Well, here it is September and I've been kvetching about low census and getting called off (including on Labor Day when I could've gotten time-and-a-half).......all of which was made up for in one 8-hour shift yesterday. I mean, we got SLAMMED. Eleven surgeries, ten admissions (4 of which I did myself) and two transfers from the ICU, all on the 3-11 shift. I didn't sit down all evening except for a 15-minute supper break, but that was the least of my worries. One of my admits was a total care pt. with new-onset seizures who was supposed to have VS every hour, and another was a woman with blood sugars in the 400s who needed fingersticks every hour for 6 hrs (should've been in the ICU w/insulin drip if you ask me).
Then one of my patients was a 1:1 (LOL with urosepsis) whose urine suddenly turned to frank blood and large clots, and I was supposed to irrigate her Foley catheter every hour!! No CNA to help with any of this, so a lot of it didn't get done. And I wasn't the only one who had a hard night......everyone else was running just as fast as I was, and on top of all of it we just started using a new computer system (MediTech) and it crashed, leaving us
unable to order labs or do anything else for almost 2 hours.
Finally, just as I was coming to the end of the shift, my post-ictal pt., whose VS I hadn't had time to check in several hours, dropped his BP from 120/70 to 80/38, and still another admission came in (ETOH and Ambien OD) who couldn't find her butt with two hands, but kept going outside to smoke. I felt awful that the
vitals hadn't been done, but there was no way on earth I could've gone any faster or done any more than I was already doing. We usually are staffed better than this, but last night we could have had half the nursing staff on the floor and we STILL wouldn't have had enough bodies.
That's easily the worst shift I've had in the 6 months I've been back at the hospital, and one I won't forget any time soon. The kind of shift that leaves one wondering why in the world they paid
good money to learn how to be a nurse in the first place, and at the same time terrified of losing their license for something they did or didn't do in their rush to get things done.
So.......what were some of YOUR most memorable shifts from hell?
IT'S BEEN AWHILE SINCE I WORKED THE FLOOR, BUT WE HAD RULES ABOUT PATIENTS WITH HOURLY VITAL SIGNS. Hourly anything actually--they were to be on the care unit with one on one care-ie.-ICU or tele. Did those rules change?
Variance reports, incident reports, unusual occurence reports, whatever your hospital uses, should certainly utilized in this case!! That's unsafe practice and you are placing your license on the line!!
Your point is so valid. But in some hospitals if you choose to go that route you will be punished in one way or another. Definately not right but still a reality of what many of us face daily. Sometimes you just have to vote with your feet.
To all who offered me warm fuzzies, back massages, foot rubs......ohhhhhhhh I'm in heaven. :kiss :balloons: Thank you, thank you, thank you!
I've given notice that I am leaving the unit I am on. I'm filling out a transfer form tomorrow for another job. I'm going to work Part Time Nights....11 to 7. It will be better for my state of mind, my emotions, my health, and my autonomy level. I use to prefer nights until I started taking a medication for my cholesterol that must be taken at bedtime. I'm sensitive to meds, and wouldn't be able to stay awake working long stretches of nights, but I can certainly manage three 8 hour shifts on nights a week. I'm looking forward to the transition and the change from days back to part time nights. I was more myself on nights than I am able to be on days.
I have to say that I spoke with a very very nice compassionate and understanding nurse manager who knows everything about what I am dealing with on my current unit, and she welcomed me with open arms. She spent one hour talking to me on the phone very intently. I told her the 100% truth about everything so she wouldn't be surprised to hear anything coming from anyone else I currently work with (including the manager). I did not just talk about how others perceive me, I shared with her the good and the bad that others complain about with me. I told her if she wants an autonomous, strong personality, assertive patient/nurse advocate on her floor, then I am her nurse, but if she wants a doormat, a handmaiden, a servant, a butt kisser, then I am NOT the nurse she would want on her unit.........then left it up to her to decide. She decided she wanted that kind of nurse, and offered me the position. :)
I will NOT agree to be abused by anyone I work with...patients, mgmt., staff, family or visitors. I WILL continue to give due respect to those who know the definition of the word and how to actively live what they know respect to entail.
If my kind of nursing is "outdated", and no one wants the kind of nurse that I am, then I'll keep going to different places until I find my niche in nursing. If all else fails........I'll hang up my and keep on trucking....back to college...go to law school...become a JD for nurses...patients.... My talents and gifts are NEEDED somewhere... It's a big world! I'm needed somewhere in it, and I'll keep fighting to get there. :)
Hourly VS = 1:1 in the ICU? I wish! 1:1 is rare, even in the ICU here - usually has to be a major trauma, or pt receiving SLED. We can even have pts on insulin drips requiring q1hr blood sugars on the floor - with 5 other patients. I've been tripled in the ICU, and I've had plenty of floor pts crash, and wait sev. hours for an ICU bed, meaning they require ICU level monitoring, but I still have 6-7 pts. How do we do it? Well, we run our butts off, and alot of stuff still doesn't get done.
I know what you mean about everyone talking about everyone behind their backs at work cherfuldoer, we've been short all week cause the new aide has been no call/no show, and the night shift aide had a seizure, and there was a lot of confusion between some girls trading all there shifts, so everyone's getting PO'd @ everyone. To make it all worse State is expected to walk in at anytime. I haven't had to deal w/ much of it though, cause I'm still in Nursing school, and only work the weekend.
and keep on trucking....back to college...go to law school...become a JD for nurses...patients.... My talents and gifts are NEEDED somewhere... It's a big world! I'm needed somewhere in it, and I'll keep fighting to get there. :)
Rapheal
814 Posts
Your point is so valid. But in some hospitals if you choose to go that route you will be punished in one way or another. Definately not right but still a reality of what many of us face daily. Sometimes you just have to vote with your feet.