Thursday, February 12, 2009

Today It Was 0500

Here are my new thoughts about nursing staffing in general:

1. Shift change should be outlawed...because you always know that everything is going to go crazy at shift change, no matter what time it is. Everything can be smooth sailing and then right before shift change something will snap and the next shift walks in and wonder just what the @#&* the shift before them did to turn everything into a disaster. Like my ROL that walked in this morning...she was a lose 1.5 (same as she's been in the office the week before) and hurting. She changed to a very tight 2 in an hour, that's not too big of a change, but I didn't feel comfortable letting her just walk out the door. I already had a D/C order if she didn't change and she had a dr's apt scheduled for later that morning. So what is she when the day shift checks her an hour later...3-4cm. Now don't I feel dumb for not having an IV started and everything rolling! I got that impression from the day shift nurse too...after she checked her. Stamp BAD NURSE on my forehead on my way out the door while you're at it!

Babies today: 0
Babies total: 37M/31F = 68
Vag:27M/26F = 53
C/S: 10M5F = 15
Babies 'caught' = 1f

2. We're the busiest OB department in a big city...is it TOTALLY out of the question to have one nurse sit there with no patient when we have 3 nurses, one active labor, and one cervidil that we're gonna turn active before shift change plus an antepartum pre-term? A core staff of 3 is not really enough when all 3 nurses have patients, there's a scheduled c-section coming in at 0530 that we're supposed to have ready to roll to the back by the time day shift gets there and a door wide open for anyone to walk in (or 3 or 4 somebodies as happens more often than not)? I know especially in the bad economy budget is a big, bad word, but what's more important...a budget or patient care?

3. It cracks me up when we can be running around like chickens with our heads cut off on night shift and it's OK, but when day shift shows up and they have 2 or 3 inductions scheduled and twice as many nurses as night shift had, all we hear is complaining about staffing assignments. There's no point in night shift making staffing assignments because as each nurse walks in 75
% of them complain about their assignment and switch it anyway!

4. I'm tired, and I'm going to bed now so I can go back to work for my 6th shift in 8 days. I'd be in a better mood if we hadn't sat around and stared at 2 strips for, oh about 5 hours with NOTHING, and then of course at 0500 3 walk in, one is 5-6 and changing before our eyes, one is getting active, we have a scheduled section, we already have a labor patient that's 8-9cm, and I'm supposed to be AROMing my cervidil, starting pit, etc, etc. I hate shift change!!!!

1 comment:

  1. Those staffing ratios sound awful!! Just curious, how many deliveries a month does your hospital do on average? Enjoy reading your blog very much!!!

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