] [comments]”

“Just had probably the worst doctor's visit of my life. I went to establish care with a nurse practitioner, and we were going over my diagnoses. Suddenly she got very argumentative and wanted to know why I wasn't more active. I explained how debilitating my symptoms were, but she kept arguing that I should be more active and repeatedly criticized me for not being 'ambitious' enough. I have at least four serious diagnoses, including CPTSD and severe depression. She abruptly ended o”

“I’m so sorry you’re going through this, that’s truly one of the saddest things I’ve ever heard. Advice: once the nursing trauma started keeping me from sleeping I started therapy. Best thing I ever did! Highly recommend. We deal with wayyyyyy too much stuff daily as nurses then you go through a super horrible case like this and it can really wreck you for yeeaarrss.”

“I mean, that’s the topic of this post to begin with— OP was describing this exact concept being implemented in her hospital (or at least in m/s). Did you read the initial post here? 🤦‍♀️”

“Sometimes a quick pointer on what direction to go helps a ton though. It’s bad to just assume they don’t want to try if they’re asking for some guidance. There’s definitely staff that don’t try and want everything answered for them though.”

“Working nights we thought a patient was stealing powdered doughnuts, there were powdered fingerprints everywhere… He was not, he had CHF and an edemaous scrotum that had been powdered during day shift, I will let you all figure out the mysterious fingerprints source”

This sounds like an HCA hospital, or at least my HCA hospital.

“Type A nurses are that way because they lack confidence and it gives them gratification to crap on others. You sound like an amazing nurse. I gave up working in that environment just because of those b_____s! Hang in there and thanks for your post.”

“Hi guys!! I’ve seen lots of post and stuff online about people having 1:10 ratios in the ER🫪? Is that true for every hospital in the city? Even the unionized ones? TY! submitted by /u/brenrob1 [link] [comments]”

“I know it's another anti Dr. Google post but that was the actual CC entered by one of our older, saltier nurses who was doing triage. Which is always better, by the way, than putting the noobs out there who turn every patient into a code of some sort. Anyway the patient had been drinking heavily the night before, spent all day out in the summer heat doing weekend warrior stuff with his buddies and by evening felt like crap. HA, myalgias, subjective fever, nausea. In reality he was dehydrated”

“Exactly. I’ve had patients who were examined by police/county social worker who probably REALLY needed to be placed on a hold and they still weren’t. I’ve worked in the ER full time for 3 years and I’ve only seen a hold placed twice.”

“Many ER nurses are one confrontation away from snapping. https://giphy.com/gifs/3o85xAqcGm4rV1Ig5W”

“In the first part of the year, I left a toxic outpatient PT job. I made the switch to Home Health. The training online and in person was not what I expected. I'm now about 4 months in and I feel like I am winging it every single day. I'm paid by points instead of hourly or salary. That adjustment has been difficult. What's best for the patient is not always for me to admit them. I've been out of school for a couple of years, but don't really feel like there is anyone at my co”

“If you're new, they might just be friendly, or they also might be making sure you're up to snuff. New hires can get overwhelmed in new areas sometimes (even if it's familiar work) Either way, assume the best and do your best and it will shake out in the end....teamwork and the dream and all that....”

The only thing that bothers me during report is if you got an attitude.

“I had a patient like two years ago - retired nurse, dementia, combative, you know the kind…this woman was tough. It was night shift, she’s screaming at the top of her lungs about anything and everything. I’m trying to redirect her and I’m talking to her about when she was a nurse and I said, “Hey do you think we would be friends if we had worked together?” And she replied, “No!” And I said “Why not?” Her answer, “Because you’re UGLY!”. We all laughed so hard and she got even more pissed but that”

“Hello all, I'm a 3rd year EM resident and have noticed a pattern during EMS reports I have received on patients arriving to the ER. Multiple paramedics across multiple EMS agencies have spent what feels like a disproportionate amount of time describing a non-intubated patient's ETCO2 values across their transport (like as much time as they spend describing the rest of the vitals combined) and focusing on how the ETCO2 changed with their respiratory interventions. I feel like I'm awar”

“I just flat-out tell them, politely and respectfully, how their actions are making me feel. I’m lucky in that my manager will listen to complaints but not act on them. Most patients, I’ve noticed, tend to change their tone if you’re direct with them. Firm, but fair.”

“im an ER nurse so my opinion probably doesnt weigh much here but expecting the nurse before you to provide you with so much information is kinda scary?? hit the high points with me but I am going to look at my patients chart. Which i know ICU patients can be complex so of course report will be longer & more detailed but you need to be assessing your own patients & looking up their charts period”

“I don’t know I’ve only heard bad experiences, so I was/am worried about that. I also worry what if I’m not bad off enough to justify taking a bed from someone who may need it more”

“I’m struggling with dread almost every day that I work. Sure, I have patients who are no problem but then I have several patients who I see on my schedule and it ruins my day. These patients drain every bit of energy from my soul- you know the ones who talk over you, won’t even stop talking so you can listen to their lungs. The ones who have 15 complaints and when you get up after the visit and walk to the door, “oh wait, my scalp has been really itchy, take a look.” The patients who have a daug”

Thanks for the clarification!

“Floors get a written “transfer summary” and the patient gets sent up when the bed is ready. Monitored stepdown patients and icu patients require report and the nurse to come pick them up from the ER”

“I'm a Type B ICU now Crit Care Resource nurse. Embrace the label. Your adaptability is a strength. I don't need everything to be neat and orderly, but I will damn well label my lines after the patient is stable. I'll probably make a mess, but I don't give a fuck about that if the patient has bigger problems. I'll clean it up after, and I always do. My report can be thorough, or more concise and focused depending on what's more important and pertinent to the current situat”

“Hi y'all, Some of you may know me by the unhinged first year of vet med that I have somewhat documented on this profile. I'm here to say that I think I might finally be getting into a normal hospital that I can trust. Unfortunately, I have to change everything about my schedule to accommodate it, since it's overnights. How do I safely become nocturnal? I've worked this schedule before but not in a healthy way. I have an appointment set up with my psych NP to move med times safely”

“Our hospital is about to do away with report. The floors are pissed. Give me the good, the bad, the ugly. I think people are going to quit over this. 🪦 submitted by /u/Hour-Caterpillar170 [link] [comments]”

“How do you guys handle situations in which patients are extremely rude? We can’t denied medical service but what to do if they get rude, disrespectful and nasty. What if they get aggressive? What do you do when a homeless or mentally ill patient comes in and is impossible to keep them still to get medication in or bloodwork? Do you sedate? What next? What are your stories and how does your hospital/clinic usually handles these situations. (I’m a new nurse student and wondering what to do in thes”