So i currently work in a 90 bed health and rehabilitation facility. I am one of only 2 full-time nurses to cover all 90 patients. I work from eleven at night to seven in the morning, give or take an hour after handoff reports. I rarely get a third nurse in the building during the graveyard shift so that means i am responsible for 48 patients by myself with only two CNAs at best. The thing that most people do not realize is that just because all youre patients are elderly, does not mean they actually sleep all the time. Sleep is one of the most troublesome issues in the aging population. Add issues like Sundowners Syndrome and dementia to the mix and you get an overly active and stressed out group of patients who rarely sleep. Patients such as this who struggle to sleep at night, also tend to try and get out of bed or walk and risk falling every night. With only 3 people on the unit available to tend to all the needs of these people, you spend much of your shift chasing call lights and bed alarms. The day shift often has aggressive tendencies towards third shift staff because they assume that everyone is in bed and there is little to do, implying our shift has it much easier than the other shifts. The facility where i work gave me one week training before sending me off on my own to work. Not much more than a week into my new role as night shift nurse i was assigned the entire unit of 48 patients on my own. It was a nightmare. I did not get all my medications administered by the time the morning crew arrived and they all just avoided me and made it obvious they had no interest in helping me. Regardless of being brand new to the facility. I kept working hard and night after night i gave it my all. I walked out of there an hour after my shift was over with a limp. I still walk out limping four months into my job there. What i notice most about this job is that the other 3rd shift nurses that i work with all remain committed to the job and I am beginning to really bond with the crew i work with. The rest of the staff at my facility may try hard to see the value in us 3rd shifters but i have found my place finally. I am falling hard in love with all my patients. Working on my 5th month i have not once dreaded coming into work. Im growing more accustomed to being assigned the enitre unit to myself and even though it is alot of work and hard on the body, i am finding the advantage of working third shift with less drama and more quiet. I would rather work this shift and miss out on lunch breaks than work with many of the negative attitudes that overrun the dayshift. I do feel that often times the management tries to resolve their staffing issues by pressuring the few of us that work third shift to give up our days off which are few and far in between. I love this facility especially because they allow patients to have IV’s and tube feedings, we do all our own blood draws on night shift and with all of this, having a specialty in gerontology allows us to keep these skills that you may lose if going into labor and delivery or mental health for example. I love the idea of working with people that bond together, work as a team together and laugh together. We have that even if there are only a handful of us present every night. I have accepted that there are issues in every nurse setting that must be endured or overcome. But I have also accepted that the issues in this new job are well worth the effort. I will never work twelve plus hours shifts again, i will never deal with a crowd of nurses who spend more time gossiping and complaining and at this job, when i clock out i can leave it all behind me and go home to my real life. It is hard on the body to stay awake each night when the natural design of humans is to sleep after the sun goes down. However, this too is feasable for me when avoiding all the drama that has overtaken most nursing environments. I only hope i i will continue blogging new and interesting things with this job a year later. lol. I can feel myself getting stronger to execute my job properly. I can tell this is a good place for me to learn more strength as a leader and to better supervise my crew. I hear myself thinking of all the new things i can try to bring a connection to the team and uplift others that i work with. I look forward to all i can learn and gain from this job and all the good things i have to bring to the table.
Tag Archives: nurse
Graveyard shift.
This is my 4th job as a registered nurse in last than 2 years. Thats a tough thing to swallow when your entire motto in life is to ‘never ‘give up’. The hospital was post Covid and the remaining nurses left after a mass exodus of experienced nurses were nothing short of a nightmare crew. One thing was obvious was that too many of my colleagues were entitled and got through school with so many advantages not afforded to the general working class population. Here in Tennessee it became the norm for nurses to show up for their shift with scary bed hair knots piled haphazardly atop their heads, wrinkles scrubs and old makeup that told me they were either “hungover” or simply gave up caring how they appeared each day at work. There was no more morning “huddle” and noone said “good morning” or greeted anyone at the start of each day. The hardest part for me was not just the lack of support or teamwork in my unit but the negative banter that pervaded my every day on every 12 hour shift. These were not nurses who cared about the world and wanted to help others in times of great need. It was alot more talk about how disgusting a patient was or other nurses searching patients family members to find dirt on them in order to put security tags on them and prevent them from entering our unit. We had an elderly women with advanced dementia basically living on our Oncology unit. She was abandoned by family and until the hospital could go to court and get her a court appointed POA, she had been living up there on the 8th floor for about a year. Never getting taken outside to see the light of day other than what shown in her room window, never smelling fresh air or hearing the natural sounds of the world outside the buzzing of call lights and bed alarms and constant fluorescent lighting . It was apparent the rest of the unit staff were beyond fatigued by the demands of an ambulatory dementia patient constantly triggering alarms by the way they yelled at her every time she moved. I would watch the other nurses and they did not even bother to check and see if family members of other patients were around to hear how they talked to this poor women. It was a common reaction by all of them to yell at her to “sit down!” and “get back to your chair or you will fall!” Or “you are driving me bleep bleep crazy damn it!” It made no sense why she was still up on our unit and NOT a cancer patient. It came down to money more than anything. At her age she had enough comorbidities that they justified her need for care in a health facility and i am sure they made alot of money off Medicare for her. When a bed alarm or a chair alarm goes off, the requirement is to get there as fast as you can because it means a patient who is a major fall risk has left the bed or chair and is about to fall. Falls hurt the hospital and are a major liablity. Working short staffed as the nation has been accustomed to by now and being expected to stop what you are doing every 5 minutes to chase an alarm really makes it impossible to give good care much less complete your daily work requirements. What made it even more difficult for me was listening to the way they all talked to this patient (or yelled at her). On that same hall we had a young patient in his mid 20s who was in a horrific car accident and paralyzed from the chest down with limited use of his hands. He was nearly 7 feet tall. He also did not have cancer but had been living there for 9 months because he basically refused to leave until his insurance would pay for a bed for him to return home…. one that supported him better. It took 4 people to move him up in bed and he slid down every hour. He was on his light alot and im sure higher needs than his medical conditions simply due to his size and his unattended mental health issues related to the auto accident that left him a quad. We would consider a day of great luck to have one CNA for the entire unit show up. CNAs were paid pittence because hospitals did not require them to be certified so the pay was too low to gather any interest for the public. In some ways, it made sense why all my nurse colleagues had acquired such bad attitudes considering all this nonsense we endured on the daily. But as a brand new nurse who struggled through the uphill battle of Covid nursing school, i really needed to see just one nurse who acted like they cared about their patients. I really needed to see just one nurse offer support and guidance without throwing so much shade at the new hires. My nurse educator on that floor lived with good money and her one child went to the most prestigious high school in our region. As an educator she was hardly ever there. She vacationed more than she worked. She was in a bad mood one day and began spouting about how her boss is “sick and tired of all these new hires taking 4-6 months to orient into the job and how it has GOT TO STOP!” That was her level of support for all of us trying to work our 12 hour (really 14 hour) shifts while studying for our national boards and only getting grief from our teammates in our new jobs. Our manager would only pop around to take job interviews and to tell us all that we needed to put in more hours “on the floor”. This hospital signed me into multiple training or inservice classes a week and instead of recognizing that is a key issue in losing floor time, she only demanded more time from us “new hires”. I was already putting in 60 hours a week while living in a shed trying to rebuild my homestead after a fire on top of studying for my NCLEX. When i did get time off my body was in so much pain from the long hours running up and down those hallways , i was literally good for nothing else.This work environment was so toxic, they could not keep workers. I also believe that being positive and cheerful made others uneasy on the daily. All the other nurses seemed to want to do was talk smack about everyone from the staff to the patients on our unit. I dreaded going into work every single day. These werent “my people” , this was completely opposite to why i became a nurse. I contemplated quitting for weeks but struggled of the idea of being a quitter 3 months in to my first nursing job. I realized though that the only way to survive this place was to join my colleagues in their bitterness and bad attitudes in order to even come close to “fitting in” and so i made the tough decision to resign in order to say yes to myself and preserve my hopeful attitude as a new nurse even while recognising this is nothing like what we expected it would be. I was going to choose professionalism over “ratchet” even if it meant walking away from any job I had to in order to find a place that valued my presence and my positive approach to being a nurse. Ironically, only after i resigned was anyone at that hospital willing to talk to me. I learned so much valuable skills and information at that job despite the horrors. It gave me a reslience i did not know was needed until i went to other jobs that had their own issues. I agonized and cried but ultimately i walked away with my head held high in hopes of a better path forward. I do not expect nursing in any position will be easy or without great need for positive change. I will keep pressing forward with hope of finding a decent fit for me and a place i can effect that change i wish to see. The world of healthcare desperately needs it.
Becoming RN.
I applied to be readmitted into the RN to BSN program. It feels good because it means that my house rebuild is coming along. I was already registered for classes when the fire broke out, taking everything with it. I was determined to keep going straight through college until my Masters. All the upheaval caused by the fire made it a straight uphill battle to put much focus on my studies. Being entirely online, there was no class discussion or connection to other students to help remain motivated. And all the “build my life back” took center stage and pushed my homework to the back burner. When i finished my last semester at ETSU i did not sign up for more classes. I could not even bear to look at my final grades because i knew that my personal circumstances were the only thing standing in the way of my studies and so i had to remind myself that those grades did not define me. I know i can do this and i know that i can choose to look only at the destination sometimes in order to keep pressing forward with my goals. So I did let the semester end without ever even knowing whether i passed my classes or not. Im used to failure. Im used to getting chosen last and coming into last place. But through it all i have learned a great deal about the hidden gifts inside failure. I have gained extra appreciation for every opportunity that comes my way and for how i arrived at every mile stone. I tell everyone that ive always wanted to be a nurse. That is true but not entirely. I also dreamt often of becoming a police officer. I had a major fan crush on Sharon Gless (and Tyne Daly if im being entirely honest lol) from the series “Cagney and Lacey” two badass cops who bring realness to the job and show the tough resilient side of women. I rarely saw anyone around me in my community really amount to anything. Most people in Michigan were proud to work at General Motors. Anyone who did not get the prestigious job of working any role at GM was retired from GM or on disability from GM and NONE of these people were related to me or associated with the people that were technically considered “my people”. To dream of becoming a nurse or a cop were things so far above my caste that anyone who learned of me having such goals would awkwardly praise me or laugh in disbelief. Another moment of truth is that i may not have been able to handle the demands and sacrifices required back in my 20s. I new my brain worked pretty good most of the time because i loved to read and could really place myself in any story. I fully comprehended the amazing stories i read. I also became a master of observation. Being capable of fully observing any situation or surrounding and being an avid reader told me that my brain did work in spite of the fact that i had ADHD and unless off by myself in a quiet place to concentrate on reading, it took me several attempts to fully finish reading long sentences in textbooks because my mind would not hold concentration long enough to finish. My love for reading kept me from giving up. Time is a beautiful thing like that though and as i got older, i slowly leveled up in my self confidence on what i could convince myself of achieving. By the time i began my prereqs in my 40s , my youngest daughter was in high school. So to many, becoming a college student in my 40s with alot of life experience to help me get by , this was a great advantage. But at the same time, Being in my 20s and 30s were painful and took much energy to work through alot of personal stuff to be able to step outside of myself and actively seek to achieve bigger goals. I still can hardly believe i made it into nursing school and i have been a licensed registered nurse for over a year now. I may finish last alot , but i do finish and that to me is as amazing at coming in first place. I may have faced many more setbacks but here i am today back in the game of obtaining my BSN and it feels soooo good. First up, History lol.
Becoming RN…
I called this post “Becoming RN” because i had hoped to start it way back when i was beginning my prerequesites for nursing school, then i had truly hoped to start it as i was on summer break and preparing for fall classes and studying , and then again when i had graduated and became a licensed registered nurse. That was just over one year ago and here i am only now making real effort. So much has changed in my mind from the beginning of nursing school until now. I am still amazed that i actually graduated school and was going to be able to sit for the national boards, that still feels amazing to me. I often find myself thinking about how stressful it was just a year ago to remember all the medications for all the things that ail people and now i can look at any patient medication profile and tell you what is going on with them simply by looking at what things they are taking. I think about how i tortured myself to remember soo much and here i am carrying so much more knowledge and experience my mind could not comprehend just a year ago. Everything seemed like it was an emergency as a nursing student. A year later, you calm down naturally once you learn that people can have all sorts of crazy vital sign readings or lab results and still be alive lol.Not everything is an emergency once you realize this as a new nurse, you become much more calm, I did anyway.The truth is, you often hear that you really only begin to learn to how to become a nurse once you pass NCLEX and get a job working as a nurse, THAT’S where it begins. In nursing school, the pressure of only being able to fail out once adds enormous stress to the challenge of being a nursing student. This is one of those gazillion times when you need your mother. I knew i was not going to have that option and i was determined to become a nurse, but i felt it worthy to put place that comment in here because its how life runs through my head. Instead of saying to myself ” I want my mother” its more like “I wish i had a mother to turn to in times like these.” Like a program constantly running and updating in the background of your phone, not having a mother in your life…that absence is everpresent and profound, even at my age.
Within one year of becoming an RN, i went through multiple jobs and I see from so many sides this national (and international) seachange of what bedside nursing looks like in todays world. There is much you do not get to see or understand about nursing and healthcare in general until you are swimming in it up to your eyeballs. I let it get to me quickly and even though i knew from school and the constant headlines in the news, the shock of the nursing field is more than anyone can truly prepare you for, i still felt like the reality of it all hit me like a curveball i did not see coming. The first 3 months of nursing where a whirlwind of long hours on your feet learning a computer system and all the protocols for the unit you are working on in a hospital. I was on 8 in Oncology. Only it wasnt exactly Oncology. And what i learned most in those 3 months were that you never see them or talk to them but corporate is always in charge over actual nursing care. In 12 short weeks i was carrying a nursing assignment too large for any one nurse, especially a brand new nurse. There were never enough supplies to actually DO your job , You are just another RN to fill in a slot and you will work with a broken system and very small number in your team and there is nooone person you can turn to solve the problems driving countless nurses out of the field altogether. There is not enought time and therefore as a nurse you will only set yourself back if you attempt to slow down enough to actually care or show any caring towards the patient. One of the most eye opening experiences was how quickly and how often you put your nursing license on the line just to get through your day. What i learned also is that someone or something literally sucked all the spirit out of human health and healthcare in general. You can tell that nursing is in a major shift at this time and it does not appear that all this “change” is letting up anytime soon. It is not about caring for the individual. It is definately not about a holistic approach to promote healing in the individual either. I find myself trying to hold on for the ride. But unless i turn a blind eye to all the madness , i know i am NOT gonna make it as a nurse, or at least find it difficult to stay in any one place.
My first official day on the floor, being supervised by my preceptor, I was told to go get the 9a.m. meds for the patient i was in charge of that day. The main medroom did not have any methadone so i went to the back medroom and used my biometrics to access the system. In a sudden frenzy, the other nurse bursts into the medroom and is loud and pushy asking what is taking me so long to get the meds? Before i can even respond, he pushes himself in front of me and grabs the meds out of the tray, counts them, closes the drawer, wastes half a pill and hands me the methodone tablets then proceeds to log me out of the system so that he can access it for HIS patient, He was rude and dismissive but i just left and gave meds to my patient. The next morning, there was a slip from the pharmacy with a descrepency related to my nurse login. My preceptor said its no big deal and we can fix it easily. We walk into the breakroom where the nurse manager was and when she read the note , she simply said in her loud matter of fact voice, “Now thats a quick way to lose your license!” She did NOT even bother to ask me about the incident, she gave no opportunity for discussion, she just blurted out her comment and dismissed me. I wasnt expecting a welcome party when i came onboard that unit as a nurse, but mere days into the experience i was already getting threatened.
And the patients. The high acuity of sick Americans at this time in the world is astounding. What is worse though is trying to care for 8-10 or them after they have sat in an ER department for 12 plus hours before being placed into your care and then they realize they were sent to the Oncology unit and really freak out thinking they have cancer. When i entered the workflow of this hospital it was just after the worst of Covid and we were the very first graduates of COVID nursing school since the pandemic began and after the mass exodus of nurses from every hospital in America. Having one CNA (not certified though because then you would have to pay them more for being certified) to work any unit in the hospital was a lucky break. And if you have only one then you really have none because they are so busy answering call lights they cannot really help you with nursing care. There is no cohesiveness between the ER sending patients to the units and the units themselves. And donot get me started on the poor quality of food being served in hospitals. Sick or injured people should not being eating slop while they are being treated for severe health conditions or injuries. Its insulting to see what American hospitals serve their patients to eat. The entire medical system as they are being run today are setup to fail. If that is the case, then it is no surprise why so many nurses are leaving the industry altogether. I just got here and i am being run out as well. 12 hour days are NEVER 12 hour days unless the hospital suddenly needs to stop overtime then they are like dictators when it comes to the time clock, otherwise, they work you beyond what your body should be expected, like a slave dog. I left the hospital 4 months in and i have no regrets. I am still a nurse though and shall keep pressing forward until i find my spot. This is my journey.
saka chetan 