I went to work: 14 surgical patients. The nurse assistant called in sick and they couldn't find a replacement for the first four hours of my shift.
The day didn’t start out great—-and soon got worse.
That day I asked the hospital cleaning crew to mop up some fresh vomit. "We don't clean up body fluids," she replied. I tried to borrow her mop to clean it up myself.
"You're not allowed to use my equipment. You're not trained. It's company rules!" So I went to the cleaning cupboard to get some equipment to clean the mess myself. But it was locked and the cleaner wouldn't open it for me. I ended up using a towel to clean up the vomit.
Then a patient slipped from his chair, and I found him sitting on the floor… asleep. I tried to find a nurse to help me sit him up, but couldn't find one in the immediate area. I asked the cleaner to help me sit him up.
"We're not trained to do that. It's against company policy."
My anger swelled. "I don't give a damn what your company policy is. Show some bloody compassion and get over here and help me." My appeal worked, as we helped the patient up off the floor.
Where were the other nurses? I wondered.
When I think of this type of sagging medical care in hospitals, I think back to Mr. Smith. His breakfast tray was always left out of reach. I'd come over from my side of the ward (I didn't have the time, but I did when I could) just to feed him. Every day he got weaker, more dehydrated. The infection spread throughout his lungs. He just stopped breathing one day. If he wasn't left in bed or in a chair all the time, maybe he wouldn’t have died. If there were enough physical bodies to just get him going, I'm sure he would have made it.
Managers and government people are always trying to find ways to improve hospitals. They set goals, devise plans, install new systems, but they never work.
Frankly, I think we just need more bodies to do the basic work of a nurse--which is simply to care.
Is anyone out there listening? Do you agree? I'm not the brightest or the most knowledgeable. I just want a chance to be heard. And I think I can make a difference. I think you—a new nurse—can make a difference, too.
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December 10th, 2008 at 6:31 pm
I’m not a new nurse, but I agree with you 100% I can remember when I was in nursing school and I was caring for a man who had dementia and even though he had bathroom privileges; the nurses didn’t have time to get him to the bathroom, so they would give him a bed pan. He had water just out of reach near his bed, and couldn’t drink without help…when I put the straw to his mouth, he drank like he just came from the desert. His lips looked parched and were cracked and peeling. He was really mean and would say horrible things to the nurses…he smelled and was in bad need of a bath. I decided to bathe him…I did that as well as washed his hair and picked the thick dandruff out of his hair, I shaved him and clipped his nails…when I was done, he actually cried. He had a moment of clarity of his mind and thanked me for taking the time to care for him and make him feel human again.
I don’t think the nurses were horrible people, I think they were over worked and short staffed and that makes for very bad situations and makes it easy to justify ignoring a cantankerous old demented man. That, however, does not make their actions right. Something should be done, though…and I do agree that if it weren’t about the almighty dollar, and we could have more nurses caring for patients, there would be a lot more wellness and healing out there. I was actually taught in nursing school to give massages to my patients…unfortunately, nursing school was the last place I had time to actually practice that art of healing!
December 10th, 2008 at 7:50 pm
I work as a charge nurse in a 40ish bed skilled nursing facility, and I definately feel your pain.
I’m occasionally responsible for sending a CNA home when our census is low, and it kills me to do it because there’s barely enough labor to get everything done as it is.
It’s most noticeable when it’s time for meals and AM/PM care. We have a good mix of rehab and long-term patients there, but sometimes the CNAs have to park the dementia patients in the hall next to our nurses station just so there’ll be someone there to make sure they don’t fall out of their chairs.
I think on the whole we provide good care, but there’s lots of room for improvement, mostly because our labor is spread so thin.
One measure I’m trying to pull together to ameliorate this is bringing in volunteers. I have a couple friends planning to come in to meet the diversional needs of some of our residents. The reason I think this will work really well is that the volunteers themselves will find this therapeutic just as the residents will. One woman is a medically retired nurse who would love to bring her caregiver and dogs in to our facility to spend time with the residents. Another is a dear friend who just lost her father and wants to volunteer to talk to people for the same reason she goes to support groups for people who have lost their parents.
Obviously we need more nurses, that can’t be disputed, but the shortage is so acute now that if there suddenly WERE more nurses, they would open up more facilities instead of improving our staffing. In our diligence and creativity we’ve shown the health care delivery system that we can make do with “Acceptable” losses. Acceptable to the insurance company, not to us.
December 10th, 2008 at 8:00 pm
When the economic crisis hit the first thing the hospital did was herald a hiring freeze. To hell with staffing by accuity. Then – no more agency nurses. If someone calls in sick – the department can not even call up another nurse to take their place because there is no more overtime. PCT is a no show – too bad. Share the wealth. Not a very good first impression to give a hopeful new graduate. Especially after the dog and pony show about patient care being a number one priority- and how this establishment really values its nurses.
December 10th, 2008 at 10:43 pm
Yes, this is true. I am fortunate that this is very infrequent on my unit.
I work in rehab and a lot of my work isn’t glamorous TV soundbite flashy, but as the director of my program called it, rehab is “real nursing”. I feed people, I turn people, I give baths.
My favorite part: I teach people how to live with their various disabilities. People thing rehab is depressing, but I think, in this light, it is very rewarding. We can’t change what happened to someone, but we can change attitudes and how we do things.