It
was NOT a HAPPY EASTER in the Critical Care Unit of Brockton
Hospital
from the very tired and frustrated unit nurses of Easter weekend
Let us tell you about our weekend. These are the facts, no propaganda,
and no
untruths, just the plain truth. As the weekend started Friday night,
the 11pm-7am shift was the beginning of our inadequate staffing.
In fact, there were
48 hours of time left uncovered in the critical care unit. Add
up
the hours of uncovered shifts below, which would bring our staffing
up to the
minimal requirement of 8 registered nurses per shift.
Specifically as follows:
FRI 11-7 x1 8 hours
Sat 3p-7p x1 4 hours
Sat 11p-7x1 8 hours
Sun 7-3 x1 8 hours
Sun 3p-7p x2 8 hours
Sun 7p-11p x1 4 hours
Sun 11p-7 x2 16 hours
This was not the result of any sick calls. The above times had
been posted in
our schedule book as voluntary overtime for the two weeks preceding.
It was
never filled and was left uncovered.
As a result of the inadequate staffing, and the inability of management
to
fill the uncovered hours, the following events occurred.
On Friday night a maternity nurse and an A2 nurse were floated
to cover
the unit, In addition one of our unit nurses who had already worked
12 hours
was mandated to stay 16 hours, till 3 am in the morning. She had
family issues
and commitments that morning at 7am, but was unable to refuse MOT.
On Saturday another unit nurse was mandated for 4 hours, and another
med/surg nurse was sent to help out, to make the 8th nurse.
On Sunday, a dangerous situation took place for all involved,
including
both the patients and the nurses. Sunday at 6 am, the unit was
told
to transfer a patient out to the floor, this was done to prevent
mandatory overtime from occurring again. We had only 7 nurses,
we were down 1.
However at 8:30 that morning a patient emergency on the floor
required the
unit to accept a critical patient. (Important to note, that we
were still
short an RN to cover another patient.) Calls were made to staff
and per diem at
home requesting them to come to work. Help did not arrive.
At 9:30 another emergency occurred on the floor. In addition to
no having an
RN available to care for the patient, there were also no beds available
for the
patient. The patient was brought to the CCU procedure room, (located
at the
end of the unit, around the corner, isolated from the rest of the
unit). A
unit RN with her own assignment, including ventilated patients,
was forced to
leave her patient assignment and go to the procedure room to care
for the
critical patient. She remained in the procedure room for 2 1/2
hours, at
which time an emergent chest tube, central line and intubation
occurred. Her
other two patients were covered by other nurses who also had their
own
assignments. Because there were no beds available, the one and
only patient
that could be moved was transferred quickly to an outside facility.
Finally
at noon the patient in the procedure room was moved to a unit room.
As the day goes on, we still have no available beds in the unit.
In case the
need of another bed arose, we began working on which patients could
be bumped back to PACU. This was shortly a reality. We moved a
patient out to the
PACU, to make way for yet another ventilated patient. We also had
to move
patients within the unit to make a dialysis hookup room available
for one of
our patients requiring dialysis. As this was not enough, there
was another
ventilated patient, so we then decided who could move to A2, because
at this
point the PACU could not accommodate anymore of our patients. That
afternoon
another nurse was mandated 4 hours, a med/surg nurse was sent to
take an
assignment, and a maternity nurse was sent to help. Even if we
had been
adequately staffed, there were more patients requiring ventilators
and unit
beds than we could safely accommodate. We were all unable to leave
the unit,
resulting in no lunch, dinner, or rest from the unit.
We are so appreciative to all of the med/surg nurses, maternity
nurses,
telenurses and the TCU nurses that floated to our unit this weekend,
we
cannot express how much we appreciated the help. To all of the
nurses
that floated to the Critical care unit this weekend, I know that
you will
agree that the acuity in the unit was so high, that it rendered
most of the
float nurses unable to care for, or take any sort of patient assignment.
It
would have been unsafe for both yourself and the patient.
All 48 hours were covered with mandatory overtime and nurses floated
in
from other floors. This was not the result of sick calls; this
was the
result of a staffing shortage, a staffing shortage that was known
well in
advance. A shortage that management knew could ONLY be covered
by
mandatory overtime (6 nurses scheduled, with a need for 8).
This may not be happening to all of you, but we are living it
in the units
and critical care areas. It is not fair to the patients; it is
not fair
to those of you who must float to areas you do not feel qualified
to work in.
Please realize we all have families and lives, and we want only
the best for
our patients, because WE DO CARE. We need to stick together to
end
this mandatory overtime. It may not be happening to you RIGHT NOW,
but
what lies ahead is unforeseeable. We need to unite and fight for
our profession.
We in the unit feel that the hospital is professionally and ethically
irresponsible to continue to leave us un-safely staffed, relying
on voluntary overtime and mandatory overtime to bring staffing
needs up to normal and safe levels.
This is not the MNA mission. THIS IS THE MISSION OF THE BROCKTON
HOSPITAL NURSES, don't be mislead.
Please! We are all fighting for the same thing: good patient care,
through
safe staffing.
STAY STRONG, STAY UNITED, WE HAVE THE POWER TO EFFECT
CHANGE, BUT ONLY IF WE STAY COMMITTED TO THE ENDEAVOR.
Thank you
The very tired and frustrated unit nurses of Easter weekend.
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