Increasing our workload once again!

[Sadie04]

Hi all, I work on a busy 42 bed ortho/neuro/trauma unit that includes a 6-bed close observation step-down unit. Most patients in step-down are post-op craniotomies with ventrics, multi-traumas with head injuries, several with trachs, etc. Most patients are Q2 hour VS and neuro checks. It's usually staffed with 2 RNs, or RN and LPN, (occasionally RN and CNA). The Chief of Trauma has decided to add telemetry monitorsto this unit for trauma patients that need cardiac monitoring. He says it won't be diagnostic, we may only get these patients occasionally, and he wants to implement this in 8 weeks (there are 70 nurses that will need to be trained for tele). I don't like tele, which is a reason I chose to work on this unit.

Does it sound like they are doing this half-a$$ed (only 8 weeks to implement) and will this be safe for those on tele if we only get patients like this occasionally? They don't plan to increase staffing at all. Most nurses are pretty upset about the whole thing...

[ItalianRN, BSN, RN]

I work on a Tele unit that has just added Neuro. No additional training or staffing has been offered & most of the Neuro patients are completes. Our PCT's are killing themselves & still can't keep up either. The other day I had a patient trying to kick me in the head. It got so bad that we had to call security to help. He was a big guy. It wasn't his fault, it was due to the injury but I still don't want a trip to the ER for myself. As a Tele unit we usually had 5 & sometimes 6 patients. That hasn't changed. Many nurses & PCT's, who have worked on this unit for years, are looking to transfer. It already had the reputation of being the busiest unit in the hospital, & the added Neuro patients makes it 1000x worse. I never wanted to work Neuro. I absolutely hate it.

These patients aren't getting the complete care that Neuro patients should be getting. We are not doing Neuro checks other than checking pupils & hand grasps when possible. We note speech & gait, if there is any & that's about it. We mostly send them for tests & give meds. A lot of them need to be restrained because they are so out of it that all they do is try to pull everything out & get out of bed. They're either calm & non-responsive, or they are very aggitated & want to fight you on everything. Neuro is not my thing. I knew that from my first day in Neuro clinicals when I was in school.

I am only on this floor temporarily because my Tele Stepdown unit is temporarily closed due to construction. My unit will reopen in 2 more months. We get post open heart surgery patients mostly. I already asked my Manager if our Stepdown unit will include Neuro too & she said "no way". If she said yes, I'd already be looking to transfer to the OR or someplace that they couldn't add on like this. As it is, we are all overworked & overwhelmed with our responsibilities. I do not want to risk a patient's care or my license due to administrative decisions. They really need to decrease the ratio if they are going to keep this unit as a Tele/Neuro floor. They also need to offer Neuro training & perhaps include some Neuro nurses in our staffing.

I love the people I work with in this unit, but I'm looking forward to going back to my Tele Stepdown Unit.

[gitterbug]

Typical administrative crap, keep beds full, no matter what patients really need. Glad to hear your old unit will be right up your alley.