Verdict?
I haven't blogged for some time now. Won't go through the list of my rationalizations as to why....
Want some feedback.
Hypothetical situation here......
You have a nurse with 24+ years of experience. This nurse regularly receives accolades from her higher-ups regarding her competency, commitment to her coworkers, willingness to adapt to new situations, and to assist her coworkers to do the same, etc, etc.
Now, the situation she and her coworkers are in has changed drastically. 80% new staff, babies just out of school. Have passed their boards, but still deer in the headlights looks on their faces most of the time. Licenses don't confer knowledge or experience.
They have moved the "unit" to a new location, a former critical care unit. Nicer in many ways, staff are able to see all patients from the desk, there are "hard" monitors....screens in both each room and on the desk, so that heart rhythms, bp, O2 sat, respiratory rate, and if necessary, other readings can be viewed quickly, or reviewed. The plan is to have the critical care unit nurses help with the transition, to teach them what they need to know to care for more critically ill patients. Not "unit" patients, but patients with more problems than they have been used to. Most are willing to do so, but they come with the attitude that it is beneath them to have to do so. Some are outright hostile about the situation, and while they would never allow a patient to be injured, they only help when specifically asked.
The powers that be, in their infinite wisdom, begin sending patients to the unit with things they have never seen before, even the experienced nurses. The word along the grapevine is that the department head was asked about the wisdom of sending those patients to their unit, and her reply was "They can handle it" Word is also that she asked the person transferring those patients to us to give them an inservice as to how to care for these patients. By the time the nightshift arrives, the translation has dwindled to "if this alarm goes off, you push this button to reset it". Hmmmm.
Fast forward, now. The experienced nurse is working with 2 brand spanking new nurses, the night has been a "hand you your butt" night. 8 patients, 2 getting blood, which is an involved process, especially with 2 nurses that have never hung blood before, and these 2 patients are on the opposite sides of the unit. This kind of night is disaster waiting to happen under the best of circumstances, and of course, the conditions are, shall we say, less than optimal. So, the experienced nurse is responsible for 8 patients, 2 very scared and stressed new nurses, all the BS busy work jobs they have decided are essential to the running of the unit. Most which should be done by a tech, which again, in the higher up's infinite wisdom, they have decided they don't need.
So, all survive the shift, all are still breathing. The babies are giving report to the day shift which consist of one more nurse than the night shift had, and unit secretary, TWO techs, and the doctors are roaming around, seeing their morning round patients.
Over the loudspeaker, they hear "CODE BLUE 2E, CODE BLUE 2E"......they all sympathize with their coworkers who are dealing with a terrible situation at the worst possible time, shift change.
Not 1 minute later they hear "CAT TEAM 4E, CAT TEAM 4E" Different animal, same responders. The babies are done with patient care, there are at least 6 people in the room besides the experienced night shift nurse who can handle any emergency that can arise, and the unit that has had the CAT call is right outside the door. EN turns to one of the techs and says," They aren't going to get any help, lets go see if they need us." They go out the door, to the room. It is a patient that has stroked, but vitals are stable. Nothing to do except move the patient to the unit for stroke protocol. As EN turns to leave, a member of the stroke team arrives, and the tech and she go back to the unit they came from. Report continues to its completion, and all concerned on the night shift eventually go home.
At some point later , EN is called to the "office" with a list of her infractions, a few which she has to bite the bullet and say, "yes, I screwed up, I am an imperfect human." Some of THESE entailed only being able to be in one place at a time, some entailed not knowing what one of the babies did or did not know because she hadn't trained them, and they don't ask questions, and reject any help that is offered. But this situation is on the list under the heading of "Leaving the new nurses in her care unattended to attend a CAT call when she was not part of the CAT team".....huh? On top of this paper with her crimes, is a counseling sheet with areas for her to explain herself, that will undoubtedly go in her personel record.
Now, I would like for some of you to let me know what her punishment should be.
P.S. The hospital concerned frequently vows to do whatever it takes to improve retention of staff.
Want some feedback.
Hypothetical situation here......
You have a nurse with 24+ years of experience. This nurse regularly receives accolades from her higher-ups regarding her competency, commitment to her coworkers, willingness to adapt to new situations, and to assist her coworkers to do the same, etc, etc.
Now, the situation she and her coworkers are in has changed drastically. 80% new staff, babies just out of school. Have passed their boards, but still deer in the headlights looks on their faces most of the time. Licenses don't confer knowledge or experience.
They have moved the "unit" to a new location, a former critical care unit. Nicer in many ways, staff are able to see all patients from the desk, there are "hard" monitors....screens in both each room and on the desk, so that heart rhythms, bp, O2 sat, respiratory rate, and if necessary, other readings can be viewed quickly, or reviewed. The plan is to have the critical care unit nurses help with the transition, to teach them what they need to know to care for more critically ill patients. Not "unit" patients, but patients with more problems than they have been used to. Most are willing to do so, but they come with the attitude that it is beneath them to have to do so. Some are outright hostile about the situation, and while they would never allow a patient to be injured, they only help when specifically asked.
The powers that be, in their infinite wisdom, begin sending patients to the unit with things they have never seen before, even the experienced nurses. The word along the grapevine is that the department head was asked about the wisdom of sending those patients to their unit, and her reply was "They can handle it" Word is also that she asked the person transferring those patients to us to give them an inservice as to how to care for these patients. By the time the nightshift arrives, the translation has dwindled to "if this alarm goes off, you push this button to reset it". Hmmmm.
Fast forward, now. The experienced nurse is working with 2 brand spanking new nurses, the night has been a "hand you your butt" night. 8 patients, 2 getting blood, which is an involved process, especially with 2 nurses that have never hung blood before, and these 2 patients are on the opposite sides of the unit. This kind of night is disaster waiting to happen under the best of circumstances, and of course, the conditions are, shall we say, less than optimal. So, the experienced nurse is responsible for 8 patients, 2 very scared and stressed new nurses, all the BS busy work jobs they have decided are essential to the running of the unit. Most which should be done by a tech, which again, in the higher up's infinite wisdom, they have decided they don't need.
So, all survive the shift, all are still breathing. The babies are giving report to the day shift which consist of one more nurse than the night shift had, and unit secretary, TWO techs, and the doctors are roaming around, seeing their morning round patients.
Over the loudspeaker, they hear "CODE BLUE 2E, CODE BLUE 2E"......they all sympathize with their coworkers who are dealing with a terrible situation at the worst possible time, shift change.
Not 1 minute later they hear "CAT TEAM 4E, CAT TEAM 4E" Different animal, same responders. The babies are done with patient care, there are at least 6 people in the room besides the experienced night shift nurse who can handle any emergency that can arise, and the unit that has had the CAT call is right outside the door. EN turns to one of the techs and says," They aren't going to get any help, lets go see if they need us." They go out the door, to the room. It is a patient that has stroked, but vitals are stable. Nothing to do except move the patient to the unit for stroke protocol. As EN turns to leave, a member of the stroke team arrives, and the tech and she go back to the unit they came from. Report continues to its completion, and all concerned on the night shift eventually go home.
At some point later , EN is called to the "office" with a list of her infractions, a few which she has to bite the bullet and say, "yes, I screwed up, I am an imperfect human." Some of THESE entailed only being able to be in one place at a time, some entailed not knowing what one of the babies did or did not know because she hadn't trained them, and they don't ask questions, and reject any help that is offered. But this situation is on the list under the heading of "Leaving the new nurses in her care unattended to attend a CAT call when she was not part of the CAT team".....huh? On top of this paper with her crimes, is a counseling sheet with areas for her to explain herself, that will undoubtedly go in her personel record.
Now, I would like for some of you to let me know what her punishment should be.
P.S. The hospital concerned frequently vows to do whatever it takes to improve retention of staff.
posted by Mommanurse at 5:22 AM
2 Comments:
I thought about your post most of yesterday and last night. For your protection, not your sanity, you are now in the position of RAHP. When dealing with bean counters who control purse strings, set the rules and have absolutely no idea what the employees do or how the do what customers want, need, demand,still are the ones that micromanage the bureaucratic ridiculousness that is their God on High.
My best recommendation is Duck, answer any queries with honesty and forthrightness and INTEGRITY.
Of course, that may back fire and bite you in the behind. But do it anyway. You will sleep better.
I see not much has changed since I left, understaffed.
Well, I can assure you it is not just this hospital.
Why is everyone leaving???
And WHY in the world do they think day shift needs so many more ppl to do the same job as the night crew??
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