Last Question! I Swear

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Specializes in Community Health, Med/Surg, ICU Stepdown.

2 questions in one day... but my job is driving me nuts. Other than staff exposing staff to covid, our hospital is trying to suspend our ratios so we can take as many covid pts as they want. Yesterday my covid pt crashed and I had to transfer her to ICU and help stabilize. Took me almost an hour and a half. My 2 other covid pts left unattended. Most of other staff helping me with sick pt. 

One nurse is known to do this, and yesterday did it again. He answers call lights and is usually helpful. But with covid pts he answers, says your nurse will be with you soon, doesn't check what they need or if it's urgent. Then doesn't mention to the covid nurse that they called. Yesterday it happened while I was with the ICU pt. My covid pt called for help, he told her I'd be there soon, didn't check on her, didn't tell me when I got back. She was mad and scared no one will come if she has an emergency. Had to smooth things over. He did it to another nurse when her young pt needed help to commode because dizzy and so many wires. She ended up being incontinent and crying. The primary nurse always has to explain and smooth things over.

I feel unprofessional telling pts I was with another pt who was having an emergency and that I wasn't informed they called, but what is the alternative? Them thinking I'm ignoring them and not trusting me? I apologize and try extra hard to make it up. But I'm so frustrated. I want to talk to this nurse soon. I hardly get upset but yesterday I was rude and impatient with everyone. I feel this stress is changing me. Plus they're talking about training this guy for charge. He has less than a year on our floor and I have 3. My coworkers want me to do it but not my boss. Insulting. I have a new job in outpatient PACU and planning to stay per diem here. But now I want to quit. But scared outpatient stuff will shut down because the surge in CA is bad. We brag about being liberal and believing in science, yet I see people having parties and going to Vegas and our state is one of the worst in the US now. What do you think? thank you if you read this whole thing! Sometimes I feel we're worse than the "anti-maskers" because it feels fake and hypocritical for people to look down on those people and talk about how they're doing their part while simultaneously having huge thanksgiving parties and causing covid nurses to suffer. Nurses work holidays every year to care for you, you can skip the holidays ONCE to care for us. 

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Specializes in ER, Pre-Op, PACU.

1. I have found that most hospitals don’t necessarily have the nurses that SHOULD be in charge trained for charge. For lack of a better term....most hospitals have gone corporate America and although I see how many bedside nurses do have good hearts......the healthcare systems do not necessarily have their heart in the right place.

2. I say take the outpatient job if the stress is changing your personality. Don’t stay PRN (or try it a few months and see if you still want to stay PRN or stop altogether). Nurses are dropping right and left and I think there will always be jobs especially during the covid times. I know when I left the ER, I didn’t miss it. I did miss my team and miss some of the critical thinking but the way it had changed my personality and made me constantly short tempered and irritable made me hate myself.

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Specializes in Travel, Home Health, Med-Surg.

Agree with speedynurse. The hospital was bad prior to covid and I am sure it is worse now. I would take that PACU job and kiss the hospital goodbye! I worked in the hospital many years with the same experiences you describe and only witnessed the environment get worse and worse over the years. The last place I worked told us not to tell pts that we couldnt come ( to their bedside) bc we were with another pt. I told them (pts)  that anyway bc it was the truth and never felt it was unprofessional in any way. I smoothed it over best I could but without spending too much time/energy. You need to not take responsibility for time/issues that are not within your control, that will indeed increase your stress level. I would stay per diem and see how it goes, it is easier bc you won't be there that much and can avoid the office politics and you can just call and quit whenever you want to. I think many people arent sure what to believe re: covid bc of all the hypocrisy and politicization of the virus (including Calif politicians). I hope the vaccine helps and we can get under control very soon! Good luck!

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4 hours ago, LibraNurse27 said:

Yesterday my covid pt crashed and I had to transfer her to ICU and help stabilize. Took me almost an hour and a half. My 2 other covid pts left unattended. Most of other staff helping me with sick pt. 

One nurse is known to do this, and yesterday did it again. He answers call lights and is usually helpful. But with covid pts he answers, says your nurse will be with you soon, doesn't check what they need or if it's urgent. Then doesn't mention to the covid nurse that they called. Yesterday it happened while I was with the ICU pt. My covid pt called for help, he told her I'd be there soon, didn't check on her, didn't tell me when I got back. She was mad and scared no one will come if she has an emergency.

I feel unprofessional telling pts I was with another pt who was having an emergency and that I wasn't informed they called, but what is the alternative?

I'm confused? Were you off the unit for an hour and a half? How long was the patient kept waiting? If you're that busy for that long, I think there should be a quick but formal hand-off of responsibility for your other patients.

I think it's absolutely fine to set reasonable expectations with patients. If we're very short staffed, which is happening a lot lately, I let them know that it might take me "a while" to get there. If you weren't told that they called, I think that's also fine to say ...just stay neutral and factual, as opposed to sounding irritated with your coworker(s).

When I'm unavailable for an extended length of time, no matter who's watching my patients, I'm in a habit of checking on them all as soon as I return to the floor. Maybe that would be a useful strategy for you, too.

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Specializes in Psych (25 years), Medical (15 years).
13 hours ago, LibraNurse27 said:

What do you think? 

I think you should ask as many questions as you want, LibraNurse.

You are an example of a quality caregiver and your submissions are a good reason why this site exists.

My heart goes out to you for your trials and tribulations and it does my heart good to know you are out there. In a sense, you kind of remind me of my medical nurse wife Belinda- persevering and all the while focused on and providing the best care possible for your patients.

In Belinda's case, the situation improved when nurses complained, went to HR and wrote employees up. An ineffective manager was fired and a **** stirrer was muzzled. A new manager came in and tidied things up.

I hope something similar occurs with you and wish the very best for you, LibraNurse.

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10 hours ago, Sour Lemon said:

If you're that busy for that long, I think there should be a quick but formal hand-off of responsibility for your other patients.

The problem is that by the point you start thinking like that, it's already been a long time; 45, 60, 90 min.

The alternative would be if, after 15 minutes, you feel like your critical situation is going to become pretty involved so you go ahead and tell your CN you'll need to hand off your patients. You will very quickly gain a rep of being someone who freaks out and can't handle anything and starts flailing around demanding help at the slightest hint of trouble.

Getting tied up is one of those weird things. You realize just how tied up you were, almost....after-the-fact, KWIM?

Second alternative/possibility: CN reassures you that you don't need to pass off your patients because s/he will "help you" with them. We all know what that means.

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16 hours ago, LibraNurse27 said:

I feel unprofessional telling pts I was with another pt who was having an emergency and that I wasn't informed they called, but what is the alternative?

I prefer to avoid appearing as if I'm making excuses, but in the right circumstances I have no problem reporting that there was an emergency, a patient with a critical situation, or that a message was not passed on to me. I should probably get over it, but I do have a problem playing the role of having done something wrong when in fact there were circumstances out of my control, sometimes involving choices that other people freely made. I have a very hard time taking responsibility for the fact that there are few good contingencies in place for the urgencies that administrators know are going to arise. Their contingency is that nurses will accept the blame. I refuse.

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My question is where is your charge nurse in all of this? Most times CNs don't have patient assignments to help in situations like these. Also, are there no CNAs on the unit? They can't pass meds but they can help such as call lights and restroom assists.

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Specializes in Community Health, Med/Surg, ICU Stepdown.
44 minutes ago, NurseBlaq said:

My question is where is your charge nurse in all of this? Most times CNs don't have patient assignments to help in situations like these. Also, are there no CNAs on the unit? They can't pass meds but they can help such as call lights and restroom assists.

My charge nurse was with me and the patient because the doctors were preparing for possible intubation. We don't have any CNAs or any clerk or break nurse, everyone else has an assignment. No one to hand off my other patients too but I wish =( I didn't expect to be gone that long but when we moved the patient to the ICU bed there was an almost code situation and since I was already in the room with my PPE on I was working on it with the ICU nurse and RT until some of the ICU team finished with yet another sick covid patient and came to switch me out. 

Thank you Davey Do for your kind words! Yes, all we can do is try to persevere even when the environment is not ideal. JKL33, I agree sometimes you don't realize how tied up you're going to be until the knots are already in place LOL, and yes I do have a reputation for being too anxious already =( Thanks for your suggestions on diplomatically handling explanations to pts. I'm sure everyone working during the pandemic is struggling under the current conditions. Thank you everyone for your support and suggestions

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3 hours ago, JKL33 said:

The problem is that by the point you start thinking like that, it's already been a long time; 45, 60, 90 min.

Oh no ...I think like that right away. When everyone comes to the room to "help" (gawk), I just pick out the person who seems the most reliable and tell them to watch my other patients. It's kind of like field CPR, to me ..."You- call 911!" Or another one of my favorites, "Who's watching the patients on the floor?" Someone either volunteers or they are assigned. They have to acknowledge and agree, of course.

And I'm sorry, but it's ridiculous to leave the unit you're assigned to an hour and a half. You fill the new nurse in as you're transferring and you go back to your patients. If something pertinent has been overlooked in report, they can call you.

The last thing you need after an "almost code" is to return to the unit and find a patient slumped over in the bathroom with a bleeding head wound. Don't allow yourself to be set up that way. Either there's an acknowledged hand-off to another nurse, or you return very quickly.

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Specializes in Community Health, Med/Surg, ICU Stepdown.
1 hour ago, Sour Lemon said:

Oh no ...I think like that right away. When everyone comes to the room to "help" (gawk), I just pick out the person who seems the most reliable and tell them to watch my other patients. It's kind of like field CPR, to me ..."You- call 911!" Or another one of my favorites, "Who's watching the patients on the floor?" Someone either volunteers or they are assigned. They have to acknowledge and agree, of course.

And I'm sorry, but it's ridiculous to leave the unit you're assigned to an hour and a half. You fill the new nurse in as you're transferring and you go back to your patients. If something pertinent has been overlooked in report, they can call you.

The last thing you need after an "almost code" is to return to the unit and find a patient slumped over in the bathroom with a bleeding head wound. Don't allow yourself to be set up that way. Either there's an acknowledged hand-off to another nurse, or you return very quickly.

Those are all good points! I have never had this experience before, but we are so overrun with covid and so short staffed it was a difficult situation. My ICU pt was very unstable and only one ICU nurse and RT were available. All other ICU staff were with their own pts and many of them in another unstable pt's covid room. I wanted to designate someone to watch my other pts (both very stable), but the floor was deserted and my ICU pt couldn't be left alone. I trusted my coworkers to answer my pt's light (the other one was bedbound/nonverbal/dementia), but I was let down by the person who answered and then ignored the pt.

I feel I did my best but felt so angry about being trapped with the ICU pt since no one was free to promptly take over, then come back and find out what happened to my other pt. I'm so tired of being put in these situations. We have been arguing for an extra designated covid nurse to take over when a covid nurse gets stuck with a critically ill pt/ICU transfer. We had it for one shift and it was wonderful, when someone took a pt to ICU or was in a code, that person knew to take over. They also brought us supplies in covid rooms which saved so much time and PPE. And we could take real breaks and know our pts were covered. Management determined it wasn't necessary and that it was "overstaffing."

So much for CA staffing ratios. They always find a way to follow the law but take away any ounce of ancillary support: no break nurse, no clerk, no CNAs, no transport, sometimes no lab techs, charge who is RRT nurse for whole hospital. I plan to bring up this situation as an example of the lack of safety we're currently facing. You're right, I'll tell them pt could have been found down with head injury. So scary!

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Specializes in Critical Care.
On 12/13/2020 at 2:24 PM, LibraNurse27 said:

Those are all good points! I have never had this experience before, but we are so overrun with covid and so short staffed it was a difficult situation. My ICU pt was very unstable and only one ICU nurse and RT were available. All other ICU staff were with their own pts and many of them in another unstable pt's covid room. I wanted to designate someone to watch my other pts (both very stable), but the floor was deserted and my ICU pt couldn't be left alone. I trusted my coworkers to answer my pt's light (the other one was bedbound/nonverbal/dementia), but I was let down by the person who answered and then ignored the pt.

I feel I did my best but felt so angry about being trapped with the ICU pt since no one was free to promptly take over, then come back and find out what happened to my other pt. I'm so tired of being put in these situations. We have been arguing for an extra designated covid nurse to take over when a covid nurse gets stuck with a critically ill pt/ICU transfer. We had it for one shift and it was wonderful, when someone took a pt to ICU or was in a code, that person knew to take over. They also brought us supplies in covid rooms which saved so much time and PPE. And we could take real breaks and know our pts were covered. Management determined it wasn't necessary and that it was "overstaffing."

So much for CA staffing ratios. They always find a way to follow the law but take away any ounce of ancillary support: no break nurse, no clerk, no CNAs, no transport, sometimes no lab techs, charge who is RRT nurse for whole hospital. I plan to bring up this situation as an example of the lack of safety we're currently facing. You're right, I'll tell them pt could have been found down with head injury. So scary!

Any other floor nurse could of listened out for you patients, no matter how busy it was on your unit.You should never leave the unit without giving someone report on your patients. Doesn’t need to be a full report but should include basics (ex. 503b - Full code, 2L oxygen, chest tube to water seal, needs walker to get OOB..) 

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