Sunday, January 08, 2006

The jig is up.

WARNING: boring girly stuff ahead. Nursey stuff later.

Beloved Sister has actually set a date (well, she has to re-set it, because of the conflict of a football game that weekend) for The Wedding. Which means, apparently, that she's actually getting married.

Which means that I have to start trying to look less like a fuzzy-headed, rather plump, goggle-eyed mouthbreather and more like something she would want in her wedding pictures. I am not too proud to admit that I don't particularly look forward to resembling a Russian peasant in a bridesmaid's dress, either.

So I'm joining Brooke and Eileen in the Great Weight-Loss, Weight-Lift Hoo-Ha of 2006.

Lest you think I'm totally girly, I had a revelation the other day when I tried to lift a patient out of a chair with only one other person helping. I've gotten so out of shape that it left me panting. I am no longer strong enough to do my job well, hence the weight-lifting part. *sigh*

On to the nursey bits.

I got floated to another floor. This in itself is not unusual; we often float nurses between floors at 11 am or 3 pm depending on staffing.

What was unusual was that I got floated to a fully-staffed floor.

The nurses had gotten so far into the weeds in the morning that they needed a runner in the afternoon so they could finish their charting and so on. I started an IV, took a few blood pressures, sat with a one-on-one patient (well, he was sound asleep, so I watched "Animal Planet" for a while), and picked somebody up off the floor (more about that in a second).

They'd already gotten one floated nurse; she was the only one who had gotten everything done and didn't need a hand. Now, this floor isn't known for its general efficiency and poise, but I didn't realize things had been so bad in the morning that only the person used to being sharp would actually be on top of things.

To boil it down: the nurses on the floor I floated to have such poor time-management skills that they needed somebody to save their collective asses midway through the shift. That somebody was me. Staffing was happy to float a nurse, at $Outrageous/hour, to be a dogsbody and general factotum.

I was not thrilled. My floor has the highest patient-to-nurse ratio of the hospital on a regular basis, mostly due to short-staffing. We routinely float nurses to other floors so that somebody else can go home (overtime issues, usually). We complained when the first staffing grid came out and got cut by one patient per nurse, so we were each handling five high-acuity patients on day shift. After that, complaining didn't help, so we all got very, very fast and efficient. There is little screwing around on our floor. If you have a patient with an open ventriculostomy (ie, we're draining out brain juice on a continuous basis), one with a lumbar drain, one with seizures, and two knee replacements, you don't have time to chat.

There was nothing but screwing around on the other floor. If you haven't been able to complete paperwork you got at 10:30, and it's 17:00, and the paperwork consists mainly of vitals and allergies, there is a problem.

Things came to a head at ten 'till go-home. A woman came out of a room to inform us that her husband was sliding out of his wheelchair. Nobody moved but me and one attending, an extremely elegant and disciplined woman in very high heels.

We untied the Posey vest that was strangling him, manhandled him back to bed between us, and then left the room to go back to the nurses' station, where four nurses were still sitting, staring at us like calves at a new gate.

I almost said something snarky. Then I remembered earlier in the day, when I actually needed help with a combative patient who outweighed me by about 100 pounds. I had yanked the call bell out of the wall, setting off the emergency call. And I waited, trying to keep the patient from either doing himself or me an injury.

Ten minutes later, after I grew as many arms as an octopus and managed to get him restrained, I walked out to the nurses' station and turned the emergency call light off myself.

To say I'm bugged would be an understatement. I don't mind helping out when people have a truly bad day--I've been almost in tears myself a few times when coworkers have come to my rescue. But I do mind immensely getting stuck with the cleanup when a bunch of folks've been doing their nails all morning.


shrimplate said...

Hats off to the attending that helped you get posey-man back into bed safely. She must be something else to do that in stilettos. Cool.

It's a tough job. But you're tougher, obviously.

Brooke said...

Rock on.

Anonymous said...

Jo, you get extra money for floating?? I'm jealous! When we float, it's always to the worst possible floors, and get dumped with the most difficult patients. What's your nurse patient ratio? Sounds like 5:1. Do you have a tech or CNA to help out, at all? Just curious. I had the impression you normally worked the ER. Enjoyed reading you.