Once I was working on a medical ward that started taking surgical patients when the surgical ward was closed for refurbishment. When we were first told about this we celebrated.
We assumed that the nurses from the closed surgical ward would come to us along with their patients. They were short staffed on their 20 bed ward and we were short staffed on our 25 bed ward. Their ward was closing. We assumed we would get them as well as their patients.
Wrong wrong wrong.
Management sent most of them to staff other parts of the hospital.
One morning I came into work and was handed 5 care of elderly demented patients. They were climbing all over the side rails, falling out of bed and spreading porridge in their hair as well as eating their own faeces. Constantly. Old age and dementia will come to many of us. Looking after a patient such as this is tougher than managing a group of hyperactive toddlers. One patient with dementia was having a blood transfusion and she bit through the tubing and was spraying the walls with it. In addition to that I had 5 medical patients including an alcohol detoxer who was licking the floors and very disoriented. You cannot control and or rationalise with people like this. Not at all. They need someone there at all times or all hell breaks loose.
I also had 5 surgical patients. 3 of the surgical patients were given the go ahead to be discharged at 11AM. Discharges are often multi faceted and time consuming. The patients who are being discharged think that they are the most important people in the world and don't seem to get that the nurse is running between and managing dying patients while she is also organising their free discharge drugs to take home, follow up appointments and discharge letters etc.
The two other surgical patients were for theatre in the afternoon and somehow I managed to get them ready for it, spending about 10 seconds with each one and barking orders about gowns. I wanted to be a good nurse for them but I had to move fast.. Just doing that little bit and taking the time to rush through the discharges caused my elderly patients to be on the floor 3 more times. Those discharges were done in a half ass manner as I was rushing, but it was still enough to cause neglect to my elderly patients. The site manager was up my ass because they had more patients than beds as usual and demanded that I needed to sort the discharges. I know I know, the site managers are getting shat on from a great height. I did ask her for help but she said that there was no one to send.
Before the 3 discharges were out the door the 3 new surgical cases for the afternoon were on the ward. The beds needed to be cleaned and the new surg patients needed to be admitted (time consuming) and prepared for theater (time consuming). They also had a million questions (time consuming). My 5 acute medicals and my 5 elderly dementia patients were still there, doing the same things that they were doing this morning. That won't ever change. The alcohol detoxer was still licking the floor, refusing meds and throwing things at other patients. You cannot sedate people like this. You will hurt them more. Haloperidol is a joke and benzodiazapines are out of the question for this patient.
I do not have the right to get an additional nurse to help me while I am in the middle of this kind of situation. I do not have that right. But the hospital management has every right to dump more patients on me in this kind of situation. I did not create this situation. But I am responsible for any problems and bad outcomes.
Jesus christ it has been a long time since I looked after surgical patients? Am I doing everything right? I never worked with their surgeon before and do not know his ways. All doctors have different ways that they like things done but they won't communicate this. The nurses who work with them regularly just know.
I couldn't focus on the discharges very well because I also had someone with pancreatitis who was going downhill. I did get "forced" to get the discharges done and that is when my pancreatitis patient really went south. The pancreatitis person was critically ill. There was only one other nurse on the ward with me that day. She ditched her patient to give me a hand. It took two of us to monitor and implement orders for this man, that is how bad it was. We couldn't leave his bedside. The three care assistants we had carried on with bathing and toileting. They cannot admit patients, help with discharges or deal with the acutely ill in any way. They were going to make my surgical beds up , get the new patients in them and gown them and get basic observations but the elderly patients were constantly falling. Constantly. The phone was constantly ringing.
At this point the new admit surgical patients were filtering in and the beds were not cleaned. It was only 5 minutes since the discharged patients left. I'll be damned if I am going to leave a dying patient to clean a bed and kiss arse and admit a minor hernia patient for the PM theatre list. "Welcome to Nut ward, You are my only patient and I am here to gently guide you through the journey of having your minor hernia repaired and answer all your questions and bring you tea. Can I shove my nose a little further up your ass please?" Yeah right. I am surprised that management hasn't scripted that one yet.
At this very moment the surgical doctor came onto the ward. He saw that his new admission patients for the afternoon lost were not yet in beds, admitted, or ready for theatre.
So he tries to pull me away from the pancreatitis guy (the patient of another doctor) to scream and scream and scream at me...red in the face, eyes bulging, on his tippy toes...
"WHY THE HELL AREN'T THESE PEOPLE READY FOR THEATRE. YOU WILL SCREW UP THE LIST. IF THEY MISS THEIR OPERATIONS AND HAVE TO WAIT ANOTHER 6 MONTHS FOR THEIR OPERATIONS IT IS ALL YOUR FAULT. ALL YOUR FAULT. ALL YOUR FAULT "
This is in front of the patients. 3 of them are already pissed off because they have taken time off of work and shown up onto the ward for a long awaited operation and the beds are not ready for them. The first one is first on the afternoon list and he isn't even in a bed or admitted or anything. The afternoon list starts in 20 minutes. There is not yet a bed in ITU for my critically ill patient. What about my other acute medical patients? What about my elderly patients who haven't been given a drink all day? The blood transfusion had yet to be restarted on the woman who bit right threw her first unit of blood. When was that? Over 4 hours ago? HB of 6 by the way. Oh Shit. Getting more blood and restarting that transfusion could have easily taken me away from the others for a long time. Very long time. And she will bite through the next transfusion as well because she has dementia and I will be back with the pancreatitis patient, or the other medical patients, or the surgical patients, rather than in her room.
It is not an exaggeration . It is a normal day.
Where are all these managers and highly paid matrons? Just like ghosts. We know they are there, we just don't see them.
Where are all these supposed "new nurses"? The government is telling people that there are more than ever now.
Why was I put into this position as a former e grade now band fucking 5 medical ward staff nurse?
What kind of a stupid fucktard thinks that a nurse should walk away from critically ill patients, acute patients, and at risk elderly patients to discharge and admit stable minor short stay surgical patients?
How does a fucktard such as this actually get into medical school?
Why didn't management let us have the surgical nurses if we were getting their patients? We would have had to additional RN's on the ward that day.
Why are they so against staffing these wards?
Who was in charge of the ward that day? Me. The only other RN that day has less seniority but we both had heavy and large patient assignments. I had to take the official role as charge even though I was a very overwhelmed primary nurse to a group of patients.
When is this going to end?
It did have a good ending. Kind of. At least we were entertained. I blanked the surgeon. He went even more apeshit at me. This caused the medic of the pancreatitis patient to go apeshit at the surgeon. We damn near almost had a doc fist fight. Those are the best. You have got to get your kicks somehow.
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