What are some bad experiences you have had when you have been forced to work a shift and are short at least one RN?
Or, when you've already worked a full shift and have had to stay now for a second shift because there is no one else to work?
I thunk we've all been there & done that, but I can't think of any "worst stories" at the moment. I'll mull that over. I once got stuck working round the clock in the ER for 4 days and nights when a snow & ice storm hit and nobody could make it in or out. It was kind of fun- like a group pajama party in scrubs...
I agree with Medi..none that stand out as they are all terrible.
I had a 1 to 1 pt and was asked to precept a new grad who had 2 patients..."next to mine" !!
I've been stuck @ a facility for several days due to snow...when the national guard came to take me in since I lived in town and all the highways in were closed!!
I'm sure there are others!!
DJ...
I remember numerous times having to work 16 hour shifts because my relief couldn't make it in & the supervisor was unable to get anyone else.. and I recall some of those times being so damned tired I was just grateful to have made it through the night and next morning without making any serious mistakes that I knew of or doing anything to kill a patient, or lose my license. *grin*
The worst "horror story" that I can think of though wasn't any single incident, but rather a place I worked for a while once. It was when I was moonlighting (doing extra work on the side in addition to my government position) at a small, dangerously poorly staffed, 40 bed rural hospital where they routinely staffed the place like this:
1 RN, 1 LPN and on good nights, one CNA to handle the 40 bed "floor" which had patients all mixed together with various problems ranging from fresh post operative, senile dementia patients requiring assistance with everything including fall prevention, patients on telemetry (and no one at the desk trained to know what the monitor was doing), brittle diabetics, & you name it...
1 "house supervisor" who was supposed to handle the 5 bed ER, act as pharmacist, and also help with the "floor" at the same time, and one unit clerk who was supposed to e able to handle all the floor charts and the ER charts. Ha!
Because it was an active summer resort it got plenty of water related accidents, heat strokes, car accidents, and cardiac emergency cases into the ER... now, that place was a horror story!
For the first few paragraphs DJ, I thought we had worked in the same hospital. That hospital was ultimately why I left nursing and have only recently decided to return.
I was the LPN, the RN was green, really green still a GN.
We split the florr in half, I had the chemo/telemetry and she had assorted medical, just like your hospital, a little of everything. Not that there weren't crosses between the two "sides" of the floor, but telemetry only went down one hall and many of the chemo patients were also on telemetry.
Anyway, I was also the backup house IV nurse. If the nurse in here area couldn't get it, she called me. That night, I had gone down to the ER to help with massive MI. We like to have never gotten him. In the meantime, this green RN decided she would sit with my telemetry tech and learn a little about telemetry. This is a good thing? Ordinarily I would have said YES!
Not always, she noticed a strapping young atlas type man (mid-20s) in for obsevation after he experienced chest pain of unknown origin, in a deep sleep, he dropped just below 60. Without saying a word, she decided to push. While I was still downstairs in the ER, with only her and my telemetry teck there (our CNA was busy down the hall turning pts.) she threw him into a fib.
My t.tech, quickly realizing what had happened - cart behind him open, fib, missing GN - hit the code button.
The only in-house MD stayed in the ER. The nursing supervisor and I responded to MY patient.
I lost two patients that night, my young man and the old man in the ER. It was the old mans' time, I can get over that. The boy though, it was not his time. He died becaue a green nurse thought she would "practice" nursing on MY patient.
I couldn't go back when the hospital swept it under the carpet and even allowed this girl to continue working for them!
Come to think of it, this is also the only time I ever ran into an issue with RN vs LPN. She had a real isue with me "taking" chemo and telemetry while she took what she considered the LPNs patients.
Come on, she was new. She had never even mixed an IV when she was hired, and she wanted me to allow her to mix chemo and hyperal before her pharmacy class the hospital required for such? (very small private hospital. pharmacy not open all night, everything came to the floor ready to mix, but anybody who has ever mixed them knows, it's not JUST sticking the syringe in the bag and pushing) I was mixing IVs when meds were still in bottles of 100 or more in a cabinet in the med room and IVs only came in glass bottles, and had taken the short course for mixing chemo and hyper al given by the hosp. pharmacy.) She was to learn these things form me (and take the course,) something she couldn't bring herself to do.
It didn't take long for a young man to pay that price. It's not always licensure, it is very often experience.
This is the first time I've actually spoken this story to other nurses. Oh, my husband knows and some family members but I have never said anything to another nurse. I just walked away. I still feel for that kids family, it was so wrong.
Horror stories, most nights, days, evenings everything works its way through. But not always.
What about those of us on surgical call who have worked all night and not been able to go home the next day (had to work regularly scheduled shift) due to a heavy schedule and not enough staff? I am a scrub tech and nursing student with no license to lose (yet), but it's horrible to have been scrubbed for hours all night in an emergent case (CABG or AAA) and then to have to work a scheduled shift the next morning. As one of 6 on the open heart team, I carry call about 75% of the time. I suppose it's a risk I take for accepting a position of such responsibility, but shouldn't there be laws for amount of hours worked for patient safety due to RN fatigue?
I agree, SweetHeartNursie, not only is working all night and into the day detrimental to your own health, it is a safety risk to the patients as well--whether you are an RN, LPN, scrub tech, physician, physiotherapist... How can anyone be expected to be 100% functioning when all their body wants to do is sleep?
Dear Dixie,
I hear your pain. Having been a nurse for 32 years now, I have my share of horror stories. One in particular comes to mind similar to yours where a 46 year old man, husband and father, brother and son came into the ER with SOB. Was turfed too soon to our large medical unit that was staffed by 3 new grads. Me an ADN, a diploma grad and a BSN grad all green with the newest of us only out of school a month ago and the oldest out 3 months. The man was in pulmonary edema, even I knew that, and it was the month that all the new interns were on. It was late PM shift. The man should have been given Lasix in the ER before transfer, but did not. He was going downhill, and we were waiting for the Intern to come to the floor. We had RT there, we had the crash cart there, I even had the Lasix out and draw, we called down the nursing supervisor, but no Intern. We called him stat 3 times. I begged the supervisor to give me permission to give the Lasix. She refused. Back then, nurses could not ever take it upon themselves to push any kind of med without the docs permission. The intern finally came, the man was purple and now almost too worn out to breath, and the Intern did not know what to do and would not let me give the Lasix until her checked with the Medical Resident on call. Then he still waited for the Resident to come to the floor. Seconds before the Resident arrived, the man coded and we lost him. That was 32 years ago, and I still can see the man and the fear in his eyes. Today, I push meds without the doctor there. I wish I had been a seasoned nurse back then and had the "balls" to do what was right for that man. I also have only told this story to other nurses, not even my then husband, I have told my firefighter son, because as a paramedic, we share our stories. This man should not have died. The ER failed him, and the docs failed him, and I still feel that the nurses failed him because we were all new grads and had never experienced this before. It still makes me sad to think about him, but I use that knowledge I gained from this experience to help other patients to this day.
The worst for me is working 3-11 and then getting a phone call or having the supervisor ask if I want to work 11-7 because the night nurse called out or won't be able to make it. Happens with increasing frequency these days.
Knowing I'm tired already and that they want me to try and make it through the night as well.
I'm not above telling the Nursing Supervisor to take the keys and count me out. Have left more than one job for that reason. Some places seem to have terminal staffing issues these days and I've gotten tired of getting stuck.
Management doesn't seem to care if you have to take care of a child the next day or have family obligations.
Been threatened with "abandonment" on more than one occasion. I was happy to learn from the state board, that unless you accept the assignment, you have no obligation to stay. The facility may end up firing you for leaving, but they cannot take action against your license for not agreeing to stay.
The New Jersey state board told me that was an "employer/employee" issue and they wouldn't get involved.
In Michigan it seems to happen due to immature CNA and Nurses. I expect call offs and no calls to happen in other job fields like factory or office work, but lack of teamwork in a health field is just plain careless.
For Dixiedi- thanks for sharing your story. It truly is horrible that you have had to carry that burden. Unfortunately, our profession is life and death and we all have seen/experienced tragedy.
One thing I just have to say in relation to staffing shortage- We know it's going to get worse! Agency has a bad name but it really is becoming more necessary to get those experienced PRN/travel staff into our facilities! Who would you rather have- new grad "helping" on your floor, or a nurse with 15 years experience in your specialty who happens to be at your facility for the first time? I'm bringing this up because it's kind of my thing. I am working at a travel/staffing company now and I love it. Sometimes I work PRN and sometimes I do contracts and either way, I have walked into some facilities who are in dire straights. I know this role isn't for everyone but having agency staff can really help abate some of the "horror" that could go on. Ok. Sorry. That's my soapbox! Nurses Rule!!!
In most cases, I'd take the seasoned nurse for sure. I have nothing against new nurses - Heck I was even one at one time :33:
Sometimes of course, it is annoying to have to keep orienting a new nurse to your unit, but in a case like OP talked about, it can mean someone's life.
When I was a fairly new nurse, sometime in year 1 or 2 I think, I took care of a woman, mid forties, who had the most god awful colostomy. None of the nurses had ever seen anything like it. It was an emergency surgery - she had a bowel obstruction due to a tumor of some sort and it was a VERY dirty surgery. Colostomy looked like she got shot in the gut... largest flange barely fit... Unfortunatly she got the surgeon on-call who was the worst surgeon ever...
Anyway, dirty surgery, no iv abx after... DUH! Idiot Dr should have been shot.
Anyway, I come in for my 11-7 shift and 'Betsy' a rather inexperienced nurse, who returned to nursing after being out raising kids or something... is giving me report on all the patients.
She gets to this woman and makes some comment about how she only put out about 125 cc of dark urine, and you know, wow, her pulse has been running kind of fast, and I had a real hard time getting her blood pressure...
I'm like WHAT??? :23::confused:
I almost say to her, Are you f***ing stupid? I flew into the room, and sure enough, no urine in her bag, she's diaphoretic, weak rapid pulse and of course I can't get a BP on her...
I call a code (we didn't have RRTs) and of course she ends up in ICU, septic and on a vent and eventually dies over the course of a few days.
It was so awful; I just cried when I heard. I wanted to kill that idiot nurse for being so stupid and letting a young woman die needlessly.
It was devastating; her husband was devastated. They had met later in life and married; was just them and no kids.
I still think about it today.
Needless to say, Betsy was not seen again. Don't know what happened to her, fired I imagine.
If you don't know your stuff, you shouldn't be learning on really sick people without proper supervision. It can mean someone's life. :cry_smile:
Yeah, 24 hours *is* a bit on the dicey side. But to hear my former DON talk, she's done it and 'sees no problem'.....but I won't go into that particular story. :33:
Hi Sunnijudi,
I think it's illegal to be SCHEDULED to work that long (I'm not sure what the cut off is) but under extenuating circumstances it is allowed and not illegal.
Dixiedi, Redrosegal and all others. Thanks for sharing your horror stories, I'm sure we all have many. They make chilling reading indeed.
My career is over now, I work part time in a dementia asses. unit. Nights are more convenient for me, as I am full time carer for my mother too. Night duty is a nighmare! I am the only trained on duty, should have 3 support workers with me, but often only two, sometimes one. Some of the support workers are older than the patients. Some of our patients can be very physically aggressive. This is not too great a problem is the patient is physiacally frail, but often their physical health is perfect. To obtain a doctor, we have to phone up the main hospital, half an hours drive away. Intra-muscular prn meds are never written up as routine. They are never written up until there has been an incident!
Yes I know, prn is and should be, the last resort. I do not give it willy-nilly.
Also, our ward, (22patients,) is mixed sex. It is a stuggle to meet the combined needs of frail, demented little ladies, with the needs of the relatively young men...the whole set up is a nightmare.
As an aside, I must say that basic hygiene is totally ignored. It's only when I am on duty that toilet seats etc are cleaned. Patients are never helped to wash their hands after using the toilet...( I have complained to my boss on days on several occasions about cleanliness and hygiene. He tells me that no-body ever died of dirt!) I assure you that is true. Comments please! :cry_smile::confused::cry_smile::confused:
New to board but let me give you the outside looking in view. I have been a paramedic for 17 years and there is a huge contiuing trend and problem of short staffing in the hospitals. Regulations actually say that a hopital in Louisiana can not go on diversion because of short staff only if there are no beds. Lets be realistic if you don't have the staff then you don't need the patients. The real horror comes in for us when we have 4 hopitals in a 30 mile radius and all 4 go on diversion at the same time. (Which also is not legal they are supposed to notify each other.) We can not just ride them around until they feel better. I am about to test for my nursing degree and see the picture clearly from both sides. One night I worked a code on a 58 yo male that was in V-fib. He converted and went into a sinus brady after the second shock. Obvouisly we went to the closest hospital where the doctor tryed to divert me to another hospital even though my patient was intubated hypotensive and bradycardic. I try my best to work with all aspects in the medical field but we still went there and the hospital administration got involved only to find that my decision to refuse to divert was legally correct. One of my goals would be once completing my nursing degree to try and wok as a liason between these two monsters since apparently neither has the answer now.
