I had a situation occur at work and I'm torn about how to react to it. Very busy hospital med/surg floor with max patient load of 5 patients for each nurse. 5 nurses working the floor, 3 of one race and 2 of the other. there is one "clinical supervisor" who's the same race as the group of 3. the secretary is also the same race as the group of 3. (so that's 5 of one race, and 2 of the other)
Throughout the day there are admissions and discharges. The secretary assigns the patients based on who has discharges to keep the staffing numbers equal, there is no attention paid to acuity or work load (this is a normal occurrence for this floor). Frequently there are times when a nurse will go down to 3 patients because of discharges, while everyone else stays at 5, and that nurse will get back to back admits within minutes of each other. The clinical supervisor on this floor does not assist with admits (not even to put isolation equipment in patient rooms).
On this day, 1 of the nurses, from the race group of 5, goes from 5 patients to 0 patients within a few hours. That nurse is only assigned 1 new admission, that does not arrive until after shift change.
Another nurse, of the race group of 5, starts with 4 patients... discharges 1 and receives a transfer early in the shift... this nurse stays at 4 and is not asked again to take any more admits. (The secretary is observed and overheard pulling this nurse aside saying that she knows that she won't give her any more patients)
One of the nurses of the race group of 2, starts with 4, admits 1, discharges 1, and is asked to take another admission although according to "turns in line" it should be the nurse from the other race group.
The second nurse of the race group of 2, starts with 5, discharges 1, admits 1, and has one pending discharge near the end of the shift. 45 minutes before shift change, the clinical supervisor says to this nurse "can you just take report on the new patient coming up" (This will put this nurse at 6 patients which is over the max patient load. This is this nurses first day off of orientation, this nurse is a new grad). The nurse takes report, is attempting to discharge the one patient, the clinical supervisor is "nagging" them to ensure that isolation equipment is in the room, the secretary assigns the patient to this nurse on the board. And when the patient arrives on the unit the nurse is told "your patient is here" even though this nurse was told all they had to do was take report.
I'm sorry if the story is hard to keep up with. I tried to keep it as simple as I could, while still getting the important details across.
Is the new nurse being "bullied" by the clinical supervisor and the secretary? Why didn't the nurse that went to 0 patients have to take more than 1 admit? Why was the nurse from the race group of 5 skipped over for admits (there is never attention paid to acuity of patients only numbers)? Is it racism because of the difference in treatment of the two race groups? AND if you were a manager would you want this brought to your attention? If you were the one bringing it to your managers attention what would the best way be, in order to not sound whiney or indignant?
Again I apologize for the length of the post, just trying to paint a picture.
