Worst night ever

  1. Ok so I have been posting on here for quite a while, and alot of you have read my stickie...it get's better I PROMISE....and I thank you and I hope I have helped or encouraged you to keep up the good work.

    But I have to share this one, and the only reason I am doing it is because experience and my wit were the only things I had going for me. Let me tell you a little story about the other night.

    Saturday night I get to work, fine it's my 2nd night in a row, I got back the majority of the pt's I had the night before. No problem....

    OK PROBLEM...I go to make my rounds. One of the pt's I had the night before, I went to say hello and to assess him. He tells ME, "ohh god I have been having this terrible headache and double vision for the last hour." I ask was the double vision new, he says yes. He said it's killing me...I take his pressure, its 180/110.....OK...he's already on a heparin gtt, and I am about to give coumadin 20mg...Holy crap that's alot of coumadin...I automatically called the cardiac MD service,call the tele resident, and the house MD for the night. I automatically gave him his procardia 60mg, Clonidine 0.1mg and tylenol 650mg at 8pm insted of 10pm. My fear was the pt. was going to stroke out.

    I get zero calls from any MD's. I begin my round of paging agian..finally I get the cardio MD on the phone. I tell him the s/s the pt. is having and what meds I gave. He told me to put in for a STAT head CT w/o contrast and to tell the tele resident to call himwith the results..I finally get a hold of tele resident to tell them what going on...the primary cardiac md said I did the right thing giving all the meds...ok...I put in for the CT of the head, and take the pt. down. ASAP.....

    yea....

    I get back to the floor to call the tele resident to tell them that CT was done and to call the cardiac MD with the results asap...In the mean time the headache was gone, the pressure stableized and ok....

    NEXT PROBLEM....

    I am going to the next pt. room to say hi to the pt. and the over head page is going crazy with my name. I can't do one thing with out being paged....it's security asking if family can come up to see a pt, it's the nursing supervisor, it's god asking me if I am sane....

    Finally I begin to assess my pt. and have to give a gravity peg tube feeding. I said to the UC to call the room if it is urgent b/c I am about to give a gravity feeding. I begin the feeeding, toomby and jevity, 200cc gravity bolus. I had the door shut while giving it, b/c I knew better then to be distracted while doing it and told people not to burst into the room....welll...hahahah...yea...

    As I am on the 3rd 30cc round of the feeding, I am paged in the room. It's the tele resident, I told her I would be out in a few min. and to stay there b/c I am giving a gravity peg feeding. NOOOOOO...the tele resident comes busting into the room startling me and making the pt. cough at the same time....JEVITY GOES EVERYWHERE...ALL OVER ME, THE PT, THE FLOOR...GROSSSSSS........

    OK at this point I am covered in jevity and probably part of the pt's stomach contents.....i flush the tube...go out of the room and talk to the tele resident....

    AT THE SAME TIME I am being called by the raidologist MD about results from a CT scan of the abd. that was done during day shift on the pt. with the peg. He tells me the results...I said, "Umm, you need to call the MD with the results" HE basically told me NO and blah blah blah blah and how I had to do it...I said very firmly "YOU are the on call raidologist MD, and YOU ned to call the MD. So pick up the phone call the operator and get the # of the MD who ordered the CT of the abd. if it's this urgent" and I hung up.

    Well...I know the MD who ordered the CT so I called him anyway. He called back asking why I was the one calling him with CT results...I said, "B/c the raidologist MD on call won't call you. SO here's what he told me, and here's his name."

    So about 20 min. later the same blastin raidologist called me agian with the results of the CT of the head my pt. with the uncontrolled HTN had...I said , " CALL THE TELE RESIDENT, here's the #"....I called the tele resident anyway to CYA....OMG....the resident was telling to me call the cardiac MD to tell him the results, I said, " I am not the MD, you are, I told you that you had to call him back with the results of the CT scan of the head., SO CALL HIM, he won't bite", but I put a page out to the cardiac MD to CYA....

    IT GET's MUCH BETTER....

    SOOOOO I have 4 pt's and I have to admitt 2 more...no problem

    I never got the ER report for my first admitt b/c of all of the chaos....

    The pt. arrives...she passed out at the airport, came to the ER, was in the ER wnt outside to the ambulance bay to have a smoke and passed out agian...38 y.o. female...has a basilar skull frx, stitches to the back of the head and on the back. Comes with a EEG monitor to my floor....

    UPON ARRIVAL...she begins freaking out....climbing the walls literally. Speaking both perfect english and chinese...I call the resident for a 1:1 order and an auto psych consult as per policy....

    I asked if she was speaking manderin or cantonese?? she said something then cantonese...

    SHE THEN GRABBS ME, AND CLAWS ME IN THE POSTERIOR PART OF MY RIBS in my back ON THE LEFT SIDE. She gives me a GOOD JAB. I just lost it...

    I began screaming for help...she was out of controll...

    The resident calls me back telling me that they won't sign the 1:1 order...the pt. was a service pt. so it was their resp. to sign the order...the resident and her senior resident begin telling me how they won't do it b/c if something happens to the the pt. it's their responsibility.....

    I LOST IT.....I SAID, 'I AM LOOKING OUT FOR THE SAFETY OF THE PT., THAT'S MY RESPONSIBILITY, SO GET YOU BUTTS(didn't use that word), AND SIGN THE FLIPPIN ORDER. I already called in a psych consult so JUST SIGN IT"

    I just went into super nurse mode...I began calling the nursing supervisor, the house MD, the psych MD again...the ER nurse manager who sent the pt. to me....

    I got the night shift nursing supervisor on the phone and well...let the fury loose......told her about the resident, the raidologist who won't call MD's, how the pt. assaulted me, how NOT A SINGLE MD WAS doing anything.....

    Well with in 2 min I had 5 MD's on the floor. and the psych md called back..I got an order for thorazine STAT....
    Funny b/c the EDP(emotionally dis. person)'s IV was blown so on top of it all I had to put a new IV in. That's when the pt. told me, "you have NOOO Idea how I used to hurt my self when I was younger..." I saw all the cut marks all over her....

    And I got the psych md at 1:30am the psych MD came in and eval. that pt. only to tell me to d/c the 1:1 order.....I said , "are you kidding me...LOOK AT THIS!!!!!!!!!!" I lifted up my shirt and showed him the giant bruise the pt. gave me.....she mayhave hit her head but she didn't forget how to fight..PLUS she told me how she used to hurt herself"

    I convinced him to keep the 1:1 order....

    After all the chaos I begn going through the orders from the ER...I saw in the notes howw she assaulted a nurse, had a 1:1 in the ER....I was never told....I was soooooo MAD....

    SOOO I GET MY NEXT ADMITT...I was told, actually promised, that this one was ok...WRONG...CONFUSED, with a 1:1.....

    needless to say in hindsite...if i was a brand new nurse I probably would have really flipped...but I know now that my exp. is making me stronger..I fillled out multiple incident reports, didn't back down to the MD's and did my job...

    you will come a long way I promise...
  2. Visit Morettia2 profile page

    About Morettia2

    Joined: Jun '07; Posts: 241; Likes: 607
    R.N.; from US
    Specialty: CTICU, Interventional Cardiology, CCU

    5 Comments

  3. by   changeofpaceRN
    Umm yeah thank you for further encouraging me to stay away from hospitals hahaha. You did an amazing job at CYA and I can't believe everyone wanted to pass the buck. Are they not aware of teamwork and how impt it is to communicate? Good for you keeping it together- I would have been in tears by then..
  4. by   Pixie.RN
    Other than that, my day sucked!

    Wow ... what a day!! I got tired reading that ...
  5. by   Morettia2
    Quote from LunahRN
    Other than that, my day sucked!

    Wow ... what a day!! I got tired reading that ...
    haha thanks..I know it was a long post. And I thank you for reading it!!
  6. by   Pixie.RN
    Quote from Morettia2
    haha thanks..I know it was a long post. And I thank you for reading it!!
    Not tired from the length of the post, but just imagining all the shenanigans you had to put up with!
  7. by   mixyRN
    Oh I have had nights like this! But none quite this bad though. Your night higlights what I dislike most about bedisde nursing... there are times when it seems everyone wants a piece of me AT THE SAME TIME, necessary supplies and/or staff not available to help, patients with changing condition or high acuity requiring almost constant care or intervention, other ancillary staff not doing THEIR job so I have even more work on my hands, etc. Some nights it seems like MISSION IMPOSSIBLE just to do MY job alone!

    Thank goodness it's not like that every night though. Thanks for sharing your story because it's comforting to know I'm not alone!

close