The Weekend of... 7-26 to 7-29-19

[Davey Do]

Due to insufficient staffing, I worked three different psych units in two shifts. But maybe more about that later...

Saturday I was scheduled on the geriatric psych unit with two non-licensed staff members. No big deal, as there were only six patients, but it meant that I had to do all the VS, nurse assessments & charting, pass meds, plus oversee the direct patient care.

Near the beginning of the shift, there was an "all available staff" code called for a patient behavior. Unbeknownst to me, a therapist working as a tech left the unit and went to the code. A tech working in the locked community room informed me of this.

When the therapist tech returned, I informed her that she needed to allow the RN to make the decision if she should leave the unit. I said that I would not have advised that, as she was not available. We needed her to cover the hall for patients not in the locked community room.

Two points of contention reared their ugly heads: 1) The therapist tech said she took her "stuff" to the NS on her way out of the unit and the (off going) nurses should have known she was leaving, and 2) she was told two staff members were to be in the locked community room at all times.

First, I informed the therapist tech that I was the RN on the unit after shift change. Secondly, if two staff were in the community room and I was in the NS/med room, all staff would be behind locked doors and the patients in the hall could not be directly monitored.

Well, one thing led to another and, basically the therapist tech refused to follow my assignment, walked off of the unit and said she was going to talk with the house sup. I ended up propping the community room door open with a chair and asked the tech to station himself in the community room and make the 15 minute rounds on the other patients, which he did.

I immediately informed Mandy, the house sup of the situation, and although she was dealing with staff injures due to the patient behavior, got me another tech in a short amount of time. Mandy suggested that I email my supervisor, RoofElmo, and inform her of the situation.

I sent an objective report of the situation, noting that two of the patients not in the day room were bed-bound, incontinent, non-med compliant and psychotic. I added this as a postscript:

"...please allow me to declare my firm belief that keeping locked doors between staff and patients for as long as 15 minute intervals decreases monitoring capabilities and greatly compromises patient safety."

Hence, the above cartoon.

[Davey Do]

I was working with the same tech tonight and he used the staff toilet. He said when he went to flush the toilet, it erupted like a volcano. "I've never seen anything like it", he said. He described the bathroom looking like one described to Martin Lawrence's character in the movie "Wild Hogs": "Some truck driver must've crapped and entire cow in there, man!"

Maintenance was summoned and the tech and I cleaned up and disinfected the over spill into the hallway. Maintenance came and went while I was doing other things, did their job, and mentioned to the tech that housekeeping would need to clean things up.

Since I was also busy cleaning up an incontinent patient when housekeeping arrived, I did not see them come and go. The tech informed me that two young giggling girls from housekeeping open the staff bathroom door, looked inside, stopped giggling, closed the door, and left.

"They didn't clean it up?" I asked. "No", he said, "They just left".

So I called housekeeping and spoke with a couple of dudes with whom I am on a good basis. "Maintenance has to clean that mess up before we go in there", I was told. "I said "Noooooo, maintenance is for maintaining and repairing. Housekeeping is for cleaning up- you know: housekeeping?"

"We're not going in there until maintenance does their job". "Wow", I replied, I don't like to do this, man, but I've got to report it to the house sup". "Do what you have to do" he replied as a matter-of-fact.

So I let Mandy know and she basically said "What?!" "Just let me know if there's anything I need to do", I told her.

Time went by and nothing happened, so I went to gain empirical knowledge to see if maybe, some way, somehow, I could clean up this mess described to me as something akin to a volcano erupting or the brutal slashing of a Poop Person.

I opened the door and saw a puddle of standing water in the middle of the floor and three turds on the toilet! Not even big ones! Breakfast sausage-sized turds!

So, I donned my gloves, got some bath towels and Dispatch and tackled the overwhelming feces flow of the erupted Mt Toilet!

Sheesh!

[Daisy4RN]

I cannot tell you how many times I did this very same thing (clean emesis off floor, clean toilet, fix TV etc) because it was just easier and less time consuming to keep calling different depts. and getting the run around, and like you said, not a big deal.

?DaveyDo makes me proud
Lord, don't he make me proud
he never makes a scene?

However, I do wish that others were held responsible for their jobs. And this is why I never liked the Charge RN position because no ability to hold others accountable if no back up from Management. I worked as the Charge RN at a blood donation facility and the techs ran wild bc of poor management. It should have been a fairly low stress RN position so I tried and tried to speak to management to no avail and I finally resigned.

[Davey Do]

6 hours ago, Daisy4RN said:

?DaveyDo makes me proud
Lord, don't he make me proud
he never makes a scene?

* Choke!* *Sob!*

(That's beautiful, Daisy!)

Yeah- I contacted Mandy after I'd cleaned the restroom twice over, taking me all of 10 minutes, and said, "I just wanted to let you know the damn toilet is cleaned!"

Mandy came to the floor later, and thanked me for cleaning the toilet. She said she was going to do it had I not. Mandy is like that- always there to help with no job being beneath her.

Mandy said that she has had other situations where housekeeping personnel has refused to clean any body fluids. She asked one housekeeper what they did in OR or ER and the housekeeper said, "I don't know. I don't work in OR or ER".

Probably because it's a higher pay grade due to possessing the housekeeping training, experience and rare proven ability to clean up body fluids.

21 hours ago, Davey Do said:

Due to insufficient staffing, I worked three different psych units in two shifts. But maybe more about that later...

I was pulled to the men's psych unit Friday night and was scheduled back on my home unit of geriatric psych Saturday night. At about 2230, Mandy telephoned me and said, "You can yell and scream and be mad at me but I'm going to have to pull you to the women's psych unit at 2300!"

It seems that I was the only male staff member on the 2300-0700 shift and the patient who had sent two staff members to ER had orders for the 1:1 staff to be male only.

A bump in the road is nothing when working with a great supervisor like Mandy and I was glad to help out.

But still- I bargained for a future favor:

Having used one previously with Mandy, I know this card will be honored !

[AnnieNP, MSN, NP]

Oh dear God,

I love you!!!!!!!!!!!!!!!

[Davey Do]

2 hours ago, Davey Do said:

Mandy is like that- always there to help with no job being beneath her.

There are several full time and fill in house supervisors on the psych side of WRMC and they are Chandelier, Mandy, Jason Hiney, Ranger Rodd, Bestica and Valerian.

I've mentioned Ranger Rodd in a few other threads, on how he was a decent staff psych nurse but epitomized the Peter Principle once elevated to the level of his incompetence. For example, Rodd believes that saying patients' first names in a public place is not a HIPAA violation and being a door is more important than patient safety. There are more, but I'm in a good mood and don't feel like Rodd bashing right now.

The woman's' psych unit patient who had sent staff to the ER, whose name is Miralax, also injured a nurse with whom I'm quite fond, Lil Orphan Annie, LPN.

Last week Miralax walloped Annie in the side of the head to the point she experienced pain, hearing loss, and some other symptoms. Annie requested to be seen in the ER, but Rodd denied her request all the while sending extra staff home on low census.

Annie had a few choice words for Ranger Rodd!

[RNNPICU, BSN, RN]

Davey Do:

I always enjoy hearing your weekend updates - almost feel like a Saturday Night Live skit sometimes, although this is more reality. Nice job on the cleaning and scoring a chance card - definitely pocket that one for good use.

[Daisy4RN]

Mandy sounds like a great House Sup. The first time I was Charge nurse I had a House Sup that was great too. I was a nervous Nellie, always calling her with questions etc but she was always patient and willing to help without ever making me feel like I was stupid or that she was superior in any way, very down to earth and just wanting to make sure all was well (as much as it ever could be!) and treated all the nurses in bed meeting respectively. I always appreciated her but didn't fully realize how much until I ran in to other House Sups that were not so great, some of those types up on their high horse that liked to make everyone else feel stupid and/or were completely unhelpful. It makes a big difference in how smoothly (or not) the day goes!!

[Forest2]

20 hours ago, Daisy4RN said:

I cannot tell you how many times I did this very same thing (clean emesis off floor, clean toilet, fix TV etc) because it was just easier and less time consuming to keep calling different depts. and getting the run around

I hear ya brother.

[Davey Do]

On 7/30/2019 at 8:14 AM, RNNPICU said:

I always enjoy hearing your weekend updates - almost feel like a Saturday Night Live skit sometimes

Thanks, RNNPICU!

That gives me an idea...

[Davey Do]

On 7/30/2019 at 9:48 AM, Daisy4RN said:

Mandy sounds like a great House Sup.

I say "Amen!" to your whole post, Daisy. We are consensual.

Mandy said something along the lines of "It takes no knowledge in order just to make an effort".

Shortly after Mandy began working as a house sup, she was helping me out when I was pulled to the women's psych unit. There were three psychotic acting out patients, one of which had to be sent and received back from ER (and put in restraints and get a chemical restraint), a couple of admissions, and all the other stuff one has to deal with during a shift.

Mandy called the doc for the chemical restraint order, entered it into the system, did routine charting, and other stuff that I can't remember right now.

When the smoke had cleared and we were sitting in the NS, charting, I turned to her and said, "Mandy, professionally speaking...

...I love you!"