The Lousy, Awful, Crazy, Rotten, *Really* Bad Day
It was the day from Hell, and we couldn't even blame it on the full moon or Friday the 13th. An ordinary day at an average assisted living facility turns into a scene from a battlefield as the casualty count rises by the hour, causing one paramedic to suggest (facetiously, of course) that the staff needed to stop pushing people downstairs. Here's how it all happened.I knew this was not going to be one of my better days when I turned into the driveway at my assisted-living facility this morning and saw not one, but TWO ambulances at the entrance along with a firetruck. Should've known the rainbow I'd spotted on the way in was the most peaceful thing I'd see all day......
But wait, it gets worse. We had two residents complaining of chest pain, which is an automatic 911 call whether I'm in the building or not; thus the need for two medic units. This was AFTER another resident had fallen on noc shift and had to be sent out with a bump on the noggin. She was just coming back into the facility via medical transport when all hell broke loose with the chest pain sufferers; thus began the wild rumpus.
The staff was getting the fall victim settled back in her room while the resident care manager and I started the paperwork on our two transports, when we heard a loud "BANG!" upstairs. This was swiftly followed by the sound of running feet and an "Oh (brown word)!!" from a staff member who'd forgotten to take her finger off the 'talk' button on her walkie. We looked at each other and repeated the phrase simultaneously; sure enough, another resident had bitten the dust. This time, it was a gentleman who'd sat on the edge of his chair and tipped the whole thing over---with him trapped underneath.
Unfortunately, he was complaining of severe shoulder pain, he'd bitten his lip almost clean through, PLUS the fall had raised a baseball-sized lump on the side of his head.........so out he went too. The paramedics were beginning to roll their eyes at us, and one of them went so far as to quip, "Maybe you wanna stop pushing 'em downstairs?"
About this time, Chest Pain #1 came back with no new findings, no cardiac issues, no new orders. Big shockeroo there---our local hospital, which is supposed to be so awesome with its Magnet status, rarely (if ever) investigates our residents' issues thoroughly, and all we can do is shake our heads and curse under our breath at the minimal "care" given to them. I mean, if someone brought me a pale, diaphoretic elderly gentleman with chest and jaw pain, I'd at least want tele and a series of cardiac enzymes, but I guess that's just me.
Shortly thereafter, Chest Pain #2 arrived with a diagnosis of pleuritis. Who knew? She hadn't had a cough, shortness of breath, adventitious lung sounds---we didn't have a clue until she began to complain of classic cardiac symptoms. Unfortunately for all concerned, she hadn't been home more than half an hour before she fell over her cat and had to turn around and go right back to the ER, where she was diagnosed with two broken fingers.
That was when the RCM tossed the handful of incident reports she was holding into the air and said "That is IT---I give up!!" By this time, though, it had all become so overwhelming that I did the only thing I can do in situations like this: I broke up laughing. I hee-hawed so hard that tears squirted out of my eyes and my asthma flared up, requiring a trip to the office for the inhaler I keep in my pen drawer.
Swing shift was coming in at the same time, and I waved as I ran down the hall, inviting them to "Come, join in the IN-SA-NI-TEEEEEEE!" This prompted several of them to look at me rather strangely---they don't know my brand of humor like day shift does---and one girl looked almost as if she was ready to turn tail and run while she still had the chance. I wouldn't have blamed her if she had.
It was after 1600 when things finally began to settle down. Everybody was back and tucked in, including the poor fellow with the goose-egg on his head, and five care plans were hastily being rewritten to reflect the events of the day. At long last, the RCM and I had a chance to sit down and decompress a little as we chewed over the bizarre series of occurrences.
"What a DAY," groaned my co-worker, rubbing her temples as she spoke. "We can't even blame it on a full moon, or Friday the 13th. Sure hope we can get out of here before something else happens."
"You and me both," I agreed. "I've had some crazy days working in long-term care, but this ranks with the craziest of 'em. I just hope tomorrow's better."
A loud knock on our office door startled us as the receptionist barged into our cramped space, announcing with an indignant tone that one of the few residents who still drives---and shouldn't---had just backed into the RCM's car on his way out of the parking lot.
As they say in the movies: Tomorrow......is another day!Last edit by Joe V on Oct 17, '12
About VivaLasViejas, ASN, RN
VivaLasViejas has '17' year(s) of experience and specializes in 'LTC, assisted living, geriatrics, psych'. From 'The Great Northwest'; 55 Years Old; Joined Sep '02; Posts: 25,271; Likes: 36,804.6Oct 17, '12 by Esme12, BSN, RN Senior ModeratorI love it when you write.............
I have always had those kind of days........I'm one of those nurses that a dark cloud follows. It's really bad when you walk in the ED doors (my point of entry for it controls my night as the sup)and the ED docs goes....."Oh GOD..... you're here....." Es2Oct 17, '12 by NurseDirtyBirdI can relate with the hospital issue. Our "magnet status" hospital ED treats my LTC patients the same way. I've had residents come back with reports so egregiously faked it was almost funny. The resident with contractures came back with a report of "full ROM in all limbs," and absolutely no assessment of the symptoms we transferred him for. A nonverbal dementia patient came back with, "Pt states she has no pain or discomfort." It's especially bad with assisted living, as the hospital never understands that there is no e-kit or pharmacy on site, and we can't even elevate the HOB as the residents aren't in hospital beds. We don't even have suction equipment or oxygen available. It doesn't matter how many notes we send with that info, or how many times we brief the ED charge RN when giving report, they always come back with orders we can't implement until the next day at minimum. So they get sent back...and the ED gets mad at us.1Oct 17, '12 by DSkelton711Yikes, must be catchy: sounds like where I work. Seems everything comes in groups. Sounds like y'all were able to get everything done and manage to keep a sense of humor! Thanks for the stories--always a highlight of coming to the site. Hope you have quieter days coming!