Tuesday, 3 August 2010
Charlotte Gets Yelled at For Feeding a Patient.
Charlotte is a colleague of mine who is excellent at her job. She completed her training at University about 6 years ago. She is a wonderful bedside registered nurse. She really stays on top of things and will work a 14 hour day without a break to do her best to ensure that the patients all receive their treatments and orders.
Like the rest of the RN's on the duty roster Charlotte often finds herself as the lone RN for 19 patients when she is on shift. She may have one or two apprentices to help.
Just mixing preparing and administering all of the drugs due at 8AM takes until way past lunch time when you are the lone Nurse for 19 patients.
Not only is medication administration complicated and time consuming but the lone RN will be constantly interrupted by doctors, relatives, patients, pharmacy, social services, path lab etc etc during her attempts to get her patients their first lot of drugs for the day along with a basic nursing assessment. There is no break, no let up from these interruptions.
The apprentices can neither continue with the drugs or deal with the interruptions. Many medics will show up during this time and demand that the Nurse abandon her patients to follow them around on a doctors round for an hour. The doctors don't care if patients don't get their ordered treatments or get cared for by an RN. They just like to monopolise the Nurse's time for the sheer fun of it. It takes until lunchtime for Charlotte to see each patient once and administer the drugs due at 8AM. And that is if you keep it to two minutes with each patient and then run off.
On Tuesday morning Charlotte was receiving handover from the Night Nurse. 11 out of 19 of Charlotte's patient's that day were going to be unable to feed themselves. Charlotte hauled ass that morning. She took short cuts with the drugs and ignored the phone calls from families. This was the only way she would get to a point where she could obtain the ability to feed all of her patients at lunchtime.
Noon rolls around. Both apprentices are off the ward escorting patients to diagnostic tests leaving Charlotte trying to feed 11 people by herself simultanously while handling everything else that is going on for those 19 people. She was grateful that no one was really poorly at that time and that the high priority things (blood transfusions, life saving drips that need to be put together and administered) were under control by noon.
She happily commenced a serious and whole hearted attempt to feed her 11 patients. She started with the first two patients who were next to eachother and tried to feed them at the same time while telling the patient across the bay that she would be there to help as soon as she could.
Enter Doctor Hellboy. He has been told repeatedly not to show up at lunch time to do his rounds so that the Nurses can feed the patients. When a doctor arrives to do rounds he pulls the Nurse away from whatever she is doing for a good hour and a half. But Doctor Penisbreath has a lot of patients to see and not a lot of time and it is very convienant for him to show up for rounds at lunch.
But he shows up at lunchtime anyway. He doesn't care if patients get malnourished as long as they are not his patients. He walked up to Charlotte as she was feeding her first two patients, snapped his fingers at her and announced " I am here for my rounds, come on now" and he walked away expecting Charlotte to follow him. She did not. She continued feeding her patients. He went nuts on her. Absolutely nuts.
"How dare you refuse my ward round blah blah blah how can you know what the plan is with the patients if you don't attend the ward round blah blah blah".
Charlotte held her ground and was able to get most of her patients fed.
The funny thing about this particular consultant is that he has been overheard telling the complaining family of a malnourished patient "These Nurses today cannot be bothered feeding patients, they went to university you know".
What a cock eh?
Same guy declined to give his support to our ward sister when she made a case for getting extra RN's employed so we had enough to feed the patients and attend ward rounds. Therefore we could know the "plan" with the patients and get them fed as well. My ward sister was not only shot down on that request but the medical manager, chief nurse etc laughed in her face and told her she was "exagerrating the ward conditions". None of these people have been on a ward in over 20 years.
I wouldn't bother posting this if it was a one off but the consultants are pretty much on my shit list this week for these same kinds of things. And the next few posts will reflect that.