Sal, Joey or Mikaela

[E tank]

ER nurse in an overwhelmed hospital recounts 'impossible' decision she had to make

Mikaela Sakal, on being an ER nurse in an overwhelmed hospital and the decision she had...

www.sfgate.com

If I ever see these names come across my desk for advanced practice in anesthesia, they can consider themselves dead in the water....just sayin'...

 

[DrParasite]

So they refused to clock in, and forced their day shift to stay on OT while short staffed... while they sat their in their scrubs.... during a pandemic. They should have been terminated with cause, with complaints filed with the nursing board to suspend their license for failure to do their jobs.

I've worked in bad systems, during MCIs, and ran my butt off during my shift; I feel bad for the patients in this ER. to be perfectly honest, if I was a hiring manager, and a nurse applied to work for me, and in their last job, they just walked out, making the situation worse because they forced dayshift to continue working because of their entitled attitudes, then I would tear up their application in the middle of my interview with them. They are all an embarrassment to the nursing profession.

 

[johnrsemt]

What DrParasite said
I would have fired them before 9pm Dayshift staying to help, but they refused to go out and work. They were complaining they needed more staff, but they had day shift staying over to work with them

 

[RocketMedic]

Contrary view: those nurses are still accountable, and responsible, for their patients. Their organization failed them on multiple levels and violated ethical, clinical and professional standards in the process. These nurses simply refused to tolerate the status quo any further.
It’s functionally no different than a shift of paramedics refusing to go to work in an unsafe system.

 

[Tigger]

Contrary view: those nurses are still accountable, and responsible, for their patients. Their organization failed them on multiple levels and violated ethical, clinical and professional standards in the process. These nurses simply refused to tolerate the status quo any further.
It’s functionally no different than a shift of paramedics refusing to go to work in an unsafe system.

So I guess you just leave the patients then, right? The day shift isn't "supporting them," they're providing care that their colleagues wouldn't.

 

[RocketMedic]

So I guess you just leave the patients then, right? The day shift isn't "supporting them," they're providing care that their colleagues wouldn't.

They refused to accept an unsafe assignment and demanded appropriate resources. Refusing to work was the only way to get their complaint actually addressed- do you think an administrator would have actually become involved if they were working?

You say “pandemic” like it’s an acute emergency. Guess what...it’s the new normal. A constant emergency. And accepting assignments in dangerous circumstances, or when failure is nearly guaranteed by controllable issues like staffing- that is foolish. This hospital wanted these nurses to accept inappropriate staffing ratios; the nurses took a principled stand for patient safety. It’s no different than the nurses who refused to work without appropriate PPE or in a setting they’re not trained for.
It is the role of the organization and administration to ensure that they are appropriately staffed and equipped. That was clearly not done. It took this to publicize it, but those nurses did the right thing.

 

[silver]

They refused to accept an unsafe assignment and demanded appropriate resources. Refusing to work was the only way to get their complaint actually addressed- do you think an administrator would have actually become involved if they were working?

You say “pandemic” like it’s an acute emergency. Guess what...it’s the new normal. A constant emergency. And accepting assignments in dangerous circumstances, or when failure is nearly guaranteed by controllable issues like staffing- that is foolish. This hospital wanted these nurses to accept inappropriate staffing ratios; the nurses took a principled stand for patient safety. It’s no different than the nurses who refused to work without appropriate PPE or in a setting they’re not trained for.
It is the role of the organization and administration to ensure that they are appropriately staffed and equipped. That was clearly not done. It took this to publicize it, but those nurses did the right thing.

There are other ways to protest an assignment for sure.

I wasn't in Detroit, but rather in NY and would say it was an acute emergency where anything goes. In my unit we staffed 3-5 critically ill patients per non-ICU nurse. The doctors/NPs/PAs did all the sedation and vasoactive medication titration (ICU nursing task) and all the respiratory care on top of their provider duties. The doctors also took out the trash, cleaned the floor, brushed patient's teeth, helped turn the patients. Whatever needed to happen all of us did together. None of that was normal and never will be normal. More staff came to help, but it took days to weeks not 2 hours one evening. If the nurses and doctors weren't there, no body would be there for these people...

Around this time in early April was also Easter. Interestingly, Dante begins his famous journey through hell during holy week. In the Inferno, Dante must pass through hell to ultimately reach paradise in the epic. At the vestibule of hell Dante hears the screams of the first sufferers, the uncommitted, those who were opportunists and only concerned for themselves.

We certainly travelled through hell and in our journey to paradise have no room for the uncommitted.

 

[ffemt8978]

They refused to accept an unsafe assignment and demanded appropriate resources. Refusing to work was the only way to get their complaint actually addressed- do you think an administrator would have actually become involved if they were working?

You say “pandemic” like it’s an acute emergency. Guess what...it’s the new normal. A constant emergency. And accepting assignments in dangerous circumstances, or when failure is nearly guaranteed by controllable issues like staffing- that is foolish. This hospital wanted these nurses to accept inappropriate staffing ratios; the nurses took a principled stand for patient safety. It’s no different than the nurses who refused to work without appropriate PPE or in a setting they’re not trained for.
It is the role of the organization and administration to ensure that they are appropriately staffed and equipped. That was clearly not done. It took this to publicize it, but those nurses did the right thing.

Where exactly did Tigger use the word "pandemic" in this thread?

 

[mgr22]

It’s functionally no different than a shift of paramedics refusing to go to work in an unsafe system.

I can't imagine doing that.

 

[RocketMedic]

I can't imagine doing that.

Well maybe those nurses have more courage than we do as paramedics. It did seem to have gotten the attention they needed it to- their hospital “passed” a state review with regards to staffing, which either means weak regulations or they added staff.

Accepting unsafe work assignments because of a servants heart is a great way to make sure they stay unsafe.

this is also the “dead bodies in random back rooms of the hospital” hospital so there’s that:https://wdet.org/posts/2020/05/14/8...-storage-photos-says-state-not-investigating/

 

[silver]

Accepting unsafe work assignments because of a servants heart is a great way to make sure they stay unsafe.

So the alternative is for the individual to actively choose to make it a substantially less safe environment and screw your colleagues?

 

[Carlos Danger]

Well maybe those nurses have more courage than we do as paramedics.

Let me make sure I understand…..

Some nurses were sick of being understaffed and overworked. So they forced other nurses to work for them. The nurses they faced to work for them:

• Had already worked a full shift
• Were presumably also sick of being understaffed and overworked
• Had no choice in the matter because they had no one to report off to
• Were likely (at least some) scheduled to be back the next morning

And you call that courageous?

 

[RocketMedic]

So the alternative is for the individual to actively choose to make it a substantially less safe environment and screw your colleagues?

it is not the primary responsibility of the employee to ensure safe staffing ratios. That is solely the responsibility of the employer. The day shift ED admin was perfectly aware of the staffing problem and neglected to do anything about it before the night shift was scheduled to come in. The night shift nurses just called their bluff.

Imagine, if you will, that you and your partner are the only crew clocking in for a shift in a busy 911 system. Just one truck, and you’re normally busy- but you’re also going to be held accountable for the outcomes of everyone who calls 911, not just the ones you’re able to respond to. That’s why these nurses refused to work. Because it was the only way that their hospital was going to address the problem.

Yes, it did force their colleagues to stay over. Yeah, that sucks. But more importantly they forced the hospital to bring in more nurses and actually fix the problem, not make excuses.

 

[Carlos Danger]

it is not the primary responsibility of the employee to ensure safe staffing ratios. That is solely the responsibility of the employer. The day shift ED admin was perfectly aware of the staffing problem and neglected to do anything about it before the night shift was scheduled to come in. The night shift nurses just called their bluff.

Imagine, if you will, that you and your partner are the only crew clocking in for a shift in a busy 911 system. Just one truck, and you’re normally busy- but you’re also going to be held accountable for the outcomes of everyone who calls 911, not just the ones you’re able to respond to. That’s why these nurses refused to work. Because it was the only way that their hospital was going to address the problem.

Except that isn't at all how it works.

There were other alternatives.

 

[RocketMedic]

Except that isn't at all how it works.

There were other alternatives.

really? Like what? They’re the ED nursing staff, they’re going to be held accountable for all of the care provided (or not) within that ED. What other alternatives do they have? An emergency complaint to the nursing board? Acceptance of their assignment? A strongly-worded letter to the media (that actually got one of their colleagues fired, see the “bodies in back rooms” report)?

 

[Carlos Danger]

really? Like what? They’re the ED nursing staff, they’re going to be held accountable for all of the care provided (or not) within that ED. What other alternatives do they have? An emergency complaint to the nursing board? Acceptance of their assignment? A strongly-worded letter to the media (that actually got one of their colleagues fired, see the “bodies in back rooms” report)?

Look, if you are dead set on believing that the ONLY WAY to address this problem was to screw their co-workers and essentially abandon their patients like they did, I'm not going to waste my time trying to convince you otherwise.

But it doesn't really take too much imagination to think up other strategies. It isn't as though this problem has never existed anywhere else.

 

[RocketMedic]

Look, if you are dead set on believing that the ONLY WAY to address this problem was to screw their co-workers and essentially abandon their patients like they did, I'm not going to waste my time trying to convince you otherwise.

But it doesn't really take too much imagination to think up other strategies. It isn't as though this problem has never existed anywhere else.

They acted in the best interests of their patients and colleagues and forced the hospital to staff appropriately.

 

[Carlos Danger]

They acted in the best interests of their patients and colleagues and forced the hospital to staff appropriately.

Yeah, I can see how forcing the day shift nurses to endure an assignment AFTER THEY HAD ALREADY WORKED ALL DAY that the night shift nurses didn't want to accept when they were fresh was definitely in everyone's best interests.

Do you think the staffing situation for the night shift magically improved for everyone when the night shift nurses went home? Where did this extra staffing magically come from?

Have you ever worked as a RN in a busy urban ED?

 

[ffemt8978]

They acted in the best interests of their patients and colleagues and forced the hospital to staff appropriately.

No, they acted in their own self interest. The best interest of the patients would have been to have rested nurses on duty taking care of them, instead of the previous shift having to work extra.

Besides, until they clock in and receive a report from the previous shift, they don't have any patients to look out for.

 

[RocketMedic]

No, they acted in their own self interest. The best interest of the patients would have been to have rested nurses on duty taking care of them, instead of the previous shift having to work extra.

Besides, until they clock in and receive a report from the previous shift, they don't have any patients to look out for.

Which means that not only are they accepting responsibility for those patients, they are accepting the inadequate and unsafe conditions propagated by their employer. Their refusal to clock in and assume care forced hospital administrators to actually deal with the problem, not just shrug their shoulders.
E Tank, you’re a niece anesthesist, right? Would you deliberately assume care in this circumstance?