The real trick, as a nurse, is figuring out what makes wheels squeak in the first place, and trying to address potential sources of family discomfort before they get blown up out of proportion and lead administration to try to solve the problem, which is to say protecting administration from fallout. Their job all too often seems to be making the lawyers happy, while it is our job to keep the patient and the family (serving as patient by proxy), happy. Well, as least keep their discomfort to the minimum possible, considering all too often, especially in critical care areas, the outcome is unlikely to make anyone happy.

I was always taught that part of our job is working with the family, and have learned that although this can be one of the most difficult parts of our job at times, it can also be the most rewarding.

But the real reason I write this is in response to you comment on the first step up the chain of command being the Charge Nurse. True, this is where the problem can often be best addressed, often only if to see if the problem does need to be hoisted up the chain of command for resolution. As you rightfully state, the charge nurse is supposed to take care of problems that arise on the unit during their shift.

Unfortunately on our unit, a 12 bed Intensive Care Unit, our Charge Nurse is also assigned a full patient load of two patients, and often the two sickest since Charge is also usually the most experience nurse on a crew that contains a number of nurses who are new to critical care, new to nursing, or both. She is also responsible for bed assignments on the unit, calling in for extra staff if the next shift is short, figuring out whose turn it is to float out to other units if those units are short staffed, answering questions of protocol, doing narcotic counts, checking the crash carts and getting them restocked if used, taking and giving report on all patients in the unit for shift change, and making sure that all nurses get their lunch breaks as well as getting out on time. Oddly enough, the Critical Care units at our hospital seem to be the only units without a full time Charge Nurse, and getting new nurses to take on the added responsibilities of being in charge for that extra $1.00 an hour is like pulling teeth, so the duty keeps falling back on the same few overworked souls.

Are we the only hospital in this situation? I’d like to hear if other hospitals are also in this situation of Charge being such a Sisyphean task.

And since this is m’first posting here, thanks for your blog. It’s really a joy to read, one which helps shine a light into that world of deeply guarded, HIPPA shrouded secrets that is life on a Critical Care unit. And it is especially rewarding to find that family members are also reading it, hopefully finding some understanding of what goes on in the minds and lives of nurses charged with the care of their loved ones. The truth is always kinder to them than unfounded speculation and overly guarded, technically burdened acronyms and jargon.

May we never forget that, in some way or another, we’ll all be on the other side of those siderails at some time in the future, and treat others as we’d wish to be treated ourselves.

Nurse Zen

Even though I don’t deal with long term care issues, as long as you aren’t one of those people calling the nurse every 5 minutes cause the TV needs changing, the pillow needs fluffing, or you are just bored, I can attest to the fact that more times than not the complaints are taken seriously.