As a veteran Med/Surg nurse, I ought to know better than to EVER mention the fact that tonight's shift is going better than last night's.........but I forgot, however briefly, that the nursing gods have a twisted sense of humor, and the karmic retribution that followed was swift and severe.
I'd had a horrendous shift Thursday night---indeed, the worst I've had in months---and I was definitely NOT looking forward to the next one. Then I got called off from 3-7 yesterday, and thought I was home free.......only 4 1/2 hours, and we all know you can do ANYTHING for 4 1/2 hours, right? Especially when the first three of those hours go smoothly.....I had complex patients, but I was able to get their assessments and meds done in a timely fashion, and even some of the little extras I like to do for my patients at night to make them comfortable, like fetching warm blankets, offering herb teas and pain meds, etc.
That's when I made the fatal error of saying out loud to a co-worker, "Oh, tonight is sooooooo much better than last night!"
It wasn't 5 minutes after this that my alcohol-withdrawal w/seizures patient went into full-blown DTs. This gentleman, a skinny, fortyish fellow who had actually been quite appropriate and even polite when I'd assessed him at 2130, suddenly came off the spool and began cursing at staff, climbing out of bed and yanking at his IV lines, swearing there were bugs all over his arms and that we were experimenting on him for genetic engineering purposes. The aide and I couldn't physically stop him by ourselves, and he was headed for the exit so I called a Code 5 (violent/aggressive patient or visitor) and within seconds we had about 12 people in the room.
Wonderful........but I don't believe I've ever seen such an incredible display of strength as I did last night, when this 120-pound man fought off eight fully grown adults, including an enormous security guard named "Tiny" who's about six-foot-six either way you look at him, a takedown team of four ER staff members experienced in this sort of incident, the nursing supervisor, another security guard, the CNA, and myself, for over an hour. I'm pretty strong myself, but it took every ounce of muscle I had just to hold down one shoulder while the takedown team worked to get four-points and a vest restraint on, and even then we couldn't let go because he'd start biting and grabbing fingers (he almost crushed two of mine before I got loose). I must have given him 12 mg of Ativan during all this, and it didn't touch him......I've never seen anyone fight like that, not even the 400-pound ETOHer I took care of a few years ago who literally marched his bed across the room while in four-point leathers.
I finally got out of there after writing several pages of progress notes and an incident report, debriefing with the involved staff and the supervisor, and making sure all my I's were dotted and my T's crossed (I hope, anyway....
). The adrenalin rush lasted until about three AM, when I finally fell into a disturbed, restless sleep. Now I feel like I've been rode hard and put away wet, as my father used to say: every muscle in my back, shoulders, and arms aches as if I spent the night rowing a boat, and I'm so tired all I want to do is sit around in my pajamas and doze like a kittycat. And all the way home last night I was thanking God that nobody got hurt, and especially for the fact that I never had to go through something like that myself.
As much as I dislike taking care of alcoholics who come in to be detoxed, only to go back out and do the same thing all over again, I know that there isn't that much of a difference between us. Maybe that's why I hate dealing with them........they could be me, or I could be them, if it weren't for some really good timing on the Lord's part over 12 years ago when my then-infant son developed pneumonia and I realized how easily I could have lost him had I not been sober the night his breathing went bad. Heavy stuff.
At any rate, I'm deeply grateful to have the rest of the weekend off. Think I'll take that little snooze now............