Wednesday, August 6, 2008

Regroup and Refocus

Another night at work with my spirit touched by many. Unfortunately, some of the touches were malicious and had NOTHING to do with the patients I care for.

The touches..... Blue Eyes came in by ambulance, talking and visiting with his nurse. He was not put in my assigned room, but I did visit with his wife as she stood outside his door waiting for his inpatient assignment. Beautiful smiling, loving and concerned wife. Later noticed a sense of panic in MNurse's eye, and went to help out. Pressure was dropping and Blue Eyes was not doing well. MNurse had bolus running, and I quickly grabbed a second liter. PoorRN was in charge, and was at desk "calling the doctor." Pressure continued to fall, liquids and reverse Trendelenburg were not helping out. Wifey in tears outside doorway, noticing increased level of urgency. Attempts to comfort her were neglected as Blue Eyes needed us. MNurse and I made decision to move Blue Eyes to larger room. PoorRN was upset with us as there was still a bed in new room. Seriously? How about we push the bed to the side.....

PoorRN was at ER bedside sporadically - "Did he tell you to hang third liter?" "Did who tell us to hang third liter? You are suppose to be calling MD - we're trying to save the patient." "I just asked....." Oh my gosh, has she even called the doc to let him know about changes? Who is giving orders to hang meds? Another PoorRN leadership moment.

Spent lots of time under sterile drape monitoring Blue Eyes as central line was attempted. Visited with him about family. Told me he was very tired: "Close your eyes and sleep - I'll wake you every now and then." Pressure still dropping, and CT waits. Wife, family and pastor waiting in hallway as our attempts become more futile. Got him to CT, then to inpatient room. Monitored him from ER, and watched as he came closer to his final rest. My heart pushed me to the elevator, and upstairs to his bedside as his family said their goodbyes.

Shift ended with staff members reprimanded by management, one told to look for another area to work. Personal agendas/vendettas continue, and the real problem (PoorRN - my opinion only) is allowed to continue to weed out those she desires. My assertiveness and need to question may have me on her short list. We are told to document such instances of her management style, but we see no changes in PoorRN's behavior and Hitleristic management style.

Pursuing my dream of Hospice care tomorrow. Too old/crotchity to play mental games, especially when the care of patients is jeopardized. I became a nurse to care for others, not to worry about whether management is viewing my neck with a sharpened blade. It's embarrassing to work side by side with someone whose nursing practice is substandard and whose objectives are self-centered. I have no desire to justify the poor care and insolent attitude of those who claim they are fabulous nurses as their actions show otherwise.

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