Nurses struggle to keep up with admissions

Where: Children’s Hospital-St. Paul

What happened: Repeated phone calls made to supervisor, patients waiting for nurse assignment

Why:  We were working 4-5 nurses short.  We combined assignments to have all patients covered.  We had two unexpected admissions and covered those too.  Some assignments were unrealistic to get all the work done on time.  (Babies were fed late, medications were given late, an order to extubate was delayed until staff had time to be at the bedside to monitor).  The patient census was at 58 with 18 vents and 24 nurses covering.  There was no CSA available.  Nurses were not able to take breaks or were limited to 15-20 minutes for the entire 12-16 hour shifts.  Due to the lack of CSA support many of our supplies at the bedsides had not been filled so many extra trips to find supplies from the main room took us away from babies’ bedsides.  Treatments were delayed due to admissions and unable to carry out orders as they came.  Both transport and charge nurses assisting at bedsides unable to get full report on all babies and any changes.  We were unable to assist every nurse that needed help.  The orientation for RNs was cut short as they took on five babies between them.  This is a frequent occurrence on the night shift, and the staff is burned-out.  They hear that help is coming but it appears that nurses are just shuffling between shifts.  Other Twin Cities’ hospitals are full with very few beds for neonatal babies, and even fewer nurses there are available to take care of them.  The fear is that one of these nights an event will occur that will jeopardize the baby’s safety and the nurse’s license.  In the middle of the night, you have what you have.  There is nowhere to pull from.  All units are working short.  You can’t jeopardize other units or patients either.  Need to have more proactive staffing for nights and weekend shifts.  Supervisors cannot help if they have no tools to help with.