March 4, 2011

Mass Chaos

Time is apparently getting away from me...I don't think I've ever been such a slacker about posting! Work has continued to be chaotic. We are short staffed, we have mandatory call, and even with the call schedule, we are still short staffed. One night a couple weeks ago, we had 3 labor nurses on...and started the night with just a couple laboring patients. Then the gates opened and everyone, and I mean everyone, came in in transition! I think we had 6 admissions, all wither 7 or 8 cm. About the time I was unplugging the bed to take one of my patients to the OR for a c-section for failure to progress, another mom came in, 33 weeks, complete and breech. So mine got bumped and we had to rush to get her prepped. By the end of the am, no one really had assigned patients - we just went to each room, doing what needed to be done. "Ok, she needs an IV, this woman is waiting for an epidural, this room needs an exam to check for dilation. It was unsafe, but the charge nurse on that night did everything she could to get us help. But no one answers their phone at night, except one day shift nurse who came to help, but we needed about 2 more nurses with what we had going on. I can't remember the total number of admissions/deliveries/patients that night, but it was unsafe patient loads. At one point, the anesthesiologist that was doing the c-sections/epidurals we had going on was just standing at the desk, waiting for them to get our second OR up for my c/s that was bumped for the breech 33 weeker, and it was getting crazy, with patients needing things right now. So I handed him the lidocaine I had pulled for an IV start in one room and said "Here, help me, start her IV in room 6". He said "You can't get it?", to which I said "Well, I have to go into room 3 because she is going to deliver right now, and that patient needs her IV and wants an epidural, plus my patient who was bumped needs to go to the OR once they get it ready. If I could clone myself to do it, I would, and I don't think you want to go be the labor nurse & nursery nurse for the patient who is delivering. Please help". So he did. Patient delivered, baby was skin to skin with mom (love it! we're trying to do that more and more), give quick report to a post-partum nurse who was back to help with the recoveries, and out the door I go to help with the epidural for the patient I sent anesthesia to see to start her IV on. Epidural in, charge nurse comes in to monitor patient for 20 minutes after the epiural and I head back to the OR with my patient. It was crazy. The house supervisor had come up and was trying to help, but unless you work in OB, there's not much you can do but start IV's, and answer call lights. If one more thing would have come in, I think we all would have crapped. But we survived the night, patients delivered healthy babies, they didn't have great nursing care, but we really did the best we could do and tried our best not to look too harried! All my charting from midnight on was done after passing off to the dayshift...I didn't get home and to bed until about 10am. We need more nurses, but no one seems to be able to pull any out of their arse. Hopefully management will figure something out, but unless we get some experienced labor nurses in and fast, I have a feeling this will continue. February is statistically a SLOW month for us, has been the slowest since I worked there, so who knows what the rest of the year will bring!

5 comments:

Scribe said...

Wow! I can't imagine... sounds like a goat rodeo! I miss the days (long gone) of enough staff to give the kind of care we were trained and WANT to give...

I would love to come work with you... my hospital shares turf with another and the tides have switched and we have low census right now... I've been having to float to ER to get my hours... was in NICU yesterday for my mandatory call. I hope I don't forget how to check a cervix!

Jessica said...

Three nurses!?!? No wonder you were drowning!!!

Also...you use lidocaine to start your IV's?

Nurse Lochia said...

Yep, we use buffered lidocaine for IV starts. It's supposed to be house-wide, but there are a few nurses out there that still think it makes IV starts harder (I think it makes it easier) and that it isn't worth it b/c it's 2 sticks. (it makes a BIG difference. I actually convinced an OR RN a few years ago to use it b/c I just always use it, and she said she always thought it wouldn't help, but she didn't even feel it. I love using it, and it really decreases patient anxiety and increases patient satisfaction. I'm a big advocate for it, if you can't tell!

Jessica said...

I had a CRNA show me how to do it...I'm gonna try it! =)

Mrs. Mama said...

i'm an RN as well... and know this story too well...staffing is a huge isssue.. and unsafe scenarios do come up