Change of shift funtime!

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Specializes in Utilization Management.

What happened at change of shift that ruined all your plans to get home on time?

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Specializes in Psych, M/S, Ortho, Float..

Having been a float nurse, I occassionally wound up on the telemetry floor. After working a very busy 12 hour night, we were all catching up on some charting as we were getting ready to go home. Then one of the alarms went off. It wasn't a loose lead, it was the actual tombstones on the EKG and patient was heading for total cardiac arrest. So out comes the crash cart, calls out to everyone, nurses and doctor coming out of the woodwork and we are in a full code situation. Lady in the room next door screams and someone peeks in to see what's up and the woman projectile vomits lots of blood across the room and passes out, then quickly goes into respiratory arrest, leading to cardiac arrest. Needless to say that no one got out before 10 am.

Fortunately, they both lived to see another day. It was just wild having 2 code blues at the same time. Of course, these were the two patients out of 34 that had slept all night.

Another funny thing about working on a cardiac unit is the domino effect that you get with chest pain. No sooner have you got one nitro'ed and morph'ed, you get another and another. Usually happens as night shift is coming on. We figured out that it was the lasagna that they had had for supper that was causing indigestion and/or cardiac symptoms. So if they have any kind of pasta for supper, we are guarenteed a busy night! Always a lot of fun!

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Specializes in Utilization Management.

Yep, I noticed the CP at shift change too. I think it's because they feel the tension in the air and the anxiety sets off their angina or something. But each chest pain takes us an average of an hour to resolve, so it can really cause delays.

Not to mention 2 CODES!! OMG!! :eek: :eek:

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Specializes in Psych, M/S, Ortho, Float..

CP at shift change always makes the little voice in my head say "you're doing this on purpose!!!". I don't always believe my little voice but it does make you think.

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What happened at change of shift that ruined all your plans to get home on time?

Mine is not so exciting, but I will share it anyway. Right at shift change, I had a patient that was cleared to come off isolation for C Diff. Of course we had to put her in the shower chair, roll her down the hall, and clean her up with that special soap. (Can't remember the name.) Not to mention cleaning up all the medical equipment that had been in her room. You just can't leave things like that for next shift. :lol2:

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Specializes in Utilization Management.
Of course we had to put her in the shower chair, roll her down the hall, and clean her up with that special soap.

Hibiclens?

And now that brought to mind the wonderful (yes, I'm being sarcastic) patient who refused to have her procedure all night long, refused the prep, refused the teaching, refused the new IV start----suddenly deciding ok, she'll do it at 0700, fifteen minutes before I leave.

Fastest IV I ever placed....

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Specializes in ER.

Oh, let's see. How about the night we worked our butts off all night trying to get the ER cleared out - we had a full waiting room and every bed full at 0300. Not sure how we managed it, but at 0630, there were a total of 3 patients in the ER, and we were finishing up charting, stocking lab baskets, getting things in order for morning shift. When suddenly the scanner starts going off, and the squad phone starts blowing up (usually just them calling to give report - this time, 3 different units calling to verify/request orders for meds). 5 minutes later, we have a total of 7 backboarded, bloody, combative patients wheeling in the door. Two started crashing about the minute they got to a room, and the others were obvious belly bleeds, and required expidite CTs, which means an RN has to accompany each of them! :eek: Believe it or not, these were all from separate traffic incidents. Then, the icing on the cake - squad pulls in with a VERY large man - 600+ pounds - fell down a flight of stairs - not sure how he was up walking around to fall down the stairs, but somehow he did. So, more expidite CTs - oh wait - I forgot - no CT, pt. too big to fit through the CT scanner we have. SOOOO, gotta transfer - in the middle of paperwork for that, and the guy up and codes. So, apparantly he had a lot going on with him that we couldn't see because no CT, because he dies on us. I didn't get home until almost noon - and I'm not even an RN yet... most of the night nurses were still there when I left.

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Specializes in M/S, OB, Ortho, ICU, Diabetes, QA/PI.

I've left work late too many times to count due to babies that decided that they all wanted to be born at shift change and their deliveries needed all nurses from both outgoing and oncoming shifts!!

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Oh, let's see. How about the night we worked our butts off all night trying to get the ER cleared out - we had a full waiting room and every bed full at 0300. Not sure how we managed it, but at 0630, there were a total of 3 patients in the ER, and we were finishing up charting, stocking lab baskets, getting things in order for morning shift. When suddenly the scanner starts going off, and the squad phone starts blowing up (usually just them calling to give report - this time, 3 different units calling to verify/request orders for meds). 5 minutes later, we have a total of 7 backboarded, bloody, combative patients wheeling in the door. Two started crashing about the minute they got to a room, and the others were obvious belly bleeds, and required expidite CTs, which means an RN has to accompany each of them! :eek: Believe it or not, these were all from separate traffic incidents. Then, the icing on the cake - squad pulls in with a VERY large man - 600+ pounds - fell down a flight of stairs - not sure how he was up walking around to fall down the stairs, but somehow he did. So, more expidite CTs - oh wait - I forgot - no CT, pt. too big to fit through the CT scanner we have. SOOOO, gotta transfer - in the middle of paperwork for that, and the guy up and codes. So, apparantly he had a lot going on with him that we couldn't see because no CT, because he dies on us. I didn't get home until almost noon - and I'm not even an RN yet... most of the night nurses were still there when I left.

OMG! :eek:

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Hibiclens?

That might be it. For some reason I am drawing a blank! :doh:

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I work in a nursing home with 38 patients to one nurse I have had times when people die right at shift change to do all the paper work & calling funeral home,family,doctors. Or when somebody falls right before time to leave & here come 6 pages of extra paperwork Or you have a pool nurse come in to replace you but she never been there before so you have to stay to orient her to everything --- :uhoh3:

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Specializes in med/surg, telemetry, IV therapy, mgmt.

The worst day of my whole career was a patient who we knew was not going to make it coded at about 6:45am. I so hoped he would wait until after we had left. Anyway, he was in a semi-private room. As we were working on him and it seemed like we were starting to wind things up, someone yells out, "What's happening over here!" We all turned to look at the other patient and saw he was turning blue and going into respiratory arrest. Both patients survived and ended up being transferred to ICU. After all the phone calls I had to make to relatives and doctors and completing narrative charting and the code blue sheets and making sure the crash cart was sent back to central supply and a new cart brought up, it was 10:30am. I was beat.

My second worst day involved an elderly man with COPD who decided to "end it all" at 6am. He removed his oxygen and then took a razor blade and slashed himself twice on both sides of his neck and both his inner wrists. When I found him he was in CO2 narcosis, not bleeding to death. For a couple of seconds I wasn't sure whether to call a code blue or call the house doctor. House doctor won out. Within a few minutes of putting his O2 back on, he became alert and was very dispondant that he had failed to die. He had not cut deep enough to hit any arteries. He did, however, manage to cut tendons in both wrists. Lot of phone calls on this one as well as an incident report. I stayed past 7:30 to assist his doctor while he sutured up all the wounds. I was there until 10am. The sad end to this was that when I came in to work that night I immediately enquired about this patient and learned he had been found dead at dinner time. The nurses had gotten him up into a bedside chair to eat his dinner and found him a few minutes later slumped over dead. Guess he got his wish, poor thing. More importantly, I also learned from several of the 3-11 staff that the man had been giving away his few little personal possessions the evening before and making comments that they now knew where indicative that he was planning a suicide. How I wish we had been told that in report.

Another memorable night in ICU stepdown we received an admission as soon as we came out of report. The doctor who was on call did not know the patient--his partner who was the patient's regular doctor was out of town and couldn't be reached! The oncall doctor was trying to do the best he could. This patient was in bad shape and couldn't talk. On top of all that his family kept telling us that he was supposed to be a DNR, that he didn't want to be kept alive if it came down to a code and this had all been discussed with his doctor beforehand. We all watched this man like a hawk. His first code was at about 2am and he survived it. However, there were no beds in ICU to move him to. He coded a second time at 4am. The on call doc was reluctant to just let the man go. He was now intubated and on a lidocaine drip and the family was beside themselves that this was happening to their loved one, but they did understand the on call doctor's position. Finally the oncall doc makes a decision and tells us to forget about ICU and make the patient a DNR. He coded again sometime after 6am. I think that he was about the only patient I was able to do anything for that night. I wanted to keep up on the charting because of everything that was going on with him and I didn't want to leave anything out of the chart.

One of the worst things that ever happened in any hospital I worked was a worker who fell out of a 5th story window of the hospital while doing some kind of maintenance work. It happened around 4pm in the afternoon. He fell right by the window of the switchboard operators on the second floor who put out the call for a code blue. I think every administrator and manager came running to help out because the poor man was lying outside on the top of the roof of a one story annex attached to the hospital. It didn't take long before the media got wind of this and they showed up too. I saw the man briefly in the ER (I was on the IV team at the time) while they were waiting to transfer him to a larger center. He did not make it. I mention it here because it was the office administrators and nurse managers who were getting ready to leave for the day who ended up staying way past their quitting time to take care of this. Just a awful thing when a fellow employee gets injured and dies like that.

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