Baby nurse doo doo doo doo....

[mi_dreamin, BSN]

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]

Learning from experience...

Priceless!!

Sounds like you did great, no need to call yourself baby nurse anymore:sarcastic:

[mi_dreamin, BSN]

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]

You did great! Why would you call a rapid? Sounds like every one who needed to be there was there!

[mi_dreamin, BSN]

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]

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]

Now I have that stooopid song in my head!!!!

Grumpy nurse doo doo doo doo doo doo!

Oh and ...well done!

[traumaRUs, MSN, APRN]

Tired nurse....dodoo doo doo doo doo doo!

[JKL33]

Do they have opportunities for debriefing/review, etc. where you work?

[Farawyn]

Darn it. I thought this was another thread about Nannies.

Good for you, Toddler nurse.

[mi_dreamin, BSN]

Do they have opportunities for debriefing/review, etc. where you work?

Not in that circumstance...not sure about others. That sounds like it could be beneficial though!

You did a great job you should be proud.

I am of the opinion that a RR should have been called.