[incublissRN]

Originally Posted by jbp0529

Had one of those nights myself last night. My pt was s/p cabg, avr, mvr, had an intraop MI and bleeding, and chest was left open. Was on Epi, NTG, Milrinone, Dobutamine, Levophed, Vaso, Insulin, Vec, Versed... All I did was run!! She was young, so hopefully will do ok in the next few days.

I feel for you.

I hope you got some rest after that night!

[jbp0529]

No joke. Fortunately my patient was 1:1

[CVICURN2003]

Originally Posted by incublissRN

The last two nights at work have been rough. The first night I had a patient that had a CABGx4, AVR with an IABP. The most unstable patient I've ever cared for. Vasopressin at 4 units/hr, epi at 30 mcg/min, dob at 10 mcg/kg/min. No pulses in his feet, fingers are discolored. They had suctioned his ETT the day before and he vagaled. He hadn't been turned for 2 days because if he just coughed he would drop his heart rate and pressure. Hepatic failure and renal failure - on CVVHD. Temperature of 102-104. .

Call me morbid....but I love these kind of patients. Ofcourse I like for them to get better and come back to see us, which frequently happens in our CVICU (sometimes not, obviously). I am sorry you had a bad night and I am glad you got some rest. Sometimes you can run your rear off when you have one patient like that rather that 3 other patients (not your case the second night tough). But I still love those patients...

[incublissRN]

Generally, I do too. I work nights and if there is a chance to receive I jump on it. I like running machines and I like sick hearts. I took this patient because I need experience with the IABP and no one else really wanted him. But this guy felt dead/looked dead/smelled dead and it bothered me a bit.

[healingtouchRN]

Hang in there, been there myself. Nightmares in my sleep as well. Dreaming I forgot to chart, etc...
Amazingly enough, I've seen some people who I would have swore were gonners, come back & actually go home with a decent quality of life. Prayer, good nursing, good medicine, family support & miracles all must have something to do with it.
Wanna read about some really rough nights? Look at what Nightingale went through in Crimea when she set up that hospital with a hand full of nuns to help her. I read her ordeals & thought I have no idea of what she & they went through. She was truly a saint & leader.
Keep up good work!!

[Morettia2]

Yea I had a crap last 2 days..I had a pt. 2 night ago come from another Hospital for an LVAD eval, stage IV heart failure and Labs off the chart, pt had a BP of 70/30 with a Dobuatmine Drip, confused in every way possible, pt said to me go cash my check and get my cell phone. and last night into this morning I had 2 RRT's and a code blue. One pt came from another hospital and had an ICD extraction for infected ICD (way too many pt's have this problem, they have the ICD placed at another hospital and end up at mine ), pt had a chest tube that was removed at the other hospital, when I recieved him the drssing was saturated and the site was making tht high pitched sound..ahh yea petro gauze right away, DOE, CP, v-tach 8 beats, stat abg's,labs,ekg, cxr's ect...pt was so swollen that the pt looked like a sausage lasix IVP which didn't do a damn thing, nebs, venturi, xanex..RRT#1... then 3 hours later pt's spo2 went down to 79..BP dropped, and pure accessory muscle breathing RRT#2...more abg's, cxr's, nebs, lasix, labs, chnged the petro gauze again..pt. improvd better then expected..which the pt' thanked me and gave me a hug and asked me to stay for a little while after my shift was over..which I did. The code blue I had which was 5 min into getting report I didn't even put my pen to paper yet when we looked up and on the monitor pt's HR plummeted to 15, BP was 50/palp, spo2 65..ran into the room (the person who invnted ACLS is my hero)..atropine, rapid fluids,O2,labs..you know the drill....then the residents come ready to cut into the pt, invasive cart comes flying down the hall...CVL, trach, the works, the pt's stomach was so rigid I thought it was pertonitis, to top it all off they put a rectal tube in..my god..this poor pt...but she stableized...not a good night infact as the Nurse Supervisor said it was the Night from HELL..thought I would share. OH yea and to top it all off the 3rd pt. I had thought it would be fun to urinate all over the floor and the walls...I love being a nurse sometimes.