Thursday, September 20, 2007

Beyond Simple Staffing Issues

I realized the other night that though the lack of nurses available to staff the ER is a bad thing, scraping the bottom of the barrel to keep the ER staffed is just as bad, if not worse.

We have a plethora of new nurses in the ER. Not New Nurses, just new employees. Most of them are worse than New Nurses. New Nurses are inexperienced to begin with, but they learn. These nurses are not New. They just suck. (No, Lola, I'm not talking about you. You're just a pain in the ass.)

When you look around at the beginning of the shift and realize that there are only two or three nurses working (out of 8-10) that you know you can count on in a "situation", it just plain bites. If you spend 8 hours praying that there will not be any critical patients because you're not sure if the new ones can handle even helping with a fast-paced AMI or trauma, then you have a problem that extends past basic staffing issues.

Having one or two bad nurses on a shift isn't unmanageable, because you can stick them on Kootchie Row or in the Crayzee Annex. But when you have to assign them to the semi-real patient beds, it's worrisome. And if they're on the front side (Trauma/Cardiac rooms), too, well, that's just a recipe for disaster.

When your good nurses are all either jumping ship or going to PRN status so that they don't have to deal with the bullshit anymore, and their replacements are slower'n molasses and sharp as a bag of wet mice, it makes for a hostile work environment.

I'm not sure where this new crop of nurses came from, but I wish they'd go back. And take the bad techs with them.


I miss the good nurses. Come back, good nurses, come back! (I know you're reading this....)


John McElveen said...

Wow- That is scary. Are they New Grads or just coming from places that have already fired them. At Urgent Care we are having a great resurgence in LPN's which replaces the Techs- although we Techs are awesome because we are Paramedics- but the LPN's can at least give IM and Most Meds and we Paramedics can take care of the Cardiac and Trauma.

Our acuity is getting higher and we are seeing 100 to 120 and 3 days we saw 140 in 12 hours! With 1/2 staff of our ER. Of course your overall acuity and numbers probably still make ours look easy but we really aren't an Urgent Care- (Doc in the Box type).

Good luck MG- don't get Burned or BURNED OUT and Watch your License LOL. (although Not really-) be careful!!!


John McElveen said...




NYC EMS said...

I want more details!!!

mielikki said...

I am grateful every day for my co-workers. Somehow, somewhere, my previous boss managed to scrape together some good ones, who have actually stayed in the Podunk ICU. Lately, though. Some have been leaving. And I'm scared. . .

Anonymous said...

As one of the good nurses that left your ass hanging...I'm sorry, I'm sorry, I'm sorry. But those of us who worked relatively hard for our license, well, we prefer to keep it...and when at the beginning of the shift you say two hail mary's, kiss the wind, and throw some salt over your shoulder in hopes that no one will kill anyone that shift, well, you know it's time to haul ass outta there! And let's not forget when you're the only one besides the charge nurse and one smart-assed tech who knows how to do CPR...those are good times! I love you, I do, but you'll follow, very, very soon! We'll be together again, my little monkey!

Nurse K said...

And let's not forget when you're the only one besides the charge nurse and one smart-assed tech who knows how to do CPR...those are good times.

*eek* *shudder*

Kim said...

Good nurse, bad nurse. Good paramedic, bad paramedic. Ain't life grand?

RealisticRN said...

Yet again, you make me wake my family in the middle of the night! I should have known you would write something to make me laugh uncontrollably and loud (Lola comment!)
At any rate, I won't be leaving anytime soon--unless they make me--(and who knows, you may be hoping I would go back.) But know that the few there who actually know what's going on are so thankful that YOU are there!!!!!!! It will be ok...and rest assured, they won't last long.

Anonymous said...

At least if I'm a pain in your ass, your always still glad to see me. And not scared when you see me either, except for the amount of BS I intend to give you that night. I think I'm going to affectionately refer to you as "My little enemy". So step it up on the diet.

beajerry said...

A few nurses left the floor recently, and they were the good ones. Now I'm stuck with mostly the bad ones.
I feel your pain.

The ER does burn one out, though. What do they say the burn out time is, after 7 years?