WILTW 10/8: Flexed to Tenacity

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Specializes in Pediatrics, Emergency, Trauma.

This has been a VERY eventful week!

Although this is the beginning of the busy season at my hospital, it has reached a plateau; the reason may be we are fully staffed, or the flu season hasn't hit yet. The buzz word from hospital administration is "flex down" and "over budget". Word is that the hospital wants to freeze overtime, while trying to retain nurses by giving out bonuses.

Around this time last year, we lost 100 nurses from the budget cuts that an outside consulting agency "suggested" to the hospital, along with middle management pushing experienced nurses out, many who were mentors and had a good reputation and good years of service. With the union in place, these practices have ceased; and if they need to do a layoff, they must ask the union first.

The irony of it all is that my facility makes money, we usually make above revenue projections, but because we are controlled by a organization that owns other hospitals, this affects our growth; however since this corporation is known to suppress labor in favor of paying their executives top dollar.

The silver lining in this is the push for safe staffing in my area; doing a movement while pushing for the best for our patients. To be a part of this and utilize my education from my nursing leadership class about FTEs (full time equivalent), skill mix, and budgetary discretion, is a valuable skill set to have.

What I have learned this week:

-That I have the tenacity to continue my quest to have some adult ED experience; I have been passed over some contact per diem positions because of this lack of experience, but I hope to make an impression on a few of the smaller local hospitals or even a Urgent Care Center-wish me luck!

-My educational calendar has suddenly become more busy; from learning to be a preceptor to studying for the ENPC (Emergency Pediatric Nurse Course) TNCC (Trauma Nurse Core Course) and planning to take the ATCN (Advanced Trauma Care for Nurses), and even pending education for sexual assault and physical assault-not to mention being an educator for the trauma room and being mentored to be an asset for the trauma program-I hope I can balance it all.

-Going to the media about unsafe staffing is very liberating; to express how complex our job is and how we worry about giving great care can shift the "blame" from the nurse and gets the community informed and increases support.

-An increase of return of old faces that are experienced, and helped me shape the nurse that I am and faces that disappeared before I came that have great insight makes for a great team, even with challenging times.

-That I am looking forward to to Emergency Nurses week. I missed the whole week last year due to me being in London for a much needed holiday, and may miss it next year, and to actually pick up overtime on that week and get fed and thanked and have such an increase in morale makes it a little easier to have to miss a vacation this year.

Here's the tenacity that I and local nurses are involved in:

Comments

So, what have you learned this week?

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Specializes in Palliative, Onc, Med-Surg, Home Hospice.

I learned that even if your patient is a nurse (and you know because her husband won't shut his big mouth), you need to explain what is going on. Please do not rush into your patients room with another nurse, start to gather belongings and just announce "your being transferred to the ICU" like you are announcing the soup of the day. I was admitted for severe asthma exacerbation and I completely freaked out, which made it harder for the ICU nurse to get a second line in me. Needless to say it was not a pleasant situation. I didn't quite understand it until the next day (but then again, I was out of it because of the DKA and respiratory failure)

I also learned that being a patient on the unit can be really hard. I am not used to having to ask for help for everything. I wasn't allowed out of bed without my nurse at my side. And I was only allowed to use the bathroom. It was hard for me, as I felt so helpless.

Asthma sucks and is going to be the cause of my having to retire from nursing. I am hoping for a few more years but that is up in the air. Never underestimate asthma. It can be a deadly serious disease.

And again, I learned that breathing is good.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

I learned that hearing of a loved one's health problems is never easy. My mother suddenly lost the sight in one of her eyes and, after seeing three ophthalmologists, no one knows what the issue is.

Mom thinks she may have an aneurysm due to her other symptoms such as the localized headache and neck pain. I hope she is not right. And if she is correct, I hope it does not rupture.

Anyhow, thank you for another nice WILTW thread, LadyFree.

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Specializes in Critical care.

I learned that a jerky doctor can really get to me on a day that I'm stretched too thin. Normally I just let it roll off my back and shrug it off, but it really got to me this week and I ended up in tears. It was just the icing on the cake of a really horrible day that just got worse after it. Especially after I spent a fair amount of time that morning running my butt off for that doc.

I'm also giving serious thought to going to the Nurses Take DC rally in May that someone posted about in the comment section of the link that LadyFree posted. With the acuity of patients my tele unit gets I don't always feel safe with our ratios and this scares me because I know my current ratios are better than a lot of places. DC is a short drive from me and I have friends in the area. Did anyone go to the rally last year?

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Specializes in Pediatrics, Emergency, Trauma.
I learned that even if your patient is a nurse (and you know because her husband won't shut his big mouth), you need to explain what is going on. Please do not rush into your patients room with another nurse, start to gather belongings and just announce "your being transferred to the ICU" like you are announcing the soup of the day. I was admitted for severe asthma exacerbation and I completely freaked out, which made it harder for the ICU nurse to get a second line in me. Needless to say it was not a pleasant situation. I didn't quite understand it until the next day (but then again, I was out of it because of the DKA and respiratory failure)

I also learned that being a patient on the unit can be really hard. I am not used to having to ask for help for everything. I wasn't allowed out of bed without my nurse at my side. And I was only allowed to use the bathroom. It was hard for me, as I felt so helpless.

Asthma sucks and is going to be the cause of my having to retire from nursing. I am hoping for a few more years but that is up in the air. Never underestimate asthma. It can be a deadly serious disease.

And again, I learned that breathing is good.

I hope you are improving well CelticGoddess!

I recall not being the best patient when I was in the ICU...when I didn't sleep, I would look at my monitor while being AAOx3-4 and hemodynamically unstable; they encouraged visitors to distract me; by the time I went to the floor, I was a beast because the potassium drip I needed would burn at the site and I would turn it off because I wanted a different IV...they eventually gave in to my requests and gave me liquid PO, even though my vocal cord was jacked up from being intubated. :laugh:

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Specializes in Pediatrics, Emergency, Trauma.
I learned that hearing of a loved one's health problems is never easy. My mother suddenly lost the sight in one of her eyes and, after seeing three ophthalmologists, no one knows what the issue is.

Mom thinks she may have an aneurysm due to her other symptoms such as the localized headache and neck pain. I hope she is not right. And if she is correct, I hope it does not rupture.

Anyhow, thank you for another nice WILTW thread, LadyFree.

Aww, thanks Commuter!!!

I hope all goes well with your mother; my mom is nearing Stage IV CKD...it's amazing that she is not on Dialysis; I freak out whenever she complains that she didn't take her BP meds because she didn't eat her breakfast; she doesn't miss often, however I don't want her to miss any doses AT ALL.

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Specializes in Pediatrics, Emergency, Trauma.
I learned that a jerky doctor can really get to me on a day that I'm stretched too thin. Normally I just let it roll off my back and shrug it off, but it really got to me this week and I ended up in tears. It was just the icing on the cake of a really horrible day that just got worse after it. Especially after I spent a fair amount of time that morning running my butt off for that doc.

I'm also giving serious thought to going to the Nurses Take DC rally in May that someone posted about in the comment section of the link that LadyFree posted. With the acuity of patients my tele unit gets I don't always feel safe with our ratios and this scares me because I know my current ratios are better than a lot of places. DC is a short drive from me and I have friends in the area. Did anyone go to the rally last year?

So many of us were too new in the union that we didn't go; however, I hope to go next year with my union. To present to the media that nurses want safe staffing was fun and empowering too! ;)

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I hope all goes well with your mother; my mom is nearing Stage IV CKD...it's amazing that she is not on Dialysis
Same here...my mom's eGFR is in the mid 20s. CKD can be relentless in its progression. I hope everything goes well with your mom, too.
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Specializes in M/S, LTC, Corrections, PDN & drug rehab.

Celtic Godess, I hope your asthma lets you continue to work.

TheCommuter, I'm sorry to hear about your mother.

I learned I miss working/school. I hope I can get into the nursing program in my town when I am ready. Not only would that help our income, but I would enjoy it.

Also, thank you everyone for the congratulations!

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Laser eye surgery hurts. Every time the laser was triggered, it felt as if I was being stabbed in the eye, and the longer it went on, the worse it got. In fact, this might be the most painful event I've ever experienced. And to make it even worse, I had to have both eyes done, as I had bilateral retinal tears.

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That a patient can have a Hgb of 6 with a recent surgical site that is constantly oozing blood, and none of the 3 physicians "managing" his care want to address it. That had me at my wits end. Thankfully the RESIDENT decided a transfusion was needed.

I know I sound like a broken record, but I REALLY dislike my current employer and am ready to take just about any other job to get out. I seriously considered doing the waitress thing until I am done with school this summer, but I am terrified I won't make enough to keep food on the table. I do have a few job interviews lined up, so I guess we shall see.

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Specializes in LTC and Pediatrics.

I have not worked for 4 weeks and am itching to get back I work per diem which makes taking that much time off easy. I have been traveling. An home now and signed a 4 week contract today. Start on Friday..

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