FNPtobe2020
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Where I live in northeast Ohio where we got hit with two feet of snow overnight the Staffing office was sending out text messages Sunday afternoon offering Monday dayshift staff a place to stay within the hospital on Sunday night so they could be at work on Monday morning. When I left for work Sunday night at 6 PM there was no snow but I watched it snow heavily overnight and it never quit. The employee parking lot was ridiculous. I do have an all wheel drive and I was lucky that I was able to get out of the hot mess that was our employee parking lot, let alone get down the 2 feet of snow that covered my side street at 7 AM. I also only live 4 miles from where I work. I live in the snow belt and knowing that, I always have a vehicle that is either four wheel or all wheel drive and my all wheel drive is what enabled me to get home this morning in Snowmageddon! That said the staffing coordinator was way over line with her remarks!
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I was away from acute care nursing for 7 years when I got hired at my current job, a 12 bed CCU taking care of STEMIs/NSTEMIs, CABG pt, etc. Things have changed. But not enough that Ididint remember all I had learned once upon a time. Like IABPs(they time themselves now!), Equipment I’ve never heard of, FlowTrac, VapoTherm, AVAP, Ekos, but I picked that up easily enough. I like working three 12 hr shifts a week as opposed to 8’s. We also do self-scheduling & my schedule is almost always honored because I work straight night shift. I don’t like the current situation right now! Too many patients and not enough RNs. There have been nights I’ve had four ICU patients! I’m hoping things will settle down soon but seems to only have worsened over the last month. good luck with your decision!
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I was at the ER with my husband the day after Christmas this past year. That was after we had already gone to an urgent care center who referred him to the emergency department where I work in the CCU. He sat in the waiting room for six hours before he got taken back to an ER bay. Once it got to the ER bay things went relatively quickly, he got the CAT scan on his head that he needed which was why the urgent care center referred us to the ER to begin with. Then when they drew his bloodwork they discovered and abnormally high glucose level. come to find out my husband has been diabetic for a while but until we were seen in the ER for something completely different we would have never known. he was admitted to the hospital but sat in the ER bay until the 28th when he was taken to surgery to have the infection drained and cleaned out on the back of his neck. The ER was absolutely overwhelmed. Holding many patients that are awaiting an inpatient hospital bed except there just aren’t enough RN staff to take care of everybody. I overheard the ER physician on duty literally say that to one of the patients that was awaiting a bed on one of our nursing floors. I would’ve gladly helped out the emergency room staff with taking my husbands vital signs and then giving them to his nurse to write down and chart. Except I could never find their Dinamap. once my husband got an inpatient bed after his surgery, I assisted the floor staff in their duties, programming his IV pump To make sure he got his full dose of the Vanco he was on…helping him to the bathroom getting him washed up at the sink changing his bed linens because the wound on the back of his neck leaked blood and stuff on the pillowcases I took his meal trays back out to the cart for dietary. And on his last day I helped the surgeon change his dressing because he was now on MRSA Precautions I told every nurse that I work there and what department and shift and not a single one of them didn’t appreciate my assistance because there are far too many patients and not enough nurses.
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As a current ICU RN, I agree with most of what you spelled out. What worked for me is to look over each patients VS’s, because they are on the monitor in their room and on the units monitors as well. See who is unstable based on VS & shift report. Some times you have to assess those patients first because they do not have stable VS as opposed to the stable pts. Or maybe a previously stable patient is now unstable & requires immediate attention. Then I like to check my MAR to see who needs what and when. Also go through the orders on each patient. Because the previous shift may have overlooked some thing that needs to be done right now that was not told to me in shift report. Such as an EKG or a blood draw. So I know when to look for those results. I wrote my pt’s VS down on my ‘brain’ and urine output hourly. Every ICU patient gets those done hourly at least in my experience. And was easier for me to notice trends. That’s what I do with my patients who have a Swan after I’ve ran their CO/CI or written them down off the FlowTrac. When I have downtime, I make sure our blanket warmer is full because you cannot give your patient a warm blanket if there aren’t any in the blanket warmer. We rarely have a nursing assistant in the ICU at least not on Night Shift. I also make sure the Accu-chek machine has lancets, gauze sponges and alcohol swabs easily accessible so my coworkers don’t have to run to the stock room to grab those. No nurse is an island. If you’re caught up, ask your coworkers if there is anything you can do to help them. Some may not ask for help. And some will take advantage of your assistance. You Will figure out which nurses take advantage of coworkers and which ones don’t. However always offer to help because that says more about you than it does them. Never be afraid to ask your coworkers a question. There is no such thing as a dumb question. The only dumb thing is not asking questions when you need to ask. While I am not a new RN, I am relatively new to the facility where I currently work and even though sometimes I ask my coworkers questions which may seem to be dumb, it helps me learn how things work at this particular facility.
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I work in an acute care hospital. They pull staff to cover my unit. Including the charge RN to take a pt assignment. We cannot be mandated to stay for OT per our union contract. The M-F charge RN is management so some days she has to take on a pt assignment. They ask if nights wants to stay another 4 hours. NOPE! Not today! I had 4 patients on my CCU on Thanksgiving night. So did the other RN. 2 RNs for 8 ICU patients! Lunch break? What’s that? I charted & ate at the same time. ER holding patients for days. Floor RNs with 10-11 pts each. Ridiculous!! Staff RNs leaving to travel. Might as well get paid the big bucks for the same level of craziness for every shift you work, not just the OT! ??♀️
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Speaking of awful nurses, I had my wisdom teeth removed under general anesthesia at a surgery center when I was 15, since they were all impacted. When being taken to the PACU area, as my mouth was stuffed with gauze & I couldn’t speak, I recall snapping my fingers. All I wanted to be told was that I was OK. I distinctly recall the nurse telling me that if I snapped my fingers one more time, she’d tie them up!! Mind you, I hadn’t gotten to see my mother yet. I just wanted reassurance from somebody that I was OK. I always tell my patients, whether they’re post-op or in a state of delirium, that they are safe and will be OK no matter what colorful names they use towards me.
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I’ve been an RN half of my life now. I KNEW I was gonna be an RN since I was 5. How I knew that back then, I can’t explain it. But I knew. I’m good at what I do. Even though as a night shift RN, we don’t get the recognition that day shift does. But I’ve saved plenty of patients from death in the middle of the night, even though they won’t remember my name. I don’t do it for the recognition. I do it because I love it!
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Document document document! If a patient comes to your facility from a long term care facility or home make sure you document a complete wound assessment if they have one upon admission. That way the hospital/facility where you work isn’t liable for a pressure ulcer that was there upon admission to your facility. If you call a physician after hours, document it! Keep calling until you get a call back. Go above by following the chain of command. Tell the charge RN, the house supervisor that you’ve done XYZ. I have been told several times that my documentation has saved the facility from a lawsuit by a patient/family! Always CYA!!
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I’ve been on this site since 2001. Mostly now as a browser but rarely a poster/commenter . So this is not my original user name. I have followed @Davey Do & his Wrongway Saga and @SilverBells issues. At one job over 20 years ago, I mentioned this site to a coworker. Said coworker found a post I had made and turned me into HR. Even though I didn’t list any personal ID and made no HIPAA violation. Yet I still was reprimanded. I had Admin delete the post and my original User ID, so yes, anonymity is important to me.
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Patient comfort comes first. To me, leaving a hospice patient sitting in a chair because his nurse who was assigned his admission seems unfathomable, but that’s just me. Why not just assign the ‘more complicated admission’ to the other nurse who was initially assigned the hospice patient? As the hospice patient arrived first.
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