Monique Hernandez remembers when she decided to be a Nurse.
“My teenage aunt was diagnosed with leukemia when I was six. I remember being at the hospital all the time during her years of treatment,” says Monique. “I wrote in my journal when I was seven that I would be a nurse. I still have that journal. The following year, we lost my aunt. My resolve to be a nurse just grew stronger. In my child’s mind, I somehow thought if I became a Nurse, I would be able to bring her back.”
When Monique fulfilled that childhood dream and went to nursing school, she discovered that her heart was too tender for pediatrics. She had friends already working at her future hospital and learned that they enjoyed working in Telemetry, specializing in patients who require constant monitoring, including those recently released from ICU.
So Monique went into Telemetry. There she learned that both RNs and patients valued the calm-despite-chaos quality she brings to her nursing practice.
“I especially like helping families cope with their fears about how they’ll handle things when their loved one is discharged,” says Monique. “It brings me a lot of joy to help them know what to expect and teach them how to help.”
In her ten years as an RN—all at a hospital in Riverside, California—Monique has followed her heart in her career path decisions and goals. She wanted to earn her way to a Relief Charge Nurse position in Telemetry. She did that. Then some RNs in ICU recruited her into the Surgical ICU unit. She did that, too—and, in her words, “I learned more than I could ever dream of.” More recently, she started hearing from RNs back in her old Telemetry Unit about their struggles with being pushed to take an illegal number of patients. So when a position opened up, Monique took it in order to see the problems firsthand and to become more involved in her Union’s efforts to improve things for both patients and nurses.
And sadly, she is experiencing the problems firsthand.
One recent morning when she was assigned to a Charge Nurse role, the floor was short-staffed and she was given two patients, which meant she was pulled “into ratio” and the floor was without anyone fulfilling Charge Nurse duties. Suddenly they had a “Rapid Response” situation with a patient on their floor who’d fallen and was lying unconscious on the floor in a pool of blood coming from his rectum.
“We all had to pull our pants up to not soak up the blood. I got down on my hands and knees next to the patient to try to both rouse him and comfort him,” said Monique. “’You’re fine…you’re safe…’ I told him. But it was chaos. The residents were asking ‘Where’s the Rapid Response Nurse?’ In the meantime, I knew we had to treat him ourselves as best we could. I told the residents to order fluids. We had to squeeze the saline fluid into him as quickly as we could, especially with all the blood he was losing.”
After Monique and other nearby RNs got the patient to slowly come to and used an opera lift to get him off the floor and back into his bed, a Rapid Response who’d been on another call finally arrived to assist, followed by another Rapid a few minutes later. Luckily, they helped get the patient stable.
“It was chaos. And not even organized chaos. Lately, it’s extremely unsafe chaos,” said Monique. “It’s the worst I’ve seen it in 10 years. Did we get the patient safely to ICU? Yes we did, but we just felt lucky. And speaking of luck, my two patients with no one to attend to them during all of this were fine, too. What if something happened to one or both of them? Remember, these are patients who require constant monitoring…who are just as prone to the kind of setback we were dealing with. I couldn’t leave the man in a pool of blood to care for someone else in crisis.”
The other bit of luck is the way Monique learned about the bleeding man on the floor. They were stretched so thin that day and the patient had a substitute RN who wasn’t as familiar with the floor—and there was no active Charge Nurse. So it wasn’t until the bleeding man’s roommate called out ‘Hey! We need help!’ that Monique and other RNs came running.
“There are simply way too many ‘whew! we just got lucky!’ moments,” said Monique. “What if the man didn’t have a roommate? …or the roommate had been asleep? Our patients would be terrified if they knew how much we rely on luck. We have excellent doctors and excellent nurses. I’ve seen us be excellent. But how can we be excellent with the hospital leaving things up to luck? This reckless disregard for safe staffing has to stop.”
Nurses like Monique used their strength in numbers this year to introduce legislation designed to strengthen enforcement of California’s nurse-to-patient ratio regulations. Read more about California Senate Bill 227 here.