Tele turn Tele/Neuro

[ItalianRN, BSN, RN]

I work on a Tele unit that has just added Neuro patients. No additional training or staffing has been offered & most of the Neuro patients are completes. Most can't even move themselves in the bed. A lot of CVA patients with severe physical deficits. Our PCT's, along with the nurses, are killing themselves & still can't keep up either. The other day I had a patient trying to kick me in the head. It got so bad that we had to call security to help. He was a big guy. It wasn't his fault, it was due to his head injury but I still don't want a trip to the ER for myself. As a Tele unit we usually had 5 & sometimes 6 patients. That hasn't changed. Many nurses & PCT's, who have worked on this unit for years are looking to transfer. It already had the reputation of being the busiest unit in the hospital, & the added Neuro patients makes it 1000x worse. I never wanted to work Neuro. I absolutely hate it.

I don't think these patients are getting the complete care that Neuro patients should be getting. We are not doing Neuro checks other than checking pupils & hand grasps when possible. We note speech & gait, if there is any & that's about it. We mostly send them for tests & give meds. A lot of them need to be restrained because they are so out of it that all they do is try to pull everything out & get out of bed. They're either calm & non-responsive, or they are very aggitated & want to fight you on everything. Neuro is not my thing. I knew that from my first day in Neuro clinicals when I was in school.

I am only on this floor temporarily because my Tele Stepdown unit is temporarily closed due to construction. My unit will reopen in 2 more months. We get post open heart surgery patients mostly. I already asked my Manager if our Stepdown unit will include Neuro too & she said "no way". If she said yes, I'd already be looking to transfer to the OR or someplace that they couldn't add on like this. As it is, we are all overworked & overwhelmed with our responsibilities. I do not want to risk a patient's care or my license due to administrative decisions. They really need to decrease the ratio if they are going to keep this unit as a Tele/Neuro floor. They also need to offer Neuro training & perhaps include some Neuro nurses in our staffing.

I love the people I work with in this unit, but I'm looking forward to going back to my Tele Stepdown Unit.

[CarVsTree]

Wow! That seems like a bad combination.

So you're tele or you're step down. Do you have drips? I can't imagine mixing heads with drips. I work trauma step down. We have one 4 bed observation room 4:1. And then we have 26 med/surg trauma pts. Charge has 4, iso room RN's have 5 and the others have 6. We are often stretched to the limit with this group.

We have polytraumas, concussions, 23h obs and many in between. We DO NOT have drips with the exception of insulin and heparin. And we can do 3%saline drips in the 4 bed observation room (always a nurse or tech in that room).

I hope you get back to your normal floor. It sounds like a mess. I can't imagine all those cardiac patients with head injuries/strokes. If your cardiacs didn't have an MI our patients will drive them to it!

Take care & Good luck!