It is mind boggling for sure!! You know how when you are driving down a road, and up ahead you see a little old lady just stepping off the curb, or you see a kid on a bike on the sidewalk...you start making some kind of contingency plan in your head??? Nurse have to do that on the floor!! See that call light WWaayy over there out of your pts reach...clip it closer, and avoid a fall!! Taking report on a new admit...you hear Tube feed (HOB elevated, drain gauze, 60cc syringe, resids., all should be in your mind), or antibiotics (I need to grab the thermometer...)
Unsafe patients should not be left alone in thier rooms...I recently had a patient who was scheduled to be med flighted the next day across the country to a new LTC facility closer to the rest of the family. He had a history of impulsive behvior, & poor safety awareness....the family paid $16,000 for the flight alone. He came everywherre possible with me the entire weekend until he left...burden yes!! BIG TIME!! But having him fall would have been a disaster with minimal costs of $16,000 for the family! Obviously it is unrealistic to think we can do this all the time.....but nonetheless.....An ounce of prevention!!!
Watch for safety hazards as you work...it takes 10 seconds to place a call light within reach...pick up that blanket on the floor....20 seconds to put slippers on someone who is about to walk to the bathroom barefoot....
P.S. if you suspect someone of not giving meds, or taking short cuts simply out of laziness....you MUST report your suspicions! It sucks I know... Recently I was taking care of a pt. who was a diabetic. He was sched. for QID Fingersticks..6:30 am 11am 4pm, and 9 pm. When I went to check the 11 am blood sugar it was 28!! I remembered the night shift nurse (supervisor) told me that his 6:30 level was high and he got 8 units of Regular Insulin!! I re-checked his blood sugar with another glucometer..it came up 30!! He was completely asymptomatic!! I gave him a large OJ with sugar....called the M.D. and while I awaited her call back I checked the history on the glucometer....the night nurse actually checked his blood sugar at 4:15am
Admin. 8 units of regular insulin just about the same time the mans own body would once again increase its production of insulin (to the extent it was able)!! Not to mention that the pt. had NOT eaten anything for 12 hours (he refused his HS snack). I had heard that this nurse sleeps on nights, gets out of her chair once or twice and that is when she does meds, treatments, blood sugars etc... Patients complained all the time that she did not bring pain med, and frequently scolded them.... Her shortcuts were (are) appalling!! I reported her.....she was not even reprimanded, because of the fear of losing a nurse in the midst of the "shortage"!!
NO SHORTCUTS!! Get Organized!! Ask for HELP!!! I have even asked a custodian to help when all the pt. wanted was to have the blind opened or the bedside table pulled closer!! Stay till the job is done, and try to learn how to work together as a team with the shift before and after you to get the job done right!! Nursing is one of the hardest jobs in the world, and one of the most thankless jobs there is...The best gift you can give yourself is to be sure you have done the best possible job for your patients, and that you will have no regrets!!
Hang in there......