Yesterday while working I developed an attitude when my team leader was unwilling to help out on the floor.  I work on a CVICU unit and we had several patients that are very sick.  Three of the 6 patients require one to one nursing care.  The patient that I had was an CABG from a few days ago that went in ARDS and had to be reintubated.  The surgeon has stated that his patients are not to be teamed up with another patient.  So the regular staff that worked that day were already consumed by these patient's and we got the dreaded call from cath lab that they had another patient for us.  We had other staff that they pulled to our unit  that were not qualified to take care of this patient so of course I was going to have to take the patient.  When I asked the team leader why they pulled staff that can't take care of the patient's that we have on this unit I was ignored and then she went into her office to "tell on me".  I asked why they couldn't do a double pull and send us an ICU nurse.  I was basically told that it is not conducive to others attitudes to do a double pull.  I then asked when patient safety became important to them.  So by now I know I am going to get into big trouble.  I questioned the team leader.  So the new patient arrives and has a sheath in and I am responsible for the sheath while a telemetry nurse is taking care of the patient.  The cath lab nurse explained that well they could have pulled the sheath except they have staffing issues and don't have the staff to pull it.  I pointed that out to my director and she agreed that they should have not said that but didn't offer any help.  So I check to see if I can pull the line but unfortunately I wasn't able too.  Then it was time to check to see if it was time to pull the line, I asked my team leader if she could check his ACT and asked if she remembered how to do it.  So this time it was able to come out.  I gathered the supplies to pull the line and did one last check on my sick patient.  My patients blood pressure was 70's. So of course I wasn't able to pull the line.  I then got extremely busy.  I then told the team leader that I will not take another patient.  She then pulled another nurse from the CCC floor to take the patient.  And guess what my team leader left at 4pm.  It was bluntly obvious by this point that no one cared about the safety of these critical patient's.  So the surgeon comes to the floor after surgery and the other new critical patient arrives, and starts yelling at me because some other nurses did things the day before that he didn't know about.  So after I fix those things he comes up to me as the charge nurse and states that these three patients are to be one to one care.  Oh I left out one important detail my team leader and director knew this before they tried to give me that other patient.  So before I left that night about 2 hours after my shift ended.  With no lunch break and maybe pee'd once in 12 hours.  Before I left I called the director and told her that the MD was strongly stating that his patients are to remain a 1:1 ratio.  This is not the first time that this MD has gotten involved in the staffing issue hell he has stayed on the unit and called administration until they miraculously found nurses.  So this time, I emailed my director and the director of nursing and requested a meeting.  So now I am waiting to see if I am going to get written up for my attitude or fired because of my attitude.  But hey at least my concerns will hopefully get attention this time. 

Good for you D and I think you're a great nurse!  Stand up for your patients and what kayak has said is very true.