Weakest Link

I AM TIRED 

 Been slightly snappy the last couple of days; less patient with patients, off hand with parents & family members and short with colleagues ... although not colleagues on my working area (we're all in 'it' together) Those working on wards in close proximity, members of staff in the admissions area referring patients, those asking to borrow something or simply ringing for advice. 

Short. Not very nice. Verging on the horrible. Plainly not like me at all. 

Although I never actually said it out loud every utterance seemed to have a desperate and exacerbated "Oh for F*cks sake!" muttered under breath. I feel ashamed even admitting that.

One mother staying in one of the four bedded bays with her son expressed in the middle of the night "Children crying?!?!"  With hindsight this bullet statement was probably down more to her limited English and concern, than any complaint or criticism and my response of "It's a hospital, children are ill. What do you expect?" was neither helpful or particularly accurate. Children were crying, parents were unable to placate or were too concerned about their own sleep to try to sooth. Certainly not this anxious mothers fault.

So final night tonight, and the one I'm most concerned about. In their wisdom they have reduced the night staff from five qualified nurses to four, and do we feel it. Twenty six to four doesn't sound a bad ratio, but the way the ward is set out (and parents unwillingness to have their children cut in two)  doesn't make the devision of six and a half each very easy. We tend to divide the ward ten to two and sixteen to two.

It only takes one sick child to knock you off kilter completely, a single child and their family can occupy you all shift. And frequently you have more than just one of those children. We continue to offer a half-hearted high dependency service, whilst at the same time because we're the medical ward take the majority of admissions. There is minimal respite with only four staff, and each morning on leaving you rack your brain to imagine what you may have neglected to do or omitted.

Tonight is the shift I have been most concerned about, as I'm working with our perceived weakest link. She's a nice girl, clearly a bit troubled and a bit scatty. I don't believe she means to be neglectful but she's her own worst enemy. If you make a mistake or forget something, hold your hands up. If you don't know something or are unsure, ask. These are the most basic rules of nursing care, but rules she appears often to ignore. Replaced with a sense of back-covering and back-peddling.

I've always said anyone who criticises anyone for asking questions or seeking clarification is an idiot.

We are a hard team to breach, many very 'cliquey' (is it cliquey or clicky?) and she has always appeared an outsider (I'm probably an outsider, just an outsider that everyone knows) and hasn't made it easy on herself. A few months ago I was fearful that the pack would hound her out 

I feel sorry for her, I maintain her motives are good and she would be heartbroken to know how she is perceived by the majority of the team. I am our most even handed, the nicest perhaps, and even I'm unsure.

The other three staff nurse were working last night, consequently it's inappropriate to move staff to a different end. Wherever she is put it's potentially a problem; but as the nurse in charge, the most experienced and just because of how I am I will fall on my sword and work alongside her. It's only fair, it's only right ... ... ... or alternatively it's not fair, it's not right!

It does make for a stressier shift, not only do you have manage your own workload but you also have to supervise someone else's ... whilst at the same time not make that supervision too obvious for fear of causing offence. Consequently I am very concerned about tonight.

Final night, feeling tired, bit snappy, bit anxious and not probably firing on all cylinders myself; it feels like a nightmare to come.