Day 2 of "orientation" to charge/Day 3

Well, day 2 of orientation was just like day 1. In other words: no orientation, just thrown to the wolves.

Day 3 (officially off orientation, even though I technically never was oriented), and I was in tears and ready to totally quit nursing one hour into the shift. Seriously. I threw my badge down and everything.

I asked another (much more experienced) nurse to please, please, take over charge and she did. She even admitted that the unit was absolutely dangerous. Too many patients, and not nearly enough nurses. So, at least I know it wasn't me!!!

What was my final straw that said "enough, I quit"? One bed left, and in rolls a preterm patient who was completely dilated. And we're supposed to be staffing for a c-section (not emergent), and we didn't have nurses available for either the fully dilated pretermer or the c-section. Oh, and a day shift nurse tells me that the patient assignment that she had, that I gave to the oncoming evening nurse, was not possible for the evening nurse to do. Really? You did it. Why can't she? (Yes, I know, that is almost a "nurse eating their young" type of attitude, but what more could I do at that point?)

I also had just received report on one of my two patients (she needed to be weaned off of magnesium sulfate and a terbutaline pump started), and my 2nd patient hadn't even been put on the monitor yet, and she had admission labs and an IV (as well as the full admission) to be started.

And in rolls the completely dilated pretermer. The doc chomping at the bit to go examine her. I actually told the doc to hold her horses. I can't pull a nurse out of my ass to assist you right now. I ended up going in with her, then pulling another nurse from her own lesser acuity assignment to go in and have the birth with the preterm mother.

Then I cried. Threw down my badge and said that I quit. Get the managers to come back in, get them to take care of it all, I CANNOT DO IT!!!

I cried, explained to the manager and nursing supervisor that I absolutely refuse to do charge nurse duties. It's unsafe and I was never properly oriented. I should have refused to be "oriented" the way I was (not) in the two previous days. The other, more experienced nurse took over charge duties, while I finished crying. Then I went about my day and took care of my two assigned patients.

I also wrote an email to the unit manager, clinical manager, and unit educator telling them what happened, and that until I am actually TRULY oriented to charge duties, I REFUSE to accept charge nurse assignment. I reiterated that the staffing is chronically short staffed, and the patient acuity level remains too high for the unit to be run safely. I emphasized UNSAFE and SHORT STAFFED several times. I know it's like talking to a deaf ear, but I at least started a paper trail.

Next: writing to the chief nursing officer and the CEO of the hospital.

Running an acute care unit with fluctuating patient acuity levels with a chronically short staffed nursing staff is WRONG. It is DANGEROUS. We cannot keep running this unit like this.

Charge nurse role: a hate/hate relationship

Ok, so my charge nurse orientation? Might as well have just never had orientation. Day #1 of 2 for orientation and I was pretty much running solo the whole shift as charge (and having a patient assignment too).

You know what? I don't like being in charge. I like being "just" a staff nurse, with an assignment, and taking care of my patients. I don't like giving sub-standard care to patients, and trying to make everything run smoothly (or rather, putting out the fires left and right).

Yep, I'm a nurse. Proud of it. Love to care for laboring women, sick pregnant women, new families.

Don't like: being in charge, figuring out patient assignments, running the OR staffing, readjusting patient assignments, trying to pull more nurses out of my ass for patients that are sent from the office and need admitted, figuring out lunch relief, providing multiple other nurses lunch relief because some lazy ass nurses who I assign to relieve them won't do it (or come up with excuses why they can't relieve another nurse), nurses get angry because they don't get lunch relief til 2pm (well, I would be too, hypoglycemia sucks), and the constant ringing of the charge nurse phone. That doesn't even cover everything I have to do when in charge, but that is quite enough to mention.

Oh, and I'm "orienting" to charge nurse again tomorrow, then will be "in charge" on Thursday.

Yippie.

Woe is me

I'm really not so sure about this charge nurse thing. I was told when I arrived on a recent shift that I was to be in charge. I think I've done charge (maybe?) three times. Those times were only because there was no one available who did charge, and I was the most likely choice to do it. I haven't been trained or oriented to do charge. It was kind of a "toss her in there and do it" situation.

So, I did it again. Tossed in to be in charge. I need to be paired up with an experienced charge nurse for several shifts, before I can feel like I'm really doing things right. It's like I'm putting out fires left and right for the entire 8 hours.

Initial patient assignments........planning for emergencies (like a c-section, which takes 2-3 nurses off the floor).....readjusting those assignments and emergency contingencies when the patient population and acuity levels change yet again. Getting everyone dinner coverage. Making physicians happy about if they can do a non-urgent c-section now or later. Stat c-section on another patient (we actually did REALLY well on this one!). Walk-in patients who we had no idea were coming now need a nurse, and I have none left to spare.

Oh, and to top it all off? A call off for night shift. I try to call the on call manager to come in for nights, and she refuses. I call the nursing supervisor, and between the two of us, we make some last minute phone calls to try to get ANY nurse to cover ANY part of nights. No go. Argue back and forth with the on call manager, who really needs to come in, and she still refuses. Too bad, so sad. You're on call, and we can't get any other nurse to come in and we are poorly staffed as it is for nights, and now with a call off? You have to come in!

When I left, the night shift charge nurse was still arguing with the on call manager about her having to come in. How can a manager get away with refusing to come in, when she's on call? I just don't get it!! If it was a "regular" nurse on call, who refused to come in, she would be written up and reprimanded, possibly even put on suspension.

All of the above, plus the charge nurse taking care of patients too? Totally NOT worth the extra $1/hr. Not one bit.