Posted: February 27th, 2023

You are the intensive care unit charge nurse

You are the intensive care unit charge nurse and have just finished an exhausting 8 hours on duty. Working with you today were two nurses who work 12-hour shifts. Each of you were assigned two patients, all with high acuity levels. You are glad that you are going out of town tonight to attend an important seminar because you are certainly tired. You are also pleased that you scheduled yourself an 8-hour shift today and that your replacement is coming through the door. You will just have time to give report and catch your plane.It is customary for 12-hour nurses to continue with their previous patients and for assignments not to be changed when 8- and 12-hour staff are working together. Therefore, you proceed to give report on your patients to the 8-hour nurse coming on duty. One of your patients is acutely ill with fever of unknown origin and is in the isolation room. It is suspected that he has meningitis. Your other patient is a multiple trauma victim. In the middle of your report, the oncoming nurse says that she has just learned that she is pregnant. She says, “I can’t take care of a possible meningitis patient. I’ll have to trade with one of the 12-hour nurses.” You approach the 12-hour nurses, and they respond angrily, “We took care of all kinds of patients when we were pregnant, and we are not changing patients with just 4 hours left in our shift.”When you repeat this message to the oncoming nurse, she says, “Either they trade or I go home!” Your phone call to the nursing office reveals that because of a flu epidemic, there are absolutely no personnel to call in, and all the other units are already short staffed.
Answer the following (5) questions:1. What can you do to resolve this problem?2. Do you feel that the 12-hour nurses are being reasonable?3. Do you feel that the oncoming nurse is being reasonable?4. What kind of negotiating skills might this require?5. Do you feel that conflict has become more commonplace because of covid? Why?
As the charge nurse, you can approach the situation calmly and rationally. First, you can try to discuss the situation with the oncoming nurse and explain the severity of the patients’ conditions, emphasizing the need for continuity of care. You can also try to talk to the 12-hour nurses and ask them to consider the situation and be flexible in trading patients. If these discussions are not successful, you may need to escalate the situation to the nursing supervisor or manager for further Helpance in finding a resolution.

It is understandable that the 12-hour nurses may feel frustrated with being asked to trade patients with only four hours left in their shift, but their anger is not necessarily reasonable. Patient safety and continuity of care should always be the top priority, and being flexible and adaptable in changing situations is an essential part of being a nurse.

The oncoming nurse’s reaction may be understandable given her pregnancy and concerns about exposure to potential infectious diseases. However, it is not reasonable for her to threaten to go home and abandon her responsibilities. As a healthcare professional, she has an ethical duty to provide care for her patients.

Negotiating skills that may be helpful in this situation include active listening, empathy, and creative problem-solving. You can listen to the concerns and perspectives of all parties involved, express empathy and understanding for their situations, and brainstorm potential solutions that meet everyone’s needs.

Yes, conflict has become more commonplace because of COVID-19. The pandemic has added stress and strain to healthcare workers, leading to increased tensions and conflicts. The shortage of personnel and resources has also heightened the pressure and workload on nurses, making it more challenging to manage difficult situations like the one described above.

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