Charge Nurse
If you know me, you know I'm pretty chill. I don't put a fight up about much. Especially when it comes to work. I literally might give people crap, but will always give a hand or do whatever has to be done. But when we as a whole are in over our heads and you mess with us.. and I happen to be in charge..hell no.
Being a nurse is no joke. Now, I have only been a nurse at the beside, in the hospital setting but this is no easy task. We have to have this shield up at all times. Yet, at the same time, we have to be able to bring this down at be empathetic. Today, I held a patients hand who was having a meltdown of emotions and frustrations because of the limitations that her stroke has caused her, but at the same time, be stern with a patient who tries to push boundaries and is manipulative. You are constantly the communicater between different doctors, physical therapy, occupational therapy, speech, lab, CT, MRI, EEG, EKG, Ultra Sound, social worker, nursing assistant, family members, etc. You are literally that core person that every single person comes to to find out information about each patient.On top of that you are continuously assessing your patients. Their vitals, pain, medications, labs, every single thing about their mental status, and physical body. It is our duty. We are the first ones. We are the first ones to notice if something goes wrong, or if something seems slightly off, because that slightly could be something huge.
When asked what does a nurse do? I can't even describe it. I see posts on facebook and I love sharing them because I feel like they always give a better description than the last. But if I had to give it a definition: nurses are in charge of the whole person and everything and everyone that effects them. We literally do EVERYTHING. With the help of delegating.
Back to my day. Being a charge nurse, you are in charge of the flow of the floor. Being a resource for the other nurses on the floor. You typically don't take a patient assignment. This allows you to do assignments, help on the floor, go over numbers, place patients in different rooms, oversee the unit. For some reason it always seems as though when I am charge, I get HAMMERED. Apparently it's not just me. The hospital has been full. Literally every floor, plus the ED. Looking ahead I knew it was going to be a busy day, knowing I had a bunch of discharges along with knowing that almost every other unit was full with limited discharges. I told staffing I was going to need a DRN. The DRN would help out on the floor, pass meds, do a discharge, do an admit, do whatever a nurse can't get to at the moment and just needs help to get back on schedule.
The first 8 hours were hectic, I helped on the floor a lot, even with the DRN. I got behind, but was able to catch up. At three, everyone was leaving and everyone was coming. The day was just getting insane. People were getting transfers and discharges at the same time. Staffing told me I would have to pull my 1500 DRN to start admitting. Little does the nursing supervisor know that it doesn't work that way. Even if I pulled my DRN, they can still only take 2 in a four hour period-- idiots. So really it didn't benefit. At this time, I was helping get admits done as well as my job as the charge done. This was with the help of a DRN. So our acuity was high. We had needy patients, or patients with a ton of things going on. So the nurses were busy, aids were doing the best that they could with call likes going off and needing another person a lot of the time to help transfer a person.
All in all, I was not being heard that we were struggling. The first nursing supervisor was wonderful, hand has been every time I work with her. But I'm not going to lie, the next one was not. She didn't care. Usually this isn't how it goes, so don't get me wrong. This isn't about me trying to hate on the nursing supervisors, it's more me just showing my frustration. Maybe at certain ones, but lets be real, nothing is ever great and perfect in any job you work. I typically get sympathy or empathy and am asked-- how can I help? But not this time. At 1900 they decided that I wouldn't get my DRN that I already had planned for, but that I would have to take away from another nurse so separate patients so we can take more admits. Now, in theory this is fine. However, we were already struggling and behind and everyone had pretty much taken a patient. So anyway, I split up some patients, but I couldn't split a nurse down three halls. This is probably all just mumbo jumbo to everyone, but at the change of shift, another new nursing supervisor came on and between the two of them "my words" got mixed up. I had said that I will do the best I can to make it work so I can take all the patients to full capacity, but I don't know that it'll work that way because of being to then split a nurse down three halls.
So essentially I had said that I wasn't going to be taking any more until I got another nursing assistant because if I have this many nurses I need another nursing assistant. Blah Blah Blah. Well she didn't like that. But I held my ground. I got another nursing assistant. Because I had to put up such a fight, I decided to write up a safe staffing report, and because our acuity was high and I wasn't being listened to. I had told the nursing supervisor that I was going to do this. She called me and decided to aggressively talk to me. Well I calmly and collectively talked to her explaining my side of it, however, she kept talking over me and not listening. I simply told her that I was done talking to her because she wasn't willing to listen to me and we were getting no where with this conversation. Anyway, the conversation went on. She understood where I was coming from and she ended up apologizing. I had other charge nurses around me who high fives me and said that I had handled it very professionally and that they were proud because this particular nursing supervisor tends to try to pull a fast one on us.
We will see how it turns form here, but before I agreed to be a Charge Nurse I chose to not be a push over and to fight for what my nurses and staff needed.
xoxo
Being a nurse is no joke. Now, I have only been a nurse at the beside, in the hospital setting but this is no easy task. We have to have this shield up at all times. Yet, at the same time, we have to be able to bring this down at be empathetic. Today, I held a patients hand who was having a meltdown of emotions and frustrations because of the limitations that her stroke has caused her, but at the same time, be stern with a patient who tries to push boundaries and is manipulative. You are constantly the communicater between different doctors, physical therapy, occupational therapy, speech, lab, CT, MRI, EEG, EKG, Ultra Sound, social worker, nursing assistant, family members, etc. You are literally that core person that every single person comes to to find out information about each patient.On top of that you are continuously assessing your patients. Their vitals, pain, medications, labs, every single thing about their mental status, and physical body. It is our duty. We are the first ones. We are the first ones to notice if something goes wrong, or if something seems slightly off, because that slightly could be something huge.
When asked what does a nurse do? I can't even describe it. I see posts on facebook and I love sharing them because I feel like they always give a better description than the last. But if I had to give it a definition: nurses are in charge of the whole person and everything and everyone that effects them. We literally do EVERYTHING. With the help of delegating.
Back to my day. Being a charge nurse, you are in charge of the flow of the floor. Being a resource for the other nurses on the floor. You typically don't take a patient assignment. This allows you to do assignments, help on the floor, go over numbers, place patients in different rooms, oversee the unit. For some reason it always seems as though when I am charge, I get HAMMERED. Apparently it's not just me. The hospital has been full. Literally every floor, plus the ED. Looking ahead I knew it was going to be a busy day, knowing I had a bunch of discharges along with knowing that almost every other unit was full with limited discharges. I told staffing I was going to need a DRN. The DRN would help out on the floor, pass meds, do a discharge, do an admit, do whatever a nurse can't get to at the moment and just needs help to get back on schedule.
The first 8 hours were hectic, I helped on the floor a lot, even with the DRN. I got behind, but was able to catch up. At three, everyone was leaving and everyone was coming. The day was just getting insane. People were getting transfers and discharges at the same time. Staffing told me I would have to pull my 1500 DRN to start admitting. Little does the nursing supervisor know that it doesn't work that way. Even if I pulled my DRN, they can still only take 2 in a four hour period-- idiots. So really it didn't benefit. At this time, I was helping get admits done as well as my job as the charge done. This was with the help of a DRN. So our acuity was high. We had needy patients, or patients with a ton of things going on. So the nurses were busy, aids were doing the best that they could with call likes going off and needing another person a lot of the time to help transfer a person.
All in all, I was not being heard that we were struggling. The first nursing supervisor was wonderful, hand has been every time I work with her. But I'm not going to lie, the next one was not. She didn't care. Usually this isn't how it goes, so don't get me wrong. This isn't about me trying to hate on the nursing supervisors, it's more me just showing my frustration. Maybe at certain ones, but lets be real, nothing is ever great and perfect in any job you work. I typically get sympathy or empathy and am asked-- how can I help? But not this time. At 1900 they decided that I wouldn't get my DRN that I already had planned for, but that I would have to take away from another nurse so separate patients so we can take more admits. Now, in theory this is fine. However, we were already struggling and behind and everyone had pretty much taken a patient. So anyway, I split up some patients, but I couldn't split a nurse down three halls. This is probably all just mumbo jumbo to everyone, but at the change of shift, another new nursing supervisor came on and between the two of them "my words" got mixed up. I had said that I will do the best I can to make it work so I can take all the patients to full capacity, but I don't know that it'll work that way because of being to then split a nurse down three halls.
So essentially I had said that I wasn't going to be taking any more until I got another nursing assistant because if I have this many nurses I need another nursing assistant. Blah Blah Blah. Well she didn't like that. But I held my ground. I got another nursing assistant. Because I had to put up such a fight, I decided to write up a safe staffing report, and because our acuity was high and I wasn't being listened to. I had told the nursing supervisor that I was going to do this. She called me and decided to aggressively talk to me. Well I calmly and collectively talked to her explaining my side of it, however, she kept talking over me and not listening. I simply told her that I was done talking to her because she wasn't willing to listen to me and we were getting no where with this conversation. Anyway, the conversation went on. She understood where I was coming from and she ended up apologizing. I had other charge nurses around me who high fives me and said that I had handled it very professionally and that they were proud because this particular nursing supervisor tends to try to pull a fast one on us.
We will see how it turns form here, but before I agreed to be a Charge Nurse I chose to not be a push over and to fight for what my nurses and staff needed.
xoxo
Good job. Not only is it sticking up for your nursing peers, it is sticking up for the patients you have. Patient safety also means we have to assure that our nurses and nursing assistants have time to care for them. It's not just numbers. Its acuity, neediness, is that nurse split, has that nurse even had a chance to take a break, etc.
ReplyDeleteAbsolutely! It's so much more than just a grid. It can be super frustrating when you feel like you aren't being heard and have to put your foot down, and have to be "snotty" or whatever you want to call it. Yet, still keeping in mind that they are trying their best to get people in and out of the ER too. It's extremely complicated. But patient safety is huge! absolutely.
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