Hi! I am looking for input on the support systems in place in other small community hospitals. I have had a rough weekend because we have had a high census with many sick calls and failing support systems. On Friday at 3:30 pm, we had a fresh post-op hip replacement and a chest pain admission literally sitting in the hallway because their room had just been vacated by 2 patients and there was no housekeeping staff on. So, the CNA and I quickly stripped the room, scrubbed and mopped it and made the beds while the patient's families looked on. An hour later, another admission came and when I went to bring her to her room, found that the room had never been cleaned from the discharge on day shift. So, again, I stripped, mopped and made the bed while the patient laid on the stretcher in the hallway. I overheard the family say, "gee, the RN's even have to do the housekeeping around here". It was very embarrasing. We usually have housekeeping on evenings but when there is a sick call, there is no one to replace her so it is assumed that nursing will pick up the slack. We have just implemented a new computer order entry system that has many problems. The lab called last night and said there were many errors that were put in by the day shift, such as duplicate orders. This is probably the computer's fault but it is hard to tell. The lab insisted that it is nursing's responsibility to fix there errors so I spent 45 minutes doing that last night, time I could have been spending with my patients and documenting. Then, the last straw was when I went to give the IV Rocephin to a 7 week old with pneumonia. I found the powdered filled vials in the med drawer with absolutely no instructions/guidance on how to mix it and no diluent. So, that took an additional 25 minutes to find out how to mix it, calculate the dose, and give the drug. Had pharmacy been doing their job, all I would have needed to do was a quick calculation to make sure it was the right dose. We don't have any formal transport program so when a patient needs to go to radiology, CT scan, etc. it is up to nursing to transport which sometimes can take them off the floor for 30 minutes or more. I have just had a lousy weekend and needed to "vent"! Thanks for listening/reading!