Just finished working 3 days in a row, and on day 3 three I started with 6 patients. SIX. On a so called 'stepdown' unit.
And, when a physician did not call back regarding a patient's discharge medications, my charge nurse and I agreed what medications the patient would probably go home on. We had no order. It's obvious the patient would not go home on IV medications yet I had no order and there were a couple of other medications in pill form. I made it clear: "I can't just write down what I assume the doctor will want."
but she did.
I can see her point of view....there was a patient who wanted to get out the door, and more importantly, there was a patient on a different floor who needed a medication NOW that could only be administered on our floor or the ICU.
So after my charge did a 'telephone order read back' and signed the discharge papers, my guy went home and the new patient came up.
The physician never called back. I left one voicemail, and had tried calling after about 45 minutes, with the call being forwarded to voicemail. The kicker? I called the operator to do an overhead page.
And the operator says....
"ok, but I don't think our overhead paging system is working." (it didn't work)
This is where I work. Six patients when I should have 4. Physicians routinely don't complete discharge orders and not return phone calls. And an overhead paging system that may or may not work.
Thank g-d I didn't have an emergency on my hands: the doctor wouldn't have called back or would have then been unreachable, and the overhead paging system to alert the attending, the ER physician, the intensive care nurse, the respiratory therapist, and the house supervisor would not be able to alert anyone at all.
Today and tomorrow I'm off....and I woke up this morning to the pitter pattering on the gutters. It's a good day to lay in bed, under blankets and look for a new blog layout, don't you think?
2 comments:
Even reading a small bit of this post gave me a flashback to my last job. If you read back far enough in my blog (which I have since edited it so it's not so bad), you would see how MISERABLE my last job was. I had a patient who kept telling me she couldn't breath and her doctor never called me back. The doctor on call (it was a community hospital with no residents, and I worked evening shift so after 5-6pm-ish, we only had the on call medicine doctor) came up, which was shocking because he's normally like "what do you want?" and "so?". Transfered her to the ICU, but her doctor never called back. It would often take doctors an hour to call me back, which left me to fend off the complaints of the patients, especially for something like Tylenol, which should be ordered from the start.
I routinely had 4-5, sometimes up to 6 patients without any assistants or transport. Housekeeping was scant. Doctors wouldn't fill out discharge medications or instructions, leaving it to the nurses to put what they "usually" do......to which my manager would scream at us, after the doctors said they "weren't coming back in" to fill them out. It's not my job to prescribe...it's actually illegal.
Ridiculous. I don't miss that job one bit, and it actually made me want to quit nursing. I cried almost daily, whether it was at work or whether it was because I had to go to work. Nursing is hard and you can't explain it to anyone who isn't a nurse....they just don't get it.
Sorry for the mini rant, but I know what those bad days can feel like!
So true. I just moved to this hospital (husband's job transfer). My previous job was at a large teaching hospital. Now I'm at a small community hospital with no transport, minimal ancillary staff, and no residents or education department to speak of. There's a lot of things I see at my new hospital that wouldn't fly at the old one....and I still feel like it's not a safe working environment (mentally, physically, and for the sake of my license). It's the first job I've ever had where I've actually cried at work (twice)! I'm slowly trying to make the best of it though...
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