Once upon a time, long ago and far away, I was nursing in an ER in a medium sized city. For some reason, I was unable to evade being placed in charge.
Lord Knows that I tried! While I have established that I can be reasonably effective in a supervisory role, I really do not like it. For one thing, it places me in overly close proximity to Suits. I do not enjoy proximity to suits. Hell, my Suit Aversion Disorder led me to work midnights, in the first place! (well, that and shift differential, as well as seven-on-and-seven-off scheduling, to be honest.)
For another, I get subjected to all the bullshit from other departments, which, invariably, appears to consist of interacting with slothlike souls who manifest only one burning desire: skate through their shifts, while expending as little effort as is needed to maintain their receipt of a paycheck. Notice, I did not attribute to these chuckleheads the desire to actually do something resembling their jobs. That would be different.
Finally, when in charge, I get to cope with all the malignant and ill considered decisions regarding staffing the aforementioned cursed suits have enacted.
So at this point I was working in a relatively urbanized area, with a sixteen bed ED, in a town with three total Eds of various sizes. We had been short staffed for an extended time. This, of course, made me oh, so very happy. Or, not. I had been bitching, complaining, protesting and generally making known that not only was this sort of staffing insufficient, but, into the bargain, was considerably short of their own goddamned published staffing parameters, written by the goddamned suits themselves, and for which I would be written up should I let someone go home leading to staffing short of these parameters.
Well, as it developed, one of the Junior Suits (our assistant director) was compelled to show her smiling face up to work some of the short midnight shifts. She was, let us say, “entertaining”, to work with. She would “help out” by triaging. Well, when you triage someone, it is helpful if you (1) obtain and record vitals, (2) ascertain, and document allergies, medications, medical history, as well as (3) history of present illness, typically elicited by asking something along the lines of, “So, Mr./Ms/Xr X, what motivated you to come out in the dark of night to join our happy little party?”. You did notice how much fun I seemed to think it was, to, ya know, DOCUMENT, the aforementioned items, right? Sort of like that was, oh, I dunno, a GOOD THING, or something?
So, it develops that Little Mary Sunshine did not document (or even obtain; it was difficult to sort that one out) vitals, allergy/med/history, or present complaint information, at least, not consistently. In addition, it seems that an ED physician with, say, a dozen patients, really, really gets petulant if these items are not there in the chart to be found. Slows him/her down, considerably.
Then, there is the part about both bedding the patient, as well as noting such fact on the greaseboard, as well as reporting off to the the nurse who would, oh, I don’t know, maybe BE CARING FOR THAT PATIENT.
Finally, it was established practice to start the needful IVs, collect the blood, and send it to the lab, along with a requisition for the bloodwork the physician was going to be desiring to see. None of which had penetrated Little Mary Sunshine’s cranial vault.
She was no more helpful as a “floor” nurse, Which is to say, she would half ass do things, not tell anybody at what point she had grown disinterested and wandered of Ghawd alone knew where, let alone document anything that she, by some miracle of random happenstance, completed.
As my partner, Andy, opined, “Ya know, she is not really a very effective force multiplier!”
Much more nicely phrased than the tsunami of profanity that was boiling away, waiting for me to spew forth as my OWN opinion of her “efforts”!
So, visiting as she was from the warm climate of Daytime “Suitworld”, Little Mary Sunshine was chilly most of the time. (she might have been warmer, had she been moving about as briskly as the rest of us, but, then….) Andy, once again demonstrating the situational awareness that made him a fine nurse and great partner, noted this fact, and brought it to my attention one long, long night during a missing Mary moment.
He implemented a plan based upon this observation, and turned the department thermostat down to around 60, from the typically balmy 70 where it normally rested.
Well, time passed, Mary Sunshine wandered around, fucking things up, and soon the HVAC system equibrillated at the new set point. Mary zipped up her sweatshirt, and began to complain that it was cold.
Nice of her to notice.
Shortly thereafter, she loudly opined that “You guys seem to have things under control. I’m gonna go back into my office and do some paperwork. Call me if you need me!”
Once she was safely away down the hall towards her (independently heated) office, we returned the thermostat to the baseline setting.
The rest of the night passed as the typical clusterfuck of shortstaffed jackassery, fortunately not exacerbated by halfwit half assed managerial fumble fingering.