nurses get blame abuse any docs out there

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sorry double posted.

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I posted this in the UK forum because many of you know the situation with targets, short staffing, recruitment freezes etc. The Americans might not realise that medicine and surgery are so divided here. They have a lot of "med-surg" there it seems.

My hospital is doing some really bad things. They have combined a medical ward and a surgical ward onto a very large ward that has many beds. They are getting rid of nurses and we are working very very short. This restructuring has resulted in nurses taking dangerously high patients loads in a specialty they are unfamiliar with and lots of bad things have happened. The management of the floor is a joke. None of us have had any cross training.

Fo example..they only had surgical nurses on duty one day and they were overwhelmed and something happened with a medical patient and they didn't pick it up...the medical nurses may have. This resulted in them getting abuse by the medical docs.

They once had one nurse to 24 medical and surgical patients on a weekday. When she asked (begged in tears) for additional help she was told "tough" and "deal with it"

We had a medical nurse left alone with surgical patients with epidurals and she had never nursed patients with epidurals before. She had a total of 13 patients which is dangerous anyway. She asked for help. She filled an incident form in. A screw up happened and she took the heat.

Letters have been written to management begging for help over the last few months and they have been ignored. Daily incident forms are ignored. The situation is getting worse. We usually have 2 or 3 nurses and one HCA to nearly 40 patients. It is a fast paced unit with lots of admits and discharges and many many EMI patients to boot. I'd say 2/3 of our patients are total care with dementia.

There are no jobs anywhere else and the powers that be know that we are trapped.

Sometimes all the beds are full and they are so desperate to get acute admits and surgical cases in (thanks to government targets) that they send them up to the ward to be admitted and we are told to get other patients "out". They tried to send one of my medical patients home without her being officially discharged. They tried to do this behind my back while I was busy with a poorly patient. They (bed logistics) had her packed up and in a chair. I refused to dishcharge her so they did. She was readmitted a few days later. This is always happening. The nurses are always taking the heat.

I was put onto the specialty I was unfamiliar with and had 13 very unwell patients..most of them total care as well as 2 complicated discharges. There were 4 admits due to come in so they were sent to me and I was told to "make room and admit them" They were for theatre that day...list to start in an hour. At this point I was drowning with my other patients. I told them that I couldn't do this and I needed help...was blown off....did fill in an incident report. The other nurse I was working with was drowning on her side.

I managed to take care of my patients and get the new ones admitted and ready and did find beds for them. I was so proud of myself. Then i get a phone call. One of the patients I sent to theatre (specialty I am not familiar with) was supposed to have a piece of equipment ordered by the nurse and sent with the patient to theatre so that they could use it there. This thing was supposed to be ordered from pharmacy by myself and sent with the patient to theatre. Getting it from pharmacy would have meant legging it down there myself.

A. I was run off my feet

B.I was not orientated to this specialty despite begging for it because I knew I would have to take these kinds of patients.

c. The bloody surgeons had NOT even prescribed the damn thing or written orders for it anywhere BUT I would not have realized that I needed to physically get the thing and send it with her to theatre anyway even if they had.

D. I had 20 minutes from the minute until she got into a bed until the minute she had to go to theatre and had many othe patients and admits.

I am totally grateful that nothing worse happened. :w00t:

Guess what. The surgeons went ballistic at me. Absolutely ballistic. I have been reported to everyone and there brother over it because their precious list was held up for 20 minutes over it. Apparantly I should have called them and reminded them to order it and then retrieved it from pharmacy. Our pharmacy is so at the minute they take hours to dispense anything.

I can take responsibility for my actions but this is like some kind of joke.

We have made multiple courageous attempts at trying to get someone to listen and help us but it falls on deaf ears. We have no option to leave unless I want to take a lower paying job and get my house foreclosed on.

I am so ****** off.

Then the next day at work these surgeons from this specialty were all glaring at me. The other nurses I work with backed me up big time and tried to tell them where to go. Couldn't get a word in edgewise and just looked like we were deflecting blame.

:angryfire

I am off now but I am still angry. I have been off for awhile now and I am not going back. This was the straw. I am sick of feeling guilty all the time. Usually I get over it after a few days but I am just still so mad!! Everyone is so beat down. No matter where we turn to report this no one cares. If anyone is going to suggest the unions, the NMC, and the health commision and the RCN all I can say is bought the t-shirt already months ago.

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Oh my... Your situation sounds very bad. I have no idea what to say. You are stuck in a rock and a hard place. No human could take what you did. I'm so sorry this happened to you.

Gail

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It's not a bad mistake at all considering some of the stuff that is happening on our ward. I'm not losing sleep over it really.

I am just so sick of the doctors and their attitudes. It's like they live in a cave or something and just crawl out to abuse nurses. Everyone knows the wards are like this yet it is open season on the nurses.

They have no idea of the battles we have to fight in an impossible situation in order to carry out their orders and take care of the patients. They get so angry when a screw up occurs yet never address the multiple systems errors...they just crap on the few nurses left.

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I was supposed to be out of there months ago but our house buyers pulled out of the sale so I am stuck until we get another buyer. I have been looking at waitressing in the meantime but if it takes time to sell the house we are screwed.

At least I can rant away on the net.

Does anyone else think that doctors are totally on another planet?

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I understand what you are feeling because it is the same in our hospital.The shortage of staff is getting dangerous.There was even a day when after closing the curtains to give privacy to one of my patients I suddenly burst into tears due to stress, I have never done that in all of my years nursing.The patient was very sympathetic telling me she has seen how I was running around all day.It is like evryday we are filling incident forms.

I hope ang pray they will do something about this.I have discussed how I feel with my nurse in charge alraedy but what can they do????It is the people on top that has the say.I wish they would come and try to do our job for a day and see how stressful it is.

Now there are no phlebotomist on Sundays so it is our job to take blood as well, House officers are busy when you need them.:sasq:

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Specializes in Medical and general practice now LTC.

Management need to come and work on the wards and see what is happening. I am tempted to keep calling them every time there is an issue and fill incident after incident form on unsafe staffing levels, cover your own back because without a doubt they won't. Why should it take a major incident ie serious injury to staff or patient before something is done.

I remember 1 manager when I worked on a MAU actually came and helped out due to bed issues and rolled up his sleeves and helped with moving beds, patients, meals and anything else which was needed that could be done without a RN. Shame he decided to leave and go into BB in the lake district but think he got fed up like everyone else

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Our managers have refused to come to the ward and speak with us. We have been making frequent requests for months. The only message that has come down from them is this "tough" "deal with it" and "any nurse who tries to refuse admissions because she claims she is overwhelmed will be disciplined" and "you must take your lunch breaks". Breaks are not possible without hurting patients. One of our nurses was the only RN to nearly 40 patients and she refused admits and she was punished. While she was in the office getting yelled at by bed logistics they put the new admits in the bed and left them there for her to find at some point.

Our sisters have written letters to them and the newspapers and a group of doctors (the ones who are not abusive) have done the same. This is been going on for 8 months. Then all of the senior nurses at the hospital wrote another letter.

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Specializes in Medical and general practice now LTC.
Our managers have refused to come to the ward and speak with us. We have been making frequent requests for months. The only message that has come down from them is this "tough" "deal with it" and "any nurse who tries to refuse admissions because she claims she is overwhelmed will be disciplined" and "you must take your lunch breaks". Breaks are not possible without hurting patients. One of our nurses was the only RN to nearly 40 patients and she refused admits and she was punished. While she was in the office getting yelled at by bed logistics they put the new admits in the bed and left them there for her to find at some point.

Our sisters have written letters to them and the newspapers and a group of doctors (the ones who are not abusive) have done the same. This is been going on for 8 months. Then all of the senior nurses at the hospital wrote another letter.

What do the unions say? Can you not put an official complaint into the Nursing director or higher management. Sorry but something needs doing as 40 patients to one RN is just dangerous and not good enough to say tough put up with it. Would serve them if all nurses handed in their notices but know with current climate very hard. Also wondering what NMC have to say may have a look as I am sure there must be some legal issues

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Specializes in med/surg.

I can't believe that with all that happened recently with c-Diff outbreaks & the numerous studies that show direct correlation between lack of staff & morbidity of patients that management refuse to listen!!

How about getting patients to write to the local paper in their droves (or nurses if not). Invite an undercover reporter ;-) that usually stirs things up. I also think you should have a serious meeting with Union reps (or get on the phone & talk to the highest person you can reach in your Union) & talk to someone directly at the NMC - again as high up as you can get.

Another really important thing you could try is writing/talking directly to both your local MP & the Health Minister - give them hard, cold facts about your dangerous work-load & management attitudes. Try & get local TV interested - it may go national - be careful not to be in breach of your contract though. One thing I do know is this simply cannot go on for both nurses & patients sakes!!

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Martinette, so sorry that you and so many other nurses & midwives are having to put up with this unethical practice. Have you considered writing an anonymous letter to the Trust chief exec, your local MP and local paper? I strongly suggest anonymity because as we know whistleblowers are not treated with much respect - even when they are right. I've experienced similar - a registrar wouldn't act on my concerns about a pregnant woman on a night shift - despite a poor history and my concerns he just wanted to get a good nights sleep as he'd been up all day. I did all I could bar perform her emergency caesarean myself!! Surprise surprise who got pulled up on their failure to escalate intervention, apparently I should have called the Consultant (at home). Since then I will not ***** foot around with doctors when I have any concerns. If they ask me why I want their input etc I tell them straight - 'you have letters after your name I don't so do what you have to to fix this' and I write screeds in the patients notes. Its all about defensive working - cover your backside. Keep filling in incident forms, document all requests for help in a diary so that if you are pulled up you'll have events to refer back to. Also go to occupational health to report work related stress, they are obliged to record your concerns in your file. Sorry this is so long I get into a funk about how poorly we're treated. Good luck and keep your chin up.

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Specializes in Advanced Practice, surgery.

I have just read through this thread and I really feel for you Martinette, your situation and ward sound intolerable. There has been lots of good advice given in this thread and I am sure that much of it you have already done.

As a nurse manager I am horrified at what you have said, especially the lack of support you feel from your senior staff and medics.

If I felt one of my wards were operating at such an unsafe level here are the actions I would advise and pursue, as I have said you may have already thought of these and done them.

Incident reports, fill them in and keep a record of what you have completed. Write letters, using terminology that will support your case throw the NMC code of conduct at them with direct quotes in your incident reporting and letter writing.

For example:

Section 8

As a registered nurse, midwife or specialist community health nurse you must act to identify and minimise the risk to patients and clients,

8.1 you must work with other members of the team to promote healthcare enviornments that are condusive to safe, therepeutic and ethical practice.

This may help remind the senior and exectutive nurses that they are also held accountable to the standards of practice and are equally accountable. If you do not feel that they are meeting their responsibilities then you can always report this to the NMC yourself. Have a good read of the standards of practice and pick out aspects that you feel are in breech within your area and reference them in you documentation.

http://www.nmc-uk.org/aFrameDisplay.aspx?DocumentID=201

Try to get all of the ward staff and ward manager to collaborate with writing these letters and incident reports, show a united front. Write to senior nurses, exec nurses and the trust board but do so in a logical and calm manner with descriptions of actual incidents including dates and times to support your concerns.

Speak to human resources and occupational health about the stress levels that you are being subjected to. Get your unions on board, if your RCN reps are not much use then get nurses who are in unison to get them involved as well.

Ask for workload assessments, this will help establish that staffing levels are unsafe and this will give you solid evidence to present to you senior managers

I would also enlist the help of your consultants, speak to them directly about your concerns for the standard of care for thier patients, they are very powerful hospital staff if you can get them on your side writing letters as well it will help.

Your trust will have a whistleblowing policy get a copy and read it, then use it to our advantage, speak to HR under the whistleblowing policy.

As I have said I am sure these are all things that you may have already done.

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