RGrif

Where I work (general med/surg) the day shift can have 5-6 patients , eves/nights 7-10---almost everyone works 12 hour shifts. On nights, there are usually 2 techs for 36 patients (we are always full) and they are responsible for doing all the daily labs at 0600---it is crazy. I feel that this is too heavy a load for all of us! If I have one crisis (and usually have more than 1!) my whole shift is a mess---They are taking about legislating nurse/patient ratios here too, but as someone else mentioned, the hospitals will do so by eliminating assistive personnel if they can---that isn't going to help matters at all!

At my last job, we had a hospice area of 6 beds, so I have had some experience with this. I think the most difficult aspect of hospice is trying to keep both patient and family happy---it is such a difficult time for the family. When I took care of a hospice patient, I would ask family members to leave in order for me to make care of the patient (turn them, mouth/skin care, etc...) I did have times where family members were literally overflowing from the room, but I would usually try to work around them as best I could. I would set up a little schedule with them---for example tell them "I would like to come in at x time to reposition her, etc". I would make sure that they knew what to expect, and I would be honest if I thought the patient might not live through the shift. I made myself approachable in terms of their needs. It can be a dangerous situation if things get too overcrowded and crazy, however----I will never forget I was working one night and another nurse had the hospice area---One room had about 10 family members in it when the patient passed away---well one of the family members was so upset and started having chest pains/shortness of breath, feel to the floor--- and ended up needed to be sent to the ED where she ended up coding---it was utter confusion trying to get all those people out of the room, and all the furniture, and trying to transfer this patient onto a stretcher to get her out, as you can imagine!

Well, let me say, that I am not a new grad! I have been a nurse for 5 years, in med-surg, and I have never had a patient "code"! (I shouldn't be saying this, I'll jinx myself!) I have had plenty of patients teetering on the edge---and quickly gotten them off to the ICU, I have had patients go into respiratory distress---pulmonary edema, etc, where they have needed to be intubated on the floor and then transferred, etc...Having a patient code though is my worst nightmare, and I am terrified of the time when it will happen! Where I work, they do not have any sort of "mock codes" and I have never even really gotten into the code cart. I have not worked at my current hospital very long, but I do not like the "clinical educaton" they have (it is one nurse who is really burnt out, responsible for nursing and "nurse tech" orientation for basically the entire hospital, excluding specialty areas, and makes one feel like an idiot when she is asked a question! I just don't think I could go to her with my "anxiety") My nurse manager and her assistant are very approachable however---I work nights so I really don't see either of them too often Also, I would like to be more familiar with reading ekg's etc (it's not something I know about, either) I don't really want to do ACLS training, but I suppose that would make me more knowledgable. Any words of advice or encouragement??