All in a days work

As I write this, I am just home after my first night shift. As any morning at shift change, the night staff will have a little chit chat with the oncoming day staff. This morning was no different. We are chatting about the night and the previous day shift, when one of the oncoming staff tell me that a staff member she worked with on Monday was complaining about me. The RN who was complaining didn't like the fact that I agreed with a doctor's order for providing "one on one" nursing care for a patient. That really burnt my twizzlers. And needless to say upset me.

Let me give you a brief overview of those past two day shifts I have just finished. I started back on Saturday. It was a crazy day, busy, missed my dinner break, but that's ok I got out on time. I had a very sick, confused and agitated patient, who was on isolation and requiring a lot of my time. One of the procedures we did on this patient that day was insert a special IV line which provided for closer monitoring of her fluid balance and hemodynamic status. Because this patient was confused and restless it took two doctors 4 attempts before being successful getting the line.

I returned on Sunday morning, my day started off not to bad. I had two patients one cardiac and the same unstable septic patient I had on Saturday. Unfortunately, during night shift that patient somehow managed to pull out that special line. The internist is unaware of this and I have the pleasure of letting him know. The Internist calls and I give him the update. He is not happy. He comes in does his rounds and then sees my patient. At which time he informs me we have to put in another line. Again, two doctors later and a couple of attempts it goes in. Guard that line with you life I am told by the doctor and he proceeds to write an order for "one on one" nursing for this patient. I agreed with him. My rationale for this is, how can I or any nurse for that matter be able to watch this patient that closely when we have another patient and have to help out with relieving for breaks and process orders and so on. Anyhow, he ,makes the order and the nursing supervisor is made aware. She comes up and talks to the doctor, she then agrees and attempts to find us staff. Good luck. But she does find us a medical/surgical RN, I am just happy she found somebody as our day now is going from bad to worse. My other patient starts to have chest pain, and we get a patient going into respiratory distress and has to be intubated. Even with the extra pair of hands, we miss our breaks and work overtime. Long day.

Anyhow, day staff comes on this morning and we are chatting, when I am told that one of the RN's I was working with on Sunday was complaining about me and my decision to agree with the doctor to have the isolation patient on one to one nursing. You've got to be joking I say to myself. Doesn't my colleague realize the doctor was doing us a favour by making that patient a one to one? He recognized that we needed more help. And by him doing that it gave us more help. Albeit, didn't get us the qualified staff we need, but it did get us help. Help that we might not have gotten. Then I find out that this nurse is also complaining that she felt she was doing all the work. I can assure you she wasn't. She had a student nurse who was helping her, two of her patients were stable and both being sent out. When the respiratory distress came in, we all helped. I helped set up certain lines, get IV solutions, helped reposition the patient whatever I could do....there were also others around, she was not alone.

It really bothered me that this nurse choose to criticize my judgement without even speaking to me about it. Rather, she spoke to other staff telling them that she was pissed at me for agreeing with the doctor. I just don't get it. I missed my breaks that day as well and worked overtime. I didn't ask her to do anything I wouldn't do myself. This is not the first time I have had difficulties with this staff member. I know she targeted me that day because I was in charge, but holy cow batman. If you have issue with something let's talk about it. Don't spread untruths.

So I guess I am going to have to talk with her this evening. I don't want this to spread or continue or I would be just as guilty by not saying something to her and clearing the air. Maybe, I need to hear her side of things directly, before I get to upset over this.