Wednesday, July 20, 2011

Shit shit shit shit shit. *bangs head on knees*

As I told Der Alter Jo on Monday, it's a rare morning that I wake up and think to myself, "Y'know, I really should've drunk *more* last night."

Call this a rare morning. Also, please butter my ass and call me a biscuit; I'm feeling peckish.

The Fearsome Foursome (that's us in the Neuro Critical Care Unit) have finished our chemotherapy certification course. That means that, after several hours of hanging chemo under supervision, we'll be okay to be "chemotherapy resource nurses" at Sunnydale. Our chemo unit is moving over to Holy Kamole sometime this year, which means all our chemo nurses will be unavailable without major advance notice.

So Sunnydale will need resource nurses. Which is understandable, but. . . .

There are real questions as to what our scope of practice will be. Will we act as actual chemo nurses, hanging chemo on those very, very rare occasions when somebody needs it? If so, how will we maintain our skills? What about the safety issues surrounding patient care in our unit if we're somewhere else, monitoring a chemotherapy infusion? If we're both certified and competent (two totally different things; the latter has to do with practice, the former with book-larnin'), will we be expected to pull shifts in the new cancer unit at Holy Kamole? Or are we merely meant as a "resource" in the most basic sense--somebody to call if a patient has a delayed reaction or a bad IV?

The other nurses in the unit are very upset. Der Alter Jo, who is an intensivist and neuro specialist, is understandably bothered that the specialized unit she signed up for is getting diluted in terms of duties and resources. "If you're gonna have an intensive neuro care unit, have an intensive neuro care unit" is how I'll paraphrase it. She has worked so hard to make certain that the CCU's been utilized appropriately and has gotten adequate staffing, and that the other nurses have all been treated with respect and given resources. I can see why she's frustrated and angry. The other two nurses we work with are worried about safety and whether or not we're going to screw things up, plus they're understandably upset about having to learn an entirely new specialty--jack of all trades means master of none.


I volunteered to take these worries to Manglement, provided DAJ put 'em all into some sort of coherent formal letter. I guess we'll have a meeting soon about it. (Meetings: BAH.)

Something tells me that Manglement and the neurology folks are not on the same page about what's going on. I only thought I was worried before.


messymimi said...

No words come to mind except a good, long "Arrrrgggghhhhh!"

Dr. Alice said...

I completely agree with your take on this: You can't use staff to plug random leaks. That's not how you get good care; you need to let them do what they do best. Good luck.

clairesmum said...

ditto what messymimi says!
sounds like Sunnydale wants to be able to claim they can provide chemotherapy infusion svcs to inpatients (look, we have 4 nurses, all certified!!!) so they can check off another service they offer as they negotiate with big insurance companies for inclusion in networks/reimbursement rates/competing with Holy Kamole across town. It's always about the money (or access to money) and not about quality of care or best care for an individual patient!!

RehabRN said...

This must be the latest hospital Manglement trend...making all nurses "jacks of all trades."

Our director said the same thing not that long ago.

I just don't think that rehab nurses are safe with tele patients and little training. We won't titrate drips (like ICU), but what's the chance we won't float all over the hospital at Washington just like the ICU nurses do now, so they can be sent hither and yon for stupid stuff?

It's just for the almighty dollar, which is worth less and less every day. Disgusting!

The Keyes Family said...

ahh.. I'm such a new nurse and i work at a skilled facility so all this talk about important nursing stuff makes me sad for wanting to be more of a nurse than I am. boo.. I feel like I learned a bunch of stuff that I will never see or hear about again. I need a different job.. sorry okay that's enough whining on someone else's blog. Sorry, ( sniff sniff) won't happen again. ;-)