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Old 02-23-2008, 10:53 AM   #1
Jookiba
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Bad night at work......opinions needed

I'm sure all of you have heard about the national nursing "shortage" that has been threatening this nation's healthcare systems. Problem is, I have figured out it's not a nursing shortage-it's a shortage of nurses unwilling to work in unsafe situations, thus risking their licensure. Even though I've got two kids to feed and a household to run, I'm finding myself in this situation.

Tonight was a prime example. There were 9 of us; one is assigned to triage, one is charge, and that leaves 7 of us to take laboring/delivering/recovering patients and their babies. The normal ratio for our Level III (the worst of the worst) is 2:1-two patients per RN.

We do have OR techs but their responsibility is scrubbing in during sections. They cannot do any patient (or newborn) care whatsoever.

I walked right into a section in which delivery time was 1915. Got her into recovery about 2030. Now with a section you are obligated to be in the room for the first 45 minutes to make sure mom doesn't have complications and bleed to death. Well, I was in recovery all of 25 minutes when my pager went off-my other patient was complete.

I had to leave my recovery patient (and newborn, mind you, which needed his own assessments & vital signs) for an hour to push with this patient-things really looked hairy because the heart rate was awful-I can't put the appropriate words on this message board it was that bad. We got a baby and all was well. That's two in recovery for me-one vag and one section.

Since both my patients were slated to leave the floor within the next two hours, guess who got the new assignment-that's right, me. I have TWO patients now (actually four, with the babies) in recovery requiring frequent bleeding checks, assessments, etc. Obviously things had to be overlooked that weren't important-all I could concentrate on were live moms and live babies at this point.

So imagine my surprise when the charge nurse pulls me aside and starts griping at me for not getting my vag patient up to the bathroom-she had to do it. Excuse me, I tried-had her on the bedpan. Her epidural catheter had not been pulled yet so I could not get her up to walk. I explained all that-it didn't matter.

I was so upset because there were two nurses all night that had one assignment-ONE-when I had four patients total myself-two of which I delivered and sent upstairs. They were never approached to help me at all and sat @ the nurses station most of the night which is a normal occurrence.

I sent an e-mail to the nurse manager because I really felt this was an unsafe situation for everyone and it was my license on the line. I also didn't appreciate the charge nurse copping an attitude with me. It was a horrible night & I'm glad it's over......but I'm so worked up I can't think of falling asleep and I'm going on 26 hours awake right now.

Would you have e-mailed the nurse manager too or let it go?
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Old 02-23-2008, 01:13 PM   #2
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You are dealing with patient safety - and your own livlihood. I'd have made sure it was brought to her attention. You can always say you wanted to be sure she knew about it for the safety of the hospital!
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Old 02-23-2008, 08:10 PM   #3
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Why in the world were you given 4 patients and the others were given one???
That makes no sense to me.

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Old 02-23-2008, 08:25 PM   #4
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I think you were right to bring it to your supervisor's attention. This is an unsafe situation for you, the baby, the mom and ultimately it puts the hospital itself in jeopardy. I sympathize with the health care shortage but this is definitely something a supervisor should be taking a closer look at.
Hope you get some sleep tonight.

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Old 02-23-2008, 09:07 PM   #5
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I would bring it up to the manager. There's no way any nurse should have three times the work load as the others.
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Old 02-23-2008, 09:59 PM   #6
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sounds like a typical night that a friend of mine had to deal with a lot before she finally found a new job... she kept quiet even though we told her to speak up... she didn't and they put more and more crap on her and made her feel incredibly worthless.

so yeah I would have spoken up big time!
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Old 02-23-2008, 10:16 PM   #7
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You had to let someone know. I hope your next shift is better. Good luck!
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Old 02-23-2008, 11:15 PM   #8
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I'm glad that you sent the manager an e-mail and I'm sorry you've had such a bad shift. I think if it's brought to
their attention then your doing what you can to change any problems that come up.

As a section patient I will say that my nurse didn't stay with me for 45 minutes in the recovery room nor in my
room. After they decided that I needed to be upstairs and Ellie in the nursery, she took me upstairs, dropped
Ellie off in the nursery with my DH and drove me into my room. When we got there I "helped" her transfer
myself onto the room bed because another nurse couldn't be found. Once I did that, she left the room. I was
in and out of it for about an hour and I didn't see her again that day (shift change). I will say that I had some WONDERFUL
nurses and some stinkers.
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Old 02-24-2008, 12:09 AM   #9
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I think you were right to contact the nurse manager...what if one of the patients did start bleeding...

This is definetly a problem and it was the right thing to notify the manager of this problem...also I do not see why you had more patients while others only had one...
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Old 02-24-2008, 02:12 AM   #10
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I think you did the right thing.
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Old 02-24-2008, 06:36 AM   #11
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Unhappy

Totally agree that you needed to send that email. I was put in that same situation time and time again even after talking with the nurse manager about the risk to patients. I finally left that job behind because I felt it was too unsafe and I was tired of putting my hard earned liscense on the line. I hope you get some results from your email. Get some rest and I hope your next shift is better
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Old 02-24-2008, 06:40 AM   #12
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Remember an email notes the time/date/address so they would be handy should your manager try to lay some blame on you. Managers tend to give more work to those who they think can handle it (so feel good about your productivity!) but if you don't speck up I expect it would get worse AND like you said it's your license!
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Old 02-24-2008, 08:10 AM   #13
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I think you did the right thing too, but shame on the other two nurses for not stepping up and helping you without having to be told to!
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Old 02-24-2008, 09:24 AM   #14
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Quote:
Originally Posted by pparm View Post
Why in the world were you given 4 patients and the others were given one???
Unfortunately it happens all the time everywhere. My brother is a nurse too (just earned his Master's) and we share horror stories about the nurses who are "buddy buddy" with the charge RN-they always get easy assignments, slow assignments, etc. etc.

It's so childish sand-box like behavior-but it's prevalent in the profession. I won't become a member of the "clique" because my primary concern is my patients and their safety-not sitting out at the nurses station talking about wedding dresses, who's doing what that weekend, etc. etc.
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Old 02-24-2008, 11:00 AM   #15
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Quote:
Originally Posted by Jookiba View Post
Unfortunately it happens all the time everywhere. My brother is a nurse too (just earned his Master's) and we share horror stories about the nurses who are "buddy buddy" with the charge RN-they always get easy assignments, slow assignments, etc. etc.

It's so childish sand-box like behavior-but it's prevalent in the profession. I won't become a member of the "clique" because my primary concern is my patients and their safety-not sitting out at the nurses station talking about wedding dresses, who's doing what that weekend, etc. etc.
My Dh is a nurse and he gets the same thing everynight. Although he works a cardic floor. He has gotten to the point that he would rather travel nurse then work at the hospital that he has been at for ten years. At least with a travel position there is a CLEAR contract and because they pay so much more there is hardly an mandatory overtime. DH is an RN, so is SIL, and MIL works in surgery. Needless to say I know
all about the "shortage"
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