All right, tonight is my 3/3 in a row, night shift and last night was probably one of the worst nigths my unit had, the only worse thing would be a patient dying.
On my 1st night the unit was busy and understaffed. I started out with 2 patients, but by 2300 I ended up with 3 babies out of which one was a term Grade 3 IVH on HFO/NO, double pressors and multiple meds, a term on HFNC and fluids/abx + bradys and a 32 weeker on NC/fluds and bradys. I should have had a 1:1 assignment. Lost 2 IV's in the middle of the night. I got help with one assessment. I thought my 1st night was awful until my 2nd night.
We're a level iii, no ecmo... 2nd night we started with 26 babies with about 4 nurses w/4 pts, rest had 2 to 3 pts. Our unit has individual rooms and it's very long and spread out. We lost a nurse at 2300 who had 3 pts (she did a 16h shift), then another nurse fell ill (she was ill the previous day and decided to come to work) and was literally green in the face. She walked away and we had to absorb her 4 pts. By 2300 i ended up with the same assignment from the day 1. By 0200, I got another 32 weeker because we got 2 admits, a term with seisures and a 27 weeker who didn't look very compatible with life who also ended up on HFO and pressors. At 0200 since we had to absorb 7 babies + 2 admits everybody except for a nurse who had 2 babies on HFO/pressors had 4 patients, she had 3.
Our charge nurse (who had 4 pts herself at this point) had called everyone who was at home and nobody wanted to come in. Finally at 0500 the manager showed up to be helping hands, and I transferred my "feeder-grower" to level ii which is in another building. Level ii nurses wouldn't take a HF baby so we stuck her on NC at 1L.
The girl who got the 27wkr was drowning. I fed one of her babies and helped with admit just minimally and felt really bad that I couldn't help more. I knew that because of the situation we were in, everyone was providing pt care that was unsafe. I felt really unsafe, my back was in knots. I was writing down everything I did because I was so scared that I'd forget something. We all made it through the night and most of us were able to chart out by 0800 except for the nurse who had the 27wk admit and the charge.
I love my job and love the unit, but dreading coming to work tonight. After two days of this I am physically and mentally exhausted and will probably have to face having the same assignment as day 1. I just hope that everything will be ok...
Our unit is in process of training 2 new orientees (none were working last night), we have no techs on nights and currently we're using one traveller.
