I’m charging now. I did not see that coming.

Our unit manager has been discussing changing our two units to having a free charge.  This week we made the switch.  It’s been a rough week.

The matrix has yet to be adjusted for the new position.  So we have a one less nurse taking patients on each unit.  And the rest have to pick up the slack.  While in theory the charge takes no patients, that is impossible with our current matrix.  Oh, and we’re also in the middle of changing to physician-entered computerized orders.  No more written orders.  Physicians are supposed to enter the majority of orders themselves.  Ha. Right. Put it all together and you have chaos.

I came in Monday morning to find the change.   I had a larger work load with one actively dying patient (and family to deal with) and several to prepare for procedures on top of the normal morning rush.  I was on the verge of tears by 10a.  I started crying by 2p.  I had not eaten breakfast.  I was trying to leave the floor for lunch.  One physician happened to be the last straw.  He was being his usual pain-in-the-ass self, and I said, “Look.  If I don’t eat right now, I’m going to cry.  Nurse So-and-so here can help you do that.”  He turned to me and put his hand out like he was going to touch my arm, and I pulled back with my arms held to my chest and said, “Don’t touch me.”  I then walked around him and out of the station.  I went downstairs to get food and returned to the lounge where I cried a little as I ate.  A brownie later and I was doing better.  By 3p we scrapped the free charge deal because we were getting too many admissions to keep that going.

On my Tuesday off I got a phone call from the opposite day charge nurse giving me the heads up that I would be free charging the next day.  I knew she was going on vacation, and I thought that was all it was.  I charge occasionally whenever I’m the most senior nurse on schedule. Wednesday morning was fine, but by 3p staffing wanted to pull someone.  Rather than make someone give up all their patients only to pick up new ones, I volunteered to go.  The other free charge would charge both units.

I arrived at work Thursday to find my name on the charge list.  The regular charge had no idea what was going on.  I had been told nothing.  I went to my manager’s office as soon as he arrived to find out what was happening.  He told me that there had been charge nurse meetings where they were told that different people would be rotated through the free charge position to see how they do.  I told  him the problem was that had been a while ago, and no one was given a clue that it was happening now.  Much less me.  And that sucked.  But then he did what managers do when they compliment you profusely and tell you that your name has been coming up every time the free charge position is discussed.  And they just know that you’ll do a great job.  You have such a calm manner that the floor needs.  Some of the doctors have commented to them positively about seeing you charge. On and on….  My charge nurse phone rings, and I have to go.  There will be more meetings to discuss the job requirements, because it’s basically being made up as I go along right now.  I agree.  We all need to meet. Soon.

And then Friday.  It wasn’t bad.