So I've worked almost 3.5 yrs where I am. So I'm not new. I've had my fair share of assignments. Some good, some really, really crappy. But RARELY do I EVER throw a fit about it. I normally just try to find a team mate and get my shit done.
Yesterday was a different story...
I worked my normal evenings and came in find 5 patients assigned to me...
Bed. 1 - young adult with a new trach (which = a lot of secretions which = lots of suctioning) who already has stage 2 coccyx ulcer (has NO adipose tissue so therefore no cushioning) which = turning every 2 hours and changing at that time as well to try to prevent the ulcer from getting worse. Also has a G tube so that's more work... and is on dilantin which means remembering to hold the feed for 1 hr pre and post administration. And of course lovely family members who are all up in your face about care being done IMMEDIATELY because they're used to one-on-one care like the ICU.
Bed 2 - open but report was already taken and it's a repatriation from another hospital and it's an acute CVA.... so admission and who knows what kind of condition the pt will be in. Although it looks easy to do, it takes at LEAST 1.5 hrs for an admission because of all the charting and such that needs to be done as well as carrying orders and contacting doctors for orders and such.
Bed 3 - CVA who requires little in terms of assistance except for meds and supplies.
Bed 4 - Parkinsons (end-stageish) who is DELERIOUS!!! And absolutely BONKERS!!! Speaks another language and LOVES to climb out of bed! Is a total feed and is incontinent of urine AND stool... also needs to be turned every 2 hrs..... so a LOT of work with this patient.
Bed 5 - a total again who has UBER amounts of dressings that have to be changed multiple times a day. Is obese so it takes several ppl to turn (always takes time trying to find someone to help!) and needs to be done at least q2hrs. Is also a total feed and incontinent of urine and stool. This one makes your back kill by the end of the night.
Now I wasn't going to say a bloody thing until I found out that bed 5 was being discharged back to the nursing home and so I would have all the work of a discharge and then ANOTHER admission....
But to top this all off was that I'm super sick with a head cold and a chest thing (I'm thinking bronchitis - it hurts to breathe but I don't have any wheezing or crackles) and the ONLY reason I went to work was because I knew my friend was working and when I needed help would come to my assistance immediately and would work as my dedicated teammate.
So THAT was where I drew the line....
I knew I couldn't do a total delerious pt, a total trach with many needs, AND two admissions.... if I wasn't sick I probably could but I just knew I couldn't.
So I went to the charge nurse and asked for a change in assignment.... and she went beserk! Talking about how everyone is always complaining about their assignment and how everyone should just put up and shut up. That was where I was like "I NEVER complain about my assignment so you need to stop".... I got another nurse involved (who regularly is charge nurse when I'm working) and even said to her, "when do I EVER complain about my assignment?! I never do" And she agreed which was nice and so the current charge nurse although irritated that she had to change the assignment begrudgingly did so.
So my 5th pt was someone who required IV meds, narcotics several times, a foley that I had to empty but was independent in every other way.... which was just fine by me!
I barely made it through my shift but at least I can say I did. Then I told the next charge nurse that they needed to cancel my shifts for the rest of the weekend cuz I was too sick to work!
Goodness! I am so glad that you made it through that shift but it sounds like it was rough! I hope you get to feeling better and I'll pray that you are able to relax some so that your health can improve.
ReplyDelete-BedpanAlley