labor nurse has been reborn and shares her experiences as a new nurse-midwife, woman, and blogger

Wednesday, August 22, 2007

Charge Nurses

If there is one thing I hate more than anything, it would have to be lazy nurses. In particular, lazy charge nurses. When I worked at Posh City Medical Center, I became one of the frequent charge nurses on the unit. Although it was not a labor and delivery unit, there still was shit that needed to be addressed in any given shift. It was the charge nurse’s responsibility to ensure that the shift was running smoothly, that one nurse wasn’t running around with like a chicken with her head cut off while the others languished in the back room eating chips and dip.

Enter my current unit. I’ve been there several years and have never been assigned charge nurse. I normally would have been miffed at any other hospital, but the place I work now is not like the other places I worked. Obviously this is good and bad. I actually would not want to be charge nurse in my current job. Most shifts include three ring circuses, whining physicians, crying nurses, and some huffing and puffing. I don’t want to be in charge of that.

There are some really good charge nurses, I have to admit. I particularly love when Nurse M is charge. She’s funny, she’s fair, and she doesn’t take shit. She also was very supportive and protective of me when I was new, so perhaps I am a little biased. Either way, I prefer her over most.

Today, on the other hand, was Lazy Ass Charge Nurse day. I actually try to avoid working days that she is on. Here’s why in a nut-shell: you get shit on for 8 to 12 straight hours. It’s the one thing in life that you could always bet money on and win. Trust me. I can’t even begin to count the times that she has pushed several patients on me so that she would not have a single one. But I’m certainly not special, it happens to all of the staff nurses under Lazy Ass Charge Nurse.

For instance, I was caring for two active laboring women. One was doing very well, was very pleasant, and was understanding that I was busy. The other was highly anxious, difficult to please, and made me feel uncomfortable for some unknown reason. I anticipated both of them needing epidurals around the same time. I went to Lazy Ass Charge Nurse to inform her of my prediction, and could we put a plan in place? There is no way that I can safely assist with an epidural in one room while monitoring the other woman. I’d be tied up in one room for at least 45-60 minutes, unable to leave to help the other if she needed me. It’s all well and good that we have central fetal monitoring so I can watch the other’s strip while in the opposite room. But what happens if I see a decel? I can’t exactly go running from Mom #1 during an epidural placement to do what needs to be done with Mom #2 having decels. This is why I was trying to plan ahead.

Of course, I got a non-committal plan of which I left wondering if one was even in place. And what do you know? Mom #1 wants an epidural. Fortunately all goes smoothly, the immediate recovery period was cake, and so I was able to go see Mom #2.

By this time Mom #2 is losing it, unable to cope with her 20 second contractions. She is begging and pleading for an epidural. And so an epidural it is. Except…. all hell breaks loose. She has one of the most extreme hypotensive reactions I’ve ever witnessed. Her blood pressure was 50/24 after the epidural loading dose. I was thinking that I might be pressing the Code Blue button. Fortunately I didn’t have to, but needless to say it took 2 hours to stabilize her. I didn’t get a chance to call out and ask for someone to keep an eye on Mom #1 until over an hour into this debacle.

Lazy Ass Charge Nurse said that she had no idea that I needed help.

Say what? Or should I say, Say Fucking What????

I was fuming mad. When I was able to leave Mom #2 for a minute I went to Mom #1’s room. There I found our most motherly of nurses, Nurse F. Despite having a full assignment of her own, she somehow became aware of my situation and stepped in to watch Mom #1 without having been asked. To say I was grateful is an understatement. I felt terrible that Mom #1 had some random nurse coming in and caring for her, but she was totally cool with it.

Now did I mention the reason I had these two patients was so that Lazy Ass Charge Nurse could have an empty plate? I already was assigned one patient when an hour into the shift she decided to dump her one and only patient on me. And as the day went on and more women came into our triage room (and of course all were admitted) she conveniently dumped each and every one of them on other staff nurses. Each of the other nurses already had 1 or 2 patients to begin with. Nurse H got the shortest end of the stick as she was given one patient after the next because she just happened to get the only patients that were delivering. No sooner would a placenta pop out would Nurse H be told that she had to take yet another woman.

This sort of laziness is more annoying than stupidity. I don’t dare go to management about this, although I wonder if anyone has. The problem with going to management is that Lazy Ass Charge Nurse is well entrenched with the management crowd, and so she is well protected. It’s funny how such people can’t manage to do much work, but work real hard at making the right connections.


AtYourCervix said...

Sounds like lazy ass charge nurse is the same charge nurse from hell that I posted about.

Or they at least went to the same dysfunctional management course.

The Nurse said...

Not only is she lazy, but she is UNSAFE... I am so blessed in my department, we all help eachother out. My change of shift delivery this morning was wondeful, as my charge (who had a load of her own) stepped in, along with another RN so we could all get everything accomplished on time and quickly... they did so much for me behind the scenes so I could be at my patient's side during her labor & delivery and STILL get out on time.

Anonymous said...

my husband has a guy on his boat that's like that. he fails all his quals but is somehow magically qualified because he's a brown noser. it's really lame.

Rachel said...

"50/24" - Just, damn.