“We are lucky that no one died that day.”

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Yolanda Tominac found nursing via an unlikely path: a previous career in the cutthroat world of film industry advertising.

“I wasn’t fulfilled in my job. I wasn’t helping anybody,” says Yolanda, an R.N. in the San Fernando Valley. “Looking back, I wish I’d left Hollywood sooner. I love being a critical care nurse.”

Yolanda has been a nurse for almost 13 years. In addition to her full-time hospital job, she is a clinical instructor for first year nursing students at Pierce College. She chose Critical Care because she feels she can make the biggest difference.

“I love working with the sickest patients. It might not always be the outcome we’re looking for, but you also get to help and comfort the families in some of the most difficult times of their lives,” says Yolanda. “I recently had to tell a father that his son who’d fallen into a pool ended up with irreversible brain damage. You can’t be robotic about something like that. There’s so much humanity you have to bring into nursing. That’s what I love about it.”

Yolanda consistently brings that humanity into her nursing practice. Even with patients that others might consider sort of unlovable.

She remembers a time working with a patient who’d been a longtime drug addict didn’t have any family or friends around. She was alone. Alone in the hospital with a history of liver disease. And she was dying.

“I know some people would look at her and say ‘she did it to herself.’ But I tried to look at it as a disease,” says Yolanda. “She would have never qualified for a liver transplant, but I wanted her to be as comfortable as possible. I talked to the doctors about managing her pain, her withdrawal, her nutrition. And when it was time for her to leave this world, I got a few other nurses to come into her room and we stayed with her and prayed with her and held her hand until she died.”

So yes, Yolanda’s work is meaningful work. She loves it. She never looks back on that decision to leave Hollywood. What she doesn’t love are the constant struggles with hospital administrators to properly staff her floor.

“We often have staffing levels that don’t take the actual patient acuity into consideration. And we never feel adequately staffed for an emergency,” she says. “If a patient gets worse and requires one-on-one attention, there are times when the supervisors don’t listen to us. They refuse to reduce our caseload. Especially if on paper the patient’s acuity doesn’t meet some arbitrary standard. But those of us at the bedside know best.”

Yolanda describes a day not long ago when she was the charge nurse for the shift. It ended up being a chaotic day, with too many patients and not enough nurses. The E.R. had a patient with a gastrointestinal bleed and no bed. The E.R. was understaffed that day, too. They had to bring the patient to Yolanda’s Critical Care unit. Yolanda had already assigned a resource nurse to care for patients, which meant she had no one on hand to give lunch breaks to her nurses working 12-hour shifts. This resulted in one ICU nurse getting an extra patient.  To make matters worse, one of those three patients ended up in a crisis which required one-on-one care.

“I tried to help as much as I could and do charge nurse duties, tried to give some semblance of breaks. It was impossible to do my resource rounds and multidisciplinary rounds. And we should have had an additional resource nurse available to go to ‘code blues,’ but management has permanently eliminated that position, deeming it as ‘unnecessary,’” says Yolanda. “Other floors started calling us for help because their charge nurses were doing patient care, too. There was no one to get blood or to even help with the simplest tasks. We are lucky that no one died that day.”

 

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