I am feeling the need to rant. I hereby declare you my audience.

So last week I had a couple of nights where I wasn't done with everything until around 6am... just in time to finish things up and leave relatively close to on time. The week before that I didn't get out of there until 8, because I didn't start charting until another nurse assumed responsibility for my patients. Our patients are getting sicker, and the number of isolation's on the floor have at least doubled.

This morning I went to a staff meeting. It was at 715, so I was not really awake to begin with. Then, in the middle of a bunch of routine business, our nurse educator started pulling out patient protocols. These are the things that tell us what we have to do. We have always worked off the "care of the acutely ill pt" protocol. However, with the opening of the CCU they just developed a new protocol for acutely ill cardiac patients. Apparently someone just realized that our floor gets some of these patients so we now have to follow it as well. To summarize we now have to completely assess each patient twice a shift (normally we do it at the beginning of the shift), 6 hours apart. We have to assess all pulses every 4 hours. Every pulse that is a 1+ or less has to be dopplered (we have old cardiac patients. no one has good pulses). We have to diagnose every strip printed on the teles, not just 1. There is more... but that is the main part of it. Oh, and then after that it was announced that our patient satisfaction scores have gone down on noise at night, and could night shift please be more quiet so our patients can sleep?

I asses at 730-8pm. midnight vitals get done 1130-12. I guess I do pulses then. Second assessment would be 130-2am? then pulses again around 4am, with morning vitals. When do they expect patients to sleep? When do they expect me to chart? They get after us for patients saying we don't respond to their needs fast enough, that we don't make life quiet enough and then they give us things like this that will do nothing but make it worse. I respectfully explained my problems with the subject to the nurse educator, and she thanked me for my input.

Last month they started bedside checks where the oncoming nurse has to go around and meet each nurse with the off-going nurse. It isn't a completely bad system, but it makes me about 20 minutes late in everything I do for the first couple of hours.

They are completely changing the charting system the first week of December. Yup... right in the middle of holiday season. I am a computer super-user, and am taking the class on Thursday. The plan as of right now is to have me and several others go to a 4 hour long class, then take go and in the middle of the night teach the other nurses... have them take turns holding pagers so that nurses can have the class. If it is going to take headquarters 4 hours to teach me how do they expect me to do it in an hour? And with all the extra stuff they are making us do how do they expect anyone to have time to take a class in the middle of a shift? Don't want to pay us to learn new charting? Don't change the charting.

I like my job. I really do. I don't like this part of it. Not at all. It is life, however, life at a hospital facing budget cuts, staff shortage and a whole bunch of new regulations coming down the road.

This is my blog, so I can rant on it if I want. Tomorrow I will go to work, and I will do my job. I will do it to the best of my ability, fulfill their requirements as much as I can, and pray to heaven above that I don't forget to do something and lose my license because it was written on a protocol by someone who hasn't had direct patient care in more years than anyone can remember.
I am a nurse. My responsibility is my patient. As long as I remember that it will all work out in the end.

Thanks for listening to my rant.