7am - After taking report, I discovered one of my NA's had not arrived. Called staffing coordinator, who informed me she had called to say she'd be 15 minutes late. Fine.
So I count and start med pass on the side I always start on, due to people needing their early insulins/diabetic meds. Then call lights start going off on the other side, the one aide is busy passing trays for the whole floor (18 residents at this point) and so I grab the lights, which have been on for a while already. One very heavy woman needs the bedpan, so I put her on. Another pt, a virtually immobile, also heavy CVA pt. wants to be changed. Mind you, this woman wants her brief changed every five minutes. I tell her, 'your aide is running late, she should be here any minute.' She's very understanding. As I go to try and re-start meds, Lady #1 is done with the bedpan. Aide is 1/2 hour late at this point. I go to take her off the bedpan, bedpan is dry, pads are soaked 'cause I couldn't really visualize where to put the darn thing she was so large. Thank goodness the sheet was dry. So a change of bed pads/brief, pulling pants up, rolling back and forth and back again later, I think I may just be able to get some meds passed.
But first I need me an aide. Call supervisor, who vents to me about how aides have called off and she's having such a hard time staffing the floors. Then I inform her about my missing aide. She's not happy, naturally, but tells me she'll send someone. Who didn't arrive till 8:30.
Now there's a pt. going to an appt. we didn't even know about, and her son wants her dressed. Sure, ok. Hey aide, stop passing trays, this lady needs dressed. (the hypochondriac family takes her to a different specialist every week)
Still trying to pass meds on first side. I go into Mr. A's room with his meds, he's curled up on the bed, quivering. Repeatedly I ask him to sit up and take his pills. Finally he kind of sits up in bed, but he's mumbling incoherently, and his mouth is drooping. When I go and take his temp, he can't even close his mouth. So I page nurse practitioner. Of course she hasn't arrived yet. what to do. So my unit manager gets there and is able to hang with pt. for a minute while we wait for NP to arrive. (Thankfully guy is a 90 y.o. DNR) NP finally arrives while I pass meds on the other side (Therapy throws a hissy fit if ppl aren't medicated). I don't actually get a chance to touch base with NP till 1000, who had to go to another floor. Suspected TIA, we don't need to send him out, just get some stat labs, let family know. Ok. So I call for stat labs and CXR (on hold with lab forever...) and admissions comes to tell me I've got someone coming at 1100. Hospital calls with report shortly after.
1145 - admission not there, but labs are back on Mr. A. Hgb is 8.3, CXR showing infiltrates. Trays arriving. I figure I better dash into Mr. Z's room real quick before lunch since his staples have to come out today, and I may not have another chance.... Of course he talks my ear off about his prostatectomy and I'm in there longer than anticipated, not to mention when I was closing his door, I saw my admission being wheeled by.. oh, well.
Social worker ended up picking up the paperwork for the admit for me. Thank the Lord for her, anyway.
So now we need to send Mr. A out for a transfusion. As I'm trying to get the paperwork together, I try to page the unit manager and supervisor for help with no results. I call for transport to ER, then call report to ER as stretcher rolls in. Followed by my supervisor. Dropping off results from the CXR that we already had. I ask, "are you busy" she says "yeah" and I burst into tears. LOL. I get out some gibberish and swear words, and ask if she can do some treatments or something. LOL all the crap hitting the fan and I was worried about tx's. So she does a couple txs while I finish sending guy out.
Oh yeah, my admission. All the way at the end of the hall. I grab his vitals, thankfully he got a lunch, so that's my excuse to put off the assessment. "I'll just let you finish eating, sir." Back to meds and accuchecks. Of course most of them have already eaten by now. Now I have to chart skilled assessments. Did I mention everyone is skilled? I don't think I finished them all. And the vitals I asked the aides to do by 1pm I don't receive till 1430 so I have to put them all in the computer. Somehow I manage to finish the admission, then I get a call at 2pm from another hospital about another admission I didn't even know was coming. At least he didn't show up till during report. Not mine! :)
So, if you've lost count, census is now 20. Yay. I'm actively looking for another job. I can't do this crap anymore.
If anyone made it this far through the gibberish, thanks for reading. If no one did, I don't care. I needed to get it out. There's so much I didn't even mention. I figured it was long enough already.
Take care, all. I know tomorrow will be better. :heartbeat
