Hey y'all--
I know, I know, I never come over here unless I want something, do I? (Sorry--just love me anyway, please)
I'm having trouble at work, and need some objective Christian advice (if this is the wrong forum, somebody let me know, and I'll move it or you can.)
OK, that aside, here we go: I'm House Supervisor at a hospital (I work nights), and I am responsible for OR, ER, ICU, OB, medical/surgical floor, Housekeeping, Dietary, AND, the Chemical Dependency Unit and geropsychiatric units across town. Now--my job involves taking care of staffing, and troubleshooting when necessary, nursing assignments for the med-surg floor, oh--I forgot, I am also pharmacy--we don't have a 24-hr pharmacist on duty, so if we get new medicines for patients, or if we have new medicines, or if the ER runs out of something, I have to go to pharmacy and get it for them.
Whew! OK, that's enough without the next part...
Our staffing is supposed to be as follows: On the medical-surgical floor, it's Me (RN), Charge Nurse (RN)--he/she is responsible for going into all the patients' rooms and introducing himself as charge nurse, being liaison between the LPN's and doctors, hanging all the IV medications (including IV pain meds), bed assignments for new patients coming around from ER, and is the liaison between the doctor and the other nurses who work with us, which means that at night, the charge nurse is the one who has to wake all the doctors up, etc., and if any bad lab results come back to us, they have to take care of all that, as well as being responsible for taping report for the oncoming shift...
The three LPN's are responsible for making rounds every two hours, passing out other medications, opening charts--performing head-to-toe assessment, and documenting on the chart to reflect all the admission diagnoses for the patient, passes out any other medications, and keeps up with vital signs, which the CNA's take at 1000/pm, 0200/am and 0600/am, and if there is a problem which they cannot handle (it's outside the scope of their practice, etc.), then they turn it over to the charge nurse to handle. They are also supposed to do a 24 hour chart check to make sure that all the orders which have been given over the past day have been properly "taken off" the chart and executed, and if not, they are to see that it's done, and write it up if necessary...
We have two CNA's--nursing assistants who do the vital signs every four hours, and are supposed to turn and clean bed-bound patients every two hours--if the vital signs are not within normal limits, they tell the LPN, who takes care of it immediately. They are also responsible for a brief assessment each time they enter a patient's room, and are to tell the nurse if they believe the patient has had any significant change in condition...
None of the LPN's that I work with are IV certified, so they are unable to hang their own IV fluids...
Here's the problem: I have no charge nurse for the floor, so for the past three months, I have been doing the job of both charge nurse and supervisor, and I can't do it anymore! What they didn't tell me when I was hired was that these particular nurses have a long history of eating supervisors ALIVE! THey have gone through about 8 of them in the past two years. *sigh*
Now, I'm pretty tough, but last weekend the light came on for me...I feel like the concern is not about patient care, but rather, "I'm not going to do a bit more work than anyone else here"..and no matter what I have tried to do, I can't seem to get them to.
I will be the first to admit that I am NOT a supervisor--I am a worker bee, and I like it that way. But since I have had to do both jobs, I've not been able to properly delegate responsibility all over the hospital, and I cannot monitor the behavior of adults for 12 hours without patient care suffering, so I don't do it, and they know I can't do it, and I am being taken advantage of...
In addition, I feel like my nursing license is being stretched to the limit, as we have an immature OB staff without proper supervision, and I feel like I have to check on them as well (I have never worked OB, but am more than capable of assisting.)
So, my job now consists of the following: Responsible for staffing and pharmacy for OR, ER, ICU, OB, medical/surgical floor, Housekeeping, Dietary, AND, the Chemical Dependency Unit and geropsychiatric units, making nursing assignments for the med-surg floor, calling the doctor as needed for patient change, or to report labs and other test results that may have come in from the previous day, hanging all the IV medications (including IV pain meds), bed assignments for new patients coming around from ER, AND, because they won't do it as they know I'm unable to check behind them, I try to catch up on the 24 hour chart check to make sure that all the orders which have been given over the past day have been done.
Something else I forgot--we don't have a ward clerk, so anytime a patient does come to the floor, I have to stamp up the chart, and take off all the orders--entering the labs in the computer, etc., as well as making sure all the AM blood sugars are entered for the next day, as well, as writing out a daily hospital census at midnight to send to the ER secretary for their records, and a diet sheet for dietary to know what diets to bring the patients, and a report sheet on the patients, with all the vital information on it for the next shift.
This is bad enough--but there's something else...the nurses that work with me detest the OB nurses. See, OB is feast or famine. They have to have staff in the hospital, in case of a delivery, and I want them too! There is absolutely no way I am going to run two departments!!! (Especially not such a high-risk one as OB, and because sometimes the OB nurses are without patients, they have nothing to do, and it is like pulling teeth sometimes to get them to come out on the floor and help us--the whole hospital knows how much there is to do on my shift and we don't get a lot of volunteers...
, and the nurses on the floor literally HATE them for that, and (as I overheard the other night), they apparently despise me as well, because I can't hate them--my job requires that I treat all employees exactly the same, and some folks aren't good with that. (again, how is this relevant to patient care?)
Bottom line: I am completely and totally burned out....bleah! I love my job--and I have tried to be a good boss to the nurses--there is nothing I won't do (changing a patient, answering a call light, giving medications, taking vital signs, cleaning up after a sick patient--doesn't matter--it's all nursing) I buy them pizza on occasion, because they have been overworked as well these past few weeks, before the third nurse came on board last week...and I thought I was going to be able to hang in there until "we find someone"...but I overheard one of the nurses telling the other one how "two-faced" I am, and how I "let that bunch (OB nurses) get away with murder", and how I "talk about them (again OB nurses) behind their back and I'm nice to their faces, and how they "don't care what I say they aren't going to another department"--MESS unrelated to patient care, and I just (finally) had to sit down and cry...
This was last Saturday night, and I watched them on Sunday night...all this time I have been defending them, because they are good nurses, and I have seen them take excellent care of the patients, but if the bottom line for them is not to work with me, but rather against me, for whatever reason, then I can't win. I can't even place--I don't even show up...
They don't respect my authority (how can I have any with this sort of workload?), and they don't try and help me (much). I'm not angry with them--won't do any good--and I don't feel like a failure because I can't do it anymore, but it's like the LIGHT came on the other night when I heard them talking so bad about me, so now I know.
So my question is this: What in the world can I do to make this right? I have talked to administration, and (depending on who I talk to), they will go right behind me and tell a different story, and they usually get their way.... My boss says to write them up and send them home (again, how in the SAM HILL am I supposed to their jobs too?)
I make a lot of money at this job, but my peace of mind is wearing very, very thin, and I feel like I am on my own. Any advice is most appreciated--talk to me about management, please (I told them I wasn't a manager when they hired me--I wanted to be charge nurse only), and if I've done something wrong, I need to hear that as well...Thank you all in advance for this, and again, if this is in the wrong place, I'm sorry...
I might mention that I have been an RN for ten years, and have only worked at this facility since the first of October...
Thank you all again...
love,
Dixie
I know, I know, I never come over here unless I want something, do I? (Sorry--just love me anyway, please)
I'm having trouble at work, and need some objective Christian advice (if this is the wrong forum, somebody let me know, and I'll move it or you can.)
OK, that aside, here we go: I'm House Supervisor at a hospital (I work nights), and I am responsible for OR, ER, ICU, OB, medical/surgical floor, Housekeeping, Dietary, AND, the Chemical Dependency Unit and geropsychiatric units across town. Now--my job involves taking care of staffing, and troubleshooting when necessary, nursing assignments for the med-surg floor, oh--I forgot, I am also pharmacy--we don't have a 24-hr pharmacist on duty, so if we get new medicines for patients, or if we have new medicines, or if the ER runs out of something, I have to go to pharmacy and get it for them.
Whew! OK, that's enough without the next part...
Our staffing is supposed to be as follows: On the medical-surgical floor, it's Me (RN), Charge Nurse (RN)--he/she is responsible for going into all the patients' rooms and introducing himself as charge nurse, being liaison between the LPN's and doctors, hanging all the IV medications (including IV pain meds), bed assignments for new patients coming around from ER, and is the liaison between the doctor and the other nurses who work with us, which means that at night, the charge nurse is the one who has to wake all the doctors up, etc., and if any bad lab results come back to us, they have to take care of all that, as well as being responsible for taping report for the oncoming shift...
The three LPN's are responsible for making rounds every two hours, passing out other medications, opening charts--performing head-to-toe assessment, and documenting on the chart to reflect all the admission diagnoses for the patient, passes out any other medications, and keeps up with vital signs, which the CNA's take at 1000/pm, 0200/am and 0600/am, and if there is a problem which they cannot handle (it's outside the scope of their practice, etc.), then they turn it over to the charge nurse to handle. They are also supposed to do a 24 hour chart check to make sure that all the orders which have been given over the past day have been properly "taken off" the chart and executed, and if not, they are to see that it's done, and write it up if necessary...
We have two CNA's--nursing assistants who do the vital signs every four hours, and are supposed to turn and clean bed-bound patients every two hours--if the vital signs are not within normal limits, they tell the LPN, who takes care of it immediately. They are also responsible for a brief assessment each time they enter a patient's room, and are to tell the nurse if they believe the patient has had any significant change in condition...
None of the LPN's that I work with are IV certified, so they are unable to hang their own IV fluids...
Here's the problem: I have no charge nurse for the floor, so for the past three months, I have been doing the job of both charge nurse and supervisor, and I can't do it anymore! What they didn't tell me when I was hired was that these particular nurses have a long history of eating supervisors ALIVE! THey have gone through about 8 of them in the past two years. *sigh*
Now, I'm pretty tough, but last weekend the light came on for me...I feel like the concern is not about patient care, but rather, "I'm not going to do a bit more work than anyone else here"..and no matter what I have tried to do, I can't seem to get them to.
I will be the first to admit that I am NOT a supervisor--I am a worker bee, and I like it that way. But since I have had to do both jobs, I've not been able to properly delegate responsibility all over the hospital, and I cannot monitor the behavior of adults for 12 hours without patient care suffering, so I don't do it, and they know I can't do it, and I am being taken advantage of...
In addition, I feel like my nursing license is being stretched to the limit, as we have an immature OB staff without proper supervision, and I feel like I have to check on them as well (I have never worked OB, but am more than capable of assisting.)
So, my job now consists of the following: Responsible for staffing and pharmacy for OR, ER, ICU, OB, medical/surgical floor, Housekeeping, Dietary, AND, the Chemical Dependency Unit and geropsychiatric units, making nursing assignments for the med-surg floor, calling the doctor as needed for patient change, or to report labs and other test results that may have come in from the previous day, hanging all the IV medications (including IV pain meds), bed assignments for new patients coming around from ER, AND, because they won't do it as they know I'm unable to check behind them, I try to catch up on the 24 hour chart check to make sure that all the orders which have been given over the past day have been done.
Something else I forgot--we don't have a ward clerk, so anytime a patient does come to the floor, I have to stamp up the chart, and take off all the orders--entering the labs in the computer, etc., as well as making sure all the AM blood sugars are entered for the next day, as well, as writing out a daily hospital census at midnight to send to the ER secretary for their records, and a diet sheet for dietary to know what diets to bring the patients, and a report sheet on the patients, with all the vital information on it for the next shift.
This is bad enough--but there's something else...the nurses that work with me detest the OB nurses. See, OB is feast or famine. They have to have staff in the hospital, in case of a delivery, and I want them too! There is absolutely no way I am going to run two departments!!! (Especially not such a high-risk one as OB, and because sometimes the OB nurses are without patients, they have nothing to do, and it is like pulling teeth sometimes to get them to come out on the floor and help us--the whole hospital knows how much there is to do on my shift and we don't get a lot of volunteers...
, and the nurses on the floor literally HATE them for that, and (as I overheard the other night), they apparently despise me as well, because I can't hate them--my job requires that I treat all employees exactly the same, and some folks aren't good with that. (again, how is this relevant to patient care?)Bottom line: I am completely and totally burned out....bleah! I love my job--and I have tried to be a good boss to the nurses--there is nothing I won't do (changing a patient, answering a call light, giving medications, taking vital signs, cleaning up after a sick patient--doesn't matter--it's all nursing) I buy them pizza on occasion, because they have been overworked as well these past few weeks, before the third nurse came on board last week...and I thought I was going to be able to hang in there until "we find someone"...but I overheard one of the nurses telling the other one how "two-faced" I am, and how I "let that bunch (OB nurses) get away with murder", and how I "talk about them (again OB nurses) behind their back and I'm nice to their faces, and how they "don't care what I say they aren't going to another department"--MESS unrelated to patient care, and I just (finally) had to sit down and cry...
This was last Saturday night, and I watched them on Sunday night...all this time I have been defending them, because they are good nurses, and I have seen them take excellent care of the patients, but if the bottom line for them is not to work with me, but rather against me, for whatever reason, then I can't win. I can't even place--I don't even show up...
They don't respect my authority (how can I have any with this sort of workload?), and they don't try and help me (much). I'm not angry with them--won't do any good--and I don't feel like a failure because I can't do it anymore, but it's like the LIGHT came on the other night when I heard them talking so bad about me, so now I know.
So my question is this: What in the world can I do to make this right? I have talked to administration, and (depending on who I talk to), they will go right behind me and tell a different story, and they usually get their way.... My boss says to write them up and send them home (again, how in the SAM HILL am I supposed to their jobs too?)
I make a lot of money at this job, but my peace of mind is wearing very, very thin, and I feel like I am on my own. Any advice is most appreciated--talk to me about management, please (I told them I wasn't a manager when they hired me--I wanted to be charge nurse only), and if I've done something wrong, I need to hear that as well...Thank you all in advance for this, and again, if this is in the wrong place, I'm sorry...
I might mention that I have been an RN for ten years, and have only worked at this facility since the first of October...
Thank you all again...
love,
Dixie
It sounds miserable. Might get better, might not. A good book to start with might be "Who Moved My Cheese" by Spencer Johnson, M.D. All the best to you! 
