I feel for your patients....

[Key_]

I work on a Telemerty floor and we have 6 "pods" that are divided into 3 separate catagories. We have 2 pods for medical tele, 2 pods for post CABG, and 2 pods for chest pain/vascular/post cath. I work on the last. Normally you work on your home pods but you can be floated at any time. Once on a pod you usually stay on that pod until you have a break between your work days.

So I started my week on my home pod. I was working with some nurses from my home pod as well as two that were floated from the medical tele floor. One of these nurses just kept commenting on how easy his night and how easy his week was (he was on his 5th shift on our floor) because we were 3:1 (we go 3:1 on our floor if we have fresh vascular patients, have a-lines, fresh carotids, etc) He didn't have any of these kinds of patients (thank goodness!!) because he has not had the classes for these patients. I didn't really mind the comments because being 3:1 really is great, you can spend the time you need with your patients and not worry about neglecting you other patients.

Having said that, here is the problem. We have wonderful clinical managers on with us throughout the shift. One of the things they do is go around and get report on all the patients. It is a short report that includes what procedures the patient just had or will have the next day (I work nights), what gtts they are on, and if they will be discharged the next day. It also includes who has central lines, PICCs, foleys, or anything else that is high risk for infection. While listening (eavesdropping) to the nurses report who had floated and was having such an "easy night" I over heard something awful.

While giving his report on a patient that had been there for quite some time, he mentioned she had an Ileostomy but no foley. The aide (our best aide I might ad, she is wonderful) piped in and said yes she does have a foley! He was like no, she doesn't, her ileostomy was just draining into a foley bag. At that I point I leaned back on my chair and looked into the patients room. From there I could see that there was a foley bag that was filled with urine. I of course said "Joe (not his real name) there is urine in that bag." Him and the manager (the aide and I watched from the door) went into the room to look. The manager pulled up her gown and you could clearly see that there was an ostomy bag on her side and that a foley in place.

So this means that this nurse had had this patient for 5, count them, 5 days, and didn't know she had a foley and an ostomy. Had he even been in the room? No wonder he was having such easy shifts, he didn't even assess his patients!!!:angryfire

It is so scary to think what could happen to his patients, he as been a nurse for a long time so I am sure that this is not a one time thing. For the rest of the night I kept peeking in on his patients. Thank goodness we have heart monitors that are seen in the nurses station. And thank goodness for our aide, this patient was one of his total cares and she had been doing all the work on these patients (turning, cleaning, emptying the ileostomy AND the foley, etc)

How could someone, especially a nurse, be so negligant???

[Virgo_RN, BSN, RN]

Sounds like he assumed she had an ileoconduit. Sounds like he didn't even look. That *is* scary.

[cardiacmadeline, RN]

Yep, some nurses make you wonder, don't they?

I just have to ask because this stood out to me, you only had three patients for night shift? I want to work where you work! Just curious, how many patients does pm shift have? We always have 3-4 on pm shift, I am on a cardiothoracic surgical floor. Night shift always takes 4-5 patients.

[OutlawNurse86, BSN, RN]

I get a kick out of the nurses I see who don't even have a stethoscope. I'm like "How the hell do you assess a patient?" I guess they just stand outside the room, touch the door with their hand and telepathically assess.

"Mhhhmmmm..... I am hearing crackles in the LUL...."

[Key_]

I just have to ask because this stood out to me, you only had three patients for night shift? I want to work where you work! Just curious, how many patients does pm shift have? We always have 3-4 on pm shift, I am on a cardiothoracic surgical floor. Night shift always takes 4-5 patients.

Yes, I have a good job. It is only one of our pods that goes 3:1 and it is when we have fresh carotids (fresh is

[LOLRN]

You do have a good job. I work on a telemetry floor with cardiac, neurology, and medical patients (a variety!) and our ratio on days is 6:1 normally, and it is the same on nights! I even reported one night to a nurse that had only 5 patients, and I had 6 on day shift. Grrrr... Feels unsafe at times. And, I want to give all my patients great care.