Red Flag Reflection

Upon reflection of “red flag” situations, in one particular situation I was exposed to was on a day shift in the medical/Surgical unit. As I passed through the unit, I overheard a conversation of a nurse and unit supervisor discussing the work assignment that was placed on this particular nurse. She currently had one patient assigned and would receive four admissions back to back after handing off her current assignment to the nurse who was in charge of the unit that shift. In this unit charge nurses were only assigned one patient while they were in charge. I could see the nurse pleading with the supervisor who merely wasn’t interested in what the nurse had to say or what her concerns were, but instead stated “ in every other med/surg unit your

assignment would be 6 patients so you should consider yourself fortunate. The situation only got worse as the nurse continued to voice her concerns stating but these were complete admissions and it was a lot for one nurse to take on. The unit supervisor then said this is her unit and she makes the decisions and then walked away. The first admission came through he door, and the nurse started in on her admission routine, within minutes the next one came and then the next. I could only offer to help perform tasks and assist with documentation. The charge nurse sat at the desk taking care of her one and only patient not ever once offered assistance to the nurse who was now being swamped with her third admission. This next admission was not so stable, not to mention a little out of the scope of practice for this nurses skill level. You could see this nurse now had become overwhelmed, frustrated, and worried for her patients that she now had very little time for any of them. The fourth patient came in ready for admission from the Emergency room as all the others did, and I assisted in settling the patient to the room and then could hear the yelling of the drowned and defeated nurse directing her anger toward the charge nurse. As I continued to settle patient after patient, I could not believe what was taking place, not to mention neither could the patients. I thought to myself, never in my career have I witnessed lack of teamwork and collaboration among staff. The nurse resigned shortly after, the unit supervisor was dismissed form her position, and the charge nurse disciplined and required to enroll in an online course for leadership skills.

According to Ritter (2010, p. 28), Unhealthy work environment found personnel having characteristics such as, abusive behavior, disrespect, and lack of leadership, only to mention a few traits. This was certainly demonstrated in this unit that day. I was only too happy to have walked into the unit that day, if not only to assist the nurse but, reassure and provide care to the patients who were subjected to the animosity and turmoil in the unit. I don’t believe a mandatory staff ratio in this case would have helped but, I think having a time frame on when the nurse could safely receive her patients and time to settle each one would be beneficial. The unit needs a lot of work in collaboration and teamwork. I agree with the statement in the American Association of Critical Care Nurse (AACN, 2005) in that it is important to have methods in place for improvements in working relationships, whether it is nurse to nurse or nurse to physician. Finally, the knowledge and abilities of each professional are respected when true collaboration exists and as a result, the goal for providing safe, quality care for patients is attainable. After all, our ultimate responsibility is to our patients. I think we missed

the goal on this one.
References
American Association of Critical Care Nurses. 2005. Standards for Establishing and Sustaining Healthy Work Environments. Retrieved from; http://www.aacn.org/WD/HWE/Docs/HWEStandards.pdf
RITTER D. The relationship between healthy work environments and retention of nurses in a hospital setting. Journal Of Nursing Management [serial online]. 2011;19(1):27-32.