INR Features

Two years ago my mother-in-law at 92 years of age, was admitted to the hospital with recurrent rectal bleeding. She lost her sister to colon cancer. She was advised by her physician to have a colonoscopy. She is approx 4 foot 8 inches, crippled up with osteoarthritis, extremely unsteady on her feet and walks with a cane or a walker. She was admitted to a local hospital. She had an IV started and was given the standard bowel prep. I, as a Registered Nurse, elected to stay at her bedside to assist with her care knowing that there was no way a staff nurse, nursing assistant, or health tech could get to her bedside quickly enough when she had to make a run to the bathroom. For a "normal" person on bowel prep this is a challenge, not to mention struggling with IV tubing and a "heavy" IV pole, remember this woman is only about 4 feet 8 inches tall. A commode was asked for; however, she never did receive it. She wobbled from her bed, around the IV tubing, holding onto me and onto the IV pole multiple times during the night, and when she had to go she had to go! Potential to fall/injure self was high on my list of preventions. During the night shift I did not sleep, I saw the staff twice. They didn't even come in to assess how much bleeding she was having.

I have been a patient myself at least three different times in three different hospitals. Once during labor of my second child, when the pain was so severe I felt was about to die, my Nurse kept leaving, saying she'd be back soon. I am frightened, I am in severe pain, and I don't think that it is an unusual request to have your assigned nurse with you during these last minutes prior to the actual birth?

I have been in these situations myself when there are more patients than I can reasonably handle. How fair is it to tell them I will be with you in a minute, and that minute stretches to 15, 20, ½ hour or longer? How fair is it to these patients when you have four call lights on all at once and each one is a task that takes you 15 minutes or longer? How do you triage this? How do you explain to the patients I can not be with you right now. How do you tell the scared patient who keeps calling every 5 minutes that you know he/she is scared and you just can not spend all your time at their bedside. There is IV therapy to start, beds to make, patients to turn, wounds to dress, phones to answer, charting to do, medication to distribute, blood transfusions to give, patients to assess, families to comfort and give information to, and the list goes on and on.

When there is no other help, when bedside staff has been cut back so far, you do what you can reasonably do. You go until you cannot go any further. Being a staff nurse zaps every ounce of energy you have. To say there is a shortage, you don't have to look far, just become a patient yourself, or have a family member become a patient and see for yourself the condition that Nursing is in.

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