We’re drowning here.
| We’re drowning here. The unit has moved back downstairs to our regular haunts, now that the money-making Interventional Cardiac Unit is in its spiffy new digs, the remodeling of which we had to suffer through. My first night back after that occurrence, I was disheartened but not surprised to find that our patient:nurse ratio has been upped to 4:1. While we were upstairs our census had been increased to 7 patients, with one nurse having 3 and the other 4, and everyone predicted this was coming. Still, it was a nasty shock, even if expected. Adding insult to injury, we rarely have a tech any more; there’s one who works days, but only 4 a week, and one who works 2 nights a week, but rarely when I’m on, for some reason. Depending on who the supervisor is, we *might* get one for part of a shift, though there’s one who will almost always give us one if she has one to spare. Oh, and the patients? Well, surprise, there’s no decrease in acuity. We still have all the cardiac and vasoactive drips, our chronic vent, the recently extubated, complicated wound care, blood to give, and those who aren’t too terribly tightly tied and like to climb out of bed and do “face plants” on the floor, not to mention a few who think they have a private duty nurse who will cater to their every whim. This morning we got a call “Can you take a labetolol drip?” (this is a continuous infusion of a heavy-duty blood pressure drug which can take a nasty turn if you’re not careful) and the oncoming charge nurse said “No, not even if we had a bed, which we don’t.” Technically we *might* take such a thing, but it would be dangerous with the number and acuity of our current patient load. Oh, and the category I forgot.the gynormous, those weighing over 300 lbs., who are killing our backs and shoulders. And how do they justify all this? It’s being done in the name of “productivity,” a model designed by the bean counters who have no clue about what really goes on out here in the world. Everything is measured by some formula which appears to be completely divorced from the reality of caring for the sick. “But we have to make money to keep going!” they wail. Right, and how many of YOU do we need? How much middle management is required to keep an outfit going, and why does the CEO need to make that much money? My dearest dream is that part of the curriculum for all programs in health care administration will include a year actually working as a tech, and at least 6 months closely shadowing nurses in a variety of units. In the best of all possible worlds.but it will never happen. The result is burnout, despair, and a lot of bodies heading for the door. Our assistant manager left for one of the critical care units; one of our best day nurses took an assistant manager position at a smaller inner-city hospital; another went back to New Jersey; and almost everyone else has applications out or is looking either in the system or out. Of course there’s a hiring freeze on in the system, it being the end of the year and all. I thought about posting an account of what happened last night, but just thinking about it makes me exhausted all over again, and considering what we might have overlooked is painful. Meanwhile our other 7 patients went unattended, and one nurse was there for nearly 20 hours. ame in for day shift, stayed over for 4, and it was her patient that tanked, so she was there past 1:30 charting. Please tell me how this can be safe? |
| murkier and murkier Well, the picture becomes more and more murky. The new manager is Nurse Micromanager, apparently, a total control freak. The first dictum handed down is that all travelers will hand their timesheets to her and she will scrutinize and sign them.and word is that she wants the *exact* minute we clock in and out, not the rounding to the nearest quarter hour the companies want. Okay, well and good.but the first time my timesheet’s not in by 10 a.m. on Monday and I don’t get paid that week will be the last time I do it! I’ve already notified my recruiter and will send her the manager’s phone number so they can call her instead of me when the timesheet doesn’t get there. Next thing is that there are *compulsory* unit meetings this next week, all at times which are grossly inconvenient for me, either 6 or 10 a.m. I’m not going to be very amused at having to get up at what is MY middle of the night to drag my butt in for a meeting that promises to create more problems than it solves. Oh, and the schedule! Well, the schedule is still a mess. I had asked not to be scheduled 4 in a row with the fourth night being Christmas Eve, and even given her several possible alternatives, but she chose to ignore my request. I have signed up to be put on call, but somehow I doubt that will happen, even if, as in previous years, they close the unit. Not to mention I got taken out of my weekend rotation this coming week. And then there’s the fact that on a number of nights there are 4 nurses scheduled, which sounds to me like we’re being used as back-door float pool.kinda like the National Guard getting used as a back door draft. (You do NOT want to get me started on that!) Is it any wonder I’m seriously thinking of settling down in a permanent, non-bedside job? Color me fed up. |
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