W-w-what??? Unbelievable!

Ahhh, so much to share with y'all.  First off...my nephew's baseball team...ahhhh...it wasn't a pretty ending.  In the state semi-final game, they got their butts whooped like NEVER before.  They lost 10-0, game ended in the 5th ending due to the "mercy" rule.  I can't even say that the other team was the reason they lost.  Yes, they were good, but our guys just did not play like they usually do (obviously).  There was no momentum to be found.  It's too bad...this group of seniors over the last 3 years compiled a record of 84 wins & 11 losses.  Pretty darn good!  Too bad they couldn't also claim a state title.

My nephew's graduation party was on Sunday.  I still can't believe he's all grown up & moving on to college.  He was supposed to go to The Citadel, but he has changed his mind & will more than likely go somewhere local or not too, too far away...unless he gets an offer to get drafted.  I'll know more in June. 

Now for the title of my entry.  I called in sick to work on Monday.  I followed procedure...called in to the appropriate person & way before 5 pm (the cutoff to calling in as a nurse is usually at least 2 hours before the time you are due at work).  I ended up on the phone with the VP of nursing at my hospital pretty much threatening me that if I don't come in, I will be written up.  My reaction was "W-w-what???????"  Since when are we "not allowed" to call in sick?  She ranted & raved, basically told me it's my responsibility to take better care of myself & proceeded to word for word say "If you do not come in, consider yourself written up."  Which of course I politely told her I would NOT be in.  It's not like I have excessive call-ins....in fact, it's been over 9 months since the last time I called in sick.  I thought her behavior was ridiculous.  I understand we are short-staffed (her fault), but do not take that stress out on me.  Perhaps if administration was doing a better job with staffing, she wouldn't flip out like this, but that's not in my hands & I'm not going to be bullied or harassed into working if I'm not feeling well.  Am I wrong on this?

I did end up working on Tuesday & Wednesday.  I don't know if or when I will be written up.  I don't see under what basis she can write me up.  I haven't done anything wrong.  It's so aggravating working with people that don't appreciate all that you do...I mean I have picked up many, many shifts when they are short-staffed or when they rather have staff working than agency.  No "thanks" or "job well done" when I volunteer for that...just an angry administrator when I call-in sick one time.  I'm wondering if it's a sign to move on...to throw myself out there in the world of agency &/or travel nursing.  I know there is more money to be made outside of the hospital I am at.  The ONLY things keeping me there are the staff (outside of administration).  They are so wonderful & helpful & easy to get along with.  There are a few I don't like, but for the most part...we all help one another out, even without asking.  The other reason is that it's so close to my house & I don't really care for driving long distances (anything over 20 min is a long distance in my book...lol).  Wouldn't you know it...I've had 3 different agencies call me within the last 48 hours asking if I wanted to work for them.  So I don't know.  Am I ready for major changes?  I'm so comfortable where I'm at, but I am getting fed up with being short-staffed.  Not that I expect any other hospital not to be short-staffed also, but I can reason better with a lack of staffing when I'm getting paid twice as much as what I'm making now. 

Tuesday night wasn't a bad night for me.  I only had 3 patients the entire night....and all of them were alert & oriented.  Well, scratch that, I started out with one patient that was confused & restrained.  I heard he had quite a mouth on him, but he was being fine with me...very cooperative.  My clinical leader informed me that there was another confused male on another wing (still PCU) & they wanted to combine these 2 guys into one room in order to free up the room for alert & oriented patients.  Soooo, she asked "Do we have the other confused male come down here to us or do we send your confused male to the other wing?"  I spoke up & said "Well, the other wing has a patient care tech & we don't.  That's an extra set of hands to take care of these confused patients."  She agreed with me & we ended up moving my confused guy down to the other wing.  Wouldn't you know it...about 15 min after we moved him, we somehow ended up with a patient care tech...lol.  Rarely does it work out that way, but I was glad we had some extra help. 

So I was down to 2 patients & eventually got a new admit. An older woman in her 80's that was alert & oriented, had no problems with her.......until last night.

I went into work Wednesday night knowing we were short-staffed (big shock!) & there were only 3 nurses & no tech...which lately is the norm.  I had 5 patients last night...one of them being my new admit from the night before.  Who went from being alert & oriented, to still quite alert...but confused.  Not a good mixture!  She kept trying to get out of bed, so I finally put a posey vest on her.  I was worried if she got out of bed, she'd fall & break a hip or something.  She got fed up with the vest & resorted to pulling out her IV...blood everywhere.  Ugh!  But like I said...the other 2 nurses & my clinical leader were in there before I could even get there & they were taking care of it all.  One was cleaning up the blood, another was starting a new IV & the third was getting supplies.  Talk about teamwork!  I ended up putting soft wrist restraints on so that she wouldn't be able to pull out the new IV.  She wasn't happy & she did not sleep for a single minute last night.  I don't know what was going on with her, but it was very time consuming...not that I mind it, but when you have 5 patients & no patient care tech...you just don't have time to spare between the patient's needs & the paperwork. 

Add on top of that I had another confused patient that was also in restraints that was able to repeatedly pull herself to the end of the bed...she was like a regular Whodini.  I put a call in to the doctor in hopes of getting her a sleeping pill or something to relax her & got an order for Ativan.  That did stop the squirming to the end of the bed, but she didn't sleep all that much either.  Just kept picking at the sheets & laughing.  At least she was pleasantly confused!

My third patient was in with c-diff.  Normally I would cringe at hearing the word "c-diff", but when I heard he was alert & oriented & able to get himself up to the bedside commode without any assistance...it stopped me from cringing.  C-diff is just literally nasty diarrhea.  It has this icky odor to it & you usually have to go to the bathroom a lot.  Most patients we get with c-diff aren't even able to get out of bed, much less be able to make it to a bedside commode & clean themselves up.  So he was easy to care for.

My fourth patient I had the night before.  He was in need of a blood transfusion...so that was my priority.  He had received 1 unit during the day, then was given lasix & I was to start the 2nd unit at night.  Lasix...a blessing only if you have a foley catheter.  This gentleman did not....so he was having the urge to urinate quite often....not fun at nighttime when all you want to do is sleep.  He was for the most part able to stand up on his own to use the urinal, but a few times he missed & got the floor instead....can we all say "ughhhh" together???  I didn't have time to think about it...I thru some towels on top & went about my business.  I know, sounds gross...but when you don't have time to spare, you don't have time to spare.

My fifth patient probably thinks I'm a dumb blonde nurse...because he would ask for something & I would tell him "Ok, I'll be back shortly"...only to find it would take at least 20 or 30 minutes to get back to him.  And of course it was never anything quick with him....it wasn't his fault though.  For instance...he needed pain medicine...Demerol 50 mg IM...so I would draw that up.  Then he also had IV meds...one of which was Lopressor...which you have to push slowly.  His dose was 10 mg IV...Lopressor scares me a little...you have to watch that heart monitor closely to make sure they are tolerating it ok as well as checking the blood pressure.  He also had an IV piggyback that needed to be hung and an accucheck which required me hunting down someone whose badge would actually work because for some reason mine & nearly everyone else that works at the hospital...our badges don't work - even though we've done all that we are supposed to do in order for them to work.  Anyways, it's time consuming all of these things & it would seem like I'd always forget something & his room was like the absolute farthest away from everything.  He was ok though, he said he understood...but I still felt like I just wasn't meeting his needs the way I would have liked "if" we weren't so short-staffed.

Just an addendum...we aren't short-staffed because of a lack of resources, we are short-staffed because admin. is cutting back on their budget.  So much for patient & staff satisfaction.  Saving $$$ is where it's at I suppose.  I always wondered in the past why our hospital is unable to meet any of the criteria standards when it comes to interviewing our patients after they have gone home.  We always get lower than average ratings...but I can see now that perhaps if we did have the right amount of staff, our gallop scores would go up.  If I can figure that out, you'd think admin. could also.  <sigh>

So that was basically my night....6+ hours of running around meeting patient needs, another 4+ hours of paperwork & finally something like 10 minutes to myself to recover.  I will enjoy my time off this week for sure.