I’m not exactly sure when things first started to get bad for me. Thinking back, it was all rather like the analogy of the frog in the boiling water. Put a frog in a boiling pot, and it will immediately jump out. However, if you put the frog in cold water and then gradually heat it up, the frog will just sit there and happily boil to death. I am not sure if this is true, and if it is, then frogs must be a special kind of stupid. Still, you get the point. There were no sudden changes to my mental state. The changes were far more subtle than that, and they occurred over a long period of time.
The department had been through so many difficult periods those last few years, and this was especially hard on the senior staff. We felt overworked and undervalued. More importantly, we felt silenced. This period of time saw the second great exodus of people from our department. Every one of my teammates seemed to be leaving at the same time. My support network was rapidly unraveling.
Perhaps the biggest challenge for us was the changing dynamics that occurred within our local community. We are a very busy department, as you already know. What had always been our saving grace each year was that we also had lulls, particularly during the summer months. Usually, once flu and pneumonia season came to an end, our numbers would drop off just a little. This allowed the staff a chance to catch our breath. We were still busy, of course, but not as busy.
That began to change, drastically. Over a period of about two years, our city experienced a very large influx of seniors. One nearby town grew by over five thousand people. This, in turn, created a surge of patients coming to the hospital. As most were older, they often had multiple medical conditions. They would almost always require more complex care. The whole system became overloaded because, once again, no one had thought to make extra resources available.
In the emergency department, this translated into a genuine crisis. Though the actual number of patients we saw in a day stayed about the same, what did change was the type of patients we were seeing. More patients came in that were not mobile. Thus, many required stretchers. Until this time, having patients in the hallway was a rarity. Now, it became the norm. Our normal workload in the monitored area had been three or four patients per nurse. Suddenly, it was not unusual to have six to eight patients per nurse. The complexity of the care we had to provide also increased. This meant that more patients needed to be admitted to the hospital, as they would have been unable to manage at home. Of course, this creates a rather large problem, because a hospital is a finite space. There are only so many people that can be crammed in at any given time, even when you start stuffing them into TV rooms and broom closets. The hospital was running at 130 percent capacity or above, every single day. Think of it this way: If you try to cram too much toilet paper down the toilet, things are going to back up, making a rather large mess. This is exactly what happened in our department. The floors can only take so many people. Once they were full, we were forced to keep all the rest. The toilet exploded, and we ended up covered in crap.
“T. C. Randall” is an emergency room nurse and author of The View From The Wrong Side Of The Day: A Story About Nursing, PTSD And Other Shenanigans.
Image credit: Shutterstock.com