As the title on this post indicates, I left my shift yesterday feeling kind of funny about a situation; even though, I know I didn't do anything wrong. I am charge in a busy 34 beds ICU that has turned into COVID central in the last couple of months. Yesterday, I was short staffed and my staffing office provided me with 2 nurses (both ICU travelers). Right at change on shift ,when I was about to do huddle with the day staff, one of the travelers approached me and asked if the patient who was pending to come to the unit (assigned to her) was a COVID patient. When I said it was, she started crying and shared that this was the first time she would care for a COVID patient after her own father passed from COVID last year. Myself and some of the staff in the nurse station expressed our condolence; however, I told her I was unable to change the assignment without assigning another staff with 2 COVIDs or taking an assigning away from one of my staff who is pregnant. At this point she is fully bowling her eyes out and it just seems anything I said made things worse. I told her to take a few minutes to herself and that I would get back to get because I needed to do huddle with the day staff, who were already waiting for me; after that, she went to the restroom. Next thing I know, she walks in during huddle still sobbing and sniffling; after huddle, another nurse came up and told us she was still crying. I pulled her aside and ask her if she would be more comfortable in another unit (we have 4 other ICUs in the hospital), because I could not accommodate her. At this point, the day shift change nurse got involved and basically told her we could not accommodate her since as a contract nurse, caring for COVID (all ICUs are saturated with them....even our burn unit) was an expectation; to which she agreed and verbalized her understanding. I honestly felt horrible for this particular nurse; this was her first assignment and she was on week 3, but somehow had managed not to get an assignment with COVID pts. I personally think her expectation of not getting assigned COVID patients is extremely unrealistic, but I could tell she was really in distress. I just feel like I could had been more supportive (somehow) but, honestly I was so taken aback by her reaction that nothing else occurred to me to comfort her at the moment.
Nothing new to add to the general consensus that you did the right thing. Human decency demands that such issues be handled with some respect - which you did. But the bottom line is that the workplace is not a therapy group. If she cannot do the work for which the facility hired her, she needs to cancel her contract and find both a competent grief counselor and a job that doesn’t trigger her to the point of inability to function professionally.
I wasn't there but from your post as written it is not a given that she had that expectation or that she pursued travel ICU nursing thinking that she would be able to weasel out of caring for covid patients.
It's very possible, maybe even most likely, that she knew she was going to have to face it and when the moment came it hit her harder than she thought it would and that is what you witnessed. Maybe her grief was fresh again given the scenario plus the matter of being in a new place with new people, new routine, without some of the supports that have helped her get through the past year.
I was thinking something similar. Grief is a funny thing. It just pops up where it wants to, sometimes when you're not expecting it at all. Or maybe you expect it, but the intensity takes your breath away. My guess is that this nurse "knew" she would have COVID patients, but knowing something in your head can be really different from experiencing it in the moment.
The whole situation sounds unfortunate, but there are no villains here. The nurse seemed to be doing her best (she got overwhelmed and broke down in tears, but she didn't pull an attitude or refuse the assignment). The staff tried to support her as best they could in the moment, but had to prioritize safe patient assignments. I don't think there was really anything that could have been done differently in the moment. With COVID still all around, it was inevitable that one day she'd have her first COVID patient, and no way she could have really prepared for how hard it hit her. Sometimes we just have to go through awkward and difficult situations on our grief journeys. Hopefully, the nurse made it through the shift, and was able to regroup before the next.
Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.
I worked in OB. I had several pregnancy losses, including ectopics, miscarriages and a loss in the 2nd trimester.
I certainly did take my turn with people who had still births and other losses. It's not fair to be in such a specialty knowing these tragedies happen and expect my coworkers to carry the whole load. It's heavy and painful for all.
To answer your question,no you were not insensitive.The recruiter is at fault for not being clear in hiring practice or as many like to say "transparent".The travel nurse is still unwell from her loss and needs to step off the travel merry go round until she is better. She needs to ask and get clear answers to her requirements for accepting travel jobs, we are not mind readers.
We had a bright lite in hiring that changed job descriptions to get more band for the buck.Jobs became peds/peds ER or highrisk antepartum/LD...they were oriented to both areas..when time came to put up or shut up the tears ,sobs were loud...claims of "I don't know the area,have not been on my own before "etc of course they were then given the easier assignment....but this was not possible in your situation,so no ..you were not insensitive.
Specializes in ER/School/Rural Nursing/Health Department.
I think you did everything correct.
When I worked in the ER, I had a miscarriage. My coworkers knew. My charge gave me two weeks without miscarriage/pregnant patients. But we were a level 1 Trauma center and busy. I understood when after 6-7 shifts that I started having those patients again. Yes, it sucked. Yes, sometimes I cried in my car on the way home. But I took those feelings and became a more empathetic nurse to those patients. As nurses I'm sure we have all taken care of a patient with a trauma or disease or health issue that we would just prefer not to take care of.
I worked in OB. I had several pregnancy losses, including ectopics, miscarriages and a loss in the 2nd trimester.
I certainly did take my turn with people who had still births and other losses. It's not fair to be in such a specialty knowing these tragedies happen and expect my coworkers to carry the whole load. It's heavy and painful for all.
I got therapy for my pain and pressed on.
I also had recurrent losses, including one in 2nd tri. I worked oncology, so one might think I’d never encounter a pregnant patient, but alas. After my 2nd tri loss, I cared for a patient who had to have a termination before starting chemo, a patient who wasn’t a cancer pt but found out she was pregnant and cried the whole shift because she didn’t want to be pregnant. And one late in pregnancy who was getting chemo and had to get fetal heartbeat checks every shifts. It suuuuuucked. And I cried surreptitiously. But it had to be done. I did realize I could never work L&D, or at least not for a long long time.
heron, ASN, RN
4,640 Posts
Nothing new to add to the general consensus that you did the right thing. Human decency demands that such issues be handled with some respect - which you did. But the bottom line is that the workplace is not a therapy group. If she cannot do the work for which the facility hired her, she needs to cancel her contract and find both a competent grief counselor and a job that doesn’t trigger her to the point of inability to function professionally.