You know the shift is gonna be a hot mess when ...

[CardiacDork]

You know your shift will be a hot mess when your patient is on a PEEP of 25, Fio2 100, PaO2 50, febrile @ 40 degrees Celsius, maxed pressors, white count

Glad I had a cup of joe.

Who wants to continue?

"You know your shift will be a hot mess when..."

[loveu123]

When you see 5 ambulances in front of the ED and walk in to see the staff coding a patient while holding other ICU admits.

[meanmaryjean, DNP, RN]

When you ask who the intensivist is for the night and the day charge says "Dr. Doom!"

[Wrench Party]

When you're literally not even on the unit, and you see your coworkers rush by with the code team and the surgeon, ready to take the patient back to the OR, and then you walk onto said unit, and another team is running an RRT. (Oh boy, that was a fun night).

[Here.I.Stand, BSN, RN]

When your patient is medically paralyzed, heavily sedated, has had multiple doses of hypertonic NaCl, and bilateral craniectomies...ICPs are still >40 (can you really call it intracranial pressure after a bilateral crani? Wouldn't it be more like intra-scalp pressure??)....

and nobody wants to discuss futility.

[CardiacDork, MSN, RN]

These are hilarious and so true guys! Thanks.

I'll add more...

--- When you walk in to the ICU and your assignment has a crash cart in their room and a sign that reads "hemodynamically unstable, no turns, please see RN".

--- When you sit for report and the phone goes off 5 times from CT, lab, Vascular, and pharmacy all on the same patient.

[quazar]

When you walk in and look at the central fetal monitoring screen, and at least 5 babies are in distress, there are currently 2 c-sections in progress in the OR, and triage is full. Yee-haw.

[cardiacfreak, ADN]

You know it's going to be a bad night when you walk onto the floor and the charge nurse looks at you and says, "OH, THANK GOD YOU ARE HERE."

[blondy2061h, MSN, RN]

-Crash cart parked outside your patient's room

-You have one patient. Everyone else has 3.

-You can smell the stool as soon as you get off the elevator

-You pass one of your most obnoxious frequent flyer's wife walking out in the parking lot. Without her husband.

[DesertSky, BSN]

When the charge nurse looks at you when you walk in and says "I'm sorry..."

[KatieMI, BSN, MSN, RN]

- what is the JP for? - It is supposed to be for "x" but let me make sure later...

- what he is going on CT/MRI/etc. for? - I do not know...

- since what time the pressure going down? - hmmm... honestly, I do not know...

- did he had labs today? - .... I am not sure....

Also, when you see your assignment on the "firing list" with at least 1/3 other nurses already not desired by family.

[Caffeine_IV]

The census is low and there are at least 8 surgeries scheduled and you aren't staffed appropriately

When you do bedside rounds and 3 out of 5 patients are confused/fall risks with no family

When "person who shall not be named" is the charge nurse for your shift

When "other person" is the CNA assigned to your patients

When you get report on a patient who doesn't look great and they say "They've been like that all day".....those tend to go bad

When you start getting report and get called overhead because the assignment needs to be re-done..somebody put "Shannon" on the schedule but she's on vacation

[kiszi, RN]

Your post-STEMI patient who's been stable for hours bradys to the 40s with pressure in the 50s during handoff

-that fixed, your other patient's daughter watches everything you do like a hawk, tells you "the other nurses don't do it that way" and makes sure to mention that she and the CNO "go way back" to Everyone.