Hello, all!
I am a seven-month old nurse, for those who don't know me. I float between a Level II transitional nursery and a Level III Neo-ICU.
The other night, I showed up at work for a twelve hour night shift and immediately began receiving pitiful looks from the staff. After two hours, I still couldn't figure out why. Finally, one of the nurses who was to leave at eleven said, 'I hope you brought your lunch tonight...' and rolled her eyes. I said, 'What is going on here? I have been getting looks from you guys since I walked in the door.' She said, 'Oh, nobody told you?' I was like, um, NOOOOOOOOO, could you be so kind as to enlighten me? Well, when she told me that I was the ONLY NURSE AVAILABLE TO STAFF MY LEVEL II THAT NIGHT and that they couldn't find any help for me, I almost started crying.
Apparantly, because of the fourth of July holiday, some genius in management (I will decline to say exactly who) gave a few too many people off. PLUS three nurses who had been scheduled to work, including two for my unit, had called in sick at the last minute. (I KNOW that at least two of them called in because they went on vacation without telling anyone, as they have a tendency to do frequently and without warning.) Not to MENTION that nobody was available to be pulled from other units, which were also suddenly short-staffed for various reasons, including but not limited to those above.
After another hour of fretting and calling the staffing office multiple times, it was finally decided that our section manager would come in to work. She had worked that morning and had gone home at three. It was now ten o'clock. We have no CNA's; two of them quit a few months ago and one of them is pregnant and works day shift only. Just as I began to breathe a TAD bit easier, because I know that six babies is horrible on our nursery (I had six about two months ago and I was just running ragged and praying that the babies don't get sicker than they are- it's really a quality and safety issue. With total care patients, as babies are, how can you give them what they need with only ten minutes per baby averaged over the evening?? Anyway, I figured with our manager working with me, I would get through it because she is organized and experienced...) it was then determined that she would have to go help staff our Level III across the hall, who had a one-to-one baby and was expecting a new admit from L&D any minute. Obviously, Level III was priority, because those babies were sicker and more critical, and I am not upset that THEY were adequately staffed. If it has to be one or the other, it's Level III all the way with me. However, I was...well...upset...to put it kindly, that I was ONCE AGAIN the only nurse available for the twelve babies on our unit.
I am a new nurse, and have only been out of orientation for four months, but despite my natural lack of knowledge this seemed WRONGWRONGWRONG to me, though I cannot cite a specific rule or law to back myself up. At eleven on the dot, it was decided that a nurse from Peds would be pulled and a pool nurse would come in- one would come to us, with 12, and the other would go to Level I, who had 27 babies and two nurses.
The nurse who came to my unit was a girl who graduated with me in December. We had both been hired in the NICU and began orientation, when, after four weeks of maternal/child and NICU dayshift orientation, during which we had about two-three babies each so that we could acclimate to the unit, she failed her NCLEX. She was already an LPN with adult M/S experience, and she was moved to Peds until she could successfully pass her boards. This was about six months ago. She had not set foot on my unit for six months, and also had gotten used to Peds, whose unit is run completely differently than my own, right down to the flowsheets. I was assigned the charge nurse duties, and between the two of us, we were supposed to get through the night.
Well. Whatever hope I had of making it unscathed was shot to hell as I quickly realized that she remembered NOTHING about NICU or babies and had not a shred of knowledge that could help me in any way. It is not a personal thing- the girl is very sweet and I used to eat lunch with her all the time when we were orienting together. However, she needs a terrific amount of reassurance ALL THE TIME, and when I wasn't doing her work for her because she didn't know something or was panicking or couldn't remember what this or that meant, I was patting her ego and telling her how good she was doing considering the circumstances and that she should just stop worrying and do what she could. Priorities. Make sure they're breathing. Feed and change them. Medicate them. All the rest takes a back seat.
Despite my attempts to help calm her and direct her care, she insisted on doing chart checks from eleven to four in the morning.
FIVE HOURS TO CHART CHECK SIX BABIES.
Um, I'm feeling hysterical here, so will someone please tell me how this is possible????????????????????????
(this is the sound of me screaming at the top of my frustrated lungs, much like the babies who screamed the night away, creating a cacophonous and in retrospect somewhat amusing soundtrack for the evening, until seven a.m. on the dot when they finally went to sleep...day shift came in and could only comment on how cute and precious they all looked, while I considered jumping from the window to a messy death on the sidewalk...but I digress.)
The entire night I did not sit down once. I did not leave the unit. No break. No lunch. Nothing to drink, although I did once cup my hand under the faucet and drink what little water I could hold while running past the sink. No bathroom. I was a wreck inside, and amazingly, managed to hold it together and bust ass so that by six thirty a.m. my care was completed on my six babies, and I had a half hour in which I could devote myself completely to helping her finish all that she couldn't do, which included charting (she had only charted one set of vitals for a new admit in all eight hours at that point), starting an IV on a baby who needed stat medication and fluids, reviewing her flowsheets looking for meds that hadn't been given, and drawing labs (She couldn't do a heelstick for a CBC!) on five of her babies. One nurse came from Lev.III to enter orders into the computer for us at six forty-five, and another came to draw a CMP/Bili Panel/CBC etc. on another one of her babies, and one of the babies had no labs drawn at all, which brought on yet another pleasant conversation with a bunch of green-footed third year med students who couldn't understand why we 'f*cking nurses' hadn't been able to draw blood on their baby who was a near-term feeder-grower. Someone hand me a gun. I could go on for hours. I'm sorry, it seems that I have. Forgive me. I finally left at seven-forty and discovered that my car's front windshield had been smashed to bits outside the hospital because I was parked in the path of vandals (and only because the hospital had no parking availablity, due to the fact that employees who quit or DIED thirty years ago were not removed from the parking list, and thus their empty spaces sit forever unused on the slim chance that they will raise their worm-riddled corpses from the ground and drive to work just for the hell of it). Two-hundred and fifty bucks out of my tight wallet was the only thing I got after all of that. No, I must correct myself. To their credit, I got a call at eleven yesterday morning, disrupting my much-needed sleep after four days straight of working in hell, during which my section manager offered me overtime if I came in to work. OH. MY. GOD. I'm becoming a firefighter. It has been decided. Anyone want my new stethoscope? I just bought it but suddenly, looking at it makes me want to vomit. Thanks for listening.
I can't even spell my own name. Look what they've done to me.
Oh, not to mention that when I came home, my husband yelled at me and told me 'F*** you' about ten times when I refused to do anything but go to bed and sleep. I have a migraine.
