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Staffing question & your cardiac floor



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  #21  
Old May 22, 2007, 09:26 AM
Senior Member
Join Date: Mar 1999
Re: Staffing question & your cardiac floor

Originally Posted by laurenjarrod View Post
Thank you everyone for your advice. I want to let you know an update on what has happened since then. A few nurses and I went to our CNO's office and told her what happened. We also attended a forum we have quarterly with the president of the hospital. Our CNO was shocked and wanted to "walk in our shoes for a day". I am not sure what will happen when she comes to work with me but I am chosing a day when we have 3 nurses so she can see how it really is. She told us that our nurse to patient ratio should be 5-1, and not 6, 7 or 10-1! Just wanted to give an update. I will post again after she comes to the floor. As far as the president of the hospital he was useless.
Good for you!I hope your CNO can convince the President of your hospital that the purpose of the hospital is nursing care.
Every other service is available as a n outpatient or in a hotel with room service.
If you dont need nursing care you are not admitted to a hospital.

SO ensure safe staffing!

You nurses are advocating for your patients. That is your obligation and therefore your right!

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  #22  
Old Mar 24, 2008, 04:49 PM
Morettia2 (Female)
Registered User
Join Date: Jun 2007
Re: Staffing question & your cardiac floor

Originally Posted by laurenjarrod View Post
Hi everyone,
On Wed. when I went into work for my 12hr. shift I was greeted by the night shift nurses at the elevator (not a good sign). It turns out that we had 1 RN call out which left us with only 2 RNs for 20 patients, so I wound have 10. I had 1 Natrecor and Lasix gtt, 1 patient had to get 1 unit PRBC and 4 units FFP with ER shiley placement for dialysis, 1 patient was dying, 2 were combative and confused, 1 Amiodarone gtt, 1 Cardizem gtt, and 3 were semi-ambulatory. Mind you all were on tele, I/O's, etc. I was so overwhelmed I cannot even describe the state of mind I was in. We can have up to 7 patients with drips, tele (we have to read our own), etc. but 10 is unsafe to say the least. My nurse manager was on the floor and didn't seem to see the problem. Personally I feel she should have taken an assignment. The other nurse and I pulled our manager to the side and told her that we cannot work like this, that it is unsafe, tele alarms are going off, patients are practically being neglected, and she told us we just have to prioritize. I wanted to run when she said that. Prioritize! Was she serious? The answer was to get another nurse. Later on in the morning, a nurse who lives 2 blocks from the hospital dropped in to say hello and had no idea what was happening b/c they never even called her to come in(I come to find out that 4 RN's that I talk to outside of work were never called to come in either so I wonder if they even tried to replace the call out). When she asked if she could stay and take an assignment our nurse manager told her no they are doing fine. I cried the entire way home and even harder when I got home. I have never had such a terrible day in my career (mind you I have only been a nurse for 8 months but still this topps all) We generally have staffing issues but never in the entire 8 months that I have been there has things been that bad. Does anyone else think this is unsafe? Am I overreacting? All we needed was a code and that was it. They would have been doing CPR on me. Any advice on what I can do going forward to help prevent this? (Our chief nursing officer doesn't even know we are short staffed per our head cardiologist) Any advice would be appreciated. Thanks for reading.
Lauren
wow that sounds EXACTLY like the floor I work on. I work Interventional Cardiology and I too work 7p-7a. we are constantly under staffed. When a good nurse manager is on they take 4 pt's. but there are certain nurse managers I have that take maybe 1 pt. I had posted before about situations I have hada. Like I was in the middle of a code, bagging a pt. and my manager came in and tole me I was getting an ER admitt. That was on top of the other 5 pt's that I had which were s/p PTCA, S/p STEMI, and I can't remember the other 2. I said "NO you are gonna have to give the admitt to another nurse I am in the middle of a code" It is unsafe, I agree. I hate nights we have a House MD and a tele resident and that's about it and there is a list of doctors that the House MD covers and I swear I always have at least 2 pt's that the house MD dosen't cover, so I call the Tele resident and I am lucky if they even bother to listen or even come eval. the pt since the house MD won't do it. I have even called the pt's cardiologist at 3am and woke their butt up b/c they are not covered by house MD and the resident basically told me that she had better things to do then come eval the pt, umm yea pt's O2 SAT is at 79-80% on 2L NC, pt is dyspnic, ST on the monitor, BP is in the toilet, I call a RRT my nurse manager ignores me, 3 more time I call for an RRT and I still am ignored So I SCREAM at the top my lungs for a CODE b/c no one would listen to me, finally ot somone's attn. pt is also s/p STEMI with CK in the 4000's and troponin at 0.20 and pt just came from the cath lab 1 hour ago at 2 am..for a 650 bed hospital that is AWFUL. So I called the pt's cardiologist at 3am b/c no one would give me orders..yes he was miffed that I woke him up BUT he understood only b/c he is young and he said we can call him anytime day or night if it's one of his pt's..hehe let's see how long that lasts..If you call a RRT or a Code at like 4am, 3 people show up..the House MD, the tele resident and the Respiratory therapist. but If you call a RRT or a code during the day >10 people show up and then some.I am getting my one year in and going to another unit..Every night I work I think is tonight the night I am going to put my license in Jeopardy..I have talked to my director, managers and educators and I get the same crap that cames out of their mouths..."well if it's to much tell the night manager and they can change your assignment..." OK like that's going to happen, cause even if my assignment is changed I am still going to be dealing with the same b.s. Drips out the wazoo..Primacore, Dopamine, Cardizem, Natrecore, PRBC's, Heparin. OHS pre-op pt's which require a ton of work, pre- PTCA,ICD,TEE,LHC/RHC,STENT. S/P STROKE,STEMI, S/P PTCA with a 6 fr. Arterial Sheath that has to be pulled by me..which I love doing espically when you are susposed to be off orientaion for 6 months b/f you pull your first sheath..umm I was one day off orientation and pulled 2 that night. I have pulled bout 20 A-Lines(Femoral Arterial Sheaths) and I am just 6 months off orientation. My educator flipped when she found out I am pulling sheaths..well I told her what was going on at night as soon as I started on night shift, she shouldn't have been shocked and she even had the nerve to yell at me..I said maybe if you clean the $&*! out of your ears, you would have heard me say that I pulled my first sheath my first night off orientation..but I am 8 months into it and I have a love hate relationship with my job. I just recntly learned to stick up for my self and say NO. any way thanks for listening to me rant. sorry about all the animation but I worked 13+ hours and the educator thought it would be funny to have my critical care classes at a diff. hospital that is an hour and a half away and start at 8am. OK worked Sunday night got home 9 am monday morning and have to be up at 5:30 am tuesday morning for a class. I decided to forgo sleep today and just stay up and go to bed at 8pm. thank god it's my last class!

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  #23  
Old Mar 26, 2008, 02:56 AM
Senior Member
Join Date: Feb 2008
Re: Staffing question & your cardiac floor

Originally Posted by Morettia2 View Post
wow that sounds EXACTLY like the floor I work on. I work Interventional Cardiology and I too work 7p-7a. we are constantly under staffed. When a good nurse manager is on they take 4 pt's. but there are certain nurse managers I have that take maybe 1 pt. I had posted before about situations I have hada. Like I was in the middle of a code, bagging a pt. and my manager came in and tole me I was getting an ER admitt. That was on top of the other 5 pt's that I had which were s/p PTCA, S/p STEMI, and I can't remember the other 2. I said "NO you are gonna have to give the admitt to another nurse I am in the middle of a code" It is unsafe, I agree. I hate nights we have a House MD and a tele resident and that's about it and there is a list of doctors that the House MD covers and I swear I always have at least 2 pt's that the house MD dosen't cover, so I call the Tele resident and I am lucky if they even bother to listen or even come eval. the pt since the house MD won't do it. I have even called the pt's cardiologist at 3am and woke their butt up b/c they are not covered by house MD and the resident basically told me that she had better things to do then come eval the pt, umm yea pt's O2 SAT is at 79-80% on 2L NC, pt is dyspnic, ST on the monitor, BP is in the toilet, I call a RRT my nurse manager ignores me, 3 more time I call for an RRT and I still am ignored So I SCREAM at the top my lungs for a CODE b/c no one would listen to me, finally ot somone's attn. pt is also s/p STEMI with CK in the 4000's and troponin at 0.20 and pt just came from the cath lab 1 hour ago at 2 am..for a 650 bed hospital that is AWFUL. So I called the pt's cardiologist at 3am b/c no one would give me orders..yes he was miffed that I woke him up BUT he understood only b/c he is young and he said we can call him anytime day or night if it's one of his pt's..hehe let's see how long that lasts..If you call a RRT or a Code at like 4am, 3 people show up..the House MD, the tele resident and the Respiratory therapist. but If you call a RRT or a code during the day >10 people show up and then some.I am getting my one year in and going to another unit..Every night I work I think is tonight the night I am going to put my license in Jeopardy..I have talked to my director, managers and educators and I get the same crap that cames out of their mouths..."well if it's to much tell the night manager and they can change your assignment..." OK like that's going to happen, cause even if my assignment is changed I am still going to be dealing with the same b.s. Drips out the wazoo..Primacore, Dopamine, Cardizem, Natrecore, PRBC's, Heparin. OHS pre-op pt's which require a ton of work, pre- PTCA,ICD,TEE,LHC/RHC,STENT. S/P STROKE,STEMI, S/P PTCA with a 6 fr. Arterial Sheath that has to be pulled by me..which I love doing espically when you are susposed to be off orientaion for 6 months b/f you pull your first sheath..umm I was one day off orientation and pulled 2 that night. I have pulled bout 20 A-Lines(Femoral Arterial Sheaths) and I am just 6 months off orientation. My educator flipped when she found out I am pulling sheaths..well I told her what was going on at night as soon as I started on night shift, she shouldn't have been shocked and she even had the nerve to yell at me..I said maybe if you clean the $&*! out of your ears, you would have heard me say that I pulled my first sheath my first night off orientation..but I am 8 months into it and I have a love hate relationship with my job. I just recntly learned to stick up for my self and say NO. any way thanks for listening to me rant. sorry about all the animation but I worked 13+ hours and the educator thought it would be funny to have my critical care classes at a diff. hospital that is an hour and a half away and start at 8am. OK worked Sunday night got home 9 am monday morning and have to be up at 5:30 am tuesday morning for a class. I decided to forgo sleep today and just stay up and go to bed at 8pm. thank god it's my last class!
That is insane you need to get out of there!!! What city/state do you live in?

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  #24  
Old Mar 26, 2008, 09:34 PM
Morettia2 (Female)
Registered User
Join Date: Jun 2007
Re: Staffing question & your cardiac floor

Live in NYC but work in Newark, NJ..i am currently looking for a new hospital...I love being a nurse but hate where i work!

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  #25  
Old Mar 27, 2008, 09:59 AM
Senior Member
Join Date: Feb 2008
Re: Staffing question & your cardiac floor

Originally Posted by Morettia2 View Post
Live in NYC but work in Newark, NJ..i am currently looking for a new hospital...I love being a nurse but hate where i work!
Where you work sounds like hell!!! There are better places out there!!!

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  #26  
Old Mar 31, 2008, 04:34 AM
Registered User
Join Date: Jun 2005
Re: Staffing question & your cardiac floor

You lucked out. Nothing went wrong. If something did, YOU WOULD BE HELD ACCOUNTABLE. Remember, when a mistake is made, it's difficult (if not impossible) to say that you were short staffed. If a med error was made, would your nurse manager be held as accountable as you? No!

Take it from me, there are too many nursing positions out there to put up with this. Get your resume together, call in sick, and start the job hunting process. There is no reason to go back to that position. If there were a code, you don't even have a enough people to bag, do compressions, and push meds much less defib and record.

If if were me, I would have punched back out and gone home before I got report.

CrazyPremed

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  #27  
Old Mar 31, 2008, 12:35 PM
SMK1's Avatar
Senior Member
Join Date: Sep 2003
Re: Staffing question & your cardiac floor

I can't even imagine 10 patients let alone on a tele unit and it sounds like on top of that without a tele tech. THe fact that nothing happened is sheer luck...

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  #28  
Old Apr 28, 2008, 10:16 AM
Registered User
Join Date: Apr 2008
Re: Staffing question & your cardiac floor

WOW!!! We have a max of 6pts on day shift. This situation would have been considered a disaster. What was the situation in the rest of the hospital? Couldn't someone be pulled from another department? That manager is awful and of that situation should be reported to someone over patient care services,risk management,human resources and whomever else will listen. That situation was totally unacceptable,especially when there was staff willing to help.

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  #29  
Old May 02, 2008, 03:12 PM
NancyNurse08's Avatar
Senior Member
Join Date: Oct 2007
Re: Staffing question & your cardiac floor

That is downright dangerous.

Our ratio is 4:1.

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  #30  
Old May 11, 2008, 01:50 PM
Registered User
Join Date: Feb 2008
Re: Staffing question & your cardiac floor

Hello,
Ten patients on day shift are unsafe. I would have refused the assignment, remember it is your license. You and the patients were lucky this time, but who is to say the next time. Administration and the md over the unit should be made aware of this situation in detail and in writing. That is unsafe nursing practise. Sounds like your immediate supervisor doesn't care about the staff or the patients, and will use the fact that nothing "bad" happened this time to justify increased patient load. What a way to ruin good nurses! Hats off to you for keeping it together through out the day!

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