We lucked out times two the other day. First of all we had 3 staff nurses on duty. Usually that would not be enough. But something else happened that was lucky.
The same random force that can throw all critically patients at you when you are more short staffed than usual can also throw all stable patients at you when you are well staffed.
Actually there was a third lucky thing that happened. The bed manager will usually float a nurse away to another unit if we have more than 2 on duty. But she didn't on this day.
Only two people were on IV meds. No one was acutely ill.
Since there were three staff nurses we decided to put one staff nurse for each group of 14 patients with yours truly in charge and coordinating.
This allowed the staff nurses to get on with the care uninterrupted while I sorted the doctors rounds, the phone calls and intercepted any interruptions before they got to the primary nurses. I answered call bells, assisted the HCA's and made sure that the primary staff nurses were left alone to concentrate on their drugs and the rest of their job. I got their insulins and IV's out of the way for them to save them time. I helped the HCA's with daily care.
I babysat a confused and wandering patient to keep her from escaping to the motorway on foot and half naked yet again. The previous day when there were only 2 staff nurses on it took them until 11:30 AM to get all the 8 AM meds out. On this day because I was there to intercept interrutpions and deal with problems they were done at 09:15 AM.
When our main consultant showed up for his round I approached him, introduced myself as the nurse in charge and told him that I would be attending the ward round for the whole ward and I knew all the patients very well. I had done two night shifts recently and had time to read all the notes etc. He looked surprised. I explained that I was an extra nurse today so we are coping well, and that there would be two staff nurses on the ward attending the patients while I was on the round (which takes 1.5 hours). He was really pleased.
I like going on the ward rounds. It's easy to trail after the docs and answer questions and take notes. I won't even consider attending if it means I have to abandon my patients for hours without having another RN keeping on top of their care. That is just hasking to get hauled before the NMC. I always learn a lot from ward rounds and it helps me get a better handle of what is going on.
Not only did we get everything done but we got it all done well. The patients were happy and the next day a relative gave us a beautiful thank you later. We even had lunch midway through the shift. That was cool.
Just one extra staff nurse and lower acuity allowed for this!
We have approached management asking if we can always have a senior nurse in charge and coordinating every shift just for this reason. Two words: Shot down.