Mia logged off the computer and sighed. It had been a long, busy day in the Step Down Unit and she was tired. They'd worked one RN short again and everyone felt the extra pressure.
She glanced at the clock and then at her list of things to do before the end of her shift. As she turned to get started, the shift coordinator stopped her. “We’ve had a sick call for nights again” she reported, her frustration evident. “I haven't found anyone to come in yet, so I’m looking for a volunteer to stay until I can find someone. We need everyone tonight―we’re swamped.”
Mia took a deep breath and replied, "I’m not sure I can do that. I’m pretty exhausted. Give me a few minutes to think about it.”
“Could you let me know as soon as possible?" the shift coordinator wearily asked. “Everyone's tired but we need someone to stay until we find a replacement,” she said, walking away.
Mia considers the situation as she walks down the hall. The unit is having difficulty finding staff. She’d heard rumblings from others about being short-staffed and working overtime. Everyone is stressed. She’d half-expected to be asked today, but that didn’t make the decision any easier.
Mia’s dilemma
Mia ducks into the nurses' lounge for a minute, and tries to sort out what is important. Her clients' safety and well-being is her primary concern. As a professional, she is accountable for her decisions and actions, including determining whether she can continue to practise safely.
Would working extra hours put her clients at risk? Could it put her at risk? Could she stay and safely provide some care? Could she stay for a few hours? Mia recognizes there is no ideal solution to the dilemma. What is her
best option?
She thinks about what she must consider:
- the clients, care needed and its complexity
- where was she in her stretch of shifts
- how many hours had she been awake already and her level of alertness now
- whether she'd had appropriate breaks and nutrition over her shift
- her commute home
If you were Mia, what would you do?