Nellie's Shift

Nellie volunteered herself to do an extra shift on her day off.


There was only one nurse for the ward that day and that is dire. Beth was to be that nurse and she was freaking out about it. Nellie said that she would come in and work the day shift.


It was chaos. Thank god Nellie came in. A childminder may be able to set a limit on the number of people she looks after but a nurse cannot. A childminder cannot have additional children dumped on her with no warning, on top of her other charges. But we do this to nurses and expect them to function every day. Otherwise, they would have to close much needed beds.


Nellie and Beth had a crap day. Half the patients were acute medicals with massive amounts of stuff going on. The workload was unreal. The other half of the patients were 100% dependent elderly patients.


I would feel safer leaving my 9 year old unattended on a ward than my 98 year old grandmother. My 9 year old can follow directions, ensure his own safe environment to a point, ask questions, communicate, remember instructions etc. He will not throw himself on the floor, or try and eat his own faeces. He will not forget that he has a broken leg and try and walk to the toilet. I am not being disrespectful to people with dementia. I am explaining to you the facts of their condition and why they need so much care, rather than an overwhelmed nurse who cannot be there.


Your average person will go on and on about how they cannot help grandma in hospital. But if it was his or her 9 year old child, their arse would be parked on that ward 24/7. Visiting hours. On my ward we will let you stay as long as you behave. But no one wants to stay with grandma. They don't have the time. If it was their 9 year old child hospitalised they would find the time and not leave his side. Yes but it is the nurses who do not care. Right.


Nellie and Beth had a patient go into cardiac arrest mid morning before they even finished the 0800 tablets. It was a bad one. I am so glad I wasn't there. I would have freaked the fuck out. Cardiac arrests are the norm on medical wards. But when it catches you unexpected its like someone sticking their fist into your stomach and pulling all over your guts out and stamping on them. I cannot describe how I feel in those situations any better than that.


At 11:00 hours Beth needed to go in and talk with the now dead patient's family. This left Nellie on the ward. Alone. By 11:30 she had got through 5 of the 13 patients that still needed their 0800 meds. She was focused. She was rushing and nearly made a massive medication error but luckily she re-checked and she caught it. She became even more focused. Medication errors kill thousands of people in hospitals every year. Many (some say most) of these errors are caused due to the nurse being interrupted and or overloaded. It's a big problem.


There are mountains and mountains of individual drug charts each with many different medications prescribed on them and every single thing on those charts needs intense scrutiny. It took her until after lunch but she sorted the mess out. And it was a big mess. There was a lot of other things going on as well that only a nurse could deal with. She could hear the weeping and wailing from the family room, and knew that Beth wasn't having a good morning either. Only 3 HCA's were trying to hold down the fort basic care wise. They managed to bedbath and wash every patient who needed it. There were 15 patients such as this who need at least 15-20 minutes each if you are going to do a half ass job. Before they moved onto their next patient the previous ones were crying out again. That it. Two nurses (one with a grieving family) and 3 care assistants with a whole entire ward of patients who are more dangerous on their own than a young child.


A few weeks later our manager received a complaint to respond to. The reason for the complaint occurred on the day and the time of Nellie's extra shift. It went like this.


"I visited your ward on such and such a date around 11:30. I was appalled to see the condition of the patients. Call lights were not being answered. There was a lady who did not have any shoes on and she was sitting out in her chair. Her bed was unmade. Nursing care has really gone downhill. The nurse was in the middle of the ward staring at a trolley, oblivious as to what was going on and did not appear to care anyway. Her name was Nellie Doe. I looked at her name tag. I believe that if matrons came back to hospitals nurses like this would be dealt with."



True story. It's really not funny. This is getting beyond a fucking joke.



Thanks for coming in on your day off and working your tits off Nellie. I doubt you'll be suckered into it ever again.

Fact is, this is the kind of bullshit that the complaints department has to wade through on a daily basis.

I have a friend who works on a medical telemetry floor. The nurse's station is in the middle of the ward and their are monitors all over this station, displaying patient cardiac rhythms. That is telemetry. The patient wears a device that sends a reading to these monitors at the nurse's station. These monitors need constant monitoring. Sometimes you have a few patients to on telemetry and a staff member to just sit and watch the monitors. Some times most patients are on telemetry and you have no one to watch the monitors. Leads need to be printed etc. A missed assessment will kill on there.

My friend who works in telemetry reported that they are always getting complaints from visitors about "the nurse's sitting at the station watching TV's. Why do the nurses need those TV's? Why can't they look after the patients instead?"

Documentation and Computerised charting is essential, ESSENTIAL to patient safety whether we like it or not and there is a hell of a lot if it that needs to be dealt with for all your patients, during the course of the shift.

"Why are all the nurses playing on the computer rather than looking after the patients".

Yes, this is the kind of bullshit that the complaints department has to deal with. No wonder the real complaints don't get deal with properly.

So who thinks we will talk Nellie into taking on another extra shift?