It's The Grim Reaper, Charlie Brown

Well, my DNS seems to have found a way to keep me working, at least from week to week while the census is down. Last night I did my first shift in six months as the medication/treatment nurse on the subacute/rehab unit; of course, I was VERY slow and felt overwhelmed with all the PRNs, and I didn't sit down all night!!! This is no job for an old woman like me---I swear, I'll never complain again about how hot it is on my unit!----but it's better than losing the hours entirely, even though it kicks my butt.

The nurse who was working my unit while I slaved away on the opposite end of the building totally refuses to do this position, and I don't blame her---she's got about fifteen years on me, and seniority to boot, so they don't even ask her. She is, however, willing to work all shifts, while I can only do evenings or days (it takes me two full days to recover from a noc shift, so I don't do them at all), so I guess it will all even out.

Would you elaborate on this, please? I'd like to hear why your feelings have changed.

Well, the good news is, I don't believe I have to worry about my hours anymore: our census is going up thanks to the impending closure of the only other nursing home in town. The bad news is, our staffing has not yet caught up with the census, and we are being driven into exhaustion trying to care for too many people with too few nurses and aides.

Last night was easily my worst since I've been at that facility. Since our census went in the dumper, the nurses from the skilled wing have been watching over the residents from the middle section, but now that their census has gone up also, they have enough to do with their own patient loads. Which is unfortunate, because several residents from that middle section are Alzheimer's patients and they wander onto MY unit and a) fall; b) exit-seek; or c) get parked at the nurses' station while I'm charting and jabber at me, pick at themselves, set off their personal alarms, undo their dressings, and otherwise make it impossible for me to think straight. :scrm:

Last night, dealing with these folks (who technically are NOT "my" residents) was like trying to herd cats: one fellow kept zipping out the door when a family member or staff would go out---of course, he didn't have a WanderGuard on, so he didn't trip the door alarm. Another one fell trying to transfer himself into bed, requiring the usual stack of paperwork, assessment, vitals, fax to MD etc. (not easily done when you don't even know the resident). Still another kept removing the dressing on his foot stump, which is already in bad shape..........and I hadn't even gotten to my own people yet, six of whom were on alert charting and one of whom was a new admit.

It was so bad, in fact, that I didn't even get my 2100 blood sugars and insulins done until almost 2300. I also had to make up THREE skin sheets for one resident who had multiple skin tears---some of which had been treated, but none of which was documented anywhere. She was flailing around so much I could barely clean and slap a dry sterile dressing on the wounds, let alone measure them and try to approximate the edges with steri-strips per our facility protocol. More reams of documentation followed that one. Still another resident came back from an eye surgery with detailed instructions and several types of eyedrops that needed to be done on a precise schedule..........well, any of you who've ever worked LTC will get the picture.

So......guess I don't need to worry about job security at this point. Now all I need to do is try to stay sane until TPTB bump the staffing back up to where it should be with this number of residents!!

Ouch! so do mine..........I just finished three days of total looney-tunes shifts and am exhausted, then today work called me twice to come in because the nurse with all the seniority had to take off yet again for yet another family crisis, which has thrown the schedule into complete disarray.

I know I'm probably going to Hell for this, but I just let both calls go to voice mail....and then I turned the phone off completely

I'm all for teamwork, but I'm running about a quart low on energy right now and I don't even know now if I'll get my nine-day vacation that's scheduled for the 7th through the 15th. I need it badly. My arthritis is flaring up, my feet and legs hurt all the time, and I'm feeling the early stirrings of burnout. I love my residents and enjoy my job most of the time, but I enjoy it a lot more when I have adequate time away from it. My body also does better if I respect its limits---a three-day stretch is good, four in a row......not so much. And if I'd gone in tonight, they'd want me to work tomorrow night as well; then I have two nights on, one night off, then two more on before my vacation starts.

Having been management, I feel terrible for my DNS because I KNOW how tough it is to find coverage on short notice. On the other hand, it is no longer my responsibility to worry about it, and I'm not going to work on my days off if I don't want to.

So why do I feel so guilty??