We've all been there. Imagine your unit suddenly turning into a battlefield. Many bad things are happening at once. There is a crashing patient coming out of the OR or ED. An acute bed crunch is taking place and nurses are being pressured to transfer patients elsewhere in order to make room for sicker ones. Patients are climbing out of bed everywhere. The tele alarms won't stop going off. Phones are ringing off the hook and the secretary, as usual, is nowhere to be seen. It's 5pm and all the managers have left for the day. Now someone falls, then maybe a rapid response or code occurs. The entire pace of the unit has shifted dramatically. The small talk has stopped and people are shouting commands across the unit. Everything is amped up for the next two hours, and the environment is no longer therapeutic for you or for the patients.
For some of us, depending on where we work, this sort of shift in the pace of the unit happens seldom. For others, it happens every other day. It all depends on what type of unit we work in and the shift. However, regardless of those factors, most of us have experienced it on at least a few occasions and by the end of the day, we feel pretty run down.
The purpose of this thread is to discuss how you deal with these situations. What do you do when people are shouting at you and pressuring you to move patients. Do you tune those people out and keep doing what you're doing in order to maintain focus? Do you inadvertently start rushing tasks that require deft hands, patience, and focus? Does it cause you to make mistakes?
One of the things I will do when the unit picks up and people start going crazy, people are shouting, and tele alarms and bed alarms are going off non stop is to take my break, if I didn't do it already. I'll find the least busy person I can and tell them I have to go do something and will be off the floor for fifteen minutes, and can they please watch my patients. Then I use that time to sit down and gather myself and prepare for the rest of the day. I find that that kind of "pause" helps me function enormously better for the rest of the shift and makes me far more productive and able to contribute to my coworkers better. In really acute situations, like a code, I'll go to the bathroom and wait there for a bit so that the initial dust can settle. In those situations, people are shoving each other around the bedside, carts and furniture are being flung, linens are flying, and people are charging down the hall to do compressions and that kind of situation is just not therapeutic for me. So during those times I tend to go to the bathroom until the situation has calmed down a bit. Then after things are under better control I'll help with compressions, transferring, and so forth.
Use this thread to discuss the challenges you personally have faced in these scenarios and your strategies for making the situation more therapeutic for you.
Specializes in MCH,NICU,NNsy,Educ,Village Nursing.
"I am a proponent of nurse-centered care over patient-centered care. Nurse-centered care utilizes a nurse's unique set of skills to maximize patient outcomes by integrating their individual preferences and goals to make them as productive and helpful to patients as possible."
So, why in the world did you go into a profession that at its heart and origins is the patient?
I work in a CTICU and there is always a literal swarm of people at every code. It is so bloody packed that people can barely navigate in the coding patient's room and we actually have to tell people to go away because of how ridiculously crowded it is, between surgeons, midlevels, nurses who are just trying to "make an appearance." The number of people in the room is a hinderance, not a help. It isn't good when people can't bring over meds from the code cart to the actual patient because the room is chock full of rubberneckers who are just diddling around. People are way too overzealous and I think part of it is due to ICU staff loving to grandstand and needing to be the center of attention. STAND BACK..!!Look at ME! I'm skilled..!! So...yeah, I'm usually not needed if it isn't my patient coding. However, if I were asked to do compressions or push meds, I always do.
I think it should be therapeutic for everyone.
I am a proponent of nurse-centered care over patient-centered care. Nurse-centered care utilizes a nurse's unique set of skills to maximize patient outcomes by integrating their individual preferences and goals to make them as productive and helpful to patients as possible.
Ok first of all, I get that you would like it to be a therapeutic environment and be able to focus better.. I really do get that. But because of the nature of our jobs, **** happens, and we can't just get going when the going gets tough.
I understand taking a break to unwind if things get hectic but are not an emergency and if there is adequate staff to cover you. You do need to recharge.
But when I was a CNA in a hospital and all the nurses were in the coding pt's room and if there was nothing I could do to help, I would take over the call lights, toilet people, do things that I could do, that they were unable to.
Even if my time allowed it I just feel it's not good practice to leave the floor of anyone is coding.
Are you speaking from personal experience? I don't do drugs so I'm not sure.
Do you just post to jerk the rest of us around? You have previously posted that you're a "recovering addict" (and also asked about using recreational drugs while in a monitoring program if they're not addictive).
This is funny to me because you guys are all scolding him for wanting attention as you lavish it upon him.
Since He Who Shall Not Be Named is hopefully skiing and crossing all kinds of boundaries, this is good stuff until he returns. Dare I say, even BETTER than HWSNBN?
Since He Who Shall Not Be Named is hopefully skiing and crossing all kinds of boundaries, this is good stuff until he returns. Dare I say, even BETTER than HWSNBN?
This is really disappointing to read. I work in the ER and actually have a coworker who hid in the bathroom while HER patient coded. I honestly don't trust her with anyone at this point and have zero respect for her as an RN. It comes with the territory no matter what department you're in, you never know what can change, and hiding isn't a solution. I always take comfort in knowing the majority of my coworkers are right there in the **** with me when the ER gets crazy. Codes are not so scary when you know its a team effort. Clearly you aren't making any effort. Even if you aren't in the code because it may not be your "forte" and that's okay, at least go make rounds on other nurses patients to make sure they are okay while that nurse is busy helping a dying patient, holding down the fort is being a team player.
kakamegamama
1,030 Posts
"I am a proponent of nurse-centered care over patient-centered care. Nurse-centered care utilizes a nurse's unique set of skills to maximize patient outcomes by integrating their individual preferences and goals to make them as productive and helpful to patients as possible."
So, why in the world did you go into a profession that at its heart and origins is the patient?