You know its going to be a bad shift when...

You know its going to be a bad shift when...

its a full moon

you arrive for report to be greeted by a CNA who has just sustained a concussion from an aggressive resident, and the phone rings from the agency to tell you the other RN will not be coming because she has just had an accident on the highway and is being sent to hospital. (this happened to me)

...day shift waits until 1800 to give a 98-year-old woman Go Lytely, and yes, she will be your patient!

...The code cart hasn't had time to be restocked before you hear "code blue"...again...

...4th of July, in ED, need I say more?!

...You walk by room 351 to discover the walls and floor have a nice "brown" tint and the room is supposed to be blue.

...As you're noticing the new decor of choice in 351, you notice the patient is now sporting war paint.

...The day shift nurses look slightly frazzled and the first words out their mouths is "I haven't even begun to chart yet..."

...You have to use a bulldozer to clear a path through the family at the ICU doors.

...You walk in to work to see 3 squads sorting through rhythm strips (should I say code strips?) and as you walk through the doors in ED the nursing supervisor's face lights up when she spots you (and you proceed to walk quickly to your other destination!)

...The weekend you are scheduled to work is also the same weekend as the crap magnet trio is (certain ED doc, nursing supervisor, and on-call primary doc).

...you're an hour into the shift and your ER has run out of defibrillator pads. (two weeks ago)

It's a day that ends in Y.

The coordinator has started on page 3 of the add-on surgeries list, the first three cases on that page including words like "abdominal aneurysm, "carotid", "exploratory lap", "ORIF". (this was today).

You know your day has already gone to hell when you arrive to work at 0645, and the only nurses waiting for report are the ones coming on duty. The nightshift nurses are tied up with their patients...STILL!

It's a full moon weekend in summer, it's 100 degrees out, and there's a carnival in town.

Well, there's the 4th of July in ED and there's Halloween in ED. I've never worked in an ED for 4th of July, but I've been in one on Halloween and boy howdy, if it gets more "interesting" than that, I don't want to see it!

Oh, I know all about them!

You know it's gonna be a bad shift the first day the hospital tries a 'rapid response team' to prevent codes: result - 2 'codes' in 1 shift show up in your unit unannounced (after all, the PURPOSE was to avoid codes, so we didn't have to notify the code team/ICU, right!) or better, "Aren't you glad we got them to you before they coded. Oh and where do you keep your ambu bags and the doc wants V and V now (vecuronium and versed)."

You know it's gonna be a bad shift when all the NPB840 vents, and the PB7200 vents are in use and they're breaking out the old Bear IIIs and Servos. . .

You know it's gonna be a bad shift when the docs last words on the phone were 'I've never seen anybody code over this before, it'll be fine . . .'

You know it's gonna be a bad shift when the comment about the 'closed down room' is "do you really need a functioning monitor to admit a patient; don't you have portables somewhere?"

You know it's gonna be a bad shift when THAT GI doc is coming into do an afterhours EGD - you know the one that can't aim when he's aiming the blood at a non-bio trashcan . . .

You know its gonna be a bad shift 10 minutes after your idiot co-worker comments how quiet it is. . .

You know it's gonna be a bad shift when you have 1 patient, the rooms on either side of you are empty, and the charge nurse says "After your admit, we're gonna have to triple"

You know it's gonna be a bad shift when the ABP and SPO2 alarms are turned off because "they wouldn't shut up". . .

You know it's gonna be a bad shift when there are 7 IV pumps in your room, and the off-going shift is looking for more . . .

You know it's gonna be a bad shift when the OR is bringing their equipment up with the patient 'just in case' - had the OR leave a continuous TEE in a patient the other night. . .just in case.

You know it's gonna be a bad shift when THAT doc that likes to write 4 pages of orders is both your patient's primary and he's writing orders when you show up for report.

You know it's gonna be a bad shift when the off-going nurses first remark to you is "Do you know where the tube exchangers are?"

You know it's gonna be a bad shift when the doc asks you to set up a balloon pump, just in case . . . and then slinks out.

You know it's gonna be a bad shift when the off-going report is something like "After CT scan, he's going for a VQ scan and a bleeding scan. Oh, and the first of 3 units of blood is hanging and the 2 units of FFP are thawing"

You know it's gonna be a bad shift when the wife says "I gave the nurses station's phone numbers to his 11 siblings, 23 nephews/neices, 8 children, and 2 ex-wives . . .but I'd prefer if you don't tell them anything."

Should I continue?

~faith,
Timothy.

When the local party college is in session again.