I worked the weekend, noc shift. I was team leader. Four nurses, 26 very needy pts and our only aide injured her back and went home after a trip to the ER (she was gone by 2015).
The house supervisor told me that she had two admissions waiting on us. This was around 2030 or so. Shortly after 2100, she told me that she got "one of the other floors to take one of the admissions".
I had 2 units of PRBCs and 2 units of FFP to get up on 2 different pts. Also had one pt who is in w/ end stage liver CA who was intent on getting up to the BSC every 10 minutes or so.....she was not safe to transfer on her own. In addition, another pt needed an NGT dropped (which is not my strongest skill). Another pt's continuous pulse ox was constantly alarming (sats dropping to low to mid 80's and pulse dropping down into the low 40's). These issues along w/ the call bells going off every 5 mins or so.....I told the house supervisor that I would not be able to receive the pt until 2330. She didn't say anything except to let her know when I would be able to take the pt. I thought we had an understanding that the pt would come shortly after 2330.
I once again (right around 2315) told her that I was still overwhelmed - still passing 2200 meds. Right around 2320, I was in the Pyxis room, asked her to come in and witness a med. As the two of us were walking back into the room, the unit sec told me that ER was calling to give report on the admission. I told her that I could not take report at that moment. The house super told me, once we got into the Pyxis room, that the pt HAD to get up to the floor, they had been waiting 2 1/2 hours to come up. I re-iterated once again, that I absolutely could not take report, would be ready ~about 10 mins. She said that the pt must come up now....PERIOD.
I got angry, slammed my hand against the Pyxis window to close out my name and left to go to the bathroom to decompress. I admit that I was very angry/frustrated/overwhelmed. No excuses but I am a person before I am a nurse.
My manager called me back in yesterday morning. The gist of the conversation was this: "It is the expectation on this floor that pts come up "now" regardless of what else is going on." She had the day shift team leader sit in on the meeting. She asked her if she was wrong in assuming that the top priority is to get the pts up to the floor. And the day shifter told us that she has to juggle taking care of 5 pts and still is able to get pts up to the floor. I am sorry but it is totally different on the day shift. More staff available to help out (i.e. 3 aides plus at least 6 nurses on each day shift).
She told me that "it is the expectation that pts get up to the floor and that personal needs did not take precedence over that".
She told me that "my" nurses will be professional at all times...PERIOD. At this point I asked if we were allowed to get frustrated, angry, or show any emotion at all. She re-iterated that "my" nurses will be professional 100% of the time and that emotions needed to stay at home.
Now I have to go back and talk to her again today. I am not sure that I will be able to hold my tongue. I am so angry for everything that has happened. I am a kick butt nurse. I get frequent "WOW" cards from my pts. I am an excellent morale booster. I am forever trying to be positive in spite of the high stress on the unit. My co-workers can always ask me for help and I am there.
I don't know if I should just go in and give my notice. Let her terminate me. Just sit there and take the crap that she has to shovel out.
I need people to give me their take on the situation. Am I wrong? Am I just being a wench-bag?
Well I am meeting w/ the manager tomorrow. One of two things will happen...either I will be fired or disciplined in some other way (I ignored the phone calls from the hosp yesterday).
Not really sure what will happen. But I do know one thing....the manager is new (hire date Aug 1st) and I am sure that she will "make an example" out of me. Well, if she does terminate me then so be it! Change is needed.
Let me share with you what happened to me one night. I worked 3-11 on a med surg unit, and usually split the floor with one other RN, and 2 LPN's (one for each side). If we were really lucky, we had an additional aide.
I came in to work even though I was about 8 weeks pregnant and severely nauseated. I had just come back from being off for 3 weeks due to severe n/v and unexplained abdominal pains. (I was told by my OB/GYN that it was round ligament syndrome, but I had been admitted for a couple of days as the pain was so severe that I was passing out). So I wasn't feeling well. I came in to find that the other RN had called off, I was only getting an LPN and an aide. The aide had a reputation for "hiding" for hours at a time. My supervisor had come round and informed me that I would not be getting any more help.(I had immediately gotton on the phone to speak to admin about this ratio, the unit was full, 26 patients.) I had one comatose patient (turn q2h, needing frequent suctioning) I had one pt receiving blood, a couple of postops, and a CHF-severe. This patients legs looked like water balloons, and I had actually broke the skin with a piece of paper when I was passing meds. Water poured out of the open wound. Water was actually seeping out all over her. This was a med surg floor! She was very orthopnic and had a severe cough, for which she was ordered Hycodan every 2h prn. Believe it, she wanted that cough med every 2 hours on the dot. So after passing my first round of meds, I couldn't find my aide anywhere, my LPN had left for dinner, and I was on the floor on my own. I had to suction the comatose pt, I could not turn her myself. I got nauseated with the suctioning, almost threw up on the pt while doing her care. I had a couple of postops to monitor, the blood hanging, at that time there were no IV nurses, so I had to hang all my own IV antibiotics myself. I came in a few minutes late with CHF's hycodan. her daughter was in the room furious that I was late. I explained that we were short staffed that night, and she calmed down just a little.
It turns out when I left the room and called my supervisior about us being short staffed when her mom needed so much care. (I should say she was on about 10 liters via NRB mask, very cyanotic, with these seeping legs, a real mess, not responsive to lasix or bumex. should have been on tele, no beds.
still no sign of my LPN or the disappearing aide. I was already to cry when my supervisor came up and yelled at me for telling the pt's daughter we were short staffed. she said we are not short staffed, I gave you an LPN and an aide. and I told the girls over on the other side (I was on east, the other side was west)to come over and help as needed. (thanks for telling me). I quit on the spot. I said I am too sick, I have all this going on, I cant find the aide, and the LPN has been at dinner since 4pm!
I took off 7 years, then went back part time.
I don't like stress, to me life is stressful enough,and I will not go to a job that is so life and death that you have to worry about losing your license every day. I work in an office environment now, and I love it, steady daylight, weekends and holidays off, and I don't feel personally responsible for the lives of the patients. That is how I dealt with it.
I worked the weekend, noc shift. I was team leader. Four nurses, 26 very needy pts and our only aide injured her back and went home after a trip to the ER (she was gone by 2015).
The house supervisor told me that she had two admissions waiting on us. This was around 2030 or so. Shortly after 2100, she told me that she got "one of the other floors to take one of the admissions".
I had 2 units of PRBCs and 2 units of FFP to get up on 2 different pts. Also had one pt who is in w/ end stage liver CA who was intent on getting up to the BSC every 10 minutes or so.....she was not safe to transfer on her own. In addition, another pt needed an NGT dropped (which is not my strongest skill). Another pt's continuous pulse ox was constantly alarming (sats dropping to low to mid 80's and pulse dropping down into the low 40's). These issues along w/ the call bells going off every 5 mins or so.....I told the house supervisor that I would not be able to receive the pt until 2330. She didn't say anything except to let her know when I would be able to take the pt. I thought we had an understanding that the pt would come shortly after 2330.
I once again (right around 2315) told her that I was still overwhelmed - still passing 2200 meds. Right around 2320, I was in the Pyxis room, asked her to come in and witness a med. As the two of us were walking back into the room, the unit sec told me that ER was calling to give report on the admission. I told her that I could not take report at that moment. The house super told me, once we got into the Pyxis room, that the pt HAD to get up to the floor, they had been waiting 2 1/2 hours to come up. I re-iterated once again, that I absolutely could not take report, would be ready ~about 10 mins. She said that the pt must come up now....PERIOD.
I got angry, slammed my hand against the Pyxis window to close out my name and left to go to the bathroom to decompress. I admit that I was very angry/frustrated/overwhelmed. No excuses but I am a person before I am a nurse.
My manager called me back in yesterday morning. The gist of the conversation was this: "It is the expectation on this floor that pts come up "now" regardless of what else is going on." She had the day shift team leader sit in on the meeting. She asked her if she was wrong in assuming that the top priority is to get the pts up to the floor. And the day shifter told us that she has to juggle taking care of 5 pts and still is able to get pts up to the floor. I am sorry but it is totally different on the day shift. More staff available to help out (i.e. 3 aides plus at least 6 nurses on each day shift).
She told me that "it is the expectation that pts get up to the floor and that personal needs did not take precedence over that".
She told me that "my" nurses will be professional at all times...PERIOD. At this point I asked if we were allowed to get frustrated, angry, or show any emotion at all. She re-iterated that "my" nurses will be professional 100% of the time and that emotions needed to stay at home.
Now I have to go back and talk to her again today. I am not sure that I will be able to hold my tongue. I am so angry for everything that has happened. I am a kick butt nurse. I get frequent "WOW" cards from my pts. I am an excellent morale booster. I am forever trying to be positive in spite of the high stress on the unit. My co-workers can always ask me for help and I am there.
I don't know if I should just go in and give my notice. Let her terminate me. Just sit there and take the crap that she has to shovel out.
I need people to give me their take on the situation. Am I wrong? Am I just being a wench-bag?
Im not yet a nurse but in our nursing issues class we were discussing unprofessional conduct and misconduct. Its considered unprofessional conduct to accept a patient assignment that you cannot properly care for. Our instructor said it is better to refuse an assignment all together in the interest of patient safety than to jepardize your license and patient care by accepting one that you are unable to adequately care for. I am not sure where you are or if this is just in NYS but you can certainly use that arguement to your defense. You refused an assignment that you could not adequately and safely care for. You were putting patient needs first which is what must be done always. You did not have enough staff either--why wasn't a per-diem CNA called in or something? Maybe you could address these issues to management and together create a plan so it doens't happen next time. Maybe if they see you as being proactive it will help the situation. You sound like a very caring nurse and very dedicated and they should be proud to have you working with them.
I would admit that perhaps you didn't act the best way you possibly could have, but under the circumstances you did the best that you could and you would appreciate support from the manager. I get angry when managers in order to make their units look good to other departments are supportive of their own nurses.
You're manager needs to get a clue as to how stressful it is and that we are only human. I'm known for my calm, cool, collected attitude when I'm in charge, but I even loose it. I've hung up on a recovery room nurse once, but handled it myself with an apology. Once I lost it to the day shift who complained for the 100th time about their assignment "fine, I'm sick of making the assignment anyway and you make it yourself". My manager was supportive, understanding that we're under stress and can't be 100% professional 100% of the time. She still didn't like the way I handled it, but understood and asked me to continue to make the assignment and how to handle it.
Don't sit there and take what she has to throw at you. Perhaps acknowledge that you were human and had a human reaction and will try, but will not guarantee, to act in a way that she describes as professional.
I would surrender to the fact that you can't fight ER transfers. Our policy is that we under no uncertain terms are allowed to obstruct ER transfers. Usually the ER is great about waiting if we can't take the patient, but if they insist, I never argue no matter how stressed or busy I am. It's made live a bit easier surrending to that fact.
Good luck. I'm feelin' ya all the way. Been there and done that.
What a shame that your manager will not support you. Only you can decide if you want to continue to work in this environment. I think before taking pts from the ED, you need to be able to care for the patients you already have. Banging against the Pyxis wasn't professional, but you already know that. It is ok to be fustrated. It is nice if you have a manager that supports you, even if she then tells you another way to handle it. She/He should be offering ways of dealing with difficult situations, not giving you more grief!
Good luck.
I guess this is just a vent.
I worked the weekend, noc shift. I was team leader. Four nurses, 26 very needy pts and our only aide injured her back and went home after a trip to the ER (she was gone by 2015).
The house supervisor told me that she had two admissions waiting on us. This was around 2030 or so. Shortly after 2100, she told me that she got "one of the other floors to take one of the admissions".
I had 2 units of PRBCs and 2 units of FFP to get up on 2 different pts. Also had one pt who is in w/ end stage liver CA who was intent on getting up to the BSC every 10 minutes or so.....she was not safe to transfer on her own. In addition, another pt needed an NGT dropped (which is not my strongest skill). Another pt's continuous pulse ox was constantly alarming (sats dropping to low to mid 80's and pulse dropping down into the low 40's). These issues along w/ the call bells going off every 5 mins or so.....I told the house supervisor that I would not be able to receive the pt until 2330. She didn't say anything except to let her know when I would be able to take the pt. I thought we had an understanding that the pt would come shortly after 2330.
I once again (right around 2315) told her that I was still overwhelmed - still passing 2200 meds. Right around 2320, I was in the Pyxis room, asked her to come in and witness a med. As the two of us were walking back into the room, the unit sec told me that ER was calling to give report on the admission. I told her that I could not take report at that moment. The house super told me, once we got into the Pyxis room, that the pt HAD to get up to the floor, they had been waiting 2 1/2 hours to come up. I re-iterated once again, that I absolutely could not take report, would be ready ~about 10 mins. She said that the pt must come up now....PERIOD.
I got angry, slammed my hand against the Pyxis window to close out my name and left to go to the bathroom to decompress. I admit that I was very angry/frustrated/overwhelmed. No excuses but I am a person before I am a nurse.
My manager called me back in yesterday morning. The gist of the conversation was this: "It is the expectation on this floor that pts come up "now" regardless of what else is going on." She had the day shift team leader sit in on the meeting. She asked her if she was wrong in assuming that the top priority is to get the pts up to the floor. And the day shifter told us that she has to juggle taking care of 5 pts and still is able to get pts up to the floor. I am sorry but it is totally different on the day shift. More staff available to help out (i.e. 3 aides plus at least 6 nurses on each day shift).
She told me that "it is the expectation that pts get up to the floor and that personal needs did not take precedence over that".
She told me that "my" nurses will be professional at all times...PERIOD. At this point I asked if we were allowed to get frustrated, angry, or show any emotion at all. She re-iterated that "my" nurses will be professional 100% of the time and that emotions needed to stay at home.
Now I have to go back and talk to her again today. I am not sure that I will be able to hold my tongue. I am so angry for everything that has happened. I am a kick butt nurse. I get frequent "WOW" cards from my pts. I am an excellent morale booster. I am forever trying to be positive in spite of the high stress on the unit. My co-workers can always ask me for help and I am there.
I don't know if I should just go in and give my notice. Let her terminate me. Just sit there and take the crap that she has to shovel out.
I need people to give me their take on the situation. Am I wrong? Am I just being a wench-bag?
Well I had my meeting w/ my manager. And I still have a job. Not sure if I should put an exclamation point at the end of that sentence or not.
I no longer will be team leader which is my idea. I apologized for slamming my hand against the Pyxis. Stupid of me I know. No excuses except that I am a person before I am a nurse, employee, friend, mom, gramma, sister, aunt, etc.
I guess I need to get my act together somehow. Not let the stress get the better of me. Thanks for all of your support and kind words and your blunt honesty. Sometimes we need a good swift kick in the back side to see things as they really are.
Well I had my meeting w/ my manager. And I still have a job. Not sure if I should put an exclamation point at the end of that sentence or not.
I no longer will be team leader which is my idea. I apologized for slamming my hand against the Pyxis. Stupid of me I know. No excuses except that I am a person before I am a nurse, employee, friend, mom, gramma, sister, aunt, etc.
I guess I need to get my act together somehow. Not let the stress get the better of me. Thanks for all of your support and kind words and your blunt honesty. Sometimes we need a good swift kick in the back side to see things as they really are.
Hey we are ALL only human, after all...why is it when we become nurses we aren't allowed our human frailties any longer? Don't we ALL make mistakes on occasion??
Congrats...glad it worked out for you and I hope things go well for ya! :)
stidget99
342 Posts
Well I am meeting w/ the manager tomorrow. One of two things will happen...either I will be fired or disciplined in some other way (I ignored the phone calls from the hosp yesterday).
Not really sure what will happen. But I do know one thing....the manager is new (hire date Aug 1st) and I am sure that she will "make an example" out of me. Well, if she does terminate me then so be it! Change is needed.