Recovery from total knee replacement continues, the marathon of COVID-19 updates continues to stream from the news channels; life continues to be about ordinary and extraordinary times.
It’s foreign to me to focus on my own health matters, as a Registered Nurse I tend to be a healer at large, depending on the moment a confidant, advocate, and right now a non-driver. Driving my vehicle despite the traffic woes of the Greater Toronto Area; is an aspect of freedom. I have acknowledged that my vehicle is my living room on wheels, as I set the satellite radio to a genre amenable to the day, I engage in the art of war oops driving in the city. My dear father is my driver now and he truly is in the driver’s seat. I appreciate his assistance in fetching ice for the never ending ice packs to my knee, and this week I have progressed to helping with dinner preparations.
As I consider avenues to pursue in the coming weeks, one focus is a job search to obtain my next position as my means to contribute to a team, organization, and health care system. The sobering reports of nurses who have or plan to leave current direct care positions due to pandemic and other systemic issues has been a topic of discussion. Though a number of the systemic factors were known to be stressors well before March 2020.
Best practices to manage resources in health care exist, yet the pressure to be efficient and LEAN have not always translated into healthy work environments. Reports that nurses are leaving due to vaccination requirements is only a small section of a huge iceberg. Understaffing, staff mixes that are touted to save dollars, but in a number of occasions result in poor quality outcomes; including plateaued patient satisfaction scores.
Tried and true if you have a high staff satisfaction score the patient experience will be enhanced. When patients who are in hospital are more in the high acuity, high complex, and a few breaths difference from ward to critical care, resources need to be in place for quality and safe patient care. That’s not to say there are unsafe conditions, but there can be occasions where the line is wavering and staffing is a nebulous reality. Over the years research has shown differences in care delivery on nights and weekends compared to weekdays and the day shift. We can now question the efficacy of 12 hour shifts, as we explore medication error rates in the last 2-3 hours of the shifts. Fatigue is a definite factor though 8 hour shifts of 5-6 days in a row are equally problematic. A number of nurses extend their shifts to complete documentation, to finish up orders, to read emails, complete on line education modules; and for some, indeed perhaps many no pay is provided. Also there is a lack of acknowledgement that the number of tasks, assessments, and documentation on an average day do not match the shift length.
Overlay on an average day an emergency in the form of a code, transfer to critical care, a death or multiple events including the daily turnover of discharges and admissions and the work environment can be defined as busy, chaotic, and uncertain, the team struggles to juggle all the demands. This workload has additional responsibilities related to safety checks, handover, quality control checks, checklists for checklists (so it can feel like) and new initiatives; that to the staff seem to add more tasks without taking any away.
Managers are torn as they recognize the challenges, yet the sheer volume of tasks they need to perform can be derailed due to a patient or family concern, a critical incident, or the news that another staff member is pregnant (a joyous event though not so much when multiple staff announce a future bundle of joy). Corporate meetings, committee attendance, hiring, performance management, etc., are all necessary and the tasks of meeting the requirements of health and safety, environmental inspections, purchasing, budget reviews and round with the staff, patients, stakeholders and the occasional politician, senior leadership and one is never bored.
Life continues and it is the journey we are on that provides life’s memorable moments, take a minute every day and consider what is a blessing. Stay connected to your circle of family and friends who energize you and set boundaries for those who drain you. These are interesting times, though there is no pause button on our lives, live well and namaste.
Registered Nurse Storyteller, Healer, Scribe, Transformational Leader