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What do you think about this workload ?

By Ariel Garnero posted 01-29-2011 02:03

  

Few days ago I was scheduled to work at certain Community Hospital, a small one where only two RTs work per shift. This time it was I (work for an Staffing Agency) and an Staff RT. My day was good until I received my assingment for the day which in few words consisted of:
5 QIDs
2 Q4h
4 Q6h (one in ER)
3 Q6prn (one taking Q6 txs)
1TID
1Vent (vent dependent pt in isolation) Q2 checks and Q6 in line Txs
a couple of O2 checks...
When I saw this assignment my italian blood started boiling...
The Staff Rt took
4 Q4h
1 Q4prn
1 QID
1Q6h
The shift started at 06:00 am so after getting something that couldn't be called report, started my Txs at 06:30am.
Almost all the Txs were Albuterol 2.5 mg in "2.5 ml vials" and Atrovent 0.5 mg in "2.5ml" so the neb tx was a 5ml one....do you know how long it takes to nebulize 5 ml?....
I worked as hard as I could, but wasn't happy at all when the other RT was at the department watching tv...
Didn't take my lunch at all and he told me that the shift was for 8 instead of 12hrs. So I told him "well I am gonna finish my Q6 and my second round for the QIDs and Q4s but I am not gonna be able to do the 3rd round" and he answered: "How long have you been an RT?" OMG !!! Never ever in my life did I feel so frustrated and angry...He was expecting me to finish the 3rd round by 2:30 pm !!!!
So i finished my charting and I asked him: "Is there anybody coming after me? He asnswered: "NO !!!"
Well I left and sweared to God not to come to that place anymore.
I was sent home early and the workload still was for 2 RTs...only God knows who did the 3rd Q4s and QIDs round....
I thank God for all the experiences that have enriched my life working in a Staffing Agency but this one was unbelivable....
We talk too much about productivity nowadays but there is an inverse relationship between quality of Txs and quantity of them and we have to find a balance.
What would you have done if u were in my place?
What is the law that regulates the amount of work we can do?
Where do we have to report situations like this one?
I swear to God I almost left the place upon taking a look at my assingment but didn't wanted to leave the Pts without Txs...
Of course had to go to the gym after and released all my stress and anger doing benchpress and hitting the punching bag...
What do you think about this story?

7 comments
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Comments

Ariel Garnero
12-11-2011 13:27

I understand all your comments and I wanted to point something that happens in many places, not in all thank God.
It is funny how he have nice information about "concurrent therapy" posted at official websites like the AARC http://www.aarc.org/resources/concurrent_therapy.html saying that we are no supposed to do this....but we all know that happens...
We all know what is working under pressure and sometimes workloads goes up during the shift and we try to do as much as we can altough is imposible to be in all the places at the same time.
@Mark: is not who is going to pay for it? is about quality of care....we can not juice people out just because we want to produce more...there has to a balance between quantity and quality of care: We are not machines, of cpourse we have produce and at the same time legally protect ourselves and assuring that we don't endanger the pt and that happens when we can spend a reasonable amount of time with the pt,otherwise we will maintainig and passing the pts to the next shift and so on...I blame bad management of this situation. We need to protect ourselves and the Pts from this practices.
My point is that there has to be a limit and that is a Management responsibility. Staffing properly is a key and critical point. We need to legaly protect ourselves because we charge for the quality of a Tx that we know that we are not able to give because of the lack of proper time.

Lorraine Bertuola
04-14-2011 08:41

I have worked agency many times in the past. Take this as a learning experience and move on. My guess is that you would not go back to help the department out ever again. There are departments out there that believe since you are agency and getting paid more then they will take advantage. With that said, I don't think that was an unreasonable assignment. I have had times when my self and another therapist has had 19 vents patients in the ICU/CCU and had to do open suction and ABG's on every patient. Is it right? Of course not. Patients with respiratory needs deserve proper treatment and we as therapists need to voice our concerns. I don't know if you know this but in most healthcare areas of practice Respiratory is not reimbursed. Since we are a cost this is typical respiratory. We as respiratory therapists need to show our value to administration and not complain about workload. If we showed our value then administration would be more willing to staff appropriately.

Mark Stronati
02-14-2011 17:09

If you are still looking at responses. My last clinical assignment. 7 ventilator patients 6 of them on Q4 Rx. 2 non vented on Q4 Rx, 1 non intubated on Q2 Rx. a bronchoscopy, MiniBAL and 2 trips to CT scan. About average assignment. If we are going to reduce the amount of work who is going to pay for it?

Ariel Garnero
02-02-2011 21:44

The other Rt wasn't a team player, he was just trying to save energy and take it easy. That is the only thing that I can blame on him cause maybe is more a management failure. We don't know if he had instruction to do so. Managers and Administators sometimes look more at the way to increase profits and decrease the usage of staff agencies overworking their own staff. Many places where I've been so far has a motto "Do the best you can"...in few words: "We already know that the workload is too much"
Like I said before there has to be a balance between quality and quantity on treatments.
I am in favor of team workers, people that when they don't have nothing to do still are willing to help others. That kind of people creates a nice working environment and a is always a pleasure to work with them and also they encourage you to do the same not only for them but also for other coworkers.
Sometimes trying to do what is correct can make you feel stressed and frustrated and we end up getting sick or with an stomach ulcer..... so we need to find a way to protect ourselves....and some people react in a way like "I don't care about ir anymore.."
I don't know but is a balance that every one has to find....by the way I am still looking for it and when i don't feel confortable working in a place I feel like running out of energy....that is one of the reason that creating a nice working environment motivates your workers to give their best and happy people produce are more productive !!!

Lisa Becker
01-31-2011 19:03

Arial, I've seen that television watching therapist many times in my career, and some nurses, too. I don't know how it happens, but sometimes people in our field lose their patient focus. I'm not that way, you're not that way. When I come to work, I have my game face on when it comes to the quality of care that we deliver to our patients. I was never, and would never be, the kind of therapist that would come into work and look for a way to ignore the workload, to find a way to get myself a not so busy day. If you could afford the missed shifts, don't go back there again. That television watching therapist might have to turn off the television, get out of his chair, and focus on what we are supposed to do, take care of sick and injured people. All my best to you, and thank you for being there for those patients when the staff therapist was not.

Ariel Garnero
01-31-2011 00:22

Actually I talked to the Hospital administrator but who knows what happened after... I knew from the beginning that the assingment was more than what legally a person can do but what can RTs do when they face this kind of workload? Turn around and say "Thank you... but I am not gonna do it, it is unaceptable" and doing so the owner of the staffing agency would have kicked me out because of his not getting paid...I was between a sword and a hard place. The only thing I can assure you is that I didn't work comfortable and at certain point was happy for being sent home early altough getting pais less money (missed my 4 time and a half paid hours) I was wondering if that is right for the patients cause they charge them for properly given treatments and there is no way the you can give quality of treatments when you have to face such a workload...that is not fair for the RT and for the Pt. I didn't study for this kind of bull.... but the thing that really discouraged me the most was the attitude of the staff RT, so calm and quiet like "I don't care" . I don't know if he was forced to do that or not. That kind of people damages our profession. Shame on them !!!

Lisa Becker
01-30-2011 19:30

Ariel, that workload was ridiculous. When I was taking care of staffing, I was so grateful anytime that I could get an agency therapist to come in and help us, we were so short staffed. Dump on them? Never.
Rather than just going to the gym and venting your frustrations (I do that, too.), Have you considered taking your complaints to the department head? Tell them what happened, how you were treated. Times are tight, and if they have a therapist on staff that is spending her time watching television rather than contributing to a successful shift, it might be time for them to show her the door.