Making ICU nurses feel guilty for using lift team...

[Blondekristi]

I have been a nurse for 2 years, beginning on telemetry and trained to ICU 9months ago. The ICU I work on does not staff techs and we give total care to our patients. For the most part, I enjoy giving my patients total care. When patients need bathed or turned, we typically use our lift team. On night shift, our lift team is just one tech. For years, their role has been to assist the whole hospital, but they have always tried to prioritize ICU calls, especially for early morning baths. About 6 months ago, they changed the role of the lift team to include transporting ED admits to the floor. Because of this, it has been more difficult to get lift team to come help when needed. Still, we've all managed to make it work one way or another. Last week, my manager told us lift team was complaining that ICU nurses on night shift were "over using and abusing" our lift team and we "need to utilize each other more for help with turns/baths." My manager has our back, but suddenly I am forced to feel guilty every time I page lift team. There is also tension between lift team and ICU nurses now. None of the nurses have ever heard complaints from the lift team tech directly, so most of us were surprised. No one but us working the floor on nights realize that it isn't so easy just to "help one another." For example, we all have 2 ICU patients. If I have 1 RN come help me with a bath, another RN must watch their 2 patients, the RN helping me's 2 patients, and my other patient. So basically if I have 1 nurse help me, another nurse is watching 5 critical care patients by themself. If something alarms, they must attend to it leaving the rest of the patients unmonitored. Some nights we have the staff to help, but most nights we are not full and there are only 2-3 nurses in the unit. Our charge nurse manages both telemetry and ICU and aren't always available to help. I am just frustrated that I am made to feel guilty for using lift team. Am I really asking so much to have someone help turn my intubated hemodynamically unstable patient?? I find this rediculous. Ideally, they would staff a bath tech from 0300 to 0700 or whatever but due to budget cuts, there's no way that will happen anytime soon. I'm curious if other ICU nurses experience this problem and what they have found as a solution. I have a bad attitude about the whole situation and at the end of the day this is a patient safety issue and it frustrated the hell out of me.

[smf0903]

It's not just a patient safety issue, it's a staff safety issue. We regularly get patients weighing in excess of 450 pounds. Some patients, even when using a hover mat, we need 4 people to turn/reposition/change just because 500 pounds of dead weight with tubes coming out of everywhere it's no feasible to fully move them with 2 people. And not sorry that I don't care to wretch my back out.

Does your ED not have techs/aides? There has to be an insane amount of ridiculousness going on for our ED aides not to bring patients to the floors.

We regularly only have 2 RNs in the ICU, max 2 patients each. We rarely have an aide. We are lucky that the aides in other areas will coordinate with us for help with turns,etc if needed. We touch base st the beginning of shift and kinda work out a game plan.

I don't care how POed they get, I would not hesitate to call for help rather than hurt myself or the patient. Just from this outside perspective it sounds like the manager needs to sit down with the aides and clearly my out what their role is. If need be, perhaps include the RNs in the meeting so that everyone is on the same page. Granted I'm sure there will be times someone can't come help in two minutes, but you shouldn't be hanging out in left field without the help you need. Just my 2 cents.

Good luck!

[Aloe_sky]

We dont have lift teams at our hospital and we dont have aides in our ICU. How about just calling the turn team for baths and the q2hr turns can be left for the nurses?

[ArmaniX, MSN, APRN]

Your bathing scenario seems a bit exaggerated.

It is not impossible to tide 1 patient over and be sure they are safe for you to dedicate 20 minutes SOLO to bathing your other patient.

It takes one individual (you) to get the necessary bathing supplies and linens. You alone can bathe the entire front and extremities of your patient. You can create a bed roll. This way when you're ready you can ask another RN for 5 - 10 minutes of their time to roll your patient, wipe their backside and roll the new sheets underneath them.

Are your ICU rooms equipped with the ability to monitor two patients simultaneously (allowing you to see the BP and HR of your other patient)? Not having an aide or being made to feel guilty over requesting hospital resources is terrible. But don't put yourself into this hole of despair. It will only make your job and position more miserable and you'll never be happy.