Feast or Famine

What a difference a month makes..........All summer, things were sooooo quiet at my hospital that everyone was getting called off at least once a week and dark rumors of layoffs were beginning to circulate, and now, WHAM!! Everyone within a three-county radius has either gotten sick, had a car wreck, decided to have a knee replacement, or OD'd! I mean, we have been up to our eyeballs in patients........we'll discharge three, and six new admits come in to replace them. I've worked so much OT in the past 2 weeks that I might just be able to replace my computer this payday WITHOUT putting it on Visa. And even though management has all but given up on the new staffing grid---we'd been so short-staffed that several of us have literally had meltdowns---there are days when we could have 20 people out there on the floor and it wouldn't be enough.

So, is anyone else out there experiencing a sudden influx of patients in these last waning days of summer? Of course, where I live it hasn't felt like summer in a couple of weeks......it's been cool and rainy on and off, and even before that the air had a decided 'nip' in the early mornings and evenings that isn't usually there in late August. The weather isn't the only reason....seems that we've had an incredible number of MVAs in the area recently--so many, in fact, that we've had to go on divert twice this month already, and we NEVER do that unless every bed is filled.

In the meantime, the ICU is also bursting, spilling out patients who really aren't stable enough to be on a general med/surg floor.......one day I had to send back two of mine in the same four-hour time period (and we all know how much paperwork THAT generates :uhoh21: ) when they developed some funky heart rhythms along with a few other ominous signs, like my 49 YO hemorrhagic stroke patient who decided to have 30-45 minute apneic periods around the same time his telemetry tracing started jumping around like a frog on a hot skillet. That was exciting......after dealing with the 42-year-old who coded and died LAST week, I had this horrible feeling this fellow was going to go belly-up as well, and damned if I was going to let him do it on my watch!

(I'm happy to report that the patient not only did NOT code, but he got better after a few days in the unit and I ended up discharging him to a rehab facility on Thursday. :) )

What gets me is, if it's this bad in late summer---before we REALLY get into the fall and winter flu-and-colds season---what will it be like then? I'm happy to be working full-time again, I really am, because I'd run out of vacation days and was taking the low-census trend right in the pocketbook. But it's been absolutely insane lately.....these 11AM-7PM shifts have been kicking my butt, and I remember when I started this schedule I thought, oh, how nice it'll be to be home in the evenings with my family. HA! I'm home just long enough to say hi to my husband and kids, eat a couple bites of dinner and check my e-mail before my body calls it quits for the day......then I've just got to get horizontal and put my poor aching feet up!

Oh well, I guess it's feast or famine in this business........we've either got a whole 10 patients on the floor and nurses are getting cut, or we're doing 13 admissions and 8 or 10 surgeries a shift and can't even take the time to pee.