I Would Like Your Opinion.... am I right?

Specialties MICU

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I have previously posted on a co-worker in my new assignment - she left one night (she had 2 patients, so did I) and when I discovered she had gone home without saying a word to me, I called our supervisor who called her and made her come back to work -can you spell ABANDONMENT. She frequently took on the clock lunch times (one was 5 hours to SHOP), and I have a pic of her longest sleep (midnight to 6 a.m.). Long story short, I went to the unit supervisor (over my direct supervisor who NEVER wrote her up but hid her antics) who promised changes.... well, the changes were that we went from an 8 bed unit to a 4 bed unit -- the staffing problem was fixed by "floating" one RN to her unit of choice where she is to PRN... the other RN is now 4 to one.

Memorial Day (night shift) was the second night in a row I was in the unit with four (actually 6) patients without a TECH, a SECRETARY, anyone who could help me in a bind.

I started out with two patients (one the grandfather of a PA in the ER) and another young woman who became painfree, negative enzymes, negative EKG, and so she signed out AMA. I must have been drawn to the phone by the PA with "orders" at least 20 times to get his grandfather out of our unit and upstairs (I concur with the transfer - the man's problem was entirely pulmonary - he is a COPDer) then, I got two peas-in-a-pod women from our other facility (honestly, they arrived within 10 minutes of each other).... I finally got a central staff unit clerk to come down to do my admit paperworks- I REFUSE TO DO OR TO LEARN UNIT CLERK WORK.

Then the ER wanted to send a prisoner with guard. I refused because while all this other stuff was going on, the cleaning crew decided to tape down the middle of the unit, move all the furniture which made the aisle to the rooms less than 24 inches wide... the rooms themselves are only wide enough to hold a stretcher and an EKG machine - so there was no room for a guard..... suddenly this prisoner (assault/DUI) was dismissed by the police department so no guard was necessary (HONEST TO GOD, I AM NOT MAKING THIS UP)...now I have 4 rooms filled - the cleaning man wants to run the electric stripper and I say NO WAY - my patients need to sleep.. his supervisor appears to argue but I win - he manually strips the wax and rewaxes (SMELLS!!)..... now the ER charge comes over and rolls out the PA's granddad to admit through the ER to a tele floor... so I have an empty room.... the house supervisor comes to see "how things are going"... the ER Charge is sarcastic and nasty.

The fourth patient came at 0730. I applied the next day for a different position and was hired immediately.... I gave two weeks notice but the supervisor said to me, I transferred you immediately ... no notice necessary.

Am I the only person who thinks that I should not have had 4 patients by myself --- it is UNSAFE, UNSAFE, UNSAFE... now, the code cart is in a locked room - at the front of the unit... should I do the code button and then run like heck to get the code cart?

I am looking forward to my new position.... the aforementioned RN remains in the unit I just left.

walk6miles....I totally understand your frustration (((hugzzz)))....sadly this happens WAY too often all around the country and world...I did like you and raised a little hell about conditions, ect. only to be put in the same situations over and over again...I've been out of nursing now for about a year and a half , because I could no longer tolerate the BS...there came a time where it just wasn't worth it to me to put my patients & my liscense on the line daily...I'm not suggesting you do as I did...surely there has gotta be SOMEWHERE you can do a great job under reasonable conditions and leave feeling like you have made a difference........best wishes :)

Specializes in Nurse Educator; Family Nursing.

walk6miles. . .

You need to become familiar with your state nursing practice law and Board of Nursing Regulations. There may be a clause in the nursing law that requires that you report actions such as patient abandonment directly to the board. While it may take a bit of research, usually these documents are readily accessible on the web.

Specializes in ICU of all kinds, CVICU, Cath Lab, ER..

I am going to the Florida BON website right now.. I figured it was up to the supervisor but I can at the very least do some research... thanks! I will keep you posted.

Specializes in neuro, critical care, open heart..

hey walk6miles,

I guess it's going to take one of "the village idiot's" pts dying before anything gets done. It's sad to say, but I think that's how how a lot, not all, of directors feel, "as long as the patients are ok, then let them, the village idiots, do whatever"

Specializes in ICU of all kinds, CVICU, Cath Lab, ER..

Found nothing helpful on the website for BON; I am not surprised - it is confusing and difficult to manuever.

I started my new position this weekend (I work weekend nights) - three great nights in intensive care (I felt sooooo good)... and partial vindication came late Sunday night, early Monday morning - the hospital supervisor shared her feelings with me - she has seen some unprofessional behaviour from the "village idiot" and intends to do the paperwork. Additionally, my two peers (who convinced me to transfer into the unit in the first place) have gotten a dose of what I had to deal with - they howled at the top of their lungs - I'm sorry, but these two were unable to understand how serious my situation became and now, suddenly,they CAN emphathize with my feelings!! It never fails.......lololol!!

Specializes in Nurse Educator; Family Nursing.

OK, a little research found the Florida Nurse Practice Act at http://www.doh.state.fl.us/mqa/nursing/info_PracticeAct.pdf

If you look at Chapter 646.018, paragraph 8, h (on page 7) I believe you have grounds to report this nurse for unprofessional conduct.

You can save the document or print it off. Sometimes it helps to have a copy in hand.

Specializes in ICU of all kinds, CVICU, Cath Lab, ER..

KYCNM

Thank you so much for the information - I began reading but wanted to thank you for the help ... I am going back to it right now.

Specializes in OB, M/S, HH, Medical Imaging RN.
there should always be 2 nurses on floor regardless how many patients. If something happens you need someone to get help. If there is only one patient then there should be 2 nurses. That is unsafe! That is crazy, I would have been screaming up the chain of command. It is a patient saftey issue plain and simple.

:yeahthat:

Specializes in ICU of all kinds, CVICU, Cath Lab, ER..

The deed is done. Mailed today.

It sounds like it was a good move!

Specializes in Nurse Educator; Family Nursing.

I know you did this with trepidation. It's always hard to do this. I'll give you an example of an experience I had. Sorry if it's off discussion.

One night I was on call as a new CNM. I helped about four moms birth, and went to the call room about 2 am. At 6 am, the nurses called and said they had a patient "ready to deliver". I arrived and found a primip, confused, unable to answer questions, obviously medicated and the baby was "crowning". She had arrived at 3 am in active labor. The nurses admitted her, started and IV, did adm labs and chart (which was okay because there were standing orders to cover those actions). What they didn't do was call me so that I could do an admission history and physical which the hospital protocol for nurse midwives required. One of the nurses took it upon herself to medicate the patient (not on the standing orders) with Stadol 1 mg and Phenergan 25 mg "because that was what you always ordered".

When I told the collaborating physician (because he needed to know why I was delivering a mom who had no H & P), he went to the unit coordinator and the DON who reprimanded the nurse by putting her on unpaid leave for a week. They begged me not to report the nurse. I continued to have a difficult relationship with that nurse because I thought she really wanted to be a nurse midwife, but didn't want to go through the hassle of school.

Someone posted that there should never be less than 2 nurses on a floor - especially in the ICU!!!! That is absolutely true. You are very lucky to get out of that situation. Have you contacted the state board of nursing about safety issues?

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