OMG!!!

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    You wouldn't believe what happened to me the other night...from 7p to 11p, I split the floor with another RN...two of us for 26 patients (4 CNAs). Then some personnel in at 11pm so I thought things would improve...WRONG. I got an admission at 2am...an 84-year-old man, a GI bleed. When they called report up from ER, they said it was a lower GI bleed and didn't indicate that it was very serious...oh, Lord. We get him up on the floor, and as soon as he is settled in, the fun begins...he starts expelling blood..maroon blood, with clots...about 300ccs worth every time. We'd clean him and the bed up and no more than get him clean; then he would say, "I've got to go again." splurt...more BLOOD. By 4:30 or 5:00 his BP had dropped to 58/45....anyway, the doc came in and put a central line in...we started blood...then we finally took him off to ICU, which is where he should have been taken in the first place!!! WHY OH WHY was this man sent up to us.......for an extra added bonus, I was running around the nurse's station when we were getting ready to put the central line in and ---splurt---I hear what sounds like someone peeing on the floor - I look into a patient's room (an Alzheimers' patient) she is spewing liquid stool ALL OVER THE FLOOR...of course, she was my patient...then the house supervisor came down to "help" and started riding my ass about I did this wrong or I did that wrong WHILE WE WERE GETTING READY TO PUT THE CVP IN....I just told him to call the police. !
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    That's what your supervisor calls "helping out"? Man-o-man, I'd have told him where to go when he started riding my butt.And I would write a letter to your manager with copies to the director of nursing and the medical director explaining what happened (written very objectively, of course). With a supervisor like that, who needs enemies? Be careful, he may have written you up already.
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    Sirens - Isn't it awful when you're sent a patient who no way belongs on your floor?!!! We had a great time last night as well. However, I had a supervisor who had her head right out in the sunshine! I wish the same for everyone for the new year. Let me guess - this 84-year-old gentlemen did not have a code status - tell me I'm wrong! Sounds a little light on the RN's considering the acuity you describe. Ideally, you would have had a charge nurse like mine who would have told them no dice on the GI bleed. Hope you didn't have to work today. Happy New Year.
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    Well the house supervisor did help in the sense that he got the stuff together for the CVP line insertion, etc...but I didn't feel that, after the night I'd had, that his "comments" were appropriate...if he had something to tell me; he could've waited until the crisis situation was over - not add to the stress. As far as him writing me up, I don't really care.


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