Saturday, November 22, 2014
There were many times working in the ICU, when I thought, whew! that was a heckuva night, how did we possibly make it through? But here in good old Caleefornia, our staffing ratio's only allow us a maximum of two patients per nurse (ICU). Sure, there were countless nights where I never had a break, and two crashing Septic patients can seem a daunting task to face, but still...........only two patient's. Oh, I know, they could both transfer out and you get two more, and that isn't fun.
Now, in our Out-Patient Pre & Post Procedure Unit, after 5:30pm, when 5 day shift nurses split, our "Closer Crew" of two or three nurses might have 9 Recoveries, and more on the way. So, when an Atrial Fib Ablation, General Anesthesia shows up, and the dude had an 11 & 14 French holes in his Right Femoral vein, a 9, 11 & 14 in the Left Fem vein, an arterial line somewhere, and he is squirming, moaning, thrashing, vomiting.........that's what we call a 1:1. The Doc killed the arrhythmia, now it's my turn to save the patient (from themself).
So, that means my counterpart nurses, have to watch over my 3,4-5 other patient's plus their own....and some of those folks might bleed at any given moment (usually a Femoral artery).
Good old Head Nurse, also split at 5:30, telling me that there is absolutely no way, that any of the Day shift nurses could stay over and accrue overtime, because our "billing hours" are barely enough for the day. Thus, the Day Shift nurse who was not yet done with her Surgical Pre-op Workup patient.....one of us would have to assume that little task. Oh ya, and the guy that came in 8 hours ago to have an Echocardiogram and was found to have a Hemaglobin of 6.........we can have him also, for the 2nd round of blood transfusion. That leaves two nurses watching 6 patients, but one of them is the ICU player, who just arrived (emergently) from another hospital. He is in a 2nd degree heart block, with a Heart Rate of 40, whilst being on a Dopamine drip. Since I am the "ICU" nurse of the Unit, this guy is supposed to be a 1:1, because our Unit is a simple Out-Patient Recovery room.
Night after night, we feel like Gepetto and Pinochio, having just been swallowed by that whale.
So, for some reason, after I got home and had a glass of wine at midnight, I started to think of missiles, and what they are best used for.
Another usual week
We all were abused,
By the usual players
They stand accused,
Promoting unsafe conditions
Every day, post--5:30,
When the pedal hits the metal
We roll our sleeves up
And get dirty.
Beneath our daily dialogue,
How much longer can we take this
Pushed to the curb
And thrown under the bus,
That's what it feels like
In the evening, to us.
It is stressful I'm telling you
I really don't enjoy it,
If I had a SCUD missile
I most certainly might deploy it,
Aimed at the perpetrators
Those who claim to be in charge,
Point that sucker, light the fuse
Everything improves, by and large.
These are just nightmares of a dreamer
He remembers better times,
Although, adversarial encounters
Create wonderful rhymes.