Tuesday, July 7, 2009

Seething

Had a great day at work. Yeah right. We were supposed to have three Registered nurses and a kid on duty for the shift. Not enough for a large medical ward. Not enough by any means. Every single patient is due medications at the same time, first thing in the morning.

If only one RN does a medication round it would take about 3 hours to get everyone their 8Am drugs. So we split the ward and each RN takes a side. It then takes about 1.5 hours for all the patients to get a quick initial assessment by an RN and hopefully they will get their 8AM drugs by 9:30 or 10:00. That sucks but it is better than sharing the ward and having one RN running around trying to do all the meds.

By the time you finish your drug round you are locked into your side for various reasons.

The third RN was going to do charge and work with the kid doing basic care. It would probably take them until noon or so to get everyone up and washed etc. The other 2 RN's who are locked into their sides get hammered with orders, phone calls, information overload, labs, treatments, assessments etc.

So it sucks but I was looking forward to having 3 RN's rather than just the usual 2 RN's and 2 kids/care assistants.

Then I got to work.

Another ward was short and we were ordered some non nursing manager to send our third RN to work there. Fuck. We cannot only have 2 RN's and 1 kid for the whole ward. Please don't do this I said. I had visions of listening to screaming relatives tell me things I already know for the next 8 hours. I had visions of not having any kind of support in an emergency.

"We need your RN to go to ward 1 as they only have one RN for the day. But, I will send you their care assistant, then you will have 4 of you. If you struggle make the housekeeper work as a nurse" says the manager. Keep in mind that this is a large acute medical ward of well over 20 beds. And we were getting 2 RN's and 2 untrained.

Having only 2 RN's and 2 untrained really blows for a large acute medical ward but this was the deal I was getting. I reluctantly agreed. Really I had no choice in the matter. My RN left to go upstairs and the other ward's care assistant came.

She did not speak a word of English. She had no experience nor training. She had been in the country two weeks (found that out later). She was only scheduled to work half a shift and she was getting passed off as a proper care assistant. Of course no one told me this. I found out a few hours later. I would ask her to do things and get the reply "Yes, Sister" and a lovely smile. She was lovely. But she had no idea what we were telling her to do. And she didn't communicate that with us either. We were under the impression that she was an experienced care assistant. When she first came on the ward I did ask her about her credentials and tell her to tell me if she needed help. I showed her around the ward and explained the routine. She smiled and nodded. I realised something was up after I realised she hadn't checked the blood sugars (hours after I realised they should have been checked, hours after I told her to do them). I won't tell you about the rest of the fuck ups........


Then she left. She was only scheduled half a shift. Neither her nor the manager who took away my RN and sent this girl bothered to mention that she was only on half a shift. That left us with 3 staff for 20 something patients. 2 RN's and a kid.

The kid is actually very good. But she is very limited in what she can do obviously. Really she can only do basic care. But most of patients need 2 staff to be moved in the bed, cleaned, turned, and transferred...so Kid was basically fucked whilst the two RN's got slammed with admits, IV's, orders, phone calls from everyone and his brother etc.

Yes that is right. They took away my RN, sent me an untrained non English speaking non nurse person who was scheduled to leave in the middle of the shift, and then sent admissions.

And guess what. The patient's referred to the foreign woman as "that foreign nurse". Nurse.

And they complained about the fact that we didn't go around with a trolley hot drinks for everyone. If we have enough staff this is usually done by a care assistant or a free nurse at the end of the shift. The kid who was working with me had a choice between getting observations on all 20 something patients when they were due or handing out tea and coffee. There was no way she could do both. She made the right call. The other RN and I were on our knees with all the other things. And the patients complained about the Nurses being to miserable to hand out tea and coffee.

I cannot wait until the next time I see that fucking manager. He is going to wish he was never born. I really needed that 3rd RN as well as about 10 others. I cannot tell the complaining patients like it is so I am going to take it all out on the manager personally.

This is how they screw and screw medical/elderly wards and their staff day after day.

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