A key element of a nurse’s role is to prepare for the unexpected. This is particularly true for the Nurse Administrator on Call, who must be ready to handle whatever situation they are dealt over the span on their "off-hour" shifts. When dayshift staff are fast asleep or when other staff are enjoying their busy weekends, the Nurse Administrator on Call, holds a leadership role among the rest of the staff who work the off-hour shifts.
In the midst of working to ensure smooth patient care operations, other Nurse Administrators on Call and I often face unconventional situations requiring us to exercise good judgement and our ability to manage other staff and resources.
Recently during the course of a Sunday morning, I was dealt a highly unusual problem — a cascade of water pouring from the ceiling, affecting the Urgent Care area, its patients, staff and equipment. To everyone’s amazement, it continued to grow in size, increasingly flooding the area below.
I worked to further facilitate the response that was already in motion. The staff was moving patients into the observation units of the ED. Equipment and supplies also were being moved from harm’s way.
After consulting with other mangement, I had to issue the internal disaster code, for which BWH has strict guidelines. Ambulances were temporarily diverted to other facilities. The Engineering staff arrived, and within 10 minutes identified the cause of the mishap (construction in the floor above) and got the water turned off. The assistance of ED nurse management was also key to rectifying the situation. All staff worked to resume operations and comfort patients and families affected by the unforeseen dilemma.
In both routine and these stressful and unexpected situations, we as Nurse Administrators are the “go to” nurses. Together with our colleagues, we are called upon to consistently rise to the occasion. For example, if a patient or family member is upset and the staff needs our help, we help resolve the issue and do the follow-up, often together with Patient-Family Relations.
As the hospital census fluctuates, we work with Admissions and the hospital units to organize patient flow and ensure the availability of beds. Or when resources need to be shifted from one part of the hospital to another, we help make that happen.
Ultimately, our work is all about the patient. But we wouldn’t be able to accomplish anything without the collaboration with our colleagues in and outside Nursing. Recently, a patient’s husband remarked to me that he was amazed at how well things came together in a large hospital that provides such a complex range of tertiary-care services. Credit for that compliment certainly is shared hospital-wide, among every staff member. Whatever the issue that may arise — even a flooded area of the hospital — it’s wonderful to be part of the solution to restore the delivery of patient care as we know it at the Brigham. I gladly assume the role of the “go to” nurse for BWH on each of my “off-hour” shifts.
Catherine Rumble, RN, MS
Nurse Administrator on Call