Just a bad shift...

[0.adamantite]

I've had a string a bad shifts recently, and today was no different. A crashing patient in room A while my admission rolls into room B ... the blood is done in room C ... the UAP rings my phone, room D is vomiting ... a family member approaches me while I'm hustling down the hallway (a million things on my mind) saying there's something wrong with room E's television remote and it needs to get fixed NOW ...

I do my best and ask for help, but many of my co-workers are in the same position. What do you do? I try to triage needs, but how do you cope when you're patient's vomiting blood and room C is ringing for a pain pill, while your admission is being carted up next door with 6 family members in tow wondering where the nurse is?

When you think that you can stop by room B for just a few to hang their antibiotic, but then the elderly lady needs to use the toilet which can take up to 15 minutes, and you can't leave her alone because she's a fall risk? All the while, you hear the bed alarm of room C shrieking next door and the UAP calls your phone saying that room D's IV has infiltrated?

I guess I could go on and on... but the question is, how do you cope?

[VANurse2010]

There is no transferring staff on a new admission, and often our charge nurse is dealing with other emergencies on the floor. I'd say 5/8 shifts are like this. Many of our patients are also on isolation, total cares who need turning q2-4, demented/fall risk, getting pain medications q2h, almost all are fall risks ... we do an average of 1 discharge and 1-2 admissions each shift. It's a good day when I don't have a rapid response. I know many units are like this. I like my job. I guess every once in a while it gets to be too much.

I'm still not good at triaging patient needs, especially since we focus so much on patient satisfaction. For example, while dealing with all of this, a patient's family member pushed the 'emergency' button in a patient's room, and of course I (being one of the only staff out on the unit at the time) ran over to make sure everything was okay. The patient's family member wanted their mom's food reheated. I said that because the patient was on Contact Precautions, we couldn't reheat the food, but could find her something else if she gave me a moment. She glared at me and said "You mean my mother has to eat COLD food?" (cue crashing patient puking in background) I just had to apologize and say we'd get back to them. I'm sure I will hear a compliant from it.

You should not be having rapid responses qshift. Sounds like some of those people should have been in the ICU to begin with...

[Bezoars]

Yep, Nursing has become more about kissing their ass then saving it. I would be running down to the crashing person's room while yelling to call a rapid response, I would have sent the CNA in with the Old Woman, and asked the Charge or whoever to stick their head into the new admission and make sure they were alive and well. I would yell for a nurse or whoever to turn off the IV in infiltrated room lady and spend the next two hours assisting with the rapid and documenting it. The remote control issue would have never been thought of again

[bluenurse85]

My question is, where in Hades was the unit manager during all of this?