Sorry, don't often dump here but I have had two days from HE$% or two days that make one wonder why nursing, and not flipping burgers? I work on a CC "step down" (yeah right) unit. Because we are classified as "step down" we have unit protocols for the type of patient we can accept on our unit, the ICU nursing co-odinator had our protocols rewritten by an MD to meet her needs to empty ICU beds. Our staffing is also set by our classification of "step down" Well yesterday and today I had 4 pts., we do not do team nursing, we do primary nursing. Pt. one was from the ICU, trach, vent, PEG, MERSA, PICC, obese, PO2 in the upper 70's on 50% trach colar with RR of 37-42 who in her spare time tachys to the low 150's. Pt. two also from ICU, RCW Port-A-Cath (dual), PEG, ileostomy, NG, IV's running: NSS @ 80, hydromorph PCA, TPN, lipids, vanco, fortaz, Zofran, AND 1/2 NSS @ 20 of K set at - "Doc to RN Note": "caluclate and set infusion rate to replace 1/2 of shift GI loss at a rate of 100-125 cc/hr not to run into next shift", GI loss my shift 2100 cc via NG, ostomy and emesis: don't think that ANY way I do the math I can replace 1000 cc at 100/hr and NOT run over the next shift. Oh, by the way, in the time left over, pt's wife may be a canditate for Munchounsen Synd. (sp) by proxy- Gomco's stop working, lines become disconnected, IV's flow faster or slower than set, NG drainage changes from billious green to pale yellow even though pt is NPO and wife swears she is NOT giving him water, ostemy bags are disconnected, and meds some how wind up running into the TPN line This patient also tachys into the mid 150's and has a PRN lopressor IV for "HR over 120". Wife is VERY demanding and nasty. Patient three is a very plesant gentelman COPD with new dx of abd. mass- he is VERY emotionally needy but won't ask for help so he disconnects his O2 and tele monitor to walk into the bathroom, he'll hook them back up right away so I know HIS sats are in the low 80's with a HR of 124 and a RR of 28-32. Pt. four is a 83 yo man with a dx of IDDM, SOB, COPD, CP, MI, previous CVA AND Alzhimers dementia. Mr. Room 5 has tried to climb from bed 5 times, has pooped on the floor, bed, chair, and in the hall when he got free from his bed and pulled all his lines including his PICC. Oh buy the way, I have had student nurses for both days. Past two days, no lunch, no potty break, not sure I got everything done. I know I did not do right by my patients or the students I worked with. I HATE days like this. It's one thing to be too busy for lunch when you get done what you have to and you know your patients got the best possible care from you, and it's another to be too busy for lunch or bathoorm, be an hour late getting out of work, fail the students you are supposed to be helping AND know your patients suffered with substandard care. Bottom line, being a nurse really bites some days and today was one of them. To all the students here, sorry, don't read all of this-it was just a REALLY bad day and you have them no matter what your job, even flipping burgers. Thanks for letting me dump on all of you.
Connie: I feel for you, Girlfriend! :kiss Were the planets in some wierd conjunction or something?? I just spent two days like yours also! Except my floor is med-surg-tele. Day was awful PLUS I was the Charge nurse for both days. Fortunately, I had WONDERFUL NAs working with me. (I also had the student nurse thing going on...)
I came home last night ALL bent outa shape and spent 2 hours venting to my husband and son while we pigged out on pizza with everthing...and a big ole glass of beer. (Nah...I am on a diet...I only had ONE piece of pizza and drank Diet Coke...worked for me!!:) ) But the "venting" worked. I hope you had someone who you could "dump" on in your home.
I am glad you have the weekend of. And GOOD FOR YOU - You and your son going on the breast CA awareness walk. I read your post about that. You must be sooooo proud of your son! What a good mom you are! ENJOY that walk and treasure the time w son!!!
You almost want to stick the student in the room with the interfering wife... since you probably can't get mgmt to back you up on getting her out of the room.
Let calgon take you away!
Kitty
I am a student, and that was my first thought. I would not have minded staying in the room with that patient to make sure his wife was not mucking him up. Even if I wasn't "taught" a lot that day, I would have learned just by being there! I would gladly have monitored it just so someone could be there advocating for the patient. If that many things were screwy, then things were going on in that room and it sounds like it would be more than enough of an assignment for a student!
LOL, I was saying all day that there must have been some strange planetary convergence going on. Glad it wasn't just the heavens above here. Monday HAS to be better. Val, thanks for the offer but I would NEVER have done that to a student. Your job is to gain as much hands on education as you can no matter what is going on on the floor. As a student you have the grab every clinical experience you can.
Specializes in Gerontological, cardiac, med-surg, peds.
Connie, so sorry about your situation! It frankly makes me very upset reading all this, because you are being placed in a very dangerous situation--dangerous for your patients, dangerous for your license. NO ONE, no matter how experienced, could manage such a patient load safely. If this is "typical" for this unit, or even a "once-in-awhile" scenario, you need to GET OUT ASAP!!!! You are a relatively new grad with such a kind, considerate heart. It is obvious that you are a great nurse but that TPTB are taking advantage of your relative inexperience. I am afraid if this stuff continues, you are going to be burned out from bedside nursing before you reach your second year out of school!!!! And TPTB could care less!!! All they care about is the "bottom line." This just burns me up--putting patients lives in jeopardy, putting the professional staff through so much hell, all over the almighty dollar. I am a new ADN nursing instructor and the institution in which I was recently employed had the "step-down" units also. Certain of these units are terribly unsafe, unmanageable, and are mere dumping grounds from the ICU's or overflow from the ICU when the ICU doesn't have any more beds!!!! I advise my students to NEVER even THINK of working there!!! (Any patient on a vent or multiple drips, IMHO, needs to be in an ICU with 2:1 ratio.) I don't want any of my "babies" getting burned out in their first year out of nursing school and I am doing my best to steer them clear of the shark-infested waters.
Scavenger'sWife, RN
269 Posts
Connie: I feel for you, Girlfriend! :kiss Were the planets in some wierd conjunction or something?? I just spent two days like yours also! Except my floor is med-surg-tele. Day was awful PLUS I was the Charge nurse for both days. Fortunately, I had WONDERFUL NAs working with me. (I also had the student nurse thing going on...)
I came home last night ALL bent outa shape and spent 2 hours venting to my husband and son while we pigged out on pizza with everthing...and a big ole glass of beer. (Nah...I am on a diet...I only had ONE piece of pizza and drank Diet Coke...worked for me!!:) ) But the "venting" worked. I hope you had someone who you could "dump" on in your home.
I am glad you have the weekend of. And GOOD FOR YOU - You and your son going on the breast CA awareness walk. I read your post about that. You must be sooooo proud of your son! What a good mom you are! ENJOY that walk and treasure the time w son!!!
They grow up way too fast.