You know the shift is gonna be a hot mess when ... - page 3

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 < 100, and bleeding from every orifice. ... Read More

  1. by   MYSTICOOKIEBEAR
    You know your shift will be a hot mess when... You already have an ECMO patient and your attending is running down the hall in street clothes, and then have to help your attending insert another ECMO into a coding patient in the ED trauma bay.

    While the above was happening, let us not forgot the type A Dissection coming in, Liver transplant coming out, Heart transplant coming in, lung transplant coming in, and the x2 Open hearts that have not come out from OR yet.
  2. by   CardiacDork
    Quote from MYSTICOOKIEBEAR
    You know your shift will be a hot mess when... You already have an ECMO patient and your attending is running down the hall in street clothes, and then have to help your attending insert another ECMO into a coding patient in the ED trauma bay.

    While the above was happening, let us not forgot the type A Dissection coming in, Liver transplant coming out, Heart transplant coming in, lung transplant coming in, and the x2 Open hearts that have not come out from OR yet.
    Think I peed reading this....
  3. by   VivaLasViejas
    When you step onto the unit and the wild-eyed charge nurse yells, "RUN! Run while you still can!"
  4. by   nursej22
    Your manager calls you at home on her personal cell phone, hoping that you won't recognize the number to plead that you come in.
  5. by   AvaRose
    Quote from 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 < 100, and bleeding from every orifice.

    Glad I had a cup of joe.


    Who wants to continue?

    "You know your shift will be a hot mess when..."
    Sepsis? Just curious I like trying to figure out puzzles...as soon as I have some actual experience I could see myself moving into critical care...
  6. by   knurse10
    When the previous shift is tracking you down the second you hit the floor to give you report and you haven't even clocked in.
  7. by   Lev <3
    When you walk in through the ambo bay and there are 6 ambos lined up and it's only 1030 in the morning...

    ....you go into huddle and the charge nurse tells everybody that there's no huddle today and to just get out there and start working.
  8. by   decembergrad2011
    If no one is at the nurses station when I walk on, and report doesn't start until 7:15, I'm scared for what the shift has in store.
  9. by   CardiacDork
    Quote from AvaRose
    Sepsis? Just curious I like trying to figure out puzzles...as soon as I have some actual experience I could see myself moving into critical care...
    Not sepsis directly. It could've been sepsis in addition but it wasn't the "killer". There was a lot going on with this patient and this patient went from talking and walking to dead in less than 24 hours. It's immune related. Not HIV/AIDS... Think kinds of cancers.

    PM me for more elaborate conversation. I'm up for clinical discussions anytime. I bleed this stuff. True nurse nerd.
  10. by   blondy2061h
    Quote from kiszi
    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.
    My CNO is super supportive of bedside nurses and thankfully wouldn't tolerate anyone using her as a threat. She has been known to go scold physicians from our hospital of they're the patient to remind them that they're the patient and are expected to act as such.
  11. by   blondy2061h
    Quote from Caffeine_IV
    The census is low and there are at least 8 surgeries scheduled and you aren't staffed appropriately
    Worse yet- start day full, 8 scheduled surgeries, but 8 discharges too. Happy marry go beds!
  12. by   blondy2061h
    Quote from nursej22
    Your manager calls you at home on her personal cell phone, hoping that you won't recognize the number to plead that you come in.
    Oldest trick in the book! I trust no numbers.
  13. by   MYSTICOOKIEBEAR
    Quote from CardiacDork
    Think I peed reading this....
    I am happy and quite proud that my training and experience kicked in and held up in one of the most stressful situations that I have ever been in. I don't think I have EVER had to Critically think so hard in my professional life or in my life at all for that matter. Especially when my attending and fellow were inserting the cannulations and needed to concentrate on the task at hand. I took over managing the patient's oxygenation via the vent, and hemodynamics via drips, fluid, and blood administration.

    I am certain that the trauma bay and ED had never seen an ICU RN calling the shots and managing the patient while an attending was performing surgery. I am not sure if I ruffled any of the ED MD's feathers since I basically took the reins from them (basically what I saw when I came in was the ED MDs telling other MDs and RNs to titrate and change things and then my attending telling them "no" but not explaining the reason since he did not have time to explain the physiology of what was happening and was getting visibly annoyed). Whether or not the ED MDs/RNs were annoyed or impressed, I have no idea, but I made all of the right calls, and none of them were contested.

    My mind was so racked from all of the critical thinking that I could barely speak English at the end of the shift......and yes it is my first language haha. I freaking love my job!!!
    Last edit by MYSTICOOKIEBEAR on Sep 4, '16

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