Feast or Famine

[VivaLasViejas, ASN, RN]

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.

[ERNurse752, RN]

I know what you're talking about. Usually we can count on summer to be somewhat of a break after enduring the hell of winter/spring. But we've been totally crazy for the last several weeks also. I don't even want to think of what flu season is going to be like...

[NeuroICURN]

Marla....

I wish I could say that I know what you meant.....but since the beginning of summer, we've been getting hit soooooooo hard (it is trauma season!) and the acuity has even been a lot higher than usual! We're all so stressed out and stretched so thin it's been almost unbearable!

I feel your pain with being busy though! I've been working an average of 50-52 hours a week for the last year and this summer has kicked my butt...I can't keep doing it much longer!

Best of luck to you all!

[Tweety, BSN, RN]

It's strange how that happens. Our floor has been holding steady at 18 to 30 patients. One day it's 18 and the next discharge five and admit 15.

But we're seasonal here, the summer isn't busy and the winter we're bursting at the seams lots of overtime to be had then.

Just make sure you're one of those that doesn't have a breakdown.

[wonderbee, BSN, RN]

Oh man yes, it's weird. We thought it was from the hurricane but it just seems that the timing is concidental. Our med/surg floor had overflow onto three other units. Our nursing supervisor has been calling at least three times a week asking if I want to put in extra shifts. What's up???? This is supposed to be slow season. What's gonna happen when the snowbirds show up?

[jannecdote]

I'm still waiting for the overflow here. For the first time in months, we have no waiting list for ICU vent patients which is very unusual. Census has been low this past month, been called off one shift a week for five weeks. My pocketbook is suffering and I'm stressing. My youngest daughter (who lives with me) gave birth this past week while my grandson has hit the terrible two's and my son moved back home from Florida.

*SENSORY OVERLOAD*

Someone get the violin out!!!! Or better yet, Calgon--take me away!!!

[barefootlady, ADN, RN]

I wish I could say I am that busy. As I mentioned earlier, I am working but really, really missing med/surg. I hope to get back to it in a few weeks. I hope everyone who is having a surge in patient activity doesn't get too overworked before flu season.

[BittyBabyGrower, MSN, RN]

We go in spurts, but our med-surg floors have been overflowing!

In our unit we can go from 20 babies and 10 nurses to 45 babies and needing 20 nurses in 8 hours...whoooboy that is so much fun!!!