Is nursing like this everywhere?

  1. I'm a new nurse about three days off of orientation. I come onto my shift and here's what I get: A patient with a K level of 2.8, left uncorrected all day, going through the DTs, in 3 pt restraints, hanging off the side of his bed; a pale, lethargic patient with a BP of 80/50 and a K of 5.3 after offgoing nurse gave too much catapres; a patient that has ZERO urine output for the last 12 hours with a Foley that the doctor called me 3 times in 1 hour so I could flush it (sorry busy with the lady with the low BP who won't wake up); a patient crying in bed because she's in so much pain and she needs her vicodin NOW!; and the list goes on...

    Oh my gosh! Is this how nursing is everywhere? It seems like everytime I go to work I'm just running sround putting out fires and not really getting anything done at all (except hours of charting)...
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    About LEM1234

    Joined: Jun '09; Posts: 14; Likes: 13

    15 Comments

  3. by   Up2nogood RN
    I think that's the way it goes on medical floors? At least they were all breathing at the end of your shift? I hear some real horror stories here and it makes me grateful for where I'm at. I've been off orientation for 6 months and I've survived relatively unscathed. It does get easier!
  4. by   oslogirl
    Are you in medsurg? If so, yep, that's a typical scenario. Hang in there. It will get easier, and you will become better and faster at prioritizing care. Get a solid year or two in med surg, and you will be more able to try other specialities, or even travel later if you wish to do that.
  5. by   LEM1234
    Yeah, I'm on a surgical floor. One side of our unit is reserved for elective surgeries and the other is for trauma surgeries. They were all breathing at the end of my shift, thankfully. I'm just glad I caught the lady with the low BP because she was not looking good.

    Can't wait to get some experience and move on!
  6. by   Up2nogood RN
    Sounds pretty crazy for a surgical floor! My unit can be busy but we have a lot of frequent flyers and pts who have been with us for months at a time (whipples). I'm glad I can do 12hr shifts so I'm only there 3 days a wk. I work nocs too and it's much mellower than days.
  7. by   LEM1234
    I work nights all the time, and some nurses are just not fun to follow
  8. by   Cherybaby
    You're going to encounter nurses that you won't want to follow. Those are the ones that put minimal effort forward and leave things for the night shift. That's normal for the floor you work on. Some nights will go effortlessly...some will seem like they are never ending. Go with the flow and you will be fine. Good luck in your new career!
  9. by   geekgolightly
    Certainly the low urine output on the one and the uncorrected low K+ on another patient needs to be reported (to more than just the physicians), and frankly, with that many emergency issues coming on to a shift, it's pretty obvious that the prior nurse was unable to handle her patient load, for whatever reason, and the nurse manager needs to be aware so that the issues can be investigated and resolved.

    Was the medication incident reported? If catapres was given and the patient was unarousable with a systolic of 80, this is a med error and needs to be reported as well.
  10. by   chicookie
    You will find that there are nurses who when you get report from them you say to yourself, "I am going to die." Its horrible what some nurses won't do for 12 hours!
    But yeah that is med-surg for sure. And you will figure out who you do want to follow and you will figure out how to always get those people. I for example let the charge nurse know that I always follow these 2 nurses. They let me do it too because they know that if I have a shift that I can control I go around and help everyone and that is always a plus on an understaffed weekend/night.
  11. by   SoundofMusic
    I can't say it's that bad on our floor. Most of our staff has been really well trained. We would not usually let K levels go like that, nor BP's. We really hammer it home to our new grads what to watch and what to do -- how quickly we need to call and address things.

    That sounds like really sloppy nursing to me. I deal with leftover messy rooms, but not much else. The pain pts -- well, they are always like that no matter what you do.

    Just dont' BE that kind of nurse yourself. Set a good example. ASK and challenge any co-worker that does not address these issues. Do it sternly.

    We are very STERNLY question and grilled over things we let go like that.

    We had a float nurse one night who left me 2 charts of unchecked orders. My dayshift after that was a living nightmare. I will NEVER allow a float nurse from any other floor to go until I've checked her charts with her/him. I just dont' allow people to leave me messes like that anymore -- but they have and I've paid for it.
  12. by   LEM1234
    I asked the nurse when she told me in report if she did anything about the K of 2.8 and she told me she talked to the resident on call and he told her "it was OK because he had K in his fluids"

    I also figured out that the lethargic lady with the low BP had not received two important medications because I guess no one ever checked her med rec form to her MAR...so for like a week she'd gone without her renagel and lasix. Actually I didn't report that...I know I should...but I don't want to be the new nurse on the floor reporting everyone. Seriously...I'd be reporting at least one incident a night. I know I should.
  13. by   cardiacmadeline
    Quote from LEM1234
    I asked the nurse when she told me in report if she did anything about the K of 2.8 and she told me she talked to the resident on call and he told her "it was OK because he had K in his fluids"
    Maybe the nurse should have gone above the resident and called the doctor. I have done that a couple of time when I wasn't satisfied with the resident's orders. If someone has a low K and are on IVF with K in them, we still administer supplemental K. What was the pts magnesium? Also, was this patient on tele?
  14. by   LEM1234
    I forget what the exact # was, but the mag was normal. The patient was not on tele up to that point...when i got the order for the IV KCl I got an order for tele too...I finally had to get a sitter for the guy because he was in restraints yet kept ending up hanging off the side of the bed and I was afraid he was going to hurt himself...my manager really questioned me about requesting an order for a sitter...but what else was i supposed to do? He was going through DTs and kept ripping off his ostomy bag (and he had mitts on) and poop was EVERYWHERE.

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