Break anyone??????????????????????

Nurses General Nursing

Published

Hi all, I have read now in a few posts that some of us have breaks regularly included in their hospitals and some don't. I just wanted to share something that happened to me over the weekend that could have ended in a really embarrassing situation for me:uhoh3: .

In the hospital where I work, (I work on a general ward, not A&E), we get 2 breaks per shift, and these are usually worked out fairly well. Ok, sometimes you get a break late, or slightly shorter if really busy, but normally everything works smoothly. That is until Saturday morning. The ward was full, and two nurses rang in sick. I, and my colleagues were rushed off our feet!! I started at 7 and was still without a break come 12. Although I was hungry, that was of secondary importance, I was absolutely bursting for the toilet. I know in previous posts, it has been said by some others that you can always make time to go, but honestly, I had not had a single chance, partly because there had been no time, and partly because the staff toilets are in another part of the building. It was the sort of need that had built during the morning, initially had come and been pushed to the back of my mind, then gone away, only to come back stronger the next time. I was working the medicine trolley, before lunch, and had to do a sort of stifled dance it was soooo bad. By 1, I was filling out forms behind the desk I actually had to grab myself once or twice, I can't believe I was doing it, but it really was that bad!!! I had now made the decision that if I didn't go really soon, I would be in trouble. The phone rang, for the millionth time!!! I was actually dancing while on the call. When I rang off, I had to find the supervisor and explain through clenched teeth, that I was going and there was no way of delaying it any longer!! I had to run all the way to the bathrooms, and franticly rip my tights down, but I had made it, only just!! It was embarrassing to think that I could have had an accident, or that most people had noticed that I was in a really desperate state, but I really couldn't have gone any earlier.

I just wanted to add this experience, because although as I said it was embarrassing. It also goes to show that even when you think that you can go when you feel like it, you sometimes can't, even when you are freely allowed to have breaks. I could have gone at any time without criticism from my supervisor, but was unable to, through just being far too busy, and wanting to do my job as well as I could I suppose.

I suppose what I am asking is, has anyone else been in this situation, when you could readily have a break for a bathroom break or food break, but not been able to take it for fear of letting your colleagues down, and the patients?? I have read many times on here about it happening due to not being allowed to by a supervisor or whatever, but not through someone's own stupidity, or dedication, whatever you want to call it??

Sometimes I'll have to tell the doctor I'm working with that I'll help him with that exam in just a minute, as soon as I use the restroom. I work for a urology group so no one ever complains. :)

Specializes in OB, M/S, HH, Medical Imaging RN.

The only nurses who get regular breaks on my floor are the smokers and they get more than 2 per shift. I'm not complaining mind you, if they can work it out, kudos to them. I go to the BR when I need to and I drink plenty as we are allowed to drink at the desks and even carry water with us. They supply the small Dasani bottles for us. I am "always" interrupted during lunch and we are not allowed to leave the floor to eat. It's a huge problem but we've tried numerous things, such as giving another nurse our beeper, and nothing every seems to work. I've decided it just goes with the job, at least where I work it does. I run from one thing to another and don't even get the time to think about taking a break. Very rarely it's not too busy and I take advantage of that without any guilt what-so-ever. I've given far more than I've taken. If the charge nurse sees you in the break room you can be sure you will get the next admission. They just don't realize! It's perceived as, oh you're not that busy, next admission is yours. I'm only PRN now at the hospital after 30 years. I'm doing home health and loving the freedom and the ability to eat uninterrupted, stop at the bank, stop at a store, pretty much whatever I want. I see 4-5 patients a day all in my own area of town. If I had 8-10 pts all over the place I think that would be very hectic as well. Sorry didn't mean to vent but it felt good!

Specializes in Progressive Care.

ok, I too have held it and held it AND HELD IT. But the manager I work for is awesome, she has ooodles of experience and brains and all that and she told me that as long as no one is coding go pee. She always makes sure that everyone has eaten and voided and is not feeling overwhelmed. If you skip a few meals so what... weight loss right? But for the love of god...go to the bathroom. A potty break is not, in my opinion, a real "break." And why, oh why are the staff restrooms so far away?

Or you could always just put a foley in for yourself at the beginning of the shift and the problem would be eliminated. Unless you feel that the bag would be cumbersome during the day...your choice.

Specializes in OB, M/S, HH, Medical Imaging RN.
ok, I too have held it and held it AND HELD IT. But the manager I work for is awesome, she has ooodles of experience and brains and all that and she told me that as long as no one is coding go pee. She always makes sure that everyone has eaten and voided and is not feeling overwhelmed. If you skip a few meals so what... weight loss right? But for the love of god...go to the bathroom. A potty break is not, in my opinion, a real "break." And why, oh why are the staff restrooms so far away?

Or you could always just put a foley in for yourself at the beginning of the shift and the problem would be eliminated. Unless you feel that the bag would be cumbersome during the day...your choice.

We could always choose a leg bag :roll :roll :roll

Specializes in Tele, Acute.

Did anybody else have to run for the potty while reading the post? :roll

We work form 630am to 7pm. SUPPOSED to have two 15 minute breaks and one 30 minute lunch. (thats what labor laws say anyway) My hospital is in its yearly lets save money, cut staff, budget hours, etc.... mode. I have worked here almost 8 years and I can honestly say there have been days where I worked the entire 12 1/2 hours without sitting down once and without a single drop to drink or bite to eat. I did not chose to be a martyr and I dont enjoy working that way. My patients were simply to critical for me to leave them and my co workers were in the same boat I was. We are required to chart every 15 minutes on chest pains and/or suspected MI's. Criticals require more frequent charting, and regular stable patients, every 30-60 minutes. How can I ask a co worker to do this for my 5-6 patients for 30 minutes while I take a break when they have 5-6 of thier own. Our ER is very busy and many times we hold vent pts. and other ICU admits waiting for beds. I dont know the solution to this, but believe me, I dont do it because I want to.

The problem is, we are not relieved for breaks. When the CNAs, ward clerks, housekeeper, etc leave the unit, who is covering for them: THE NURSES.

Same on off-shifts or when staff is short, when there isn't a ward clerk, housekeeper and less staff, who is picking up that slack: THE NURSES.

We enable the support staff to take their breaks. NO ONE enables us to take our breaks unless it is another nurse who may or may not be able to accommodate each other. Another problem is that it may be an optimal time for me to take a break, however it may be far from an optimal time for another nurse/nurses to cover me for a break, in fact in may be more prudent for me to be offerring them my assistance.

As to the original topic, do I pee during my 12 hour shifts? Rarely, because my bladder is rarely full since according to JACHO we are not allowed to have food or BEVERAGES (including water) on the unit. I've come to the conclusion JACHO started this so that nursing staff wouldn't drink enough fluid to have to pee.

It seems that the general consensus seems to be that everybody BUT the nurses in a facility is entitled to a break or lunch. We are the most accountable, most responsible, most stressed and yet everyone BUT the nursing staff gets taken care of when it come to breaks.

The bottom line folks: WE ARE OFTEN NOT TAKEN CARE OF BY OUR FACILITIES WHEN IT COMES TO BREAKS OR BASIC HUMAN ELIMINATION FUNCTIONS.

I work 12 hour shifts, and I rarely get a break. So essentially my shifts become 12.5 to 13 hours. My manager sees no problem with this at all, and I'm not the only nurse this happens to. She manages our unit, which is intermediate care, but she has never worked on an intermediate care herself! She thinks we can have as many patients as a general med/surg floor. At first I was professionally vocal about my concerns, but now I feel that I cannot say anything. When I do speak up, the constructive criticism is not taken from my manager as something our unit needs to work on. Rather, I am attacked personally, and I am told I need to change. I find this extremely disheartening. I work very hard, am very consciencious, and my patients are very satisfied with the care I give. Does anyone disagree that it is not right to make a person work such long shifts without a change to sit down and at least eat for 30 minutes?

...I suppose what I am asking is, has anyone else been in this situation, when you could readily have a break for a bathroom break or food break, but not been able to take it for fear of letting your colleagues down, and the patients?? I have read many times on here about it happening due to not being allowed to by a supervisor or whatever, but not through someone's own stupidity, or dedication, whatever you want to call it??

I have to tell you, years ago I was working in a small community hospital in the ER, only 2 nurses on nights (24-08). One night we had a bad MVA come in, 6 people, 1 arrested upon arrival and the other five were critical with head and internal injuries...they came in about 1 and by 0730 when the day shift came on I was doing the dance. I was too busy to drink even water, and that probably saved me...what doesn't go in doesn't come out! :clown:

I have to say that there are times in a 12 hour shift that I am lucky to get even 1 break!! I work on a VERY busy, VERY POORLY staffed med-surg floor. We blew a wad of money on a new computer system, so now there have been cutbacks at guess who's expense??? It is an everyday occurance for me to have 10-12 patients a shift with not to mention post-ops, discharges, special procedures, etc. There was one day when getting there at 6:45 am that I didn't even sit down til 3:30pm and didn't go home til 10:00pm plus the fact that I live an hour away from work! OH YEAH, BABY - MY EYES WERE FLOATING, FEET HURTING, AND TEMPER FLARING!! It's just a good thing I wasn't PMSing or all he** would have broke loose!!! - not to mention somebody's neck!!!!

:banghead:

Oh those breaks.....what a dilemna! Breaks are something you TAKE, not something you GET.

Here is another way to look at the importance of taking breaks:

Most health care facilities allow one 30 minute break, and two 15-minute breaks per 8 hour shift. Usually, only the 30-minute break is unpaid. If you don't take these breaks, you are giving your employer one hour of free labor per day. For the average full-time nurse, that is 5 hours per week, multiply that by 52 weeks in the year and that is 260 hours per year!!! 260 hours you are working for nothing!!!! That's between 6 and 7 weeks of full-time work! Please thank your employer for the wonderful two weeks vacation you get every year....

Self care is not selfish.

try a liver transplant, 12hours scrubbed into surgery with no break. yep that is 12 hours with no water, no food and no chance to pee! by the way you get used to the not able to scratch your nose thing. as a surgical technologist i was at the mercy of my charge nurse to send in a relief person so that i could break scrub. to just leave is of course considered: "patient abandonment," besides my liver transplant patient was on bypass. if this or manager was at all concerned about me or my ability to do my job, passing tiny sutures as fine as a human hair, she might have relieved me briefly herself. however, she was relentlessly abusive to everyone and she just didn't care. my former hospital really loved her because she has helped them to "downsize" as tenure nurses continued to leave in droves. new nurse graduates are much cheaper, more compliant and they tolerate abuse far better while trying to earn their reputation at the "best hospital in america." yes, that is how they treat their staff at the "best hospital in america" and they are still winning awards for excellence in patient safety!

while a surgeon can, and should, demand that the person assisting him is relieved, nurses and technicians fall under the control of or management which leaves us vulnerable to the vagaries of inappropriate or coverage as determined by the hospital. as a consequence of hospital "downsizing" to cut costs redundancy of personnel has been severely limited to the point where during the off-shifts especially at night and on weekends there's no free staff to break people out of surgery for even a brief run to the bathroom! calling in call team people to provide relief breaks is considered an unnecessary expense, despite the fact that there is a clearly established link between fatigue and medical errors. the sterile team scrubbed into surgery are trapped without food or water until they are relieved; this also represents an unacceptable deprivation strain on the body. however there are no safeguards within the existing us employment laws or ocha standards to insure that critical hospital workers, including those in the or, are not left for hours of continuous, and dangerous, practice without a break. why you may ask? because "breaks are at the discretion of the employer."

i was left stranded at the field without relief for 8, 10 and on the worst occasion 12 hours straight. these situations impacted my ability to concentrate as my blood sugar plummeted; each time i reported becoming sick, dizzy and faint to the point of nearly passing out. despite nearly passed out during these lengthy periods of abandonment in surgery, but my manager felt that i should be "evaluated for a sugar problem." it is not healthy to go without water or sustenance for over 12 hours; deferring bathroom use isn't healthy either. check out the site "void where prohibited" for more info on this problem. when i complained that my condition in response to this hardship presented a danger to my patients i was targeted for removal and then fired. incidents where any member of the or team is forced to remain on task for that long should be documented in an "incident report," as an extreme of this magnitude presents an unacceptable danger to the patient. i soon learned that any attempt to complain about a nurse manager's conduct was really futile. my hospital never disciplines their managers for any reason what-so-ever.

so here is a question that i have posed elsewhere on another allnurses thread: "how long is too long to remain alert while scrubbed into surgery without a break?" this is the issue rarely addressed by hospitals: are they driving medical staff to continue working when it is unhealthy and unsafe for them as well as dangerous for their patients. we are not making cookies! people's lives are in our hands so why are members of the public so astonished when we make a medication error or leave a clamp inside a patient? they do not realize we are expected to work on the brink of collapse.

i am trained as a wilderness emt and i was one of the founding members of the south florida d-mat team. one thing that is heavily emphasized in rescue and disaster response training is the need for team members to remain properly hydrated and pay attention to their own physical needs so that they do not become victims themselves. in a dire emergency it is easy to neglect your own needs, become week, dehydrated and exhausted: you will become a liability to your team under these circumstances and it is not well tolerated. i have fairly recently returned from six months as a medical volunteer out in aceh province, indonesia following the tsunami. i was pleased and reassured to find that the ngo personnel stationed in disaster zones are also encouraged to share this, team safety is patient safety, priority in carrying out their responsibilities. this vital component is absent or ignored in medical training for us hospitals.

before entering conventional medical institutions i was especially well attuned and sensitivity to the problems of fatigue; i was at sea for over twenty years delivering yachts offshore. as a us coast guard licensed captain i was responsible for the welfare of my crew while at sea; ensuring that they did not become sick, exhausted and fatigued was a top priority. a captain can choose who is qualified to sail with them, who is fit and rested enough to stand a night watch and how many people it takes to man the vessel. in the majority of cases this level of control is denied to nurses even when they are assigned as charge nurse. however, if a mistake is caused by under staffing, untrained assistive personnel or fatigue, will the hospital managers who created this appalling situation be held accountable? i doubt it.

hospital managers seem immune from such responsibility for their staff. they might as well have erected a six foot high banner in the lobby stating: "managers will never be held accountable for negligence or retaliation against subordinates." at my arbitration hearing the or managers admitted i had been left abandoned in surgery for 12 hours on one occasion. despite written hospital policies that clearly state it is the responsibility of the manager to organize breaks all they had to say in reply to why i was not relieved was "she didn't ask for a break" and the er (not the or) was busy! there was no defense as what ever the hospital management said was taken as gospel. the elimination of staff and minimal redundancy of nursing personnel means that even in most non-emergency situations there are no staff to give relief breaks. we must force hospitals to take this situation seriously as it is putting the health of staff and the safety of patients at unnecessary risk

now here are some rather shocking facts for you long suffering nurses to evaluate. the reprints are taken from the un site and clearly show that pows have greater rights to humane treatment than most us workers, but nurses and other medical staff are particularly badly abused. it is only by drawing such shocking parallels that we can alert the desensitized america public to the plight of overstressed hospital staff. compared to many us healthcare facilities what is written below looks like a quite reasonable "benefit package."

geneva convention relative to the treatment of prisoners of war adopted on 12 august 1949 by the diplomatic conference for the establishment of international conventions for the protection of victims of war, held in geneva from 21 april to 12 august, 1949 entry into force 21 october 1950 chapter ii quarters, food and clothing of prisoners of war article 26 the basic daily food rations shall be sufficient in quantity, quality and variety to keep prisoners of war in good health and to prevent loss of weight or the development of nutritional deficiencies. account shall also be taken of the habitual diet of the prisoners. the detaining power shall supply prisoners of war who work with such additional rations as are necessary for the labour on which they are employed. sufficient drinking water shall be supplied to prisoners of war. section iii labour of prisoners of war article 53 the duration of the daily labour of prisoners of war, including the time of the journey to and fro, shall not be excessive, and must in no case exceed that permitted for civilian workers in the district, who are nationals of the detaining power and employed on the same work. prisoners of war must be allowed, in the middle of the day's work, a rest of not less than one hour. this rest will be the same as that to which workers of the detaining power are entitled, if the latter is of longer duration. they shall be allowed in addition a rest of twenty-four consecutive hours every week, preferably on sunday or the day of rest in their country of origin. furthermore, every prisoner who has worked for one year shall be granted a rest of eight consecutive days, during which his working pay shall be paid him.

as hawks in the administration debate the geneva convention's ruling on how long it is permissible to keep a prisoner of war in the standing position few rationalize that ordinary workers might deserve at least equal if not fractionally better treatment. 10 -12 full hours continuously standing is defiantly in the realm of cruel and unusual punishment, but it is ok for a surgical technologist in the "best hospital in america." legally in most us states breaks are entirely at the discretion of your employer unless you are under the age of 18. they do not have to allow a lunch break at all. while their must be facilities for you to use a bathroom there are no regulations pertaining to how infrequently you might be allowed to use them. while you are not legally entitled to any breaks at all your hospital can mandate you to remain on duty for a second shift: you could go for 16hours without food or water without the hospital technically breaking the law! if you abandon your post and your patient however there are consequences as you can be charged with "patient abandonment." this safety breach could cost you your nursing license, but usually the guilt trip is enough to keep you on task.

here is an extract from another un web site pertaining to the working regulations formulated in accordance with unhcr guidelines to protect the rights of iraqi workers. let's call it: "benefit package number two!" this is an interesting reprint from a document that those who work under similar unreasonable, torturous or downright inhumane circumstances in the us should take careful note of:

43. hours of work are interspersed with one or more eating and rest periods of not less than half an hour. continuous work may not exceed five hours. the rest period in jobs which span two meal times ranges between one and four hours (labour act in force, art. 58).

unhcr is helping to legislate more humane working regulations in iraq than are afforded to us workers even in critical jobs like healthcare! the "labor act" is a un document, please visit this site: http://www.unhchr.ch/tbs/doc.nsf/(symbol)/e.1994.104.add.9.en?opendocument

there is a good reason why on the airlines you are instructed to don your our own oxygen mask first before attending to the needs of someone else. however, in our hospitals we are taught that the obligation to our patient must preempt even the most basic self preservation necessities. we are encouraged to feel guilty about abandoning the patient to take a rest break or get something to eat, when instead we should be more concerned that in neglecting ourselves we will compromise the care of others. the zero redundancy of personnel, therefore no one to cover breaks, therefore just go without, situation is happening in all areas of numerous for profit hospitals throughout the united states. it is all about the money, as our conscience is being unfairly manipulated to enable big corporations to bleed healthcare dry. the real culprits in the abandonment of patients are the hospital administrators who are striving for greater profits with chronically few well trained staff while unscrupulous management help to facilitate this process.

as i learned the hard way, choke it down or speak out at your peril; the hospital holds all the cards and you have zero rights. after five years of flawless service in the or i was fired without cause for asking to be treated in a humane manor! "at will" employment laws in most states mean that if you dare to complain you will be removed and there is little or no recourse to even minimal protection from retaliation for whistleblowers. i lost everything i had in the us and the hospital's lies may now sabotage my efforts to work as an unpaid overseas medical volunteer for an ngo in tsunami ravaged indonesia. i spent six months in aceh, but i need a stronger mandate to continue my work and that just isn't possible with the false allegation over my shameful exit from my prestigious former employer. they know how to ruin your entire life; they did it and so far they have succeeded.

if you are forced to work for hours on end without relief, without water, food or a run to the bathroom, you will be compromise the care of your patients by risking medical error. do not accept the guilt of "patient abandonment" threats while your hospital rakes in the profits from negligent care. write an "incident report" to document inadequate staffing and inappropriate intervals without relief as they represent a tangible danger to the patients. i know, easier said than done when you have no voice and no protection in the workplace. nurses must speak out, some are less able to take on this daunting challenge due to family commitments, but we must support their efforts to force industry wide changes.

this managerial negligence is fraud, as it defrauds the public of safe hospital care!

there is further information on the topic of breaks, abandonment and retaliation etc. that i have elaborated on in allnursing threads and i hope you will view these other threads.

[color=#333333]https://allnurses.com/forums/f8/re-blowing-whistle-deliberate-understaffing-and-toxic-managerial-practices-133423.html#post1432109

https://allnurses.com/forums/f100/re-do-hospital-compliance-lines-offer-genuine-protection-retaliation-139732.html#post1492339

https://allnurses.com/forums/f100/constituent-opinion-patient-advocate-hospital-staff-gagged-will-firing-139235.html#post1487926

https://allnurses.com/forums/f100/retaliation-voicing-concern-over-unsafe-pratices-131188-5.html

after a five year battle i will be going public with a petition on the internet very soon. i have been held up due to serious computer problems and inadequate space to post the petition with all of the embedded links in place. the petition has over 200 links that will provide a valuable resource to other hospital staff and interested citizens by providing a valuable insight into the situation discussed here, but i need a web space for this "links heavy" version that will link to the main petition site. please contact me with suggestions if you can help. please look out for the basic format as it will be posted soon on thepetitionsite.com. i hope you will consider signing and passing this information on to your friends,

fair winds & following seas, tsunami kim.

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