Welcome to Lovanurse Memorial Hospital! You are a new hire RN with five years’ experience and have been assigned to a medical surgical floor that has high staff and patient turnover. In addition to standard medical-surgical patients, your floor also is assigned to do telemetry overflow if there are not enough beds available on the telemetry floor. Telemetry is full today.
As luck would have it, two of your RN colleagues have called in sick today. So, it’s you, the only RN, two LPNs, and one CNA. Your floor has 15 beds, which are full. Today, there are at least four possible discharges, six planned surgeries that will require admission, and a possible patient in the Emergency Department. So, this means that you’re going to have to work with the bed coordinator to shift patients to different units. Fun!
Your staff for today:
LPN 1: Macy: 40 year old Hispanic female who has been a LPN for 12 years. She speaks English but prefers to speak Spanish because her accent is rather strong. She volunteers to take Spanish speaking patients. She is a hard worker and handles delegation well. She does not know how to perform peritoneal dialysis procedures. She has not been IV certified.
LPN 2: Mike: 57 year old Caucasian male who is going through a divorce. He is known to resist delegation, especially from new staff. He is a smoker who takes at least 6 breaks a shift, regardless of permission from the manager or charge nurse. He is extremely smart and is thinking about going back to school to get his RN degree. He is a wiz at wound care and is IV certified, which means he can start IVs, give IV medications, etc.
CNA: Gilda: 24 year old Asian female who just finished her CNA training three months ago. She is quiet and because of her cultural beliefs often seems subservient. She is in school now to get her BSN but needed money to help her get through school. She is afraid to work with patients who are in a great deal of pain or male patients.
You are still acclimating to the hospital, charting/medication dispensing system, etc. Your manager is in Hawaii. The administrator on call is aware of what is going on and says that you have enough staff because you have 2 LPNs who can take patients.
It is 0700, and the off going shift nurses want to give report.
Your unit is set up in pods with 5 beds in each pod. Typically, each nurse takes a complete pod to help patients and other staff know who will be in charge of that area’s patients. However, it is okay to assign nurses to two pods, but not more than two. You must take a minimum of four patients. LPNs, at your hospital, may be assigned up to six patients as long as you review their assessment findings and notes. You must also cosign their notes at the end of the shift.
