Let me tell you how my night went last night...

[RN1982]

My vent:

So I come in, I get my patient back that I had a previous night. A nurse doesn't show up. So the person in charge of our pod gets report on her patient then decides to give it to me because her patient is "unstable". Mind you, her patient was way more unstable the night before when the patient's HR was 210. Patient is stable and the nurse could have taken the patient she gave me. But whatever, I take the patient, she asks me if I want report, I said no, I'll just read the sheet that she wrote HER report on.

Charge nurse tells us we are gonna get a nurse at 11pm. Now, first off, had I been incharge of our pod, I would have given this nurse a patient then last admit because it's rude to dump on people especially when they are coming to help you out. So we find out around 9:30 that we are getting an admit. Another nurse with another stable vented patient takes report and tells ER to wait until 11 so we can dump this new patient on the nurse coming in TO HELP US OUT!

I don't get it. I thought it was so rude and thoughtless, trust me, my manager and I will be having a meeting about this in the morning. So I am suppose to give this nurse that came in at 11pm one of my patients. I tell her to take care of her admit, I'll do the midnight assessment for her on the patient I am suppose to give her. So basically I have had two patients for half of the shift.

Charge calls and says we are getting another admit. The other nurse who has the stable patient, the one who took report from ER and told them to wait so we could dump this patient on the new nurse coming in at 11pm, should have taken this admit and gave me the last admit. Her buddy, the person in charge of the pod, decides to make me take the admit, mind you I have already had two patients half of the night. Whatever I take the admit. I was fuming like mad too. Luckily, this was a patient I knew so the admission wasn't so bad. But I didn't want those two other nurses anywhere near me for the rest of the night. It still frustrates the hell out of me.

[carolinapooh, BSN, RN]

I know you're venting, and I'm sorry you had a bad night.

I've been called in to help out and always expected to get the first admission BECAUSE I'm there to help out. That's sort of why you're called in - so whomever is there can keep their flow going. While I'd appreciate someone trying to be concerned for me, I expect to get dumped on. I actually expect to become the "admission nurse" if I'm needed.

I'm a bit in awe that your patient load is typical at two patients! When I was a civilian I've been on the floor when it was so short everyone got two admissions, there was no one available to call in, and your patient count per nurse was brought to seven before four a.m., with the charge nurse covering as many as five.

[RN1982]

I know you're venting, and I'm sorry you had a bad night.

I've been called in to help out and always expected to get the first admission BECAUSE I'm there to help out. That's sort of why you're called in - so whomever is there can keep their flow going. While I'd appreciate someone trying to be concerned for me, I expect to get dumped on. I actually expect to become the "admission nurse" if I'm needed.

I'm a bit in awe that your patient load is typical at two patients! When I was a civilian I've been on the floor when it was so short everyone got two admissions, there was no one available to call in, and your patient count per nurse was brought to seven before four a.m., with the charge nurse covering as many as five.

I didn't mention it, but I work in an SICU, so two patients is the max we get. Our Charge does not take an assignment unless we are horribly short. If it had been me who had been running the pod last night, I would have given the nurse who was coming in at 11pm an admit, but I would not have given her one right when she got there. I would have let her come in and get her assignment, let her get to see her patient before assigning her an admission. That's what should have been done and that's what is usually done. I don't think the girl who was running the pod last night knew what she was doing because she was basing patient acuity off of insulin gtts and amiodarone gtts. Just because your patient is on an insulin gtt doesn't make them the most critical patient in the pod. And amiodarone does not get titrated and her patient was stable. So she could have kept the patient she gave me at the start of the shift and let me get the first admit instead of the new nurse getting the first admit.

[PostOpPrincess, BSN, RN]

First mistake as all nurses make the same one over and over again.

SPEAK UP (professionally always).

You just take it and take it and take it.

As for the rest of the vent, make sure you have everything documented.

J

[RN1982]

First mistake as all nurses make the same one over and over again.

SPEAK UP (professionally always).

You just take it and take it and take it.

As for the rest of the vent, make sure you have everything documented.

J

Yeah, you are right. I did speak up. I told the nurse in charge of our pod last night that it was unfair of her to dump on me and the other nurse. I will be speaking to my manager in the morning. I think this nurse is too inexperienced to be in charge of a pod. She was basing patient acuity on insulin gtts and an amiodarone gtt that didn't get titrated.

[Ahhphoey]

Sorry you had such a bad night. I've had days like that too, but I spoke up enough that the charge nurse (who was trying to give me a third patient for the last four hours of my shift while another nurse had only one patient) finally just gave the other nurse the patient to even things out. In my ICU we all get two patients and get three when we're short (which can be often), so I'd be eccstatic to have just one patient or even two without the potential for getting a third.

[carolinapooh, BSN, RN]

I didn't mention it, but I work in an SICU, so two patients is the max we get. Our Charge does not take an assignment unless we are horribly short. If it had been me who had been running the pod last night, I would have given the nurse who was coming in at 11pm an admit, but I would not have given her one right when she got there. I would have let her come in and get her assignment, let her get to see her patient before assigning her an admission. That's what should have been done and that's what is usually done. I don't think the girl who was running the pod last night knew what she was doing because she was basing patient acuity off of insulin gtts and amiodarone gtts. Just because your patient is on an insulin gtt doesn't make them the most critical patient in the pod. And amiodarone does not get titrated and her patient was stable. So she could have kept the patient she gave me at the start of the shift and let me get the first admit instead of the new nurse getting the first admit.

I thought you were in an ICU. So now it makes more sense to me.

Sometimes people just make NO SENSE.

[Zookeeper3]

I've learned that some people just have no intention of treating the "help" well. Sure you don't have to, but when you do, help tends to appear more often. I'm with you on this, I do not tripple the help or give them admits unless there is a very good reason that an assignment swap is not in the patient or nurses best interest. And when that happens, I'll do everything to assist our "helper" and thank them profusely.

[traumalover, RN]

I have had that night. It really irks me when they put someone in charge who is not ready! I don't charge much because I don't like it. At my hospital we get four freaking apache points for an insulin gtt and four for multiple vasoactive gtts. Really? An insulin gtt is as intensive as

titrating multiple pressors on a crashing patient? But an a-line is five points. argh. Sorry to vent but the scale we use is ridiculous.