Oh what a night!

  1. I'm sure there all sorts of you that can relate to this one.
    So I'm starting again on nights after my usual 2 weeks of days. I arrive on the unit and am told I am being floated from my usual special care unit (severe dementia) to a chronic care unit on the "hospital"side of the facility. Timing couldn't be any worse, because the poor nurse that I'll be leaving all alone on the unit (they are replacing me with an aide) is caving to deal with a very ill resident who is actively palliative and her family, as well as 6-7 residents that haven't been sleeping at night, aren't stablized on their meds yet and need ++ supervision because of wandering. But do either of have a vote? No! A nurse on that other unit has called in sick, cannot be replaced with another nurse - we're considered dispensible and my turn is up. By the way, this is the second time this month that this has happened to me.
    Anyway, I go to the other unit, thrilled with the fact that I I'll have to be working with thraches and gt tubes all night. The former makes me nervous because I have ZERO experience with traches and the latter, because they gross me out. I try to mention to the shift coordinator that hey, my home unit needs me tonight, but only come off like I'm whining.
    At least I was treated allright by the unit staff but it was a rediculous situation. It was a quiet night, so I was basically there because babysitting traches and and giving tube feeds can only be done by an RN. I know there are people attached to these, but I'm tired, cranky and I don't know these people. I hate working on chronic care units! They make me all philosophical about the ethics of keeping these poor people alive when there is no thought process going on. But I guess we don't get a vote in that area either. We are simply in the business of taking care of these people ad nauseum, once the families have made the decision that they can't let go of them.

    Hope I didn't offend anyone, just a wee story about my crappy night shift.
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  2. 4 Comments

  3. by   nursedawn67
    (((HUGS))))
  4. by   Brownms46
    You don't need me to tell you...but you're entitled to vent your frustrations...and I will tell you I see nothing wrong with what you have expressed. It rings of honest feelings...from a nurse who truly cares for those you're responsible for (those on your unit)....and I salute you for that.....((((((((adrienurse))))))))


    I hear so many times nurse who say the same thing about trachs. In fact I hear it more times then not! Trach don't bother me...but everyone is different. Taking care of yourself.....and doing the best you can, in difficult situations is all any of us can do
  5. by   mother/babyRN
    Hugs to you too! It is happening all around and will continue to happen. BUT, rather than pay and treat nurses the way they should, they continue to treat us shabbily AND actually wonder why there is a nursing shortage AND import people from other countries to solve it. In our facility if and when that happens, we tell the supervisor we are filling out an unsafe staffing report. EVERY time. It may not get you more help right away, but it does go into their (and your hospitals) personal file. Doesn't look good for them when accreditation comes around, and is the first step in making it better. If a union is involved, file a grievance and follow up on it. If there isn't a union, consider trying to get one in... Good luck and hope it doesn't happen again anytime soon. Is anyone floating up to YOUR unit when some one calls in sick? We tell them we are uncomfortable assuming assignments in case scenario you mentioned, as if something ever happened to a patient that you accepted an assignment for but didn't feel comfortable or competent with their care, YOU would be the one negligent in court, for whatever went wrong since in accepting the assignment makes you liable for care.
  6. by   adrienurse
    I could kiss ya!:kiss

    bUT INSTEAD i'LL VENT SOME MORE. FIRST YOU HAVE TO UNDERSTAND THE PHYSICAL LAYOUT OF MY UNIT. iT IS FOR WANDERERS SO IT IS LOCKED. iT IS DIVIDED INTO TWO LOCKED WINGS AND IF YOU ARE ON ONE SIDE, YOU HAVE NO IDEA WHAT IS GOING ON ON THE OTHER WING. iT IS FOR THIS REASON AND ALSO BECAUSE IT IS DESIGNATED A SPECIAL CARE UNIT THAT THERE IS SUPPOSED TO BE A 15:1 NURSING RATIO AT THE VERY LEAST. dURING THE NIGHT SHIFT, THERE ARE SUPPOSED TO BE 2 RNS AND AN AIDE. tHAT IS THE WAY IT IS SUPPOSED TO BE ON PAPER AT LEAST. iNSTEAD, BECAUSE ITS PRESENCE IS UNDERVALUED SO MUCH BY THE POWERS-THAT-BE, IT IS MISUSED AS A STAFFING POOL FOR NURSES IN ORDER TO COVER SICK CALLS. 50% OF THE TIME, WE ARE WORKING WITH SUB-STANDARD STAFFING LEVELS. THEY NEVER DREAM OF PULLING NURSES FROM THE REGULAR PERSONAL CARE UNITS OR FROMTHE SUB-ACUTE UNITS. tHEY FEEL THAT REPLACING THE RN THEY HAVE PULLED WITH A HEALTH CARE AID IS AN EXCEPTIBLE SOLUTION. tHIS MEANS THAT 1. i CANNOT SEE WHAT THEY STAFF OR RESIDENTS ARE DOING ON ONE WING IF I AM WORKING ON THE OPPOSITE SIDE. thE DOORS THAT SEPARATE THE TWO WINGS CANNOT BE LEFT OPEN BECAUSE THEN THE RESIDENTS COULD JUST WANDER DOWN THE STAIRS OR ELSE ONTO THE ELEVATOR AND ONTO THE STREET. tHIS LEAVES ME TO RELY ON THE CRITICAL THINKING SKILLS OF THE AIDS THAT i WORK WITH. tHERE ARE TIMES WHEN i CAN TRUST THEM TO TELL ME IF SOMEONE IS IN TROUBLE OR SOMETHING IS WRONG - BUT OFTEN i FIND OUT THE HARD WAY WHEN i COME ONTO THEIR SIDE TO CHECK THINGS OUT. mORE OFTEN THEN NOT i WILL FIND THE AID WORKING ALONE WITH THEIR EYES GLUED TO THE tv AND DON'T EVEN HEAR ME UNTIL I'M CLOSE BY. tHEREFORE i AM RESPONSIBLE AND LIABLE FOR THE BEHAVIOR OF OTHERS, BUT I HAVE NO CONTROL OVER WHAT THEY DO WHEN i'M NOT THERE.
    2, tHEN THERE'S THE NATURE OF THE RESIDENTS. tHESE ARE PEOPLE WHO ARE ON THEY UNIT BECAUSE THEY NEED A SPECIFIED AMOUNT OF SUPERVISION AND MOST HAVE BEHAVIORAL PROBLEMS. SOME OF THEM ARE VERY COMBATTIVE AND HAVE BEEN VIOLENT IN THE PAST. A LOT OF THEM ARE FALLS RISKS. iF I AM ON THE UNIT BY MYSELF AND THE TWO AIDS ARE ON THE OTER SIDE. tHEY CANNOT HEAR ME IF i AM IN TROUBLE AND CALL FOR HELP.
    gET SUED MUCH? GET HURT MUCH?

    THANKS FOR LETTING ME VENT. NOW i HAVE TO GO TO WORK:angryfire :angryfire :angryfire :angryfire :angryfire

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