While there are days that pass that leave me feeling strung out and overwhelmed, the past few weeks have not. Our 'census' as they say, has been low- meaning that our floor is not full. We have a maximum capacity to care for 18 patients - but last night we had only six.
From a nursing perspective - this translates into two things: 1. an easy night, in which we are able to truly care for our patients and not just make sure drugs arrive on time or 2. a phone call, an hour or so before we wake to go into work to ask if we want to stay home- take 'benefit time'.
This is a piece of working that I have never experienced before, and is rubbing me the wrong way. While I don't want to use up all of my vacation time on unexpected days off, I feel useless going in when there are 3 nurses for 6 patients. It leaves me feeling not-needed, which is a slimy feeling.
I worked this Saturday - which followed the week's trend. I started the day caring for 4 patients (my maximum is five on a day and six on a night) but sent one cute old man, all wrapped in blankets, to a rehabilitation floor, and sent one young Arabic man on his way, home with a prescription for percocet and a sheet of instructions. By 3pm I was left with only two patients. One man, hospitalized for the um-teenth time for a chronic infection of his sweat glands (yes, sweat glans appear in the most inconvenient places) seemed to catch on to how the day was going as I once again appeared in his room to check in: "Are you having a slow day? Because no one has ever seen me so much in one day?" I sayed calm. "No, this is just the way I practice nursing. I'm attentive." Ok, so part truth, part lie.
Meanwhile, WBUR, our local NPR station has run a 3 part series on "The Nursing Shortage: Inside out" - In it, they describe the multifaceted problems facing the nursing profession, not the least of which is overwhelmed nurses with 8 patients, feeling that there practice is unsafe. They shared the statistic that a patient who is cared for by a nurse that has 8 patients is 30% more likely to die than a patient who is cared for by a nurse with 4. It is a piece worth listening to:
http://www.insideout.org/documentaries/nursingshortage/index.asp
I suppose rather that get upset that the floor is slow at the moment, I should be grateful that I can give my patients what they deserve throughout the day - I am able to not be a drug pusher and wound binder, but a real nurse. The Florence Nightengale way.
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