[NICU_Nurse]

I took some liberties with one of the threads that I saw here and re-fashioned the ideas into a memo from administrators to nursing staff (I did this so I could email it to my mom, who's an RN, as well as some nurses at work...). I hope no one minds. I promise you I'm not taking credit for any of your ideas, but I thought you guys might like to see how it came out! ;>)

Attn: Nursing Staff
RE: Changing a lightbulb


The bulb burned out- what should you do?

First, you must form an impartial committee made up of administrators, nursing managers, clinical coordinators, and physicians to evaluate the actual need and the effectivness of a light bulb. The committee must meet a minimum of once a month to design and implement a plan, and must address pertinent concerns such as:

"Is light an absolutely essential necessity in nursing care?"
and
"Will buying said lightbulb mean we don't get our end-of-year bonuses?"
and
"If we buy a new lightbulb for the nurses, does this then mean that we can turn down their request for a raise?".

This plan must be evaluated by JCHAO to determine its effectiveness. JCHAO will in turn write up and submit a written summary with suggestions for needed changes.
The committee is required to check with at least 3 different light bulb manufacturers to get the best (i.e., cheapest) price for the bulb. Tests must be performed on the bulbs to compare them with each other and have staff input as to the "light quotient ability" of the preferred bulb. The resulting report should be presented in quadruplicate as a capital expense to the board of trustees for approval as a "necessary" item.
*Note: Committe members are encouraged to sit on
these reports as long as possible to gauge the
actual 'need' for the bulb (in other words, how
long will the nurses work in the dark before they
threaten to strike or form a union?).
Staff can expect a minimum 4 week wait for the aforementioned bulb, as they are expected to attempt to justify to management that the bulb was actually needed in the first place and wasn't an unnecessary expense in an already tight budget.
Nursing staff can plan on an additional 3 hour minimum wait once the bulb has been delivered to CMS. This is to allow CMS to claim that they never received said bulb and pretend that they don't speak English when nursing staff repeatedly call them to inquire about its whereabouts, and also to allow for CMS to slowly walk the bulb up to the unit, stopping to take at least two cigarette breaks on the way, as well as engage in numerous conversations with various personnel and hospital visitors on their way up to the unit. Nurses should be prepared for this by bringing flashlights to work, or, if flashlights are not available, twigs and rocks with which to start a small fire to see by.
Nursing staff, once presented with the bulb, should plan on at least fifteen minutes to look up the instructions for installation in the policies and procedures manual. Please be sure that the physician/intern has written an order for the lightbulb replacement before attempting to replace it. Allow plenty of time for you to attempt to contact said physician to write said order, assuming that said physician/intern will either be
a) Sleeping in a supply closet
b) Sleeping in the conference room
c) Stealing your lunch from the community fridge
because they haven't eaten in 72 hours and the
sandwich machines are not acccepting dollar
bills.

If nursing staff is unable to locate a physician, or if med students are on call during your shift, you are encouraged to write a verbal order for the lightbulb and attempt to have someone sign for it within 24 hours. Naturally, the hospital does not condone such a thing and will refuse to back you up should the doctor refuse to sign the order. In this case, installing the lightbulb has caused a breach of the Nurse Practice Act, and you will be fired immediately. If you are not fired immediately, you will be punished by being force-floated to Med/Surg for the entire duration of your career.
Nurses should plan an additional, undetermined amount of time to stack folding chairs on top of each other to reach the lightbulb socket, because to request a ladder would cause an additional four day wait as CMS and Maintenance have been instructed by the CEO to deny having ladders on premises and to pretend not to speak English when you call to ask for help. Should you fall while attempting to climb the stack of chairs, you must immediately write an incident report and go to the ER, where you will be treated for your injuries. You will be seen on a first come-first served basis and should bring cash to pay for these services. Your paycheck will also be docked for missing work, and you may be reprimanded by your section manager for abandoning your patients during their time of need.
Once these requirements have been met fully, nursing staff may then actually change the lightbulb. This should take approximately sixty seconds, but staff should plan on an additional 45 minutes to ensure proper documentation.

[jnette]

Well done, Kristi !!!
It's about the truth, isn't it? At least at my place it's sure beginning to resemble what you cooked up there! Now they're harping on us to not use so much saline...$$$... (I work in dialysis) so now when we give the patient's blood back we have to use what's left in the bag.. and if it's only a couple hundred mls, well, so be it. After we work so hard to get their hemoglobins up, now we can't even give all their blood back just so we won't use too much saline ! Makes ya wanna spit ! I guess they figure they can compensate by upping their EPO doses... because THAT is something they get back from medicare !!! Figures. That was good, though... sent it on to our DON and Chief Tech who orders all our supplies, does inventory, etc.. poor soul ! He hates to walk on the floor anymore with his news of what we can't have now... poor fella just slinks around the corner hoping we don't see him..!