Thursday, June 16, 2005

Bad, bad idea & SLACKERS!

It seems that my department's customer satisfaction gallop scores are down. So what is administration proposing? Getting rid of all patient care techs & switching over to primary nursing where the nurse does everything for the patient. Sounds wonderful in a fantasy world, but when you have 4 or 5 patients in guarded condition - it just isn't possible. Add in the numerous amount of paperwork (all done by hand)...forget it! They are saying they'll limit us to 3 or 4 patients, but we know that is a joke because they have a problem finding staffing right now, how in the world are they going to add nurses so our patient load would only be 3 patients to each nurse? Why in the world would they eliminate patient care techs & hire more nurses to do what patient care techs are trained to do? Doesn't make sense. Personally, I think we could use more patient care techs, not less. Oh well, I skipped the meeting last night that addressed their new plan. I was too tired - went to sleep around 7 pm & woke up this morning at 4 am. Guess I needed a little bit of sleep.

I'm also frustrated with my renters - the rent check was due yesterday & it's not here. I'm not having a good feeling about this & really don't want to have to go to them to get the check, but I guess that's my only option. Grrrrrr!

Work was ok this week - nothing real spectacular going on. I think one thing I enjoy is seeing the vast range of personalities. I had one guy that was writing down the results of every blood sugar taken, every BP, every temp, everything he ate & even the amount he was urinating. He had it all written on this tiny note pad. I just had to laugh when he showed it to me. I had another patient that was on reverse isolation airflow - he has aids, was neutropenic & TB. I don't think he ate very well outside of the hospital either - so while he's there, he is eating anything & everything he possibly can. After a couple of days, it caught up with him & he had the worst stomachache. He was such a drama queen the third day, I requested to not have him. I can only take so much drama.

I also had my first incident where I was called in by the clinical leader to discuss a situation. I had a post-op surgical pt that needed blood (his morning H&H were like 7.1/21). I called the surgeon around 5 am to get the order...wrote it up, put it into the computer, faxed the order to the blood bank & waited for the blood to be ready. After an hour of not hearing anything from the blood bank, I decided to look it up on the computer & I see that the order is there but still waiting.

I go to pass my 6 am meds, come back & check the computer & see that the order has been cancelled. I call the blood bank & ask what's going on with my order. It's now 6:30. They explain that since he had surgery, they had already had blood available for him & didn't need another order. Would have been nice if they had told me this an hour ago, you know? So now it's I run & get the blood & hang it by 6:45, stick around the 15 minutes observing the patient while the blood is started as well as delay everyone that is to get report on my patients? Or do I clearly tell the oncoming nurse of this patient that his blood is ready & that I already prepared all of the IV tubing & it's hanging on his IV pole just waiting for the blood? I opted to pass it along to the next nurse because a patient needs to be monitored closely when the transfusion begins. I tell her about it & we redline the orders together as well as look at his H&H lab values - so no doubts that she isn't aware of his orders for blood. Well, silly me for thinking this nurse was capable of doing her job. The blood did not get hung until after 9 am that morning & she is saying it's because she didn't know he needed blood. Ugh!!!! It's not enough that we reviewed the labs & redlined the order for blood? How about seeing tubing prepared for a blood transfusion hanging on his IV pole? Is anybody home in there?

So the clinical leader for the day shift wanted to talk to me & she says something like "I know you're new, blah, blah, blah" as if me being a new nurse is the reason this happened the way it did. She says I'm not in trouble & that it's the surgeon that was upset about it, not the hospital. I felt like saying whatever!

I've learned a valuable lesson though - don't trust other nurses to do the job right. I'm seeing more & more of how there are quite a few that are big time slackers & they either don't do what was ordered & then pretend they didn't know about it or they act as though they did it when they really didn't.

I had a patient Tuesday night that I had to hang blood on.....I questioned my clinical leader why it took until 8 pm to hang blood when the lab results were from 4 am that morning? Her H&H was awful...but the night nurse that got those 4 am labs ignored it as well as the day nurse who took over that patient. It wasn't until the doctor made rounds at 1 pm that he saw the lab values & ordered the blood. But again...why did it take another 7 hours to get the blood to the floor & the transfusion started? Slackers I say, slackers!!!!!!! Don't trust anyone to do the job right other than yourself!

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