Temporary Queen of the Universe

Last night I was the sole RN where I work. I discovered that reading the Funny Times is excellent for getting through the Witching Hour [three to four AM,  which is generally down time] and staying awake. I had the task of doing "staffing", which means taking calls from nurses calling in sick and adjusting the schedule accordingly so things still work. We also have one house in which to administer medications in the morning while we are doing this.

At about 0430 I bring the medication cart, which is rather small, so this works, into the client's room. On the top of the cart I have the irrigation set for the tube feeding; a pulse oximeter; a temporal thermometer; a pitcher of water; cups of medication, crushed and mixed with water and/or applesauce; another irrigation set for another client; three eight-ounce cans of tube-feeding formula; a small one-ounce plastic cup with a cream for the person's gastric tube site; and the portable telephone for the house.

I place the sensor for the oximeter on the client's finger, take his temperature, and I receive a message via the radio on my belt that I have a staffing call. I give the switchboard my location, and the phone rings; I take the staffing call. Just as I am about to start giving the client his medications, the radio gives me another message, I phone the LPN who called me and talk about an issue with one of her clients.

Then I give the client his medications and tube feeding, clean the stoma and apply the cream, give medications to several other clients, and return to the Health Care Center which is our "base" on night shift, and record the staffing call, adjusting the schedule accordingly. [In this case, one of the RN's on day shift will end up passing medications instead of her regular RN duties.]

At five-forty I'm in the Health Care Center and receive a call from the same house to look at an issue they just discovered on another client; I jump into the car, run over to the house and deal with that, then return to the Health Center and go into the Staffing Office to contact the various Program Area Teams; I let them know what staff they have, be sure all staff showed up to work, and record all the LPN staff assignments on the staffing sheet.

We now have a new system in place, asking RN's from different teams to help each other out by taking calls from some of the houses on a team where they are a little short of RN's. At the end of my general staffing duties, I phone one RN who has expressed the perception that she "never gets any help" to ask her to help the RN on another team. I am uncertain of success, as usually she asks for help but is reluctant to give it. I call and explain that one team has only one RN; the other team has two RN's but one will be passing medications. It takes some reasoning with her, but I get an agreement to help out. For me, a person who has an extreme dislike of confrontation, this is a major triumph.

I bring the staffing sheet in to the Switchboard, feeling like the Queen of the Universe for accomplishing this latest task. This lasts about two seconds. Immediately they cut me down to size, complaining that I am not "done yet" because I omitted recording what specific house assignments the RN's are taking on two of three teams. Doing this requires asking for  pencil and writing in "all of them." I do this, now feeling small because of the discouraging tone of the people at the switchboard; they manage to communicate as if I have miserably failed because of the one omission.

Driving home I decided that no matter how the staff at the switchboard communicated with me, I'm Queen of the Universe anyway.