So I'm working on a telemetry unit at a decent sized hospital. We have about 22 beds on our floor. Normally we have a 4 or 5 to 1 ratio of patients to nurse. During my entire 12 week training period we always had a secretary and a nurse aid/tech. I have been on my own for 6 weeks now and recently we have started to have low census on my floor. In about 20% of my shifts now I have not had a tech or secretary and one time I was left on the floor by myself with only one other nurse.
I find this very frightening. I can barely do my job when we have a full staff....actually I can only do about 70% of my job when we are fully staffed. I always put the patient first, but my paperwork and computer charting goes by the way side real fast when I start falling behind. On my floor we still do the majority of our charting on paper and have a might complicated DOS program to chart our medications. We also use the same DOS program to put in orders from the physician. Needless to say I am not very good at it even though I went to the 2 day class, mostly because for the last 17 or so weeks that I've worked there I have not had to put in orders due to the fact that the secretary was there to do it. I am also not familar with tech duties and how to chart them. Yes, I know how to give bed baths, take vitals, and change linens. What I don't know how to do is all of that AND pass my meds, change bandages, do assessments, answer the call lights for things like tea, coffee, and snacks, get my charting completed timely and correctly, and check orders.
How do I be a secrtary, tech, and a nurse with 4 or 5 patients?! Plus the fact that I still feel very new at this. I have a lot of questions and I don't know where all my resources are yet. Heck most of the time I don't even know that I need a certian resource until a certian issue comes up.
I've let my manager know my concerns and she explained to me why low census occurs and the book that dictates how much staff is needed for how many patients. I understand that the hospital is, above all else, a business and that those rules are put in place for a reason. She said that she felt like I was doing a great job, but if I felt like the pace was to fast for me she would help me move to a different floor. Honestly I don't think the "pace" will be any slower on a different floor and I know my whole issue about having a lack of resources to go to when staffing is short will not be fixed by moving. Am I lazy because I cannot function without a secretary and a tech at this point? I had a Nurse Practitioner tell me that she use to do total care for 4-5 patients all the time and do nursing duties. On my floor, as with most floors I'm sure, patients can range from pretty self sufficent to incapable of doing any self care at all. Usually you get stuck with a combination...like 1 that can do their own stuff, 2 that need assistance, 2 that need total care.
*Sigh* How bad should I feel about not being able to get all my charting done timely, or mostly forgetting to chart I & Os every time I go to work, or sometimes competely forgetting to do computer charting? How many of you guys out there do secrtary, tech, and nursing duties on a 12 hour day shift? How do you get all the work done? This all makes me feel like a crappy nurse.