Murphy's Law... (long)

[miko014]

Okay, so I had the weirdest shift last night. First, I was really busy, just because my pts were busy. I had a 90 yr old lady, LOCx1, very unsteady on her feet, who decided she was going to walk home. And the only way to keep her still was to put her in her bed, and then she screamed constantly at "that little boy who keeps getting my floor all wet. I keep telling him to go home, but he won't listen!" So keeping her safe was a full time job itself - and did I mention that she was combative? Pt #2 was very nice, but getting chemo, which takes time. Pt#3 was a young guy with a lot of pain in his back, and I had a really hard time keeping him comfortable - doc came out and yelled at me b/c pt was in pain. I said, "I just gave him his oxycodone 15 minutes ago" - not sure what he wanted me to do. Pt #4 was very VERY anxiouos, and would keep you in the room talking about nothing for an hour unless someone came on a resuce mission to get you out of there. Very nice lady, but again, time I didn't have. Then I got a new admission, and surprise - confused and climbing out of bed! So needless to say, I was running my butt off all night.

Well, pt #4 needed pain meds, so I got it out of the pyxis (2mg dilaudid IV), and was just heading to her room when I saw pt#1 trying to "go home" out the window (they don't open, don't worry!). So I dropped pt #4's meds in my pocket and put pt #1 back to bed. As I walked back out of that room, I realized my top was all wet. You guessed it! Dilaudid all over me! So I had to waste that and get new.

So I'm heading to give pt #4's meds (finally), and pt #3's wife asks for another pillow. I say, "sure, no problem" and head into an empty room. Unbeknownst to me, that room had very recently been cleaned, and the floor was wet. Yep, hit the floor (luckily only one knee and one hand - and not the hand holding the two broken dilaudid vials in it!). Why did I hit the floor? Because there was no WET FLOOR sign! SO embarassing, and pretty painful as well. And I was only an hour into my shift!!!!

So to make a long story a little shorter, some of the other strange things that happened included...what are the things called that you use when you hang an IVPB? You know, the little arm things (ours are blue) that come with the PB tubing to hang the main bag down lower? Anyway, I was in chemo pt's room, and the one holding his main bag (not the chemo) snapped in half and the bag fell on the floor. I didn't touch it. I wasn't even near the pole. It just decided to jump off the pole! I was like, "you've got to be kidding me!" Then I was getting out an IS for a pt and dropped it on the floor - it broke. I don't mean it cracked. It shattered! Then people were picking on me, trying to joke and be funny. Normally I am very easy-going and will joke and whatever, but they knew I was having a hard night and they wouldn't let up, even when I asked them to stop, and finally I ended up yelling at the person who is probably my favorite on the whole unit, and now I'm sure I'm going to look like a total jerk when I go back. I can't even think of the rest of the weird stuff that kept happening, but I have to go back this eve! I don't know whether to wish for the same group or not! And I'm still embarassed about falling - you know it's going to be common knowledge today. But, at least it was me, not a pt/visitor, or someone who might not be as resilient if they hit the floor (I'm young, I'll be fine). I just wanted to SCREAM!!!!!!!!!!

[GeminiTwinRN, BSN]

It sounds like an awful shift. I'm sorry you fell and hurt yourself, that could have been a really bad outcome!

As far as objectively looking at what might have been a culprit in some of this, I can see that you could have had some trouble because you didn't allow yourself to finish one priority task before attempting a second task. Could this maybe have led to some of your difficulties? A pillow is something that you could've done after you gave the meds, and helping a pt back to bed, while it's a priority, is something that might have been delegated to an assistive personnel on the unit. It sounds like you didn't have enough help, that's for sure! Do you not have NA on your unit? Certainly the pillow and helping back to bed are important tasks that you could have done, but when you have pain meds to give, and an assessment to complete.. those are the times when delegation has to be considered.

Just my .02 here.

I sure hope you have a better shift tonight! :)

[dekatn]

What you are describing sounds a lot like my last Saturday noc shift!!! I feel your pain!!!!! I remember mentioning to one of my coworkers that night something about Murphys Law. Don't worry about looking like a jerk, we all have these hallmark moments!!! Hope tonight is better for you!!

[grandee3]

If your coworkers had time to sit around and make fun of you, why did they NOT pitch in and help you?

[muffie, RN]

full moon or what

that kind of shift and i might have to walk out the front door !

[babynurselsa, RN]

I have days like that....Some times thing "just break" around me.

My favorite is when I pull all the carpujects of demerol out to count them, drop one back in teh drawer, shut the drawer and realize I am holding 15.

Just apologize to your coworkers (if you haven't already) and get on with life.

We all have bad days sometimes.

Good luck for a better night.

[P_RN, ADN, RN]

I had many, many of your nights. It sounds like you had a "wonderful time" that night. Ain't Nursing fun? I hope you made an accident report. I did the same thing and only weeks later realized I'd munched my rotator cuff.

[gitterbug]

Hi Miko.

No words of wisdom here, just letting you know have been there, expect to be there again, and sending you a little sympathy. I hope your fall does not come back to haunt you later. Take care.

[meownsmile, BSN, RN]

I was kind of wondering the same thing. If they had time to make a joke about things why didnt they have time to HELP. I understand about your frustration with their joking,, its one thing to try to help ease anxiety with a little ribbing,, but it entirely another when you see it isnt helpful to the person and you choose to continue doing it. Thats just rude and uncaring.

I hope you did fill out an incident report on your fall. You may be fine, but in 2 weeks when your knee buckles under you and you arent sure why, you may be in for a long recoup if you actually did something to your knee. Report it tonight,, usually you can within 24 hours. Am glad you werent cut with the glass.

[PANurseRN1]

It sounds like an awful shift. I'm sorry you fell and hurt yourself, that could have been a really bad outcome!

As far as objectively looking at what might have been a culprit in some of this, I can see that you could have had some trouble because you didn't allow yourself to finish one priority task before attempting a second task. Could this maybe have led to some of your difficulties? A pillow is something that you could've done after you gave the meds, and helping a pt back to bed, while it's a priority, is something that might have been delegated to an assistive personnel on the unit. It sounds like you didn't have enough help, that's for sure! Do you not have NA on your unit? Certainly the pillow and helping back to bed are important tasks that you could have done, but when you have pain meds to give, and an assessment to complete.. those are the times when delegation has to be considered.

Just my .02 here.

I sure hope you have a better shift tonight! :)

We all have bad nights. It was my impression that the OP was merely looking for some support, not necessarily a Monday morning quaterback reply of how she could have done things better. Sometimes, things really are out of your control, and sometimes you have a bad night, no matter how hard you try.

Also, you are not a nurse yet, so in case you aren't aware, you will have days like this, even when you've been working for years. I know students live in an ideal world, but try to have some compassion/understanding for others.

Been there, miko04...it's awful at the time, but usually you can look back later and at least chuckle.

[miko014]

that kind of shift and i might have to walk out the front door !

I was thinking window.

leslasic - I had to get that lady back to bed or she was going to fall, otherwise, that could have waited. And yes, I have thought that I should have told her I'd bring a pillow in a minute, but it was RIGHT THERE! Laying on the empty bed, just steps away! I could see it...had I known the floor was wet, I would have walked a little slower, though. And yes, I had a tech (not just for me, she had 10 pts) but she was doing something somewhere else. There was just nobody else around to help me!

As far as them sitting around making fun of me, that was at the end of the shift, the first time I really got to sit down (aside from my 20 minute lunch break). I have to admit, some of the stuff does sound kind of funny, but that was NOT the right time. I started to feel the same way tonight - My ANM was on my case about something stupid tonight...I had a family member of a pt who needed an excuse for work, and I wasn't sure what we are supposed to write for that, and there was nobody else around who knew, so I called an SW to ask. She said she would come up and take care of it. I guess she complained to the ANM for being called for something I could have done. And so the ANM comes up to me in front of everybody and says, "you could have done that yourself" and tells me how she "expects better from me". I tried to explain that I didn't ask the SW to come, she offered, but my ANM wouldn't listen. And later I told her how I felt about that, so at least I think I got *that* part of it straightened out (though her first response was, "fine, then I just won't tell you anything anymore"). But I guess I should have said something to the SW too along the lines of "sorry, I didn't mean you had to come up), but I digress.

After that, my night tonight was much better, though it didn't start out that way! Thanks for all the support - I know it happens to all of us, but I just couldn't believe all of that in one night!!!!!

And oh yes, believe me, the incident report is signed, dated, and turned in! I did it before I left last night. Luckily my ANM saw me go down (doesn't help that she was halfway down the hall at the time and screamed my name and came running - I was like STOP!! The floor's wet, I don't want you to end up on your butt too! Anyway, I'm not going to the ER for a "boo boo", but if my knee falls off next week, they're fixing it!

[morte, LPN, LVN]

I started to feel the same way tonight - My ANM was on my case about something stupid tonight...I had a family member of a pt who needed an excuse for work, and I wasn't sure what we are supposed to write for that, and there was nobody else around who knew, so I called an SW to ask. She said she would come up and take care of it. I guess she complained to the ANM for being called for something I could have done. And so the ANM comes up to me in front of everybody and says, "you could have done that yourself" and tells me how she "expects better from me". I tried to explain that I didn't ask the SW to come, she offered, but my ANM wouldn't listen. And later I told her how I felt about that, so at least I think I got *that* part of it straightened out (though her first response was, "fine, then I just won't tell you anything anymore"). But I guess I should have said something to the SW too along the lines of "sorry, I didn't mean you had to come up), but I digress.

i would think that a work excuse, would be a doc's territory....and your ANM response of "i just wont tell you anything any more" was entirely childish..totally unprofessional...perhaps a meeting with the ANM and theNM

to clear the air, and discuss how PROFESSIONALS interact should be on the agenda......the ANM should have taken your part over the SW, at least until she could obtain your side of the story....and again what kind of "work excuse" can a nurse give?,,,,would think that would come from a doc...