My nights have been pretty tame compared to the 4 or 5 code nights. Good grief. Those nights would have had me wanting beer and eggs for breakfast!
Ok but the first code on any unit I was working on, was quite a night. I had one patient with no legs who was my "good" patient. One guy getting blood who was a bit forgetful and could go in and out of A fib, whose wife probably decided to get some rest and was not staying the night. One cocaine user who wouldn't tell me how much he drank, just that it was two days ago, and he was on a bowel prep for colonoscopy the following AM. Good man, he drank all his golyte before 9 pm. One other patient, that I can't remember anything about.
I was maybe a month or so off orientation, too. So I knew to watch for DT symptoms in the one patient, and the night before, when I had admitted him, I left that AM telling dayshift to please get me some tranxene or ativan or something for him when the doc rounds... that didn't happen. So, just before 4 am, I get my VS on my patients and I find this patient eating pepper packets, paper and all, sweating bullets, high BP and just acting kinda squirrelly. Oh, and he's had no sleep 'cause he's still pooping buckets.
Come out of the room, to tell my charge that I got a DT's in progress and this blur goes past me while I hear tele alarms. Loud ones. Phone rings, tele's screaming at me "get to XXXX's room" well okay thanks; I hang up and grab the code cart and just about turn it over sideways. Turn around, charge nurse is walking by saying "well he's fine, he's peeing." So I try to fit the stupid cart back in its cubbyhole and it doesn't want to cooperate. Nurse goes back to her patient's room and as I'm fidding with the cart she screeches my name and darn near curls my hair with that noise; "get the code cart" .... Ok by now I've got the electric cord wrapped around my feet, the phone's ringing and the alarm's going off on the tele monitor. I couldn't figure out which way to move! Fortunately at that moment, a resp. tech walked by and said "ok who's coding?" I told her, she called the code and in about 10 seconds they were there. I had managed to untangle the cart and get it to the room by that point.
No problem, eh. Well then I get A fib calls from tele on my guy who got blood. He.... um. is in A fib all right but he's standing naked at his sink, pleasing himself and chewing gum. Telemetry still on him, how, I don't know. I walked right out of there, called the doc on my fella who was in need of tranxene. I get orders for ativan. No problem, he has two INT's, one of which has NS running... right?
Not anymore! He has poo in a wide swath from bed to bathroom, all over him, the whole toilet's a mess, he's sitting on it sideways, and his IV's are gone. The NS line end is sitting in the poo on the floor, leaking at a nice rate and adding to the mess. Hm. Oh yes the third nurse's patients, two of them picked out their IV lines about that time and bled all over creation because they were both on heparin.
So a nice nurse shows up from another unit and asks what I need. I tell her there are at least 3 people who need IV's all of a sudden. She grabbed the tray and went to each room and restarted IV's, me and the third nurse went behind her cleaning up. Except for the fella with DT's, I didn't put her through that. As she's getting done, I go to see the naked guy with A fib who's now in sinus. I get his gown on and realize, his INT is on the floor. So we restart his IV and get him "settled" but he refuses to get in the bed. Instead, this fella stayed by the window, standing up, sleeping. Ok.
At 0700 I was cleaning the entire room, bed, and patient (DT's) up for the third time, giving him his third dose of IV ativan, and he was starting to look more human, and pooping a little bit less. The GI doc was kinda surprised to find out I hadn't called him, to tell him that this fella wasn't going to be able to have a colonoscopy that day. I prettymuch ignored whatever he had to say about that. One nurse from dayshift was kinda ill with me for not putting the patient without legs on the sling scale to get his weight. Heck, I hadn't weighed anyone. And at that point, I wasn't worried about it.