med-surg floor

[nursepenny]

i need to vent a little, please!

i just got home after the "night from hell" on a med-surg floor. for the last 2 years i have worked icu/sdu. i was pulled to the med-surg floor last night. it was so totally unorganized from day shift, it was a shame. 5 of my 7 patients need new iv sites. i am bound to believe this came from the int not being flushed properly. our policy states int's (heplocks) should be flushed q 8 hrs, unless otherwise ordered, but at least that often. i flush before and after any push med and or ivpb. i feel if these sites had been flushed, then just maybe these people would not had to stuck again.

the reports received prior to the shift starting were sketchy at best. they left out what i seemed to think was improtant (i.e. ileostomy, ua w/ c&s needed, stools for o&p, giardia, and c&s, a person with mrsa in sputum, well you get the picture...) we didn't get out of report until 2000. then you have the chart checks that must be done prior to giving meds.

the charge nurse took7 patients, myself and 1 other nurse also had 7 pts, and the 4th nurse took 8 pts. we had 2 admits. needeless to say we were all busy. when i left this morn at 0800 the charge nurse was just sitting down to chart. we all tried to help with her pts, except for the charting. she was in tears most of the night. said she didn't feel as if she was giving the pts the care they deserved. i felt as if i was slack with my patient care and i don't like that feeling. i personally do not think the charge nurse needs to take pts, if they are going to be responsible for the whole floor, have to call the doc's, etc. ( on this floor the charge nurse has to call all the docs for orders, labs and such). is there something wrong with this picture???

day shift left now orders @1540 (an antibiotic) when pt was admitted, to be given at 2100. excuse me i was under the impression now meant now, not when ever!!!

some one had collected a stool sample on day shift and it was found unlabeled beside the secetary's desk.

i reported this to the nm and she look appalled at first, then she forgot about it. or she appeared as if she did.

and they want me to go back to that floor tonight. i think i feel a fever coming on..............or maybe nausea and diarrhea.................or maybe........lol.

i just hate the thoughts that i may have to go back tonight.

sorry, i know this is long, but boy it feels good to vent.

please forgive any typos. i am the typonese queen.

anyone can count the seeds in an apple. only god can count the apples in a seed. anon.

[Tweety, BSN, RN]

[jnette, ASN, EMT-I]

(((((((((HUGS))))))))))

What a mess. I truly do feel for you. As much as I love all that M/S has to offer in the way of variety and opportunity to learn and grow, I believe M/S is one of the least "protected" or "cared about" units in the entire hospital. It is appalling and downright dirty the way M/S floors are staffed, and what is expected from the nurses.

While I would enjoy an occasional PRN there for my own sake of learning, I do honestly believe I could not work there permanently with a good consious... it would bother me horrendously to provide minimal care at best, knowing full well, the patients deserve so much better.... and that if admin cared at all about the patients as opposed to profits, these same patients would receive the proper care due them.

Don't know what all went on during the day shift there... hard to say, but it may well have been as bad or worse than your own shift, so I won't judge them...

Sorry you had such a sorry night and glad you got it off your chest, if not your mind...

[Totone656]

Oh Penny you reminded me why I am so glad I am out of the hospital and staff nursing! Not to mention I really don't miss 11P-7A shift!

I remember nights like that! Difference was I had 15 patients a night, start IVs, catch up on what the other shifts missed or didn't want to do!

Thanks for the walk down Memory Lane and hope the next time you get stuck on the Med/Surg floor it will be a better night!

[Rapheal]

heh heh heh- Welcome to my world:) Every day is a challenge.

Here's a little thing about the IV's. Most nurses do perform the q8 hour flush. The difference from ICU to medsurg is that the paitents are usually feeling better, are more active and are using the BSC and may be ambulating or moving around a lot better. So they put pressure on their arms and hands when they are getting up (terrible on wrist and hand sites) and these sites don't last very long. Some we need to change every day.

Med surg is constant catch up. In time you do learn to make some organization out of the chaos. And as for the NM being appalled and then doing nothing- this is standard operating procedure. I think they just let these things slide because not many people want to work med/surg and if you complained about all that was not done- you could lose a few more nurses.

Come back and work with us. We need the help. You might learn some new skills and we learn from you as well. Try not to be too harsh on the nurses- as you can see the workload is tremendous. We love our ICU nurses. For one thing these guys can usually start an IV on somebody that we consider almost impossible. And they know the heart meds so well you they recite them in their sleep. So I am sure your knowledge will be appreciated. Whatever you decide- good luck and hope you get some rest and recover from your bad night.

[dphrn]

I'm with Wendy M. on this one. It is posts like yours that I know I have made the right decision not to work on the floor at this time.

I have been an RN for five years and all have been on the hospital floor. When I moved four months ago, I made the decision not to take a hospital staffing position. I feel so much better for that choice. I am also grateful our profession allows me that freedom.

I am so sorry you had the night you did. I know it is a very bad feeling to go home feeling like that. I hope you got some rest today.

[nursepenny]

thank you all for the response. i guess i did make a snap judgement when i blamed day shift for the problems we faced. i know they had a real busy day too. things have been jumping at our facility for a couple of weeks and i guess we are all a little stressed. we are short staffed and the this med-surg floor was bursting at the seams.

we had a couple of mothers with their children in the same bed. one mom had 2 children in the hospital and she was also in with the flu. the youngest, a 3 year old boy was in bed with her and her daughter, 6 y/o was in the other bed (semi-private of course). not sure how legal or ethical that was, but i didn't make the call.

it has been 2 years since i worked med-surg and i guess i kinda forgot how hectic things can be. i worked a med-surg floor for 5 & 1/2 yrs before i thought i could handle icu and now i wonder if i can handle med-surg. lol

anyway, thanks for letting me vent a little. i really slept the day away and felt a little better when i got to work last night.

we had a code in icu last night with one of the pts from the med-surg floor. family didn't think she looked just right and talked with dr. she was sent to us and seemed to be okay for awhile. she asked for something to eat and i offered juice and graham crackers. she refused the crackers but drank 180 cc of grape juice. within 1 hour she was coding. ended up on vent. lab called with results and we found out this lady's blood sugar was 9. yeah, 9. even after the juice. she is not a diabetic, but is a renal patient who refused dialysis. she still looked bad when i left this am. was on dopamine gtt and lasix gtt. i wish i had thought to check her blood sugar. maybe some of this could have been warded off. but then maybe not as she was all ready in metabolic acidosis ph 7.10.

never a dull moment in nursing med-surg or icu.

have a great day. i am off for 2 and plan to recoup. lol

senility prayer: grant me the senility to forget the people i never liked., the good fortune to run into the people i do like and the eyesight to tell the difference.

beer is proof that god loves us and wants us to be happy. ben franklin