Friday, May 23, 2014

Night shift

I swear...night shift gets no love. Last week I worked a shift where we were severely understaffed - I'm talking there were TWO nurses from 3a-7a. This ER has been getting busier and busier, so of course this was a slamming night. Want to know about unsafe patient ratios? Try sixteen patients for two nurses. 8:1 ratio. That translates to 7.5 minutes of care time per patient per hour. Which is awful. Pretty much I went from triage to triage, threw in an occasional IV, and did a couple of EKGs in that time. And charted. Sort of. And because this place has no triage nurse, we can't leave people in the waiting room like a normal ER.

By the time 7a rolled around, we were drowning. I was sitting at the desk charting the three new triages and one EKG I had done in the last 10 minutes, and the dayshift charge grabbed the staffing clipboard to fill out the assignments for the day. "Oh man," she sighed, "we're so shortstaffed today! There isn't a float to cover lunches, this sucks!"

The other night nurse and I just looked at each other. Or we would have, except she was taking up her own tele admit since we didn't have any techs.

I would be pissed, but it won't do me any good. We'll continue to be dangerously short staffed on nights, because administration needs to cut costs and nights are where it comes from. We'll continue to get burnt out on nights because we do the same amount of work with a fraction of the staff. I'll continue to blog about it because I'm just a traveler who gets pulled aside to ask why I took an hour to discharge a fast-track patient instead of congratulated for making the five minute EKG time even though I did an entire nSTEMI workup myself.

On the plus side, free pizza almost every night. And free diabeetus...


Aesop said...

Short of staff on the nights before a three-day weekend??

Say it isn't so!

(I'm betting it's the same people calling off sick before every other three-day weekend, too.)

What keeps me from travelling is crap like that, if I ever travel beyond the land of Mandatory Patient Staffing Ratios.

(They still hose us here too the same way, but at least there's the vague outline of an actual legal statute - which management treats like the Pirate's Code: just guidelines, really - they have to break to get there, which slows them down a bit.)

It amazes me how, when push comes to shove, the patients on nightshift get thrown under the bus by management 12 times out of 10, since we all know nothing serious comes in after midnight, right?

Anonymous said...

I'm guessing it's an hca hospital. They are all about times and no triage. Put them in a nice warm bed where no nurse sees them for ever because 10 others just came in at the same time but docs see them put in 100 orders that don't get done because there is nobody to carry them out. But wait, the door to doc and bed time is great for the billboard on the highway!!!

Anonymous said...

Blaaaaargh that sounds like where I'm working now.

Heaven forbid day shift not get their lunch breaks. -_-

John Green, RN, MSN said...

That sucks! All shifts need to be covered and supported. Patients are patients regardless if its 1 PM or 2 AM. I have worked at a couple places like you described and would leave wondering if everyone in my care was ok. 18 years of off-shift nursing was always greeted by day shift arriving and saving the day. As a manager I support all my team and all my shifts!