What was your worst shift ever?

  1. I had one of *those* shifts last night.

    I work night shifts on a moderate med/surg floor; 5 patients max for night shift. Four patients most of the shift, one that could have been in geri-psych if not for some wonky ammonia levels (which admittedly did not help things). We ended up having to give IM ativan and zyprexa to calm her down. While this was going on, also trying to monitor blood glucose levels on a brittle diabetic who on the day shift had been down to 26 and now was >300 due to D5 and IV methylprednisone; it's so fun contacting sleepy docs on the night shift! I get word through all of this that I'm getting an unorthodox admission from a different hospitals ER, so I contact that ER for report and hear that they're having trouble stabilizing her so they are unsure when she will be transferred. Okay, I guess I've got enough to deal with, I thought. Sure enough, in waltzed the pt with EMS at 0630, right before shift change! And now, I hear from the charge nurse that the nurse taking that patient was going to be half an hour late from the recent winter storm. Had to stay after quitting time a while to finish up on charting anyways, so what the heck.

    All-in-all, I can't complain too much; nobody died and my patients were mostly pleasant (minus geri-psych lady). Just one of those shifts that you let out a big sigh and press on. But it did get me thinking about some of my "shifts from hell" as a nurse. There aren't too many recent threads on this topic, so lets hear some stories! Reply with a summary of your worst shift ever!
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  2. 28 Comments

  3. by   VivaLasViejas
    One night I had seven patients who were mostly total care and no aide. Most of the shift went OK until about 0500, but then one needed blood, another got up and fell and gave himself a goose egg on his forehead (necessitating frequent neuro checks), and one decided to crash and had to be transferred to ICU. All at the same time! I was able to get some help from the other nurses, but what a mess...I was still there three hours after my shift ended, documenting everything. That was by far my worst shift ever.
  4. by   ThePrincessBride
    The shift I lost a baby whose gestational age at birth was less than 23 weeks and not quite a week old. :/ He was the tiniest baby the unit ever had, and I had to watch as he died in his mother's arms. I had to excuse myself to go the break room...I was in tears.
  5. by   Been there,done that
    Nine patients, one on an insulin drip, 2 on a vent.. CNA's hiding out.
  6. by   Luckyyou
    Four codes, same long-term patient. At least one massive pulmonary hemorrhage. Parents falling out on the floor, vomiting into trash cans, a hole punched in the wall, dad screaming at me "Why won't you save my baby?"... ended with me sitting on the floor holding the dead baby next to the parents, sprawled out on the floor sobbing.

    I'd love the ability to look into my nursing future to know if I'll ever have a night quite that bad, because I'd just quit in advance, thank you very much.
  7. by   RainMom
    Newish night charge with 5 pts, only 2 of us on the floor, no aide. Rapid response at 2300, comfort measure pt death at 0030, rapid response at 0200 (different pt) & chewed out at the end of shift by specialist who disagreed with orders given by primary for the 2nd RR.
  8. by   Rose_Queen
    Well, I only had 1 patient at a time, but my shift lasted about 26 hours. Started my regularly scheduled shift, stayed late to finish a later scheduled surgery, got to the locker room, and got paged about an emergency. That emergency was still running when staff arrived the following morning for the regularly scheduled shift. The joys of surgery, on call, and no off shift staff.
  9. by   cleback
    Choices, choices....

    One night I was charge on a psych floor and one patient turned unresponsive/had breathing issues and was transferred to the unit. Not a big deal but the floor was I'll equiped to handle medical emergencies and the on call medical MD was literally avoiding my calls. Had to have the ICU nurse who responded to the rapid response call him for me. The same night another patient went into labor. She was a mute, agitated schizophrenic... and again, we were I'll equipped (had to send for a wheelchair). I called our OB floor to have the nurses to assess and they told me they couldn't come up, too busy. I literally ran to get that wheelchair and then get her to l&d. By this time, all the commotion woke up the whole floor and many were agitated. I left as security was restraining another patient who was threatening himself with a plastic knife.

    All as a new grad charge. And my husband wondered I was a nervous wreck before work.
  10. by   NurseCard
    Shew... I've had some horrible shifts. Most of the worst shifts
    I've ever had actually occurred during my very first nursing job,
    on my very first Med Surge unit. I worked on that unit for seven
    years, 3 as a nurse. I remember getting buried frequently. I
    remember one night having 2-3 patients getting blood at
    the same time. Along with probably 3-4 other patients to
    take care of.

    I remember one night, I had had a horrific shift, and then
    that morning I remember having to give a Rocephin
    injection IM, to a toddler. Mom was already a nervous
    wreck. I remember drawing up the Rocephin, trying
    to give it, could not get it to go through the syringe,
    the syringe ended up coming apart and the medicine
    sprayed everywhere. Mom freaked, kid freaked... I
    freaked. *sigh* AWFUL.

    Not to mention that Rocephin BURNS and I really
    don't think it should have been given IM. But
    that's how I was told to give it.
  11. by   oceanblue52
    Edit: I missed the "as a nurse" caveat for this thread, but luckily I haven't had too many bad days in my first 8 months as a newish grad. The story below takes the cake for worst acute care experience I have had in the nursing profession.

    I was working as a CNA on a Tele floor by myself, normal ratio is 9:1, but with one CNA down and lowest census it was 11:1. Can't be too awful right? But I was working with 5 different nurses, one who decided that I had 45 minutes to feed one of her patients breakfast while all the call lights were ignored....vitals took 2 hours each round because most of our population was quite elderly, a fall risk, needing to use bathroom ASAP because of Lasix drips and what not, and then I got reprimanded about not doing the blood sugars on time. Charge did not bother suggesting until the end of shift that I tell nurses about my situation and get them to help out...Was a relatively new CNA and Nursing student and would never dream of demanding help from a superior! Oh how quickly we learn.

    Was as a relatively unpleasant shift but was just plowing through it...then I get asked to sit 1:1 for a dementia patient. She had been busy with dialysis earlier in the shift so she hadn't been too time consuming...so I sit next to her and try to create a soothing atmosphere, but she's getting worked up, nurses have already given her a bunch of meds and are depending on me to keep her calm. She is Spanish speaking only so I'm having a hard time soothing her as I only know very basic phrases. She starts picking at her IV and I prompt her to stop with my hand...then she tries to bite me. I yank my hand away instinctually and the next thing I know the IV is out, blood is spurting all over the place and it happened in the blink of an eye. The charge nurse comes in and exclaimed "What happened here?! How could you let this happen?? And then I'm told that she's an impossible stick and took several tries to get an IV in her. She wasn't mean per se, just overwhelmed and upset that I wasn't able to keep things calm. I don't cry very often, but I excused myself very quickly and cried for about 15 minutes in unit bathroom. It was one of the worst feelings of disappointing my coworkers and not being able to fulfill the simple duty of 1:1 sitting.

    Rest of the shift was similar amounts of chaos, I definitely went home that night and took a hot bath and had more than one glass of wine.

    It sounds kind kind of silly looking back now, especially knowing how much responsibility nurses have and reading tales on the site. After all, CNAs in nursing homes deal with impossible workloads everyday. Took a lot away that day about asking for help, knowing my limits, setting boundaries with requests, and self compassion. It was also the first inkling that perhaps acute care is not my specialty. I did stick with that job for awhile and take on another hospital job before graduating, but now I am in out patient/community health and would never look back. Major props to nurses that can thrive in the acute care environment and provide awesome care.

    Have a few other stories I could share being a new grad nurse, but that is the one day that sticks out most in my mind.
    Last edit by oceanblue52 on Mar 14 : Reason: Clarification
  12. by   BSNbeDONE
    This was during my LPN years in acute care. Our unit's capacity was 25. The beginning census was 2. Needless the say, all techs were cancelled. The only nurses not cancelled was myself, another LPN, and an RN charge. This was during the days of 8-hour shifts and the hours were from 3pm-11pm. We still had paper orders and the only documentation done on the now-relic of a computer system was an extremely simplified two-hour rounding notation.

    Well, by 11pm, we were at full capacity. Twenty-three admissions!!! The only thing we could do was bed-n-admit 'em! No one and I mean absolutely NO ONE received ANY medications that shift...not even an aspirin! There was no one available to process (sign off) and fax orders to the pharmacy. All three of us were knee-deep in admissions. Phones were ringing off the hook with no one at the desk available to answer, and when we did happen upon the desk, it was ER calling for another bed!

    The unit was on the 4th floor and had an outside balcony directly across from the nurses station. The door was chained because of a previous suicide attempt a couple of years back. Had it not been chained, I would have jumped that evening myself. Twenty-three admissions in eight hours on one acute care hospital floor!!
  13. by   ohiobobcat
    We had just been informed that one of our beloved physicians (who was young- in his 40s) had a cardiac event while away at a medical conference, and was being taken off life support that night. I worked in the ER and we were all super close.

    Then a 7 year old was hauled in by 2 police officers because he was SO out of control. I ended up putting a 7 year old in 4 point leathers that night after he kicked out the tempered glass window in our psych room. At the end of that shift I sat in a chair in the dictation room and bawled my eyes out.
  14. by   BSN16
    we had two call ins that night. and 2 1:1's. I was in a 1:1 CRRT had to end up taking another patient (VERY UNSAFE). every other nurse was tripled. Had a patient come up to the unit from the floor and kept coding all night long. Less than 6 years experience that entire night between all the nurses

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