I left you off last time saying that I was entering the 'bad' time of my schedule where I would be working three days in a row. Well they weren't pleasant. In fact I've only now really began to get out of my bad 'mood'.
Tuesday was my eight hour day, and I can honestly say that being the last nurse 'in' isn't fun. All of the computers were full and I had a call out as soon as I walked in the door, so I had to scramble to get a workplace set up. Technically I was in the med room that day, but the scheduling supervisor seemed to forget that and had me almost a full day's worth of appointments to keep. That meant I got into the med room late and did a barely acceptable job of it.
Wednesday was certainly not a 'normal' day. First off we didn't have enough people on staff, so there were two people brought in on overtime to cover. But the shifts that they worked were far from anything 'normal. One med room nurse cam in at 4pm. The other was scheduled in at 6, but came in late and didn't arrive until 7... just before the med pass started. Not having any time to set up the med room before the med pass invariably led to the med pass taking about two hours (as opposed to the normal one hour).
Before either of those nurses came in we all got an email saying that there was a tech working on our computer network and that we would lose connectivity for between 10 and 60 minutes. I should have listened to that doubt.... the computers didn't fully come up for the rest of the shift (and didn't fully come back up until the next morning!!). I had to reschedule several appointments that required heavy computer use, but there were others that couldn't be postponed no matter how arduous they would be sans technology. When I finally found a computer that DID have a connection it took me almost two hours to document the activities I had done in the meantime. I also had to use that computer for our batch of incoming transfers. The computer couldn't be more 'out of the way'. First I couldn't leave my transfer sitting there as I wasn't in the officer's line of site and the inmate would be left alone right next to all of the other inmate's charts. So I constantly had to ask the inmate to follow me over to the printer (thank Goddess I could print at all!!!), or over to the clinic.
I only had to stay a few minutes after the end of my shift, but the drive home wasn't relaxing as I knew I would grab a bite to eat, grab some Zs in bed, then get up and do the whole thing over again on Thursday.
Thursday was.... well it wasn't bad because of the shift. I worked with a very experienced nurse (in fact she's the one that oriented me to working in this clinic) that I don't often see, had a fairly light call out load, and ended the evening in the med room. But getting into the med room was a nightmare. After the LPN left I got in and started to process all the new med orders and put away the recently delivered meds.
A quick word about med orders. Whenever a doctor puts in a prescription, he has to put a time limit on it. That time limit might be a week (say for an antibiotic), it might be for a month (say for a new drug), or might be up to a year (for a drug used well for the past few years). At the prison, the med rooms run over 500 inmate's meds. So each and every day there are a bunch of new meds, changed prescriptions, and prescription renewals. Each and every one of these has to be documented in our antiquated paper drug documenting system (the dreaded MAR). Around the end of every month we also have to get the next month's MAR up and ready. That involves checking each and every entry to make sure it's correct as well as keeping it updated with the changes made on a daily basis.
Well.... before these shift changes were enacted, each of our med rooms had an incredibly capable nurse running them. Sadly one of those nurses moved over to the North Clinic. The first shift nurse in that particular room also quit (sadly over not getting this new shift implemented before she accepted another job). That leaves a FAR less capable nurse as the 'lead' nurse in that room.
So when I walked into the med room I saw a nightmare. New meds that hadn't been put away, a huge stack of orders that hadn't been implemented, and next month's MAR no where near done. Worse, was the fact that some of the orders had been implemented into the new MAR but not the current MAR. That's not a horrible thing to do when the med is just being renewed, but this was done on med changes too... effectively enacting a Doctor's order days late.
So I struggled to get some of this pile of work done in the time I had, but I barely put a dent into it. I even cut into my 'prep' time... and that bit me in the ass as I couldn't deliver meds to several inmates. They were either out of meds (something that should NEVER happen), or their meds weren't in the right place. One particular inmate refused his meds as I was only giving him 'two' instead of the 'three' that he claimed he should get.
I tried to explain to him that his order was only for two pills, but he kept insisting on three. After about 30 seconds of this back and forth he said "Man, I don't know if you know what the hell you're doing... is there a real nurse that can get me my right meds!?'
I lost it.
My temper flared, I pulled his meds back and told him in an overly stern voice that I would call him out later for his meds. What I intended to convey and what I should have said was "There's obviously a mistake here and I don't have time to research it and correct it right now. Instead I'll call you out and get you your proper meds."
What came out was "Get back to your unit, I'll call you out later!" He of course didn't take that well and shouted "You won't give me my meds!!??" to which I shouted in return "YOU DON'T WANT YOUR MEDS, NOW GET OUT OF HERE!!"
Yeah... not my finest hour.
He was right. He was supposed to get the two pills I was offering him AND another med that just wasn't in the right place. I come across similar problems all the time and even if the inmate has an attitude I'm able to keep my calm. But I just couldn't at that point. I regret acting as I did. Not only because I should be better, but because I honestly think part of anybody's job in a prison is to act like a responsible adult... you know... to show them what a good citizen should act like. Losing your temper and shouting at someone is NOT how I should show them a responsible adult should act.
So... Maybe it was just how the day's worked out. Maybe it was just three bad days in a row... but maybe it wasn't. Maybe working an eight out day followed by two twelve hour days is just a recipe for putting me on edge. I'm not going to make any snap judgement... it's still to close to the incident and I have to base any decision on more than a single bad day. But if this happens more often, I'll certainly see it as a very good and very valid reason for me to return to 8 hour shifts.
Meanwhile... YAY!! FOUR DAY WEEKEND!!!
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