A Tale of Two Shifts

Don't worry.  I am not going to go all Dickens on you.  I am longwinded enough already.

Once upon a time in January 2010:

Monday Early Shift:

Two staff nurses (and 2 untrained agency carers with their fingers up their  noses) for 30 patients.  Nurses receive written warning from managers that we must attend ward rounds and drop what we are doing to attend them as soon as the consultant steps foot on the floor.  Staffing is not an excuse to miss them.  There are 8 different consultants.  Was on ward rounds from 8:30 until 11:30.  Didn't even get half of the 8 AM tablets started until half past 11.  That means that 4 hours into my shift I hadn't seen most of my patients at all.  The ones I did see only had me in the room long enough to throw their tablets at them. Then the next lot of consultants came at 12:15 and kept us until well after 2 o'clock.  They don't move very fast, these consultants.  I don't think anyone was fed.  Sometimes 3 of them will show up at the same time and all stand there talking at once demanding that the lone nurse follows them around.  We don't know when they are coming and can not plan for it.

I was supposed to finish work at 3 PM.  I left at 7 PM.  Unpaid for 4 hours.  I accomplished nothing in the 12 hours I was there and barely saw my patients. Patients deteriorated.  Tablets were rolling across the floor.  God knows who had what, or if they ate, drank, voided, were turned or if there were any new orders from the medics.

This is the norm these days.

This is the norm before people start calling in sick.

Thursday Early Shift:

A miracle happened  Thursday and I enjoyed it immensly because it may never happen again before I leave.

We had 4 experienced staff nurses and 2 experienced health care assistants to 28 patients.  Two of the four staff nurse (myself and Jane) had also been on Monday AM.  Our ward sister was also there on a management day and we actually had a ward clerk to answer the phone for part of the morning.

I had 7 patients to medicate for the 8 AM drug round, which I accomplished by 9 AM even
 though I took the time to assess them and help them with their breakfast.  There were no longer an IV's.  But no one was for discharge due to social cirmcumstances.   At 9:15 I was bedbathing and care planning. Only 3 consultants showed up for rounds.   Everything was done and ready to go.  The health care assistants finished off the bed bathing etc while I organised and implemented all the consultants new orders.  I got a lot of extra things done as well.  I took a 45 minute lunch break to make up for the 4 hours unpaid  and lack of a lunch break on Monday.  While I was eating my patients were cared for by another RN.

I feel very refreshed, like I just had a long vacation.

What were the patients' and the consultants view of all this?  "Oh you nurses are so much better than the ones who were here on Monday. Those lot either ran around frantic (Jane and I) or had their fingers up their noses (agency carers)"

Um, we are the same nurses who were here on Monday with a lot more in the way of help and resources!!

Now wonder management gets away with short staffing.