EMU

Windfall woman asked in the comments if I had floated away. I haven't, but sometimes wish I had. Ha Ha.

Actually it's been a really good week. I had the Seizure unit. Called EMU, Epileptic Monitoring Unit. It's a unit within my unit, 2 monitored beds set up for EEG to monitor Brain waves for seizures in patients who have been having them for some unexplained reason or their seizures have changed, etc. etc.

When we have the seizure patients we are only allowed to have 3 patients. 1 Seizure patient and 2 regular medicine patients. The reason for that is the EEG they are hooked up to will alarm if it detects seizure activity (unfortunately it also detects head scratching, chewing, coughing, talking on the phone, etc.)

When the alarm buzzes, we have to run in to make sure it's not a seizure every time. When my unit has got a good team working this is a great gig.
When I'm in one of my other 2 patients rooms, or the med room, or the supply room, and the alarm sounds, any of my good co-workers will poke their head in for me and check on the patient. That's how it went for the last 2 days.
Those were great days.And that's how it goes ANY day for ANY one who has that assignment.

Today was an exception. I had a charge nurse with a bad attitude who admittedly didn't feel well yell at me for not staying at the monitor. She yelled at me 3 times.
Each time I was with my other 2 patients. My seizure patient never had a seizure, it was always just a false alarm.
But instead of poking her head in for me she yells at me.

That 3rd time I yelled back. (For me, yelling isn't yelling.....Really) I sarcastically (as is my fashion) asked her what I was supposed to do with my other 2 patients and stated that it was impossible for me to do my job if I had to sit outside this room all day.
She told me I needed to tell someone when I left that spot.

So I did just that.....(I can be passive aggressive at times) Everytime I walked away to the bathroom, the med room, the supply room, into another patient's room, I yelled out loud to her at the nurse's station.
Example " I'm going to the bathroom...Somebody please listen for the alarm!"

I did that soooooo many times that I think she and everyone else was tired of hearing my updates. Although some of my fellow nurses thought it was comical and that she deserved it. Could have saved her that headache if she had only been willing to poke her head in on my patient for me occasionally.



Onto other news...Change of Shift is up today. Go check it out!

COS V.1 # 13

Another Change of Shift is up. For good reading go here.

Floating

I was floated yesterday. For those of you who don't know, "Floating" is when a member of the nursing staff gets sent to another short-staffed unit of the hospital. We were overstaffed, they were understaffed.

When I signed my residency contract I was promised 6 months of no floating. I was one day short...my 6 month's mark was today. They couldn't just give me one more day of float-freeness.

I now know why all my fellow nurse's HATE floating and bitch and moan when they do.

It was horrible.

We have one unit in the hospital where we always float. Why? Because they have terrible management, they are extremely disorganized, there is no teamwork so it's every man for himself, the staff is rude and lazy, and because of all these things they can't keep staffed for very long so we have to go fill in.

I got to the floor and the charge nurse, who kept her butt at the nursing station all day, gave me my assignments and begrudgingly gave me as little info as she could about where things were, codes for supply rooms, etc.
I noticed that out of my 5 patients I had FOUR who were not ambulatory (One was a with assist). I noticed throughout the day that my patients seemed to be the only ones who were not ambulatory.

Sure....that's smart management....let's give the visiting RN, who doesn't know where anything is, the hardest patients on the floor.......the ones nobody wants.

That way the rest of the nurses can sit at the station and flip through magazines all day.

If I asked for help I got attitude.

I did find 2 people helpful. An RN who was there just to do IVs. (Yes, they floated me up there even though they did have one of they're own on staff just to do IVs........we don't have IV nurses at our hospital)
However, She was helpful and nice. The other was a brand new assistant who was still in orientation who volunteered to help me do a bed bath.

I appreciate my unit so much more now. We maybe sometimes dysfunctional but for the majority of the time, we function, as a unit, like a well oiled machine.

When we hire someone new, they stay...for possibly years because we have the kind of staff that would never pile a heavy load onto a visiting nurse. (In fact our charge tends to give the easier patients to visiting nurses)

With a few exceptions, you would almost never find magazine reading at our nurse's station when there's a nurse running like a chicken with it's head cut off.

Not on my unit.

Total Care

My unit Christmas party is tonight. We always have great Christmas parties. Everybody, including the boss, gets a little tipsy. I don't drink, but it sure will be fun watching the others get that way.

Frankly, After the week we had...we all deserve to do a few shots. Yesterday I had gotten to work to find that 3 out of my 5 patients were total care. When I whined about it, I found out the whole floor was practically total care.

How can that happen? What are the odds? What happened to all our ambulatory homeless guys coming in from the cold?

You'd think they would increase the staffing with accuities being so high. It just makes sense. I was running around without lunch breaks or potty breaks all week.

It really bothers me when I simply don't have time to give the best care to all of my patients. If it's just one patient taking up my time, I can usually manage to break away to get to my other patients. But when I'm in 3 rooms all day, changing briefs, giving bed baths, removing or starting Foleys.....I have no time for the not-so-heavy patients who still need my care.

Not even the best Delegation and Prioritization skills in the world will help if there is simply no one to help.

One patient looked pretty bad, admitted with pneumonia and UTI from a certain government run mental facility. Their temp was elevated, BP started crashing, HR increasing (Yeah...you know what this sounds like) going from unresponsive to screaming incoherently (I was told that was their baseline). I asked the Resident to consider moving the patient to a critical care floor. She said they'd discuss it in rounds. It didn't happen.
So with my heavy load, I did frequent assessments, charted everything in detail (Including the "Dr X notified of this, no orders received")
That patient had no business being on my unit.

Another patient with whom I had developed a rapport called me a "Dirty Rat". He had Necrotizing Fascitis in his arm muscles, a result of several failed attempts to shoot up some sort of illegal drug. (He didn't elaborate)
He was upset with me because the wound care nurse had taken off his bandages from a Post-op incision and drainage and I hadn't warned him about what his arm looked like. It was a big filet. Sliced open from wrist to underarm in several places.
You could get a pretty good anatomy lesson by checking out his ligaments, muscles and bone. I told him I had no idea his arm looked like that...the MD had ordered the bandages to stay on for 24 hours. He forgave me.
He'll probably lose that arm though.

I still love my job, but days like that make it very hard to continue loving my job.