We recently had a Client, young by our standards, only 79 years old. She underwent hip replacement surgery. The surgery, by all accounts was a great success, but the Client was reportedly suffering a post operative delirium.
The medical staff predicted she would recover, but they could not say how long it would take. The Client's daughter contacted me and told me her mother was reporting giraffes in her room. Also, the Client telephoned her friend at 5am wondering if her dinner would be there soon.
We decided to head to the bedside to investigate further.
When I walked into the room and greeted the Client she recognized me, did not seem to be in distress and reportedly did not have any pain.
What I noticed next was a poster of a giraffe, hanging on the wall, directly in front of the Client. The Client was correct...there were giraffes in her room.
Next I noticed the clock on the wall. It was too far away to be read by a patient in the bed (who did not have her glasses with her in hospital, I might add...) There was not a lot of contrast betwen the colour of the face and the colour of the hands on this particular clock and even if it could be read by the patient, did not have an am/pm indicator.
It was Fall. And for those of you who are early birds, like me, you know that at 5am it's dark outside- it's also dark at 5pm.
So if you were in an unfamiliar setting, waking up to the stare of giraffes, the darkness of evening and possibly hungry for something to eat - you might call your friend at 5am and tell her "there are giraffes in my room and I'm hungry for dinner".
The Patient left hospital shortly thereafter and did well with some follow up physiotherapy at home.
Friday, October 26, 2012
Scary new trend
We've been interviewing again. As a result we've been meeting Registered Nurses who are practicing in a variety of settings. A scary trend is emerging: the inexperienced float pool Nurse.
I have met a number of newly graduated Nurses who have positions in the "float pools" of large multi-service acute care hospitals. Being a member of the float pool entails being available and prepared to work at the last minute on any floor, any shift, within the hospital, where there is a staffing gap.
To their credit, these new graduates, happy to have a job, are jumping in with both feet. They answer calls for last minute staffing needs, are being placed in a variety of work environments, they are being required to perform unfamiliar tasks, with unknown colleagues on almost every one of their working days.
And in the event that you think that this is only occurring in Clinic settings or other predictable and somewhat stable environments, think again. The Nurses that I meet are being assigned to critical care units, to the emergency room and as one Nurse told me recently...it's nice to get some experience with a chest tube-that's something I've never done before!!! (I don't know about you, but if I had the need for a chest tube, I'd like to be at least the second person the Nurse had seen with such an appliance.)
These Nurses are being asked to work with patients who have complex care needs. They are being asked to administer medications that they have never administered before. And they are being asked to handle equipment and procedures that are new to them. These newer Nurses are not being sent in to these busy environments to be mentored by a more experienced and knowledgeable colleague. They are expected to function as a fully qualified and experienced member of the health care team.
They are understandably nervous; about being unfamiliar with a procedure and harming a patient; about being unfamiliar with a procedure and having to ask for assistance and then being seen as not able to handle their responsibilities; about whether or not they will be called for enough work to cover their bills; about what they will encounter the next time they answer the last minute call for work....
Patients don't benefit under this kind of work arrangement. Nurses don't benefit either.
Patients deserve quality care. And quality care is delivered through the work of experienced practitioners and by newer practitioners who are mentored by expert colleagues.
I have met a number of newly graduated Nurses who have positions in the "float pools" of large multi-service acute care hospitals. Being a member of the float pool entails being available and prepared to work at the last minute on any floor, any shift, within the hospital, where there is a staffing gap.
To their credit, these new graduates, happy to have a job, are jumping in with both feet. They answer calls for last minute staffing needs, are being placed in a variety of work environments, they are being required to perform unfamiliar tasks, with unknown colleagues on almost every one of their working days.
And in the event that you think that this is only occurring in Clinic settings or other predictable and somewhat stable environments, think again. The Nurses that I meet are being assigned to critical care units, to the emergency room and as one Nurse told me recently...it's nice to get some experience with a chest tube-that's something I've never done before!!! (I don't know about you, but if I had the need for a chest tube, I'd like to be at least the second person the Nurse had seen with such an appliance.)
These Nurses are being asked to work with patients who have complex care needs. They are being asked to administer medications that they have never administered before. And they are being asked to handle equipment and procedures that are new to them. These newer Nurses are not being sent in to these busy environments to be mentored by a more experienced and knowledgeable colleague. They are expected to function as a fully qualified and experienced member of the health care team.
They are understandably nervous; about being unfamiliar with a procedure and harming a patient; about being unfamiliar with a procedure and having to ask for assistance and then being seen as not able to handle their responsibilities; about whether or not they will be called for enough work to cover their bills; about what they will encounter the next time they answer the last minute call for work....
Patients don't benefit under this kind of work arrangement. Nurses don't benefit either.
Patients deserve quality care. And quality care is delivered through the work of experienced practitioners and by newer practitioners who are mentored by expert colleagues.
Subscribe to:
Posts (Atom)
Posts
