between a rock and a hard place

OK I have newfound respect for ICU nurses after watching them for the past 9 days. One thing I have observed is about staffing. When you have a vented patient, and another patient, it must be hard to keep up. That seems to be the staffing I've seen - two patients. The thing is when something goes wrong with one of your patients you are screwed.

So I'm sitting there with my relative who is on the vent but stable. Her nurse gets another patient post op I guess, since we are in SICU. The patient arrives and within a half an hour I hear: "anesthesia stat to room ---". Its the person next door. He had to be intubated so everybody is scrambling around.

So now my relative's nurse has 2 vented patients, one of whom is unstable. Now you might think, the other nurses will pick up the slack, and they do, but they still have their own patients. So a burden is put on them. There is no "extra nurse" to pick up one of her patients. They staffed for what was there at the beginning of the shift. So her nurse struggles to keep up until they move my relative down the hall and she gets a new nurse. Thus is the juggling that goes on in the ICU.

That's part of why we can't get people upstairs, the tight staffing. Hospitals never staff extra for emergencies. They staff for what they have. Its understandable because they don't want to pay a nurse to do nothing, but this is all part of the delay in getting beds.

Another delay is waiting for doctors. They extubated my relative today. It took til 1 pm for the staff doc to come and say it was OK. Nurses are always waiting for docs to come to transfer patients, discharge patients, do procedures on patients. Its all so inefficient.

These factors play into people in ER, PACU and admitting waiting for a bed. I don't know what the solution is. They aren't going to have any extra nurses. Doctors probably won't get more efficient. So you are left with an inefficient health care system with no real solution.

On the positive side my relative is extubated and her and the baby both are looking good. Its been a long week...