Today was a rough day. It's hard to explain exactly why. Nothing horrible happened, we didn't even have a lot of discharges or admissions to deal with. I think the main reason that today was a rough day is that the patients were so sick. When you have a lot of really sick patients on the unit...even a unit that is meant to care for them, the whole unit feels it. My assignment wasn't that bad, me being new, I'm protected from having to take the worst of the worst just yet. It didn't matter much though, because every time I turned around to ask for help, no one was there.
Nursing units work as one cohesive creature. It's part of what makes a good unit an awesome place to work, and makes a crappy one such a misery. A few people with horrible attitudes can really trash the mood for everyone. Even though we are technically able to care for a patient all on our own, it's not a job for one person. Turning, boosting, bathing, these are all practical activities that are not easily done alone, but there are many other less tangible needs.
As a new nurse, I mainly need encouragement and guidance. Often I'm doing the correct thing, but having another more experienced nurse tell me that I'm right goes a long way. This comes in the form of asking questions I already think I know the answer to "Hey Anne, I can run potassium at 20 mEq through a central line, right?" to an explanation to a more detailed process "Does anyone know where to find the order to declott a picc?"
New nurses are work. We start out being completely useless to our unit, tailing behind a preceptor, afraid touch anything unsupervised. Over the orientation process, we slowing increase our help:work ratio until we're mostly helping our unit, and very rarely requiring assistance from others. This is normal, and healthy. Having a unit where the patients are so sick that no one's available to keep an ear out for a new nurse isn't a safe situation.
Nevertheless, that's what we did today. And just like almost every day that I'm at work, nothing horrible happened because of it. Hospital managers use this as an argument that it's actually OK to strain staffing numbers to almost breaking. After all, there's really no way to prove through objective documentation that it's not....
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