"Mr. So and So rings the light. He's lying in about 15 minutes worth of poop-detail cleanup, but he's physiologically stable.
I've got a patient in the other room with a b/p of 78/42. I've paged the doc, and I am busy trying to get an IV in this same patient so that I can give fluids. Meanwhile, I have someone else who is working with me who can't start the IV, and can't take orders from the doc, but CAN help by doing peri-care on my other patient in the other room.
I've got a patient whose abdominal wound is seeping bloody drainage around the dressing. The patient's lying in a big pile of ooze. Gosh, I sure hope the wound hasn't dehissed. I need to change the dressing and see what's going on underneath all of that gauze, but I'm still waiting for that call back from the doc for my patient with the low blood pressure. I should probably take another blood pressure, go ahead and start IV fluids without a dr's order, and.......
Darn....My patient whose got the poopy but is on the light again. "I need some help!"
I poke my head in the door. "Sorry Mr. So and So, I'll be back in to take care of you in just a moment."
In the distance, I hear an IV pump start alarming. "Shoot - my blood infusion is already finished in room 424........I need some help."
I'm on my way to the IV alarm and the doc calls back. I'm sitting at the desk talking on the phone with the doc when my coworker/CNA comes to me to see what I needed. I'm writing down a lengthy order that needs to be faxed to the pharmacy, then I have to get the med, give the med............
"Can you please go help Mr. So and So - he's all dirty". (I get a dirty look from the CNA as she walks away.)
By the way.......I do care. I care about the kidneys that are about to go south on the patient with the low blood pressure if I can't get the blood pressure back up. Meanwhile, I'm taking matters into my own hands in order to address that issue - I finally get an order from the doc to cover me for what I just did.
I also care about the patient whose leaking out about two cups worth of serous/sanguinous fluid from their abdominal wound that I need to assess.
I also care about what the CNA thinks of me, but I can't even begin to explain all the reasons why I need the peri care done by the CNA instead of doing it myself.
As I get off the phone, I hear a loud crash from down the hallway. A patient tried to get up by themselves and has just falled on the way to the BR.
So much for waltzing out the door on time tonight."
And the CNA sees you sitting down, talking on the phone and asking her to do the dirty work. Sometimes they just don't realize you are doing what only the RN can do. Yes, the RN CAN clean the dirty patient, but the CNA cannot take the dr's orders, hang the blood and start the IV.
And the CNA thinks the RN has "nursitis."
You gotta do what you gotta do.