Being a nurse bites big time (well for today anyway)!

  1. Sorry, don't often dump here but I have had two days from HE$% or two days that make one wonder why nursing, and not flipping burgers? I work on a CC "step down" (yeah right) unit. Because we are classified as "step down" we have unit protocols for the type of patient we can accept on our unit, the ICU nursing co-odinator had our protocols rewritten by an MD to meet her needs to empty ICU beds. Our staffing is also set by our classification of "step down" Well yesterday and today I had 4 pts., we do not do team nursing, we do primary nursing. Pt. one was from the ICU, trach, vent, PEG, MERSA, PICC, obese, PO2 in the upper 70's on 50% trach colar with RR of 37-42 who in her spare time tachys to the low 150's. Pt. two also from ICU, RCW Port-A-Cath (dual), PEG, ileostomy, NG, IV's running: NSS @ 80, hydromorph PCA, TPN, lipids, vanco, fortaz, Zofran, AND 1/2 NSS @ 20 of K set at - "Doc to RN Note": "caluclate and set infusion rate to replace 1/2 of shift GI loss at a rate of 100-125 cc/hr not to run into next shift", GI loss my shift 2100 cc via NG, ostomy and emesis: don't think that ANY way I do the math I can replace 1000 cc at 100/hr and NOT run over the next shift. Oh, by the way, in the time left over, pt's wife may be a canditate for Munchounsen Synd. (sp) by proxy- Gomco's stop working, lines become disconnected, IV's flow faster or slower than set, NG drainage changes from billious green to pale yellow even though pt is NPO and wife swears she is NOT giving him water, ostemy bags are disconnected, and meds some how wind up running into the TPN line This patient also tachys into the mid 150's and has a PRN lopressor IV for "HR over 120". Wife is VERY demanding and nasty. Patient three is a very plesant gentelman COPD with new dx of abd. mass- he is VERY emotionally needy but won't ask for help so he disconnects his O2 and tele monitor to walk into the bathroom, he'll hook them back up right away so I know HIS sats are in the low 80's with a HR of 124 and a RR of 28-32. Pt. four is a 83 yo man with a dx of IDDM, SOB, COPD, CP, MI, previous CVA AND Alzhimers dementia. Mr. Room 5 has tried to climb from bed 5 times, has pooped on the floor, bed, chair, and in the hall when he got free from his bed and pulled all his lines including his PICC. Oh buy the way, I have had student nurses for both days. Past two days, no lunch, no potty break, not sure I got everything done. I know I did not do right by my patients or the students I worked with. I HATE days like this. It's one thing to be too busy for lunch when you get done what you have to and you know your patients got the best possible care from you, and it's another to be too busy for lunch or bathoorm, be an hour late getting out of work, fail the students you are supposed to be helping AND know your patients suffered with substandard care. Bottom line, being a nurse really bites some days and today was one of them. To all the students here, sorry, don't read all of this-it was just a REALLY bad day and you have them no matter what your job, even flipping burgers. Thanks for letting me dump on all of you.
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  2. 28 Comments

  3. by   frankie
    Hi connieRN - I am so very sorry you have this weighing on your shoulders. I am glad that you posted this, just to get the weight a bit lighter. Do some nice things for yourself - take care of the little girl inside. You could shop for something you want, but do not usually buy, or buy a favorite snack like a malt or dreamsicle. You could treat yourself to a manicure/pedicure, or a hike in the woods. Or an outside picnic with non nsg friends/family. Treat yourself with kindness and you will feel better. Hope your next days at work are filled with the patients we all love - the nice, kind, sweet ones. I am thinking of you - frankie
  4. by   BBnurse34
    Poor Connie. I'll wish you a better day tomorrow
  5. by   Lela RN
    I've been there. Try to do something special for yourself and relax when your off. Not to impose religion, but prayer helps during the tough times.
  6. by   spineCNOR
    Bless your heart! I feel for you-what a terrible day. I truly hope that your next day at work is MUCH better.

    As far as feeling you did not do right by your patients--you did the best that you were capable of given the resources you had-- and THAT'S ALL YOU CAN DO!! Don't beat yourself up and don't expect superhuman feats from yourself (though I don't doubt that you have performed superhuman feats at times, you can't do them everyday, all day long).
  7. by   capa
    Dear Connie, I just finished emailing a nurse friend of mine about the 2nd worse day I've had in my life as a nurse but your day makes mine seem easy! You did a wonderful job and I agree with the other writers. You helped me a lot. Thanks.
  8. by   hoolahan
    {{{{{{Connie}}}}}} Let it all out hon, that's what we're here for! :kiss :angel2:
  9. by   sharann
    So basically what your saying is you have ICU pts turfed to you and then you are taking an assignment of 2-4 ICU candidate pts? Sounds scary. I'm so sorry you had this horrid day. Hope you feel better after venting here. I think it helps alot of us when we have these insane bad days.
  10. by   NRSKarenRN
    Originally posted by hoolahan
    {{{{{{Connie}}}}}} Let it all out hon, that's what we're here for! :kiss :angel2:
    My sentiments exactly!
  11. by   cactus wren
    :angel2: :kiss :angel2:
    (((((((Connie)))))))
    Poor baby, don`t cha just hate days like you just had? Go fix you your favorite beverage, run a bath with your favorite bath salts, take phone off the hook,and spend enough time soaking until you resemble a prune, have seconds on that drink.........
    When I have one of those I do all of the above, and keep repeating to myself on the drive home "Welcome to McDonalds, may i take your order,?" and "Do you want fries with that ?"
    Those days suck big time,you did your best, and that`s all we can do.....And if those are your usual step down patients, I shudder to think about the ones in ICU>>>>.
  12. by   RNConnieF
    Thanks all. I DO feel better for having vented but,... one thing still really bothers me... those poor students, what must they think about nursing now? I tried to make sure that they knew that these days do happen but better days happen too. It must have been a full moon or bad planetary convergence but EVERY nurse had a bad day yesterday. The clinical leader- a nurse of almost 30 years, was in tears 4 times. As for what the ICU is like, not much worse I think. One of the unit nurses told the sister of one of our nurses (not knowing of the relationship of course) that the ICU laughs about "dumping" the patients "they are sick of" and "need a break from" on us. Sick isn't is? What ever happened to patient advocate?
  13. by   lindalee
    Connie, I worked ICU for 17 years and know I could not manage the assignment you just described. I personally think some documentation needs to go to your head nurse and perhaps risk management. (and of course you keep a copy) The assignment was impossible--and then you were expected to mentor/teach a student at the same time? Your patient acuity was way too high and if that is how the unit is, I would document on a daily basis and encourage everyone else to do the same. You need to protect yourself and your patients and this does not sound safe to me. At the very least your staffing needs to change--at least to get several good CNA's who can do the custodial care, baths, turning, incontinence care, answer lites, feed, routine vitals, that type of thing. I would not simply let this slide. If something was missed it will be you in trouble and your patient will suffer. JMHO
  14. by   mattsmom81
    This is why I maintain PCU's are the hardest units to work on.

    I honestly felt ICU was easier ...when I wasn't in charge anywho... (at least when I had set visiting hours and could get the demanding family out of my hair for awhile..LOL!!)

    Hang in there, Connie...I feel your pain.

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