I’m just settling into a few days off after a very busy weekend at work (yes myself and my fellow medical colleagues were #inworkjeremy !!!). The Sunday just gone was the second Sunday in a row I’ve worked with less staff than is safe. Last Sunday, the ward had one registered nurse, myself and two support workers. At that time we had two special nursing 1 to 1 observations, meaning these two service users presented risks which required a nurse to be present with them at all times until the risk had subsided e.g. suicide risk. This left one worker on the ward to look after the 18 other service users. It also meant we were often doing these observations hour after hour, which is against policy.
So this meant by mid- morning most service users were becoming fed up, annoyed and frustrated that we couldn’t meant their needs straight away! Even simple things like bringing clean towels and showering products had to wait. Not to mention spending time with distressed service users, offering support and empathy. I had to decline all escorted leave from the ward, as it was simply unsafe for any staff member to leave the ward. This made me quite frustrated and annoyed, that we as a team could not meet people’s needs or these were delayed. It felt like we were literally managing basic safety, rather than improving lives, reducing distressing or fostering any recovery or hope. So there were no lengthy 1 to 1 chats with patients, or meaningful activities.
Luckily the staff I worked with were great, we all clubbed together and worked as hard as we could to ensure everybody was safe and we met their needs. We let the senior nurses in the hospital know how short staffed we were and they lent some of their staff to help during the day. I completed an incident report about it which is read by the leaders of the trust I work for, and called my manager to let them know. I hoped that perhaps this wouldn’t happen again. That shift reminded me how team work and how supportive we are of each other is so important in the nursing profession. Particularly psychiatric nursing.
The Sunday just passed, the same thing happened again! One nurse, myself, when there should be two! And two support workers. This week we only had one 1 to 1 special nursing observation. However we had five intermittent observations, meaning those service users had risks requiring a nurse check them every fifteen minutes. So again, I set about letting senior nurses know about our problems with under-staffing and filled in an incident report. However today was different. I found a service user unconscious.
I put her in the recovery position and called our emergency crash team to assist us. She was later transferred to a medical ward to investigate. This highlighted to me how dangerous under-staffing is. Perhaps we may not have found this service user in time to help them. I felt so vulnerable, being the only nurse not having the support of another more experienced nurse at my side. It made me saddened and frustrated that potentially this service users life was at risk when she was supposed to be in a place of safety. I felt scared about the responsibility and accountability of my job.
Senior nurses spoke to me about ensuring my documentation of the incident was up to scratch, in case the worse happened. They spoke about presenting at court after a service user had passed away, and how difficult that was. My nursing colleague on shift at the time, reassured me we did all we could, and we potentially saved a life. Thankfully, the service user has made a recovery.
So I wonder what next weekend has in store. Whether we will be adequately staffed. I’ve been reflecting on the incident and whether I could have responded better, and I think I could have. I also wonder whether this will have any repercussions for myself as a nurse… I’ll find out when I’m next in! However no matter what, I’m glad the patient is doing well. It’s really drummed home to me, the responsibility and accountability of being a nurse. I hope that this won’t make me in to a defensive nurse, worried about covering my back rather than remembering why I became a nurse in the first place – to help people.
Photo from memegenerator.net
Newbie Mental Health Nurse 