Have any of you ever worked in an ICU without techs. I do, and I can assure you it is no picnic. Apparently, techs were abolished by management before my time; I am not sure of the original reasons, and we have never been successful in bringing them back, although we bring up the issue at each staff meeting.
I have worked in this small city ICU/CCU for two years. Our patients are mostly medical, and some of them are very sick. We have two patients per nurse. And we do everything--hourly vital signs, fingersticks, daily weights, clean poo poo poo, wound care, regular critical care nursing care duties, obviously, linen changes, feeding patients, bringing drinks for family members, (of course) and often, physical therapy and swallowing evals (while we are waiting for these departments to come, sometimes days--or the intern/resident forgets to order these consults until we, or the intensivist, remind him to). Sometimes, there is so much poo to clean that meds get given very late and tests get delayed. Often, one patient has to lie in poo while his nurse cleans her other patient.
It is exhausting. Most of the time, we are short staffed, as our managers will not hire new staff due to the economy. If a patient refuses their bath on night shift, or the night nurses do not have time to get to it, the day nurses are simply not able to get to it, either. We are not assured of a secretary, either, and some of the ones we have don't do their job at a correct pace, either. We are expected to assume secretary duties if the secretary is absent or neglectful. This includes answering phones, showing visitors back, taking off orders, putting them in the computer, and updating kardexes.
It would be nice to hear if we are alone in this, or if there are other ICU/CCUs without techs.
Any suggestions for accomplishing change? Thoughts? Ideas?
The only possible advantage I can see is that we sure know what's going on with our patients--if we get into both their rooms often enough.
I guess it just depends on how you do it in your facility. At my job, we are supposed to write up late meds, pt falls, missed or not-noted orders (like a now order that took all day to get done), labs that were missed or not addressed, things like that. Those things are all preventable and even more so with good staffing. We use a computer IR system that goes directly to administration. There is ample room to comment on what the situation was, the outcome, etc.
I think in your situation, if you just stick to the facts and don't set out to have a personal vendetta on someone then you'll be okay. Heck, I've even written up myself a few times and wouldn't be upset if someone had a good legitimate reason to do so for a mistake I made; hopefully your coworkers will understand, especially since you all have the same goal (to get more help).
Thanks! That's actually pretty helpful. I'm going to do my best to try to do that. Actually, if we just were correctly staffed, the tech issue would not be such a big deal. And we have had a lot of poopy patients lately.
My heart goes out to you. I work in a pediatric CICU where most of my patients are under 4kg; although some of them are over 90kg (teens with DCM or transplants), which is rare. Our patient ratio is usually 1:1; although it's 2:1 if the patients are getting better and heading for the step-down unit. We always have a unit secretary--usually we have two. We also have one tech during the shift. The techs and secretaries are responsible for getting blood from the blood bank, downloading our istats, paging x-ray, filing, answering phones, etc. We also have one charge nurse and one resource nurse who change our manifolds, lines, and whatever else needs to be done.
And even though we are spoiled, we sometimes gripe about this and that. I guess I will remind myself how good I have it and complain a little less.
I am used to working ICU without a tech or a unit clerk, (night shift), in a 20 bed M/S ICU. You need really good team work to make this work. I have worked in larger units (combo trauma/medical/surgical/cardiac ICU), with approx 60 beds with ONE tech. You might as well not have a tech.
I now work in a 20 bed M/S ICU that has a tech 90% of the time. There is a unit clerk 100% of the time. The techs are very helpful on getting baths done. We schedule our bath times so the needed help is there. It's GREAT!
Even better, we have transport help! When I have to take a pt to MRI or CT, or wherever, the unit clerk calls the transport team. They completely take care of pushing the bed. All I have to do is watch the portable monitor and push the IV pole/poles. Of course, an RT comes with if the pt is vented. I really like having the transport help!
The only critical care unit I ever worked that we had a tech was the Burn ICU. CVICU, SICU etc we were all RN staff. Actually I liked it as I am one of those that wouldnt ask someone else to do something I wouldnt do myself. I have been on regular floors with techs and was astounded that the RN's would search around for the tech to give a bedpan rather than do it thierselves. Time it took to find the tech they could have done it lol. I worked mostly Primary Care.
Sonia,RN
22 Posts
Thanks! That's actually pretty helpful. I'm going to do my best to try to do that. Actually, if we just were correctly staffed, the tech issue would not be such a big deal. And we have had a lot of poopy patients lately.