Tuesday, April 6, 2010

Trudging along

Last night was busy, but manageable until the final hour. Someone went into respiratory distress and someone else died. The death was anticipated and the resident was on hospice. The other resident had been in distress earlier in the day, sent out, and quickly returned with instructions to not treat. (Read: no orders for DNR/DNH, so I have to hope I don't run into trouble. But I did.) I actually got her stabilized.

The problem with these problems arising at 6 a.m. is that I'm in the middle of the 6 a.m. med pass. The pass ceases and I attend to the residents. No other nurse helps me. By 7:30 a.m., I was still attending to these two issues, with only a quarter of the meds given. My three replacements were gathered at the nursing desk, eating and chatting. They could have helped. But they don't because the unspoken rule is that problems arising on a prior shift are the sole responsibility of that shift and must be remedied and not endorsed, no matter how long or involved. I was finally able to return to the med pass around 8:00. The three nurses were annoyed that I was now holding up their 9:00 med pass. They have plenty of other work they could have done instead of standing around, doing nothing.

To top it off, a private duty aide showed up and wanted to ask questions. For some reason, she decided that I was the only "go to" person and backed off when she saw me running with oxygen and other supplies. She waited in a chair for over an hour, even after the day shift arrived. I don't understand why she thought that she had to speak to the only person who was busy and didn't dare ask the three nurses standing around. She let me know how mad she was that she waited for me while I attended to my patients. So I made her madder by asking her what her questions were, listening, and then calmly referring her to the nurses at the desk.

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