Let's hear about your worst shift ever!

[mamax3]

I work nights on a MedSurg floor and recently had what I like to call the worse shift ever. We were short staffed for the night and had no manager on the floor. During this shift we had two patients code and pass away and they both had the same birthday as me. I've only been an LPN for 9 months so this was my first experience with a night like this. I'd like to hear from the nursing community. So, tell me about your worst shift ever!

P.s. I'm sorry if there is already a thread like this. I wasn't sure how to look for that.

[Ayvah, RN]

In my worst shift I had multiple patients doing poorly. One patient started having 10/10 chest pain on my shift while seeing dead relatives. Had another patient who was pregnant (she should have never been on our floor in the first place) who went into labor during my shift and L&D refused to accept her, instead opting to send one of their nurses every few hours to spot check her (my charge was trying to get her transferred but was unsuccessful until just prior to my shift ending). Had another patient with a faulty pacemaker who's HR would skyrocket or plummet over and over so I was calling the doc constantly on that. Had another patient with a drip and new colostomy (but no one had done teaching yet for several days) and every time I went in the room my phone would ring about one of the other patients and I had to leave (it was comical how often this happened). Throw in other nurses on the floor having emergencies with their patients, leaving me without a tech, isolation, and not having proper equipment I needed stocked on the unit and it was a hellish shift. I finally finished with things 4 hours after my shift ended, and decided to stay another hour to give the poor patient teaching on the colostomy/disease process/plan of care, since I felt bad about the terrible care they received on my shift (and apparently previous shifts) since my other patients had more urgent issues.

Other bad shifts included the sudden downturn and painful death of a beloved patient, and a young mother having a debilitating stroke, among others. Another bad shift was when I had 6 heavy patients on day shift including one who was unconscious with terrible VS, and should have been in the ICU (doc was new and though he agreed the patient was very ill he wanted to get a bunch of tests first before authorizing a transfer, and charge just shrugged when I informed her... looking back I should have just called a rapid response to override the doc and charge as I couldn't give this patient the care they should have had with the amount of patients I had.)

I hope one day that safe staffing ratios will be implemented in all states.

[nursenancy27]

My worst shift ever was the first time I'd worked charge. Supervisor called up an unstable admit for our med/surg floor and I unsuccessfully tried to advocate for the patient to be sent to the ICU. So this patient arrives on the floor with his son and as we transfer him from the litter to the bed he codes (my first code). We worked on him for about 20 min before the code was called (my first patient passing). Then, as I'm cleaning up the 2 code carts we went through, I manage to get a needle stick injury from a needle left exposed. I spent the next two hours in occ health crying as they did blood work and as the doctor had to get consent from his grieving family to rule out any bloodborne pathogen exposure.

That's one day I'll never forget

[Ruby Vee, BSN]

Maybe it was the shift where the guy climbed into the window of our ground floor nursing unit and herded all of the nurses into the med room at gunpoint, took the narcotics and left us all in there until the nursing supervisor made her rounds two hours later.

On the other hand, it could have been the shift where I had 15 patients AND did charge with an LPN who had the other 15 patients and an aide who refused to go into isolation rooms. "And you can't fire me because I'm Black!" Seven or eight of my patients were on lactulose and were stooling pretty much continuously. All of them had antibiotics every four or six hours and about half of them needed to be transfused as well. We ran out of linen before midnight, so we hijacked the linen cart for another floor and then carefully set aside a clean set for each patient to be dressed in before the day shift came in. One of my patients arrested and during the ensuing code, somehow the intern got shocked. (I still think she was leaning against the metal bed when she defibrillated, but she swears she wasn't.)

Or it could have been the time I got floated to neuro. Report was recorded and went something like this: "In bed 1 is Mr. Epilecticus. He's seizing. He's been seizing all day. In the next bed is Mrs. Poopsalot. She's been stooling all day. In bed 3 is Mrs. . . ." You get the picture. I was still doing midnight rounds at 2 AM when the NA I was working with asked, "Ruby, which patient in room 4 is a DNR?" Of course the one who was pulseless wasn't the DNR patient. She was a frail 90 year old, and I think I broke every one of her ribs doing CPR. I had 15 patients, and ran charge with an NA who had never worked on that unit either. By the end of my shift, I was in tears, as was the NA. The patients all survived except for the 90 year old who had a breast tumor the size of a cantelope and probably should have been a DNR.

[RNIBCLC]

"Maybe it was the shift where the guy climbed into the window of our ground floor nursing unit and herded all of the nurses into the med room at gunpoint, took the narcotics and left us all in there until the nursing supervisor made her rounds two hours later "

This reminded me of the day I answered the phone on the labor unit and the operator told me there was a bomb in the hospital, one floor below us. I then get a call from my husband (he's a physician), telling me that one of his patients is the aforementioned bomber. This a long time ago, pre 9/11, so we were not provided much information. A few minutes later, we heard this " rat a tat tat" noise and I felt something brush against my leg. It was a bullet from the floor below. There was no bomb, it was a guy on a "suicide by cop" mission. Apparently, he had taken some poor man hostage and then fired his weapon at the swat team and was killed. He left a note with his family about his plans. Yup...that really was not a pleasant shift. Luckily, no one was injured except for the guy with the gun.

Funny, until I read the above post, I had blocked it from memory.

[tokmom, BSN, RN]

Too many too count...

[anon456, BSN, RN]

Q1H glucose checks and Q1H neuro checks on two peds patients, one not very cooperative, and almost hourly adjustments to the fluids based on the blood sugars. I had to do full sets of vitals on those same patients every 2 hours, and one (the not very cooperative one) needed frequent diaper changes. Also the glucometers were all in demand that night and my machine would often walk off between assessments and I had to track one down several times, and do the QC check a couple of times on ones I found that it was due on. Oh, and one of the patients was on isolation precautions.

I've had lots of emotionally hard shifts, and many physically hard shifts, but the shift mentioned above- I literally had no time to sit down and actually chart for more than about 10 minutes at a time. Much less go to the bathroom or take a lunch break. It was crazy.

[Cutandstitch]

Two nights stand out, both with their own distinct flavor of suck. Forgive my writing, this is being completed on my phone.

I had been a LTC cna for a couple of years and made the switch to critical care a few months earlier. I was working telemetry overnight and around 0300 I was talking with the nurses on my floor and I said that I thought this floor was quiet and that it was three months since I'd started and there hadn't been an RRT or a code or anything. (I claim youth and ignorance for even voicing those...) needless to say, 15 minutes later, this sweet LOL who spent a week dithering over whether she wanted a mechanical valve or a porcine valve replacement decided that would be the right time to code. I tempted the fates and blamed myself for awhile because I'm superstitious.

The other night that stands out was on the same floor. We had three GI bleeds on a golytely prep overnight. All three were older, all three were max assist. All three required a bedside commode. All three required extensive encouragement to drink their golytely. I spent the night going round robin for all of them going from one to the next repeating the same task for the three of them back I back. To this day, golytely holds a special place in my black flabby heart for its ability to cause misery for so many people.

[SoldierNurse22, BSN, RN]

Bomb threat. Walter Reed.

I still cringe at the memory.

[katierobin23]

I had two patients and was first admit, I ended up going on a delivery for an infant with a congenital diaphragmatic hernia. He did well in the delivery room, was fairly vigorous and was intubated easily. But when we got him back to the NICU, we couldn't get him stable enough to transfer. We tried everything, he had multiple drips, inhaled nitric, on the jet. Transport was waiting for us so they could take him for surgery, but after a few hours, the attending sent them away.

It was awful, the parents came down and we had to tell them that their baby was going to die. They knew from prenatal scans that his hernia was very very involved and his prognosis wasn't good, but seeing the actual reality of it wash across his mom's face is something I will never forget.

The baby was born around midnight, I left at 7a without moving away from his bedside. Thank goodness for great neighbors, or my other two babies would have gotten very littleattention!

[KeepItRealRN, BSN, RN]

One thing I can say with great certainty is what ever your worst shift is right now, there is another one that will be worse than that right around the corner.

[roser13, ASN, RN]

Fragile, elderly female on Golytely protocol, on & off bedside commode. Blood to hang in another room, but (at the time) required RN at bedside for first 15 minutes so hadn't hung it yet. Gang member shot by police officer, multiple family members milling around. Next door to gang member is the officer that shot him, also wounded, multiple family members milling around. High census meant that there was no other room for gang member. Family members of officer & gang member starting to mix it up in the hallway. Elderly gentleman with constant, excoriating rectal drainage. I was told I had a new admit on the way......I lost it.

[poppycat, ADN, BSN]

The worst shift of my life was when I was 32 weeks pregnant & had a stroke at work. I sooo did not want to be hospitalized where I worked!