Such praise... I'm blushing.
The exodus from our unit is starting to really concern me. Last night someone who has NEVER, no matter how bad things have been, said that she was ready to quit, said that she is ready to quit. She's been on the unit since the early 1980's and has been through good times and bad for more than 25 years, but now she's had enough. That's a good indicator of how awful things are getting. Of course, it's not just those five chronics and the lack of respect, it's the short staffing and the constant pressure to do more and more all the time with less and less. And we haven't even done the CV/med-surg split yet.
We admitted a baby who was in cardiogenic shock last night. The baby was brought in by the transport team from the sending facility; they had to take one of our patients back with them in a trade. Our unit manager on days did up the assignment for the night shift and had the nurse who was caring for the kid we were sending out also receiving the kid we were getting in. I honestly don't know how she thought that would be possible, but then that's why she's the manager and I don't even do charge. Naturally it didn't work out; we pulled another nurse and got her to do the admission. Much grumbling ensued. We'll have another Berlin by now.
The baby you described with the Glenn shunt (my condolences BTW) would not have been allowed to die on our unit. We would still be flogging that baby with whatever we had to. You have nothing to feel bad about related to your care of her, I know you did everything you could. We can't save them all, and we shouldn't try to save some of them at all.
For all that we're the "Berlin Heart North American centre of excellence" the 12 hours of training I received was not nearly adequate. It was disorganized and there wasn't much focus on nursing care. We got no outline at the beginning, no explanation of the charting requirements, there was a lot of sitting around and when I came out of there, I still didn't feel like I knew anything. My very next shift I had a kid who had been implanted the day of my class. At 0815 the German superman Berlin god came in pushing a new Ikus driver. "Here you go, time to change the driver so that one can be sent for maintenance." "Have I told you sir how much I loathe you?" :angryfire
Another thing that our management has done that hasn't helped with morale is the division of staff. When we first started the Berlin programme, they hand-picked a number of nurses who were to be the "Berlin Heart team". They made it seem as though these people were somehow superior nurses (not true! Attention seekers, more properly) and created a sense of elitism. Then they did the same thing with CRRT, which used to be part of our advanced orientation and everyone was capable of setting up, running and ending it. Well, then it came to pass that we had four kids with Berlins and some shifts there weren't any of the "team" scheduled. They asked for volunteers to join the team. I had been passed over for both the Berlin team and the CRRT team so I very deliberately did not sign up and nor did many of the others who felt as I did. So they decided that it would now be part of the orientation process but in the meantime they put together an ad hoc training day and just assigned a bunch of people to go to it. None of this was communicated to the staff at all. I had just come back from vacation to find I was on that list and I had a bit if a hissy. I ended up in the office and in the end I didn't take the training that day because there was no one to take my assignment. About six months later the CRRT situation followed the same path and they didn't have people who could do the treatment. So they again just pulled a bunch of people from the bedside and gave them four hours of instruction. They were supposed to only monitor and change bags, but are now being expected to set up and end too. Now we've got people looking after a Berlin heart and CRRT as well as the patient all alone... AND covering breaks at the next bedside. That isn't going to continue for long before more people quit.
Is it ethical for nurse managers and administrators to put that kind of load on their nurses? If the unthinkable should occur, will they stand by the nurse, or throw her under the bus? These are some of the things I'll be bringing up in my interview for the study.