Wanna Scream!

  1. Okay, I'm going to talk about my night shift last night. I finally got my marbles back together (was badly incoherent when I went home this am). I am feeling very sarcastic, just to warn you.

    Have had a pretty good week so far (not counting the toilet breaking incident and getting soaked). I even forgave one of the nurses for calling me at home Saturday am (on MY DAY OFF), to get me to settle a silly arguement between staff ( Uh they do pay people to take care if things like this).

    Anyway, I started the shift, finding out that I was working with two strangers (myself being the only regular for 30 residents). One of which gives me attitude and has a chip on her shoulder because I once reported her for falling asleep in the shelves of the linen room (but that's a whole other thread). So any way, these 2 don't know the unit, don't know the routine, aren't used to working with people with dementia -- but getting this sort of staff on the unit is not rare.

    So I'm all alone (the 2 others are on the 2nd locked wing). I have a lady who is quite ill (diabetic, urosepsis, vomitting, poor intake in last 24 hrs). I'm trying to measure her intake and output. I can't figure out why her foley is not draining and is bypassing bigtime. She is lying in wet sheets with a stage 4 ulcer on her coccyx. Miss Attitude CNA swore to me that she had changed and turned her while I was on coffee (Uh huh, I wonder what else she didn't do?)

    I look at her catheter and I can't believe it. Whoever had catherized her 2 days ago had used a 3 prong foley (meant for continuous irrigation (this shouldn't even be on the unit) and the extra port is OPEN TO THE AIR. has just been open and draining urine onto the sheets as if it is a regular foley that someone had forgot to hook up to a drainage bag (or plug for that matter).

    I have no help to recatheterize her. I should have help, but their rounds have ended (suspiciously) early and the other nurse has gone for coffee. Pt. will not stay still for procedure. Is thrashing around with hands and legs. I call supervisor to come and help me.

    I hate to catheterize. I don't do it often enough to be good at it. So I'm self conscious as well as still angry from events leading up to this. Catheterzied resident without incident. Supervisor leaves. Call-lights start ringing.

    30 min later am back in original room. Need to clean her up and change soiled linen. Notice that coccyx dressing is saturated with stool and urine. Open it up . I want to cry! Wound looks terrrible! Has been progressing so well. Smells so bad. Was so clean last week when I was looking after it. Periwound skin is broken, haematomas all over the wound bed. Very. very macerated (I guess, it's been soaking in urine and stool for 2 days). Did dressing as best as I could without tray or assistance.

    Sat at desk and documented.

    Thanks for listening. What makes this worse is I'm really emotionally attached to this woman and have been trying so hard to heal up that wound for the last few months. Wanna cry. Maybe life will look better tomorrow. Things will be better into perspective after some more sleep.
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  2. 12 Comments

  3. by   adrienurse
    Is it just me, or is my avatar looking more tired than usual?
  4. by   Genista
    ((((Oh adrienurse!)))) I'm sorry to hear about your lousy night!


    It's so hard sometimes, especially when you have no help.
    I have felt that same frustration.

    You helped turn things around for that poor woman, though. Hard to believe she was getting such poor care by previous shifts, but then again, maybe not.

    If you are feeling tired, maybe it's time to put in a vacation request! I just got back from 1 week off from work. My "vacation" went by in the blink of an eye! LOL. Hubby & I went camping. I came back to the same problems at work, of course, but for the week off I began to feel human & happy again.

    Take care!

    ~kona

  5. by   shygirl
    Who is the idiot that put a 3 pronged foley in?
    How do you stand working there with all the incompetent staff?

    You could get a job anywhere where there is plenty of help. You shouldn't have to put up with this.

    Shygirl
  6. by   kids
    I would be so pizzed over that wound going to s**t...I know what it is like to put so much into getting a stage IV to turn around and start to heal...only to come back and find that *somebody* ruined it.
  7. by   adrienurse
    My friend the CNS is gonna freak when he comes back from holidays in 2 weeks. We were just patting each other on the back last friday over how well it was granulating and how clean it is. Yes, this is the wound I have been talking about on the wound care forum.
  8. by   adrienurse
    she is dying and I'm having trouble coping
  9. by   Rustyhammer
    Yes Adrienne,
    You COULD get a job anywhere but then, what would happen to your people?
    Stay where you are, set the example and be a conductor of change. Your pts need you.
    -Russell
  10. by   Aussienurse2
    Oh God honey!! I just know where you're at! I'm there most of the time, our staffing ratios are higher though. But then again most of our staff are AINs off the street who don't know the first thing about nursing, they give them three days of orientation then let them loose on the wards. Pss me off no end. Then you get the buggers who take the attitude" Well they're just gonna die anyway" !!! I think I had a bad day too. A girl from work rang me today ( I'm on study break) to tell me that one of my patients just had an amputation done, the wound was nearly healed when I went off, four weeks later they amputate below the knee!!! How do people let these things happen??? It can't be that difficult to follow the flow charts??!!
  11. by   JailRN
    This is exactly why I left bedside nursing.
  12. by   Sleepyeyes
    (((((adrie)))))
    This is the hardest part of nursing---
    I applaud you.
  13. by   nimbex
    I'm sorry to hear of your struggle with staff, time and the future loss of your patient.

    hugs and lots of support

    carol
  14. by   sharann
    ((((Adrienne))))),
    SCREAM
    CRY
    YELL

    Then know that I think you are a wonderfully caring peson and a heck of a compassionate as well as proffessional nurse. Your patients are very fortunate to have you caring and watching out for them.

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