Monday, April 27, 2009

The Matron who actually worked a shift

I can barely type this or drink my coffee because I am laughing so hard. I did hear this secondhand. I have seen similar situations first hand and I have no doubt that the following occurred.

Let's set the scene. Not my hospital but I wish it was. Really I do. I would have had fun with this. A certain very large very acute medical ward at a hospital nearby with 30 beds was short one RN for the shift. This left one RN for 30 patients. She kicked off and their highly paid and god knows what she actually does Matron got roped in to work an 8 hour evening shift.

So Matron was to have 15 patients and the other RN was to have 15. It takes forever to do a drug round for 15 patients, let alone 30. So each nurse takes a side in order to maximise the chances of patients getting their medications on time and reducing the amount of errors. Once you finish your drug round (after about 2 hours)you are pretty much locked into being the primary nurse for that side only and you really are not up to date about the other side. That is why nurses have "sides".

Now keep in mind that highly paid modern Matrons never come near the wards. Ever. This is the case even when we are in way over our ears and we actually beg. If a mistake occurs they rip you apart....you get this mock trial thing where they all sit around you and destroy your character like high level judges in a kangaroo court. And you are guilty until proven innocent. If you really are innocent and just outspoken they will make something up to punish you for rocking the medical shitboat. I am surprised that they don't give them wigs, robes, gavels and iron maidens.

How this matron got roped in I don't know but she agreed to work a late shift.

When she arrived on the ward she informed the ward registered nurse that was going to be on duty with her that: "I will be working as an HCA because I have been away from nursing too long". Remember that today's matrons may be qualified nurses from a long time ago but really they are an extension of management rather than nursing staff. They are focused on management aims and goals.

The ward nurse wasn't having this. The matron has something like double the ward nurse's salary. She knew that it is impossible to be a primary nurse and do all drugs, interventions, and assessments for 30 acute medical patients. Matron had to take a side.

Andy by 9PM when night staff came in Matron was at the nurse's station in tears. "This is impossible, this is impossible" "This is ridiculous". "There's not enough time". "The interruptions are constant and unending" Blubber blubber blubber.

Really, Matron. No shit. Why don't you get your ass down to the ward a bit more often?

She gave a fractured and weak handover to the night staff and left. She really had no idea what was going on with her patients. Night staff said that there were so many unsigned for/ not given drugs on her side that it wasn't even funny. Nothing got done. It was like she just gave up.

The nurse who worked with her said that at mealtime she brought a diabetic patient some chocolate cake and nearly gave a confused who was on clear free fluids and plate of chips. She just couldn't keep up with it all. The drugs that got given were given late. A few warfarins and IV antibiotics were missed totally. It took nightshift the first few hours of their shift to sort out all the problems.

No wonder Matrons don't come near the wards. This one never came back to do a shift. They are not completely stupid you know.

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