I just got home from work. Some time in the wee hours of the morning, I sat outside and cried. Like you, I have almost 50 patients and two aides. I had two patients last night, on opposite ends of the building, who were reported to me as "dying, checking out, on their way." Thats been my "report" all week. - and every night this week there has been one portion or another or several of their care not being done on the shift prior to mine. - Continuity of care, provision of comfort measures..I think administering meds and i.v. fluids per d/o's fall under that, doesn't it? Except I come in to find pain meds not given, pumps shut off or i.v.'s never started. Upon reporting this I have been informed that I LOOK too hard for something to complain about, always trying to get someone in trouble. - It really isn't that difficult to "look" to see an i.v. pole at a person's bedside and wonder a.) why its there, because you weren't told about it in report, and b.) if its there, why isn't it running, and c.) if it isn't running, why does the chart say it is and has been for sometime? - and if I don't report it, then doesn't that make me an accomplise after the fact? But if I do report it then I'm a trouble maker.
THIS is the cause/affect relation to the nursing shortage, the decline of the nurse's stature, and the pathetic pay rate we receive. Suddenly the job requirement for caring for the elderly and infirm is no more than a warm body with licensure. No need to embelish on that one to answer the frequent question of "why are so many choosing to put away their nursing licenses?".
As for my two patients, they were still alive when I left. For their sakes, I hope they don't wait for me to come in tonight.