nursing shortage? how about equipment shortage?

Pediatric Critical Care Columnist · Aug 10, 2008

We are always fighting over IV pumps and pillows. Our big frustrating is running out of supplies. Sunday nights are the worst. We'll always run out of lab tubes, dressing supplies, foleys, and tubing and have to go steal from other areas. Once, we ran out of normal saline. We didn't even have 100 cc bags left. And we are always running out of linens. Makes it hard to change a butt when you don't have any washcloths to do it with.

OMG!! Do we work together???? Nah, we 're usually out of linen and supplies long before Sunday night.

The other night we had a baby s/p open heart surgery who was febrile, hypotensive and tachycardic and the treatment of choice is to cool to 35 degrees Celsius. At the same time that this baby declared a need for cooling, we admitted a 9 year old with a traumatic brain injury who also needed to be cooled. We have one cooling device. One. In our quaternary care self-proclaimed center of excellence PICU. Our transport nurse called around to see if she could scare up another one, but all the rest in the building were in use.

Then there's the whole soap suds enema saga. We have a patient who has been receiving them q8h for more than a week. Our hospital doesn't stock them in stores, we have to get them sent over from another hospital by taxi. One at a time.

One night we ran out of clean blankets completely. No flannels, no thermal blankets, no receiving blankets. 3 am and my patient is shivering... Charge nurse said to cover him with towels. Yeah right! I sent my nursing student across the hall to the adult CVICU and had him steal some.

We never have enough syringe pumps. We often have half a dozen kids with more than a dozen infusions each; our policy is that anything vasoactive must run on a syringe pump and anything running into the same lumen of their central line must run on a syringe pump... We're supposed to have 16 beds but we often have 18 or 19 patients so you can see the issue. We only have ONE monitor cable for Red Dot electrodes, so our teenaged patients will have neonatal electrodes. Might that be a problem?

I'm getting tired of this BS and am seriously considering a career change.

abbaking · Aug 10, 2008

I feel your pain! Not only does our unit have barely enough equipment, but the ones we have are antiquated broken down crap. We actually have a BP machine that was discontinued by its manufacturer in 1990! The ICU has an iron-lung (NO JOKE A REAL USEABLE IRON LUNG).

I am thinking about making a test for healthcare employees to see which shift they are better to work. It would go something like this...

Multiple Choice

"You take the BP machine to use on a patient. After using it, do you...

A. Plug it back into electical power source

B. Haphazadly leave it in the patients room for future use

c. None of the above

If you answered A - you are a natural night shift worker (always thinking of others and the safety of patients).

If you answered B - You are great for dayshift - you have the who cares attitude

FireStarterRN, BSN, RN · Aug 10, 2008

I feel your pain! Not only does our unit have barely enough equipment, but the ones we have are antiquated broken down crap. We actually have a BP machine that was discontinued by its manufacturer in 1990! The ICU has an iron-lung (NO JOKE A REAL USEABLE IRON LUNG).
I am thinking about making a test for healthcare employees to see which shift they are better to work. It would go something like this...
Multiple Choice
"You take the BP machine to use on a patient. After using it, do you...
A. Plug it back into electical power source
B. Haphazadly leave it in the patients room for future use
c. None of the above
If you answered A - you are a natural night shift worker (always thinking of others and the safety of patients).
If you answered B - You are great for dayshift - you have the who cares attitude

Wow, what an attitude on your part! :rolleyes: Sounds like you have some built up resentments... :eek:

Pediatric Critical Care Columnist · Aug 10, 2008

The cooling device I mentioned in my post is an elderly statesman and has seen decades of use. It's so old, in fact, that when the blankets start to leak, we can't replace them. This problem was discussed in a morbidity review a few months ago because of a similar situation and the doc reviewing the case was livid that we're so stripped down all the time. After that meeting I was asked by our patient care manager to look into what's available and most appropriate for our needs while I was at AACN's conference in Chicago. I did that, and brought back a bunch of literature, some brochures, some business cards and even offered up my own cell phone number as a contact to the reps. When I passed all the info on, I learned that someone else had done exactly the same thing more than a year ago, and had sent the stuff on to our director of critical care. What happened to it from her desk is anyone's guess (and I'm sure you're thinking what I'm thinking). In late June I got a call from one of the local reps for one of the companies I had spoken with in Chicago. He and I chatted for some time and he told me the company would be quite happy to put one of their devices into our unit for us to try before we buy, and he said they had already done the same thing in the neuro OR with great success. I took his contact info and passed it on the very next day. Fast forward to August 7 and the scenario we've already discussed... What happened? Three guesses.

jenrn6282 · Oct 14, 2008

I find this an ongoing frustration. Between that and filling out the pain assessment form, fall assessment form, medication reconcilation form, SBAR communication tool form, anti-coagulation flowsheet, diabetic record in triplicate, signature sheet, and nursing careplan form, it's a miracle there's any time left for patient care!

first off i agree with you here.....i work nights so yea the patient load is a bit more...but i dont even know where to begin with the paper work any more there are so many new forms...these people in the higher ups have weekly meetings and it seems every 2 weeks a new form or care plan or new policy or order set is in effect can these people who make these forms please come work on the unit for a day....and stop asking me why i forgot to write something on a form....its because i wrote on 10 other pieces of paper and didnt remember the one your asking about also.....i saw my 7 patients all of twice, around midnight and 6 am for meds.....forget q 1 hr rounding i dont have time for that anymore....thank god i have a great CNA

2nd i work on a tele floor, and have 2 bp machines.....i think that is pretty sad have talked to my DON and she is like "i am working on it" :clown: for 3 years now!!! UGH! it was messy the other night we got 4 cardizem drips brand new er admits and a nitro drip at 50 mcg.....which patient do you put the bp cuf on? :uhoh3: ha ha ha only have 2 remember.....that SUCKED!!!

sorry venting :angryfire

gentlegiver, ASN, LPN, RN · Oct 14, 2008

I gave up looking for BP cuffs, Thermometers, stethoscopes, etc. I bought my own, my work bag wts 12 lbs the last time I weighed it. I even supply my own mirrows, flashlights, and, nail clippers. Makes life easier for me, ands everyone knows where to go in a pinch. Only rule is return ASAP, don't make me go looking for you. You may not be able to borrow something the next time you have a need.

survivor08 · Nov 20, 2008

OMG....How about the patients that have a PCA and hospital protocol is that ALL patients with a PCA MUST have a SAT monitor...Too bad on our surgery floor, and hospital for that matter, not enough of these beautiful brand new SAT monitors to go around (who was the genius to get rid of the old ones that we had plenty of and worked great) and the ones we have go to patients with a "more emergent need" first so too bad for you. We are told it is OK to not have one...JCAHO where are you?