Had three patients in MICU tonight. One on CRRT, one on two pressors, and a fresh intubation. Staffing said it was that or someone gets sent to us from med-surg with no ICU experience, so I said fine, give them to me. Which is on me I guess.
Nobody died. Nothing bad happened. I just kept thinking all night about how close the edge was. If two of them crumped at the same time I don't know what I'd have done. Run between rooms I guess.
I keep going back and forth on whether I should've refused and filed something or whether saying yes was the safer choice for the patients. I honestly don't know anymore. What would you have done?
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Post replyWhat gets me is staffing framing it as you or the med-surg nurse, like those were the only two options. The third option is the hospital pays for adequate staffing, but somehow that never makes the list.
Had a night like this two years ago. Two of mine went south within ten minutes of each other, and I physically could not be in both rooms. Rapid team saved one of them while I was coding the other. Everyone survived, and I still think about it. Nothing bad happened is doing a lot of work in your post, and I think you already know that.
Did you at least have a charge without an assignment or a resource nurse floating? That changes how I'd think about it a lot.
I'll be the unpopular one. Every time one of us says fine, give them to me, it becomes the new baseline. Admin saw a triple with CRRT go fine tonight, and that's the number they'll remember. I'm not blaming you, but I think refusing is sometimes the safer choice long term.
Tripled with CRRT and a fresh tube is insane. I'd have taken it too, honestly, but I'd have been sick to my stomach the whole shift.
Taking the assignment wasn't the mistake. Taking it without paper behind it was. Next time accept it and file an assignment despite objection before you touch a single patient. You still protect the patients, but now there's a record that you flagged it and they chose to staff it that way anyway.