wildly manic. going through closets, blowing up rubber gloves, putting them in his gown like boobs, tiptoeing past the nurses station asking for the ladies room. no talking to him. no calming him. no reasoning with him. he should have had a sitter but there was a foul up. sitter wouldnt have helped anyway. i wasnt even finished with report. he wants a razor to shave. NO. now hes pissed. i call the supervisor. you MUST do SOMETHING...this patient is uncontrollable, potential for violence. he hears this, he freaks.
he is leaving. we CANT let him leave. if it comes to this he will need to be 302'd. i call the doc. she will be there soon, she is downstairs. i go to his room where he is completely mad. in my face, screaming at me. i have never been afraid of a patient before. i thought he was going to beat the shit out of me. i leave and call the doc back. she
must come NOW. the other nurses call security.
docs come up. they dont want to sedate him against his will. they want to just leave him alone. i tell them i will not care for him as i am putting my safety in jepordy. security stays all night long. he wont leave me alone. constantly at the nurses station. he sticks his hand in the sharps box looking for paper towels and gets stuck. needlestick protocol. i go have a cig and he asks security to take him down too. finally i ask security to please wait until i come back. i need a break from this guy. he goes off and they finally see the potential for violence. he goes in the linen closet. he lost a necklace. he takes the mattress off his bed and trashes his room looking for it. he draws up a flyer and i make him copies and give him tape. he posts them all over the unit. it gives him something to do.
4 mg xanax, 5 mg morphine dont touch him. i want him sedated and restrained. docs refuse. on and on and on and on and on all shift. i have a suspicion he should be on the psych unit. just a hunch. that has to wait till morning.
pt 2--his roomie
he doesnt want another room cos he likes his roomie. he takes him for wheelchair rides. he sees nothing wrong with his behavior. ok. i let him stay in that room. 4 am his bed is made and he is dressed,complete with coat and elmer fudd hat. where are you going?
im going home. you cant keep me against my will.
and he goes off,swearing at me and telling me he is leaving go get the doc...
OH MY GOD NOW I HAVE TWO OF THEM.
he wont let us give him his meds and he wont let anyone touch him. he pisses the docs off. he gets his wish in the morning. no reason to keep him. he is refusing treatment. he says he has nowhere to go. now he doesnt want to leave. he sits in a chair in his coat and hat all night and all day.
pt3
400 lbs, drinking golytely and sitting on the bedside commode screaming NURSE all night. four of us get her back to bed. she screams all night.
pt4
new admit. abdominal pain. i get her paperwork done four hours after she arrives. shes nice but whines and cries about burning when i give her iv pain meds. the burning is so bad she insists on a washcloth before i give the med. she screams when i inject it. (ativan) it doesnt stop her from calling me every two hours. then she complains because i dilute it. she cant feel it.
oh god leave me alone.
pt4
right lower flank pain. now febrile. 3 am c/o chest pain. chest pain protocol. she looks bad. assistant runs an ekg...what does anterior infarction mean?
oh holy shit.
there is a fire alert on another floor. alarms are going off. she needs constant monitoring but there is no infarct. tons of blood work. all new orders.
pt5
completely out of it. restrained and trying to get out of the siderails. mumbling to himself. agitated. i give him 0.5 ativan. the needle blows. he gets most of his dose but not all. it wouldnt have mattered anyway. he is up all night.
pt 6
no problem. he lays in bed staring at the ceiling.
non verbal.
pt 7
usually a pain in the ass, thankfully sleeps through the night
pt 8
going to a hospice in the morning. has a trach. looks terrible. nonverbal. keeps sliding down in bed. we keep moving her up.
pt 9
active TB. isolation. she sleeps thru the night but daylight has ignored stat sputum cultures. i cant get one. have to get new order for resp treatment, pg resp. and they come and get it.
i am now mandated overtime. the nurse who is to take my pts has called off. i am now looking at a double. they are going to divide my assignment so i will only have easy pts for the day shift.
i go down to have a cigarette. i am not going to get upset. its 6:30 am. i am looking forward to reporting these loonies off. i go back to the floor. my assistant says go in that room. i do. patient 8 is dead. a fitting way to end the shift.
this is the jolliest assignment in the history of jolly assignments...
