Sunday, 13 December 2009
Nurse Anne Gets Owned by a Consultant PART 1: The Intro
Argghhh. I hate it when we get moved off of our ward in order to staff one we are unfamiliar with.
Yeah yeah I am fine. It's been a long time since I got verbally murdered by a doc. I have been a nurse a long time, I know how to treat a doctor with the respect she deserves (at work anyway) and I know how to get things done and done well in less than ideal conditions. I never have any run ins with the physicians. Of course all that applies to the specialty I work in currently and most of my career. I am a general medical ward nurse. I can handle general surgery basics as I spent a few years doing that. But anything else and I am out of my scope of practice.
Nurses do not graduate from nursing school knowing how to work alone in every speciality. That is impossible these days. Impossible. If they wanted to graduate nurses with that kind of knowledge they would have to keep them in nursing school for ten years.
Definiting of Floating: Floating is when a site manager has 3 nurses on one ward and 1 nurse on another equally large floor. They will send one of the three nurses from the first ward to cover the second. This is the case even if it is an area that she has no experience in. They are covering their asses and putting the patients at risk and the nurse's license at risk when they do this. The NMC tells us that if we are asked to do this and feel that it is unsafe we should refuse. The hospital bosses tell us to float or else. They will not accept our explanations as to why it is unsafe. They think nurses merely make beds and bedbath and feel that we should be able to do that anywhere. Refuse to float and your job is on the line. Float and your license and your patients lives are on the line.
A medical nurse who has only every worked medicine would be like a fish out of water on a surgical ward. A surgical nurse who gets sent to medicine for the day would be out of her depth. Sending me to ITU would be like signing death warrants for those patients. And when they send ITU nurses to general medicine they are in tears over trying to do a drug round for 20 people. In tears. They cannot handle not be able to assess patients properly and dividing their attention between more than 2 patients. An RMN cannot function on a general medical floor. The powers that be tried to use an agency RMN to take a side alone on my floor once. I would not know where to even begin on a psychiatric floor nor am I at all familiar with the drugs they use etc.
In the USA they staff their maternity floors and psyche floors with registered nurses rather than midwives or RMN's and have been known to float those people to work in charge on medical floors. Not safe. Those nurses may be registered nurses but if they are working in maternity and psyche they don't know dick about working on a medical floor and vice versa. They are no longer familiar with those drugs, the diagnosis, the interventions that those patients need etc. It's a mess. But floating is what hospitals do to try and cover up the fact that the staffing ratio matrix that they use is a joke and it is what they do to cover up the fact that their lack of investiment in hiring and retaining people on the frontlines is a total fail and it is murder.
I arrived to work one tuesday morning to find that there were three of us-registered nurses- to staff my large medical floor along with 3 care assistants. Not enough but better than the usual.
Then the phone rang. It was the site manager. "One of the trained nurses has to staff a surgery suite for short stay and day surgery. There are just not enough beds and many elderly medical patients who came in overnight ended up in beds on surgical wards. Those beds were earmarked for incoming surgery patients. We are putting the incoming surgical patients into this thing we opened up on the third floor and praying that some of the beds on wards are vacated by the time they come out of theatre."
Oh shit. This sounds like a clusterfuck in the making. The other two Registered nurses I was on with (Julia and Kate)had both floated recently and it was my turn to go. Yesterday Julia was sent to staff a bay for overflow a&e patients. She started work at 0700. She was due to finish at 3PM. No relief showed up for her as the site manager had no one to send at 4PM..
It is illegal for Julie or any registered nurse to leave until she could hand over to an incoming RN. If there is no incoming RN you are legally mandated to stay even if your pissed off babysitter is about to walk out on your 2 year old because you are late. If you don't stay it is patient abandonment and you will be struck off. She was there until past 7PM. That is when they finally send her some relief. She will remain unpaid completely for those extra hours. She was not keen to have another go at floating now that her childminder walked out on her for picking up her kids 4 hours late. Julia may not have received payment for those hours she was legally mandated to cover unpaid. But she still had to pay the childminder.
Kate had also recently floated. She had been sent to colo-rectal surgery. She had 12 patients there and failed them all because she didn't know that area of nursing nor did she know the floor. She was just dumped down there with no support. This is what happens to us when my ward sister staffs my ward with 3 registered nurses. One usually gets sent away.
Nurse Anne on the other hand, hadn't floated in months. So it was my turn to run up to and staff the clusterfuck hastily put together "surgical suite".
Let's set the scene even more. They hastily opened this place to take overflow surgery patients who were all scheduled to have their ops today. The place wasn't prepared, there was no notes, I don't really know the routine with surgery any more or how to prep the patients excactly. I didn't know where anything was. And I was alone up there with an agency HCA who never worked in a hospital before.
And I don't know a goddamn thing about gynaecology anything. Not a goddamn thing. Not at all. I don't even think we ever really covered that in depth in nursing school. I never worked in gynae in my life. I have female bits and I know where they are. That is the extant of my knowledge about gynae. Just to reinterate, I do not know the first thing about gynae.
And this is where it all went to hell.
But how badly can you screw up with a short stay gynae patient? It's not like it's coronary care right?
Will continue this later on.