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I have been a nurse for 40 years. I worked a pm on my anniversary date and like all shifts lately we were short staffed and pushed with the calibre and acuity of patients.
As always, we did the best we could, but it never feels good enough.
The day was very special to me, I love my job believe me – but there was neither time nor cause to celebrate. During the shift, whilst overseeing a full department, supposedly ‘in charge’ of ED in the triage nurse role, and because there was no-one else, I stayed with a restless, unaccompanied, frail, combative, early dementia, falls-risk man.
He was one of three people that needed a watch in acute services at that time, with no capability to do that. I walked alongside him as he picked up imaginary things, muttering to himself or me. I thought to myself ‘I owe it to this man and his family to make sure he doesn’t fall over a break a limb, everything else will have to wait. I can’t leave him.’
My loyalties, not taken lightly, were divided between this man and:
- Potentially unstable patients in the waiting room.
- Ambulance staff waiting for me to hand over an incoming patient.
- A new graduate registered nurse (RN) potentially working beyond her capability (and I knew to be struggling).
- A health-care assistant (HCA) sitting with another combative dementia patient.
- An RN caring for two COVID-19 patients needing extra support because of isolation requirements.
- Being available for any emergency in ED or HDU
- Being on call for advice and incoming COVID-19 patients from the front screening tent.
It was an appalling situation that takes its toll on my health and no doubt that of my colleagues.
Eventually a security person from the front tent came to relieve me. We kept the patient safe but if not, his fall would have meant he’d been up for months of pain and suffering, and we would have contributed to his death.
Rightly so his family would be demanding answers, our managers and complaints staff would be asking questions and we’d have to be answerable to the Health and Disability Commissioner. I’d be the one to carry the can.
This year because of our current situation and the staffing crisis, I again feel duty bound to help out, picking up extra work (shifts in acute services) as do countless other nurses and HCAs.
Every day I am surrounded by a great team of wonderful hard-working nurses. We are however, exhausted by the ever-changing demands and short staffing. We are working extra shifts but still we run short, it’s plainly not safe.
Having paced these floors for 40 years I am older and less physically capable than I was, my FTE is 0.6 for good reason. Yet last year I joined the vaccinating team (adding an extra 0.4 FTE) since it was something I was qualified for and felt duty-bound to help with.
This year because of our current situation and the staffing crisis, I again feel duty bound to help out, picking up extra work (shifts in acute services) as do countless other nurses and HCAs. Sure, we get paid for that, but not enough.
Just yesterday, I booked in a patient to an already full HDU – the RN rostered for the shift was accompanied by an RN from another department who had never worked in HDU, let alone managed patients of HDU acuity. At the start of her shift, I could tell by the demeanour of our RN that she was not looking forward to the shift. She’d have to manage her own patients (no doubt the sickest) as well as oversee the other RN, all the while worrying if any patient would deteriorate potentially unnoticed and considering which patient would be next to off-load to the ward if an even sicker patient came in.
This is why our core staff pick up extra shifts; we know how this feels – professionally unsafe.
Ask my colleagues and they will tell you how I love a good coffee. A new coffee machine arrived last week, to thank us for our efforts apparently. I’m not sure where it came from but I’m sure it’s great. One day I might try it when I’m not slugging down half a litre of water in my meal break, having been asphyxiated by an N95 mask for hours while running a half-marathon. If asked I’m sure most nurses would rather be paid extra for the work they do, not sup coffee.
My colleague, a doctor, gets paid three times the normal rate to do an extra shift! A locum was offered five times the normal rate to do an ED shift! Yet my rate stays the same for the extra shifts I do: surely you can see that this is not right?
I sincerely hope this helps to understand how difficult our situation is. What I ask is that those at the coal face – the nurses and HCAs who uphold the hospital during this pandemic by going above and beyond at great personal expense – are rewarded. Nurses in other district health boards are remunerated accordingly.
The toll it is taking on us cannot continue to be taken for granted.
Teresa Smith, RN