Have you ever had one of those days were you wish you could just start over again

[DIPLOMATICRN4HIRE, MSN, RN]

Today was one of thoses days for me...

6 am staff meeting .. all ok

7am report I see Im in a nice room 3 cases , not bad size but atleast 2-3 hrs long each....Good techs and I love the Drs I will be working with...

Then the floor forgets that my first patient is coming to surgery... No permit, no prep, and labs arent done... This is a thoracotomy... ok send patient., get permit,epidural permit,labs drawn and stat, art lines,get the patient in the room now an hour late, Dr becomes impatient but understands its not my fault... get patient in the room, intubate, position and prep, cath and start case , now 1.5 hrs late, surgeon has a cabg in 30 minutes scheduled , call that room let them know whats going on..... get into the chest and low and behold , there is a forgein object in the pleura,

and OMG we remove it and bam like we hit aorta blood everywhere, open everything known to man to stop the blood from going , seal that leak off and look at this object we found... its a paricardial patch that has somehow manuvered itself into the lung... (I have never seen one move into that area before) hang 4 units stat, crack 3 caskets of instruments and every bit of gelfoam and thrombin I can get my hands around , now case running more over into the cabg time, call room back let them know. Fix all major problems and contiue with case, seal everything and begin to close... sats drop, pressure drops, I run grab the crash and inturnals, Dr goes back in finds leaker again and closes it, Close wound. Call Pacu, pt on vent, and will be in , in 5 . After that Dr states to just throw away forgein body.... Stunned I call Or Supervisor, of course shes in a meeting , I page her, she returns call and tells me to "save everything" and do incident report..... Ok saved reports done , patient in pacu, walking around with evidence (lol) in bucket of secrets, leave on supervisors desk...

Next case. Another thoracotomy: Patient on vent in ICU... Ok no problem.... its now after noon, was a 1015 case... Im a tad late... Go to ICU, chart missing, family freaking because we are late for the surgery, Nurse at lunch and Nurse that has covered is clueless of whats going on.... No concent.... Family expecting to go with patient into surgery, because sister is also a Nurse(lpn) but doesnt work for the hospital or even the state im in, Pager goes off its Dr in room waiting for patient. Call down tell him whats going on.... Ok he is getting some lunch... Ok great not a problem should be down soon... Well thats what I thought... waiting on respitory for assistance with vent ( since I had 4 Ive poles with multiple got to have drips going, each pole with 4 imeds on them) a swans,an artline,central line, and a peripheral line, respitory tells me she is going to lunch and if I wanted her I better step it up.... Just nod and smile and under my breath threaten her life... Oh and did I mention I had a student nurse with me observing ..... , I found her up in the ICU waiting on me , not dressed out , no scrubs in whites and determined she would contiue to wear whites into my OR...(inform her that she will go butt naked before that happens and tell her where her new scrubs will be).. I contiue to deep breathe... Ok anasthesiaologist is ready to move , we pry family and sister off the patient... convience sister that It would be a breach of patient confidentiality for her to enter the Or and also about something and insurance... that seemed to satisfy her... I pry student nurse off the chair hand her 2 poles with instructions to follow closesly and to have No tension whatsoever on the IV lines, I get a deer in the headlight look and a nod .... We begin moving down the hall, chart on bed , scd hose with machine on bed, monitor and stat pac on bed, and somewhere under all of that was the patient. In tow was the anasthesiaologist , pushing bed and 2 poles , and a grumbling Resp tech, and a student nurse.... Into the Or we go , we get in now a meer 3 hrs late than case would and should have started , we have to re -intubate her because we need a double lumen tube , yeah ...... 1 hour and 5 anathesiaologists and 2 difficult intubation carts later and the hint of a perc tube tray and set up ... we get the double tube going...

call Dr , he is now full as a tick from eating and doing charting and having a walk in the hospital and having a easy morning,smile on his face all is well in his world today... Im so glad, we postion and prep and yadda yadda yadda, we get in only a tad late just 1.45 minutes later from the time we entered the room.... Love the charting on those .... Its all in focus notes because in our computer there is no excuse for such tardiness... get in the chest

what do we find Another forgein body... thank god this Dr wants everything and its grandmother sent to path , 15 cultures,5 specimans for fresh and 4 for routine, and did I mention that student Nurse felt faint, slid down the wall , I called front desk and had her dragged out, no time to console her I left someone who had been sitting at the desk out front do it, If we see that girl again Im sure she will be a patient...

Look at the clock its now way past lunch, I was forgotten... I was so mad because other than my scheduled cases all the other rooms were little cases maybe at most 2 hrs from start to finish....ooooppps Yeah of yeah Im in the room , seriously thinking of eating a pencil or something... and I get the relief nurse how begins to tell me how bad her day was I nod and give report and hobble to lunch , its closed.... fine snack machine.... a bag of chips and a coke ... , go back to room before my time was up , hate leaving someone with a bunch of crap... good thing I did, counts werent coming up right.... The dr was closing and she didnt want to mention to him the counts were off, I almost explode, I inform dr that counts were off , we look and under a shoe was a raytec, they could have been in his pants I would have found it before he went any further on closing, close patient, anasthesia informs me we need to change back to single lumen tube, ok, not a problem, put patient in supine after dressings are on... patients cvp drops to 50/34 sats down to 50 oh crap not this again, double lumen dislodged, and someone is standing on chest tubes, I want to scream and I wonder again who is with me in the room... Stabalize patient, One of the multiple IVs which had the dopamine , had become disconected... reconected, stable no one standing on tubes, all is well.... re - intubate, another bloody intubation for this poor woman... family calls into room from waiting area ( someone gave the LPN the phone number directly in) call number 12 at least... (will have that person shot on sight),

sister demands she be allowed in , afterall she is a Nurse... I inform her unless she is a Dr she isnt coming back... hung up phone. Move patient over to bed, call pacu another one on vent , Dr of next case calls in and tells me he is ready will be in the room in about 5 minutes , I say ok but if you come in here grab a mop... he laughs and says Yeah I heard you have had a morning... Morning isnt it midnight yet... Deliver patient.. look on board OMG IM ON CALL.......

and here I sit , with cell phone on table next to laptop, so far one call the Dr with the sense of humor, Zoe you want me to bring a pizza I feel a case a coming on....

Well he hasnt called back yet, and I feel better now that I have vented a tad... Just wondering anyone else ever had one of those days

Zoe

:chair:

[BadBird, BSN, RN]

Hugs to you, how about a nice margarita?

[DIPLOMATICRN4HIRE, MSN, RN]

Oh Im fine lol just mentally wharped at this point lol

zoe

[Joan_RN_CO]

I think when I start my new job tonight No matter what goes wrong I will smile. That was a very rough one.

[RN-PA, RN]

WOW!!! And I thought Med/Surg was rough! Great story, Zoe-- I now have an even greater appreciation for OR nurses-- Good work!

[heartholder]

Hello Zoe. first you have had a rough day. second been there done that. I had a case once, just a simple CME ok. well the surgeon cuts something he shouldn't have. so we crack the chest and hang about 6 units of PRBC's and open 3 pans of instruments. and I had a brand new RN with me. yahoo.

got thru that one.

Once I was the circle on another simple case. yea right. before the case was over we had x-ray. and TEE machine and tech. a cardio-thoracic surgeron consult. called in the heart team. I survived and so did the patient. but once I was relieved for a break at lunch time. I sat in the lounge and cried. it was so overwhelming. but somehow we do what we do and we do it well. I am not as good at communicating as you are Zoe, but I laughed at your post because I could relate to it.

I hope you aren't called in tonight and have a great day tomorrow:)

[Rottie1]

Glad you are doing better now. Sometimes thats all it takes is a bit of venting. Your post was great I laughed. Deep down inside we know that everyone has crazy days, but when I get one, it seems that I am the only one. Thanks for sharing!

Of course I stay out of cardiac rooms if at all possible, but one time we had "a simple case" the doc even said it was gonna be "an easy quick" case (of course that should have been my clue!), in the end, after desatting to the 20s and turning really blue, and a trach we all survived.

Hope your call is better.

Esther.:)

[OBNURSEHEATHER]

WOW Zoe! Great story, crappy day. Hugs to you, you'll sleep like a baby tonight

Heather

[Jenny P]

Wow, Zoe, that IS a bad day! I hope tomorrow is better-- and that you don't get called in tonight. :)

I didn't get out of work til 9:30 Tues. AM myself (from an 11P-7:30A shift) and when I walked on the floor last night, everyone offered me sympathy! Last night was better but still busy; I always figure that the next day CAN'T be as bad as the previous one!

[Sleepyeyes]

((((zoe)))))) hope it gets better for you

but honey, you sure are a kickbutt nurse! :kiss

[dawngloves, BSN, RN]

Wait! You want to start this day over??!!! I think I'd run far away from it!

[SmilingBluEyes]

have a drink ON me.....and a hug.