Published Nov 21, 2018
mi_dreamin, BSN
55 Posts
This is for all the new grads out there thinking they are the only ones running around like a crazy person...
07:00: Getting report, pulling tele strips as we go.
Me: Hmm, has her heart rate been 120?
Nightshift nurse: no, it was 80 when I did her 04:00 strip, and I think she has been about 80 during this whole admission.
Me: Ms. L, how are you feeling this morning? (Writes name on board)
Ms.L: Oh I feel fine, just a little sleepy.
Me: (Checks morning vitals) Okay well I am going to be back in here in a little bit with your morning meds, use your call light if you need anything.
NN: Here's the report on the new admit that came from ED at 05:50, admission paperwork is done but I haven't done an assessment.
Baby nurse (AKA Me): I'll go see him first ? (07:30)
08:00: In new admit's room, charting, listening to nephrologist map out plan of care.
PCA: Ms. L wants something for nausea
Baby nurse: okay, I'll see if she has anything.
08:10: pulling Ms. L's meds
Charge nurse: Ms. L wants something for nausea, I'd give her something, she's vomitting.
Baby nurse: okay. She doesn't have anything on her MAR but I'll get an order.
08:13: Walks into Ms. L's room
Ms L: (sweating bullets, breathing 30/min, clutching chest)
Baby nurse: *oh crap* charge nurse said you are nauseas, tell me what else is going on...
Ms. L: my chest hurts
Baby nurse: can you describe it for me?
Ms. L: It just hurts, it's like a 10, OOHHHHH, *pants*
Baby nurse: (begins typing page to Dr.) can you tell me how long this has been going on? Have you ever had pain like this before? Does it hurt anywhere else?
Ms. L: it started about ten minutes ago, right after I started vomiting. I've never had pain like this before! My shoulder hurts, my right shoulder, and up here into my jaw...
Baby nurse: *looks around for grown-up nurse* *puts 2L O2 NC on Ms. L* *checks frantically to see if Dr. has responded* "I will be right back!" *Asks pharmacist if it is possible to override nitro tabs from the Pyxis, tells charge nurse why nitro is needed* Goes to check if Dr. has responded, again*
Dr. (via computer): nitro, stat labs, chest x-ray, call cardiology
Baby nurse: *starts putting in orders* *looks around* how do you call cardiology? *pulls nitro from the Pyxis, brings vitals cart into room, asks the PCA for a STAT EKG, administers nitro*
Dr. (via computer): call cardiology now!
Baby nurse: (to anyone at nurse's station) do I just call the paging center for cardiology?
Random nurse: yeah...
Baby nurse: *calls paging center, goes back to Ms. L* *gives more nitro*
Phone rings; "cardiology is on the line for you"
Baby nurse: *rushes out to nurse's station, gives cardiology an update* *rushes back to Ms. L, re-checks vitals*
Cardio: *arrives at bedside* *asks questions, looks at the EKG, leaves the room*
Baby nurse: how's your chest pain? A 6 now? That's good... *cycles BP again* 204/97, here's another nitro...
Cardio: *walks back in* what was her last BP? Has she had nitro? How many? We need to get her on a BiPAP, where's the hospitalist? Give 40mg lasix IVP now.
Baby nurse: 3 nitro, chest pain went from 10 to 6, BP unresponsive, I'll tell the hospitalist to come... *pages hospitalist again, pulls lasix, calls respiratory*
Ms. L: I need to pee!
Baby nurse: *searches for bedpan, sees that she is wearing depends* it's okay, you can pee in that, we will get you cleaned up later
Cardio: did you give the lasix? We are going to need a catheter put in, are they bringing a BiPAP?
Hospitalist: *comes in room* why are there fluids running?
Cardio: what was the last BP? Start a nitro drip. Let's get a STAT echo
Baby nurse: *looks up policy for nitro drip* *triumphantly remembers that meds in bottles need vented tubing* drops/breaks a bottle of nitro while pulling from Pyxis*
RT: *brings BiPAP* she is doing really well but she is very anxious, can we give her something?
Cardio: Ativan 1mg IVP now
Baby nurse: starts to put order in and leave room at same time
Hospitalist: actually do 20mg morphine IVP now
Baby nurse: *nods calmly, walks calmly to Pyxis room, frantically overrides morphine from the Pyxis* *double, quadruple checks that 1 ml is 20mg, administers*
Cardio: give another 40 of lasix, we're transferring to ICU as soon as they finish this echo.
Everyone except me, echo tech, and Ms. L's grandson (when did he get here?!): leaves room
Baby nurse: *calls report to ICU, titrates nitro up to 10, starts writing note*
Ms. L's grandson: *hands baby nurse cell phone* can you tell my aunt what is happening? *hands baby nurse a 2nd cell phone* now can you tell my mom what is happening?
Baby nurse's phone rings, unit secretary: Ms. L's son is on the phone and wants to know what's going on...
Baby nurse: *delegates communication to current family member* *continues writing note* *gives 40mg lasix* *takes Ms. L to ICU, gives updated report* *returns to unit, looks around, feels like taking a nap* *Thanks charge nurse for completing morning med pass on other patients* *completes morning assessments/charting*
2 days later
Baby nurse: *wonders why I didn't call a Rapid Response*
Insert about 10x more silent panic and frantic eyes and you've seen the whole thing!
Daisy4RN
2,221 Posts
Learning from experience...
Priceless!!
Sounds like you did great, no need to call yourself baby nurse anymore:sarcastic:
Learning from experience...Priceless!!Sounds like you did great, no need to call yourself baby nurse anymore:sarcastic:
Aww thanks! I guess I'm a toddler nurse now lol
beekee
839 Posts
You did great! Why would you call a rapid? Sounds like every one who needed to be there was there!
During the 4 (LONG) minutes between contacting the Dr. and getting a reply...never even occurred to me at the time though
nursebert, MSN
47 Posts
You are an awesome nurse already. !
No baby , no toddler, no teenager. .. I have been in this game for 22 years now and currently serving a sentence in med surg
tele hell. You are hilarious and I would love to work with you.
I am so happy that you have joined our profession. All the very best to you.
Wuzzie
5,221 Posts
Now I have that stooopid song in my head!!!!
Grumpy nurse doo doo doo doo doo doo!
Oh and ...well done!
traumaRUs, MSN, APRN
88 Articles; 21,268 Posts
Tired nurse....dodoo doo doo doo doo doo!
JKL33
6,953 Posts
Do they have opportunities for debriefing/review, etc. where you work?
Farawyn
12,646 Posts
Darn it. I thought this was another thread about Nannies.
Good for you, Toddler nurse.
Not in that circumstance...not sure about others. That sounds like it could be beneficial though!
Guest
0 Posts
You did a great job you should be proud.
I am of the opinion that a RR should have been called.