According to the managers I've asked;
- Give any /all medications yourself and then take them with you when you discharge the patient to a unit so the receiving RN can waste with you.
- Press the code bell on the wall in PACU, it only rings inside the OR because we don't need additional staff for a code...during the day when fully staff... so I never got an answer on, what the heck will happen alone in the middle of the night, other than "it's really very unlikely to happen".
- Problems, concerns, safety issues, urgently need help or medications from pharmacy, call the Hospital Charge Nurse and ask them to come help you.... What if they are busy in the ER, ICU, L&D??? This was always the point where I was told to stop being deliberately difficult, so I don't have the answer to that one.
In real life I quit this job and took a pay cut to work somewhere with much lower acuity patients and no on-call. Problem solved, for me anyway. At the point where your job feels more like an abusive relationship with the threat being to your license and having to live with knowing your patients are receiving care that is defined as unsafe by nationally recognized professional associations (ASPAN) it is time to find something else.
Less money and "losing your skills" are not a reasons to put up with situations this dangerous. The sooner more nurses start making this clear to hospitals the sooner they will stop demanding we do it.