I had a crappy shift last night on our medical surgical. My job at times is so stressful that I hate it. I always leave thinking, "They cannot pay me enough money to do what I did tonight".
Here is an inadequate description:
I started the shift with three patients (pretty good, but I had first admission). I had one patient that was itching to be discharged and the doc was there writing d/c instructions. He told the patient, while I was in the room that it would be only 15 minutes for him to be discharged. I HATE IT when they tell a patient that. I have to write out the instructions and the meds and time of last dose and blah blah blah.... So, I said, rather snottily: It will be longer than that, as I have three other patients to check and I have to write out the instructions. The doc said, "Oh". I thought, I am not letting you get away with that you asshole. As it turns out, he was STILL writing out all the meds for d/c as an order 15 minutes later. Doctors are such asses. They have NO IDEA how much more difficult they make our jobs. I had two other patients one was in with a huge tunneling gaping groin and abdominal wounds (that started out as a boil). Go figure. She had a PICC line and was getting TPN Lipids and Heparin, and she was diabetic w/two accu checks on my shift. She was a very sick lady with chronic renal failure and recent history of multi-system organ failure. She was on continuous oximetry and the monitor kept wailing ALL NIGHT. She was pretty much total care and confused. The other patient that I started with was MRSA positive and diabetic (two accu checks on my shift). He had hand and upper arm wounds from cellulitis. His blood sugar was too high all night requiring lab sticks and rechecks and admin of insulin. He was a Hmong patient and spoke little English, but he just smiled and laughed sometimes. His PICC insertion site was draining, so I changed that dressing. That is just what he needed, the MRSA from his upper extremities to get into that insertion site, cuz the dressing was lose from drainage. I then got a surgical patient Perc Neph -- back. I had to set him all up and do all of his orders, do q30minute VS checks X 4 plus every hour times six hours vital sign monitoring because he weighed 350 pounds and had sleep apnea. I also got an ER admit that was admitted with hypothermia and hypoglycemia ___blood sugar of 18 when the EMT's got there____(who's temp I couldn't get up all night). He was very sick with history of chronic renal failure and diabetes. He required q2hour accu checks and a bair hugger and q1hour rectal temps to get temp up to an accepetable lever (93.1 rectally when I sat down to chart). All of these VERY sick patients were full code measures. I did not sit down to start charting on a discharge, a surgical, an admit, a patient with 400-600 blood sugars all night, and a chronic and acutely ill patient until 11:30 PM. I charted until 12:45 AM, and then left. They all required extensive DART Notes to cover my rather large ass. I was so tired that I was starting to have blurred vision. I rolled the windows down on the way home to stay awake. When I have shifts like that, I KNOW that I need to find something else to do in the nursing field. It was a very physically and emotionally draining night. My discharge's paper work was sent down to medical records before I could chart on him at 11:30PM, so I just went home. That could be a problem waiting to happen. I just did not have one ounce of strength left in me to go down to med recs and find his chart and make a d/c note. I pray that I did all the things that I was supposed to do. I hope I didn't forget anything. So, now I have a migraine and feel gross and disgusting today. My son woke me up at 7:30 AM My other son had his allergy shot at 9 AM. I have homework up the wazoo to do (I am working on my BSN). I came home last night so riled up and stressed out that I opened the fridge and went at it. I ate turkey and cheese and two bowls of cereal. Gee, wonder how I deal with frustration and stress........... I have to find another way to earn $25.00 / hour. I know that. What else can and should I do????????????????????????????????????????????????????????????????????????? Is it ANY better ANY place else? I guess I should just SHUT up and take it, huh?
