A good shift, or a bad shift? It's not up to you.

I was placed in a crappy staffing situation one night in the ER. I was charge nurse that night, too. Had some call-ins and I asked the midshifters if they could stay for another hour or two but they couldn't. After 2300 I had a total of 3 staff RNs (with one of them in triage), a clerk, an LVN and myself. The lobby was full, the ER was pretty much full, (30+ beds), we didn't have a fast track opened because we lacked the staff and we were getting ambulances out of the wazoo. We had some pretty high acuities, too. Despite all of that, I wasn't allowed to go on divert. I pulled together my resources by utilizing the nursing supervisor and asked them if they had any staff to spare (people on call, extra staff on the units, etc) and also enlisted the help of our behavioral health unit to see if they had a mental health tech that they could spare to watch out BH pod. The supervisor ended up coming down to help. I called for a staff huddle in the middle of the shift and instead of having our assigned rooms, we decided as a group to switch to team nursing and let me tell you, that made a world of a difference! We helped each other, supported each other, and made it through a really crappy night. I was blessed to work with the amazing team that I had at that hospital. We were all really close-knit, too. I miss working with them.

I work with a wonderful team at my current job and we are helping each other out constantly, every day.

My favourite memory of excellent teamwork, however, was from when I was a student. I had primary responsibility for an elderly woman in with a hip fracture, mainly. She had other things going on as well that I can't recall specifically. Anyway she had a CXR done up on the unit and was due to head down for an ultrasound right after (I can't recall why she was getting these tests). The x-ray tech came out of the room and wrinkled her nose and said "I think she might need a bit of a clean-up." Okay, no problem, I could change a brief pretty quick at that point in my schooling. I went in, though, and found much more than a soiled brief - it was a veritable lake, a stream, a waterfall of liquid stool. The poor woman. Her bed was full, it was dripping down the mattress and onto the floor through the bed rails. She was covered neck to knee. And the porter was coming in ten minutes to get her down for her ultrasound!

There was absolutely no way I could handle this on my own. I panicked very briefly and then stuck my head into the hallway and saw two of my fellow students and flagged them down. Bless them, they must've seen the look on my face and came running. I quickly explained the situation and they ran for supplies while I pulled the curtains and stripped the bed. We were like a well-oiled machine. The patient wasn't "overly oriented" (as they say) and so wasn't able to help much but we got it done and JUST as the porter was walking in the door. The room itself looked like a crime scene but the patient and her bed were fresh and clean. We got her transferred onto the stretcher and finished scrubbing down her bed and floor while she was gone.

I was so grateful for those two fellow students I thought I would fall over and die. I brought them coffee the next morning. I'm fortunate that we're still friends, even years after graduation.

I work with some awesome people. The kind that can turn a nightmare assignment into a good shift.

I start out positive- it's always going to be a great shift! We all help each other out. If I am running around like a chicken with my head cut off, someone will offer help usually before I even need to ask. I do the same for them. Have a great relationship with PCT's. All of our charge nurses are very helpful and involved. We bounce ideas off each other and vent in appropriate areas- like the break room. We vent a LOT, which can be viewed as a negative thing, but can be essential to get through a shift with those difficult patients and/or family members.

Some discord between day and night shift. Nothing unusual just, "night shift doesn't do anything" sometimes followed up by, "so we need to add more tasks for them". I shrug and ignore shift drama because just like battles between different departments, it will never change.

We have a stupid immediate rooming thing in my ER that relies on the charge RN going out and rooming people- not an issue when it's quiet, but none of us feel it's safe when the place is busy.

Charge nurse was occupied on a busy day.

Pt signs in with chest pain, which is usually something between a cough and a lethal MI. Or it could be a mosquito bite on the nipple.

I did a quick record check, saw a recent bypass.

I went out and grabbed her. (not my job).

A co-worker saw me wheel her in and briskly grab an EKG.

As I was doing the EKG, she looked for a line on the other side, couldn't find one.

She took over the EKG, I drew started a line and drew labs.

Though we have no standing orders for nurses to put in labs, I did.

While I was triaging the PT, lab showed up, thanked me for drawing, labelled the labs with my initials, and took them down.

NSTEMI.

A night shifter showed showed up while I was doing three things at once to get a transport to the cath lab. I asked him to give me a hand instead of getting report, which he did.

In the mean time, the secretary put together my paperwork.

The PT was diagnosed and treated as quickly as possible, thanks to the cooperation of the team. And hopefully lived happily ever after.