a three-in-a-row. something i only do in dire circumstances. we will break them up, even though it felt like one giant shift that never ended.
i showed up for work saturday, checked the assignment sheet and lo and behold! SEVEN patients for me, and EIGHT for Keisha and EIGHT for Jackie. ahh hospital safety at its finest. I mean, let's be realistic, if it had been 7 or 8 patients who just wanted an ambien and would drift off to sleep, it'd be no big deal, glorified summer camp. Instead, I think this was my group:
8- no clue, but I think this was my patient... the others i'm more sure of haha
11- ah the sweet and a little weird dialysis patient who always has some symptom in the middle of the night that i have no idea what to do about. like his request for a dentist at 5 am for a toothache, and the fact that he wouldn't take ambien to sleep for fear of hallucinations, and wanted benadryl, which the doctor was hesitant to order for some reason. also his blood sugar and insulin had been all off that day and his wife was pissed, and then i mentioned to marie to let me know what it was, to make it look like i was going to take care of things, and then she snapped at me. jerk.
12- i don't remember this patient because they didn't need much haha maybe a dialysis patient?
13- my asthma/COPD patient that i'd admitted and was happy as a clam as long as i gave her ambien, morphine, and a double dose of cough syrup with codeine
18- ugh, my giant liver patient. finally with IV access, but still shitting everywhere and generally disgusting.
21- ahh a complainer. not the patient, the family. apparently the solution was to give them to the little white girl. according to keisha haha. this was the huge guy kara admitted whose wife was overly concerned about his snack. also a dialysis patient.
25- oh goodness. she was my tough patient for three days. she had a vascath, a PICC line, TPN, and the most disgusting drain ever that had to be flushed and emptied every 8 hours. i'll cover her more momentarily.
SO. apparently the fifth floor was in about as bad a shape as we were, so everyone was calling every nurse they knew to see if we could get help. Abebe came to the rescue temporarily. she essentially helped with meds I think. that was what she helped me with anyway. she gave meds to 18 and 25, and hung 25's TPN, which I had to call pharmacy about and it was a pain in the ass. I mean, going to talk to 7 patients, get their extra needs met (pillows, orders for sleep meds, pain meds, ice), and pull all their meds takes so much TIME! and not to mention the tracking down blood pressures and blood sugars to see if additional things need to be given or held, and then the actual distribution of meds, hanging of fluids, etc. Ali was the life saver and came in at 11 pm. Which meant we had to play musical patients:
he took back 11, 12, and 18 I think. he wanted my three favorites- 11, 12, and 13, but i told him he couldn't take all of them (he'd had 4 of mine the night before and wanted his patients back). Then Jackie gave me 24, and at some point I admitted 17 I think, who didn't really need much of anything. so those two weren't bad. although my admission, i did a really piss poor job on, and when i came back two days later his profile still wasn't complete... oops. i got most of the required questions, i think i failed to do the abuse screen type questions.
At like 0130, I find out my patient is running a temp of 103.2, and at 8 it was 102.3 (which would have been really nice to know, latasha, just sayin.) So then I had to call Dr. Robinson because the patient was not an MEA patient and she had no tylenol ordered). So because she was already on antibiotics and spiked a temp, its apparent she's got a new infection. He ordered blood cultures, tylenol, and a one time dose of vancomycin and diflucan. And then the computer system shut down for maintenance (ahhh how the night gets better). I couldn't even get my orders put in beforehand. I was still able to give her the tylenol and draw her blood though. The computers were shut down from 2 am- 5 am, and the tube system was shut down from 2 am til actually like two days later. That meant that we had to actually walk down to the lab or pharmacy if we needed to pick up or drop off something. And when i got my admission, I couldn't pull any meds for him because he wasn't in the system as being on our floor. in all honesty, although having the computers down was a pain in the ass, it forced us to slow down a little bit, which was SO nice.
I think we had a code and a dr pitt that night too, but it might have been a different shift. either way the code that i'm thinking of was a patient i had had back in october who had never left and was in the ICU. she was in her 50s and died of heart failure... eat your vegetables, kids.
when 5 am hit it was like all hell broke loose. we all were charting like mad (um i had 9 patients throughout the evening that i had to chart on), orders had to be put in, lab labels printed, and getting MARs checked off, going through order maintenance, and sending messages to pharmacy about my weird MAR situation (half of them were printed wrong or missing). Day shift got there to a complete mess. and the nurses i gave report to were less than understanding and i got sorta snapped at for not having the MARs done, and one set of labs drawn.
Honestly, if my patients didn't call me, I didn't go see them after passing meds. some nights are just like that. this was hands down one of the craziest shifts thus far. and not crazy awesome. crazy like trainwreck.
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