Need to vent....

Well.. no happy joy joy post today.... I'm so distressed that I have GOT to write or I'm just gonna stew and make it worse....

Well... along about July last year, our hospital began to respond to the downturn in patient flow and did the right business thing and froze hiring and closed one unit and had several more layoffs. of course, during the first round of layoffs, I became the Unit Coordinator... mostly because my old job ceased to exist. I had filled in during the summer and they offered it to me. All well and good. I'm glad to have a job that is M-F days.... By October, the census had NOT picked up.. and especially for us, we were seeing a SIGNIFICANT downturn in census... More layoffs and continued hiring freeze, except for critical positions..... such as RN's. We stayed low during November and December.... even so low that we ended up downstaffing and floating so often..... I ran out of ETO because of time off. Then came January.

As we predicted, people finally got so sick they couldn't wait.... census has been HIGH for two weeks. We have been running 25-32 patients for the whole time. Oh... yeah.... remember, we are now staffed for 20 patients. Do the math... it adds up to me having to take patients almost all of the time, not to mention trying to keep up with comings and goings of those 25-32 patients.... several on isolation (which is a big PIA because they HAVE to have private rooms.... and yep, out of our 40 beds, only 2 are in privates.... ).... oh and did I mention that we have had FOUR patient care techs leave since January 1st.... three have become RN's and one went to school somewhere....... (and we can't hire).... AND... we have lost THREE secretaries (out of FIVE) since the beginning of the year too..... do the math on that one too.... we should have one secretary 7a-11pm and double coverage from 11a-7p AND 7a-7p on the weekends.... (and we can't hire...)

SO... we are only staffed for 20 patients.... we've LOST this many people in the last two weeks and can't replace them..... so that means we are actually STAFFED for about 16 patients.

To add fuel to this... we have this flex staff pool which is wonderful, however, if you don't post your needs, you can't get them filled..... well.... I had no way to get to it until Monday... so I have DOZENS of unfilled shifts... and just a couple filled... literally. Oh, and many of the nurses in the flex pool have gone and found other jobs because they were not getting hours.




SO, today, I lost it.

it was about 2:30... I had 5 patients all day, took a post op at 1315..... making 6. Yeah, all the other nurses had 6 too. AND we only had two techs and a nurse working as a tech.... Then SICU called with a transfer (I had called earlier in the day after I knew the docs had rounded and got "nope, no transfers today... " I knew we had three patients in SICU to come out sometime and ALL were on isolation... so I wanted to plan ahead... SO... the Clinical Sup there called me around 1415 and needed to get a transfer out right now. I had no bed, would have to move people to make a bed... but had three discharges and if they could wait a bit, then we wouldn't have to move someone. I told her I'd call her back when I found out when the patient was going home.... I had no way of knowing.... I couldn't even get all of my crap done with MY patients let alone keep up with who was going home when..... PLUS, it was time to make assignments and I got NO help in the float pool.... so I had to figure out how to have 5 nurses, 2 techs and one secretary (who was working OT on her birthday... because BTW, our day secretary had been working SICK for 10 days and ended up in the ER yesterday to have a peritonsilar abscess drained!!!) take care of like 29 patients. So I called the manager of the day... to see if I could pull the PCT who was orienting to be a US off to be on the floor.... I about lost it.... but was trying to be OK.... then Jana (the House sup..) came around and was asking when I could take the patient from SI... this was about 1435.... I had already made arrangements for the patient to be moved to make a bed... and told her that was my plan, but hadn't called SI yet because it'd only been like 15 minutes and I had a gazillion things to do between things.... so she was on the phone with SI... and they had sent the patient to NI!!!!!!!!!!!!!! Per Jana "she freaked out".... and "had" to make a bed for a heart... that Jana had just told me was still 2-3 hours from being done.

I lost it.....

I felt so out of control... and I hate that feeling.

And Steph and Barb came to help me... but they were so busy too.... they still took the time to take care of me... the bad part is that it is MY JOB to TAKE CARE OF THEM.... that is my role... I should be making sure that THEY are OK and have the tools to do their jobs.... I can't DO THAT if I'm overwhelmed.....

I don't know how much more of this I can take. It's got to let up. OR, I have to let go somehow. I don't know how. I have let go of everything that doesn't matter.... and there is still too much on my plate at work.

The managers and director have done everything they can, but it's not helping. And during all of this chaos today.... they were either in a meeting or dealing with ICU issues.... I know the units were getting hit hard.....


SO... if you got this far... please send me a positive thought for peace... and perseverence.


I'm also on call this weekend. yep. joy.