But it was only for one shift.
I was the only trained for 25 medical patients and couldn't do it alone. She was from SCBU. SCBU is the special care baby unit or neonatal intensive care to our American friends. It was the only place the site manager could pull a staff nurse from. I had more than a few patients on controlled drugs and these drugs cannot be accessed without a second staff nurse. I needed an RN.
The woman hadn't done adult ward nursing since she trained in the Crimea.
So I gave her the three freaking out Alcohol detoxers, the violent mental health patient arguing with the bed (still waiting and waiting for days to see the mental health people, dumped in medicine meantime), the pancreatitis who couldn't get a bed in ITU, the COPDer who was going down the tubes and the wanderer with dementia*. Hey that's only a small group of patients! I took the other 18.
I'm just kidding. I took them all and put her to work with the 2 HCA's. At least she was there to do the controlled drugs with me. Nice woman anyway. There were 2 staff nurses and 2 HCA's with the addition of the nice SCBU nurse.
They got me all excited thinking that I was going to get a second staff nurse to take the other team of patients. Then I find out she was from SCBU. It felt like getting coal in my stocking on Christmas morning.
I guess this was preferable to me getting sent to SCBU. I'd run away from there screaming.
I got through the shift with my sense of humour intact. Lucky me it was only an 8 hour shift and I got out of there 10 hours after I started. The next day I took my kids to McDonalds for a very once in awhile treat. They think it is a treat, I think it's just gross.
It wasn't even McD's busiest time of the day and they had 9 freaking staff. Let me rephrase that: McD's had 9 fucking staff on. All at once. That is something that you will never ever see on a 25 bed medical ward, or even the 35 bed one. I nearly threw my diet coke across the room. I bet they don't leave new starters alone to run the place either.
Just needed to whine a bit. I have to hold it all in and smile pretty at work.
* patient details changed. Confidentiality has not been breeched.
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8 comments:
form your blog it seems that you are the only staff nurse one quite often Do you double check your IV's?
No we usually have 2 staff nurses for 25 and we do try and check IV's and insulin. The SCBU nurse is an RN so checked things with her.
Bloody hell.
Did Satan ride to work on a snowplough on the day the evil bastard management gave you an extra nurse?
Glad you were able to keep your sense of humour!
Re. the patient with mental health.
Contact your local crisis team and ask:
Do they know if he/she has a care coordinator?
Can they come up to assess or liaise the situation?
Can the MH liaison nures or, God forbid, the psychiatrist (staff grade - Consultants rarely leave their safe offices or clinics) pootle over for a looksee?
It may be pissing into the wind but if the patient is well known to MH services and has a severe/enduring MH illness, it's very likely they have a care coordinator who should drag their arse over to see 'em.
Also, you state "violent MH patient". Is this historical or currently happening? People outside of MH tend to imagine the worst and young males with schizophrenia, history of aggression and 'lookin' odd' often equate with medical ward staff to 'mad swinging from the chandeliers waving an axe and severed heads getridofthemnow!!'
But for you to do your job properly you do need some support or guidance from MH services.
We often get called up to the wards to assess deliberate self harm, but also to liaise. i.e. Bonkers Bob who lives on the street, drinks heavily and talks to his imaginery pals is plonked into a medical bed. His fragrance, clothing, and foul language are already winning him friends and influencing people. His paranoid ravings and discussions with non-existant friends will put the cherry on the cake for the staff and other patients. Someone like that would be an eye opener for a SCBU nurse!
I wish you luck because I know from experience that it can be pot luck when you phone the crisis team as to whether you'll get the helpful team member who'll wander up to chat with the patient & staff or the numpty not my jobs worth who will politely tell you to bugger off and let them get back to painting their nails.
I do wonder whether any senior management ever give a thought to their own & loved ones' health and future use of medical facilities.
Have you ever asked a manager "That could be your mother in that bed. Is this the care you want for her?"
Great blog & required reading for all in the NHS.
The old mental health patient on the medical ward issue.
In a nutshell: No one does a fucking thing. Ever. Have tried all the suggestions you have made on here.
I have about 7 blog posts in the pipeline and I am getting around to that one.
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