Saturday, September 28, 2013
Who has been sleeping in my bed?
On the psych ward, a census is taken every half hour. The assigned staff member must look at the patient long enough to confirm that the patient is alive and not in distress, and then indicate where on the ward the patient was at the time of the census. The purpose is to quickly uncover elopements or problems.
On my psych ward, it's a source of conflict, which you should not be surprised to read at this point.
Customarily, the night shift prepares an accurate list of patients and rooms to present to the day shift to begin a new 24 hour form. In reality, when patients were discharged, admitted, or changed rooms, this took days to be reflected on the census. Arguments ensued.
As a remedy to the accusation of an inaccurate census, the night shift stopped preparing a new form. The day shift now takes about an hour to try to figure out how many patients are supposed to be on the ward, their names, and their room numbers.
It's a real risk to my license, taking on a chaotic floor with an estimated number of psychotic patients and an angry mob of attendants.
I was back on my usual ward after a few days off. In my absence, the census had grown wildly inaccurate. I pointed out to the outgoing night shift nurse that she had signed off that the census was correct, even though at least ten of the patients listed had been discharged over a week ago.
"It's nighttime," she explained. "The patients are sleeping. What do you want me to do, pull back the covers to see who is really in the bed?"
"Yes, that is exactly what I expect," I answered.
"That is not how the attendance works," she persisted. "Think of it as confirmation that someone is occupying the bed. Who it is, you shall find out in the light of day."
As ridiculous as this sounds, she gets away with it. Every time.