You know the shift is gonna be a hot mess when ... - page 7

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   sevensonnets
    Patient died on night shift but the family isn't here yet so patient hasn't been wrapped. Family isn't answering the phone. Central is out of morgue kits and doesn't know when they'll get more. And, by the way, admitting is on the phone. This is the only open bed in the building and they need it for an urgent admit that needs to be prepped for surgery by 8:00. Then a visitor comes to the desk all wide-eyed because they came to see mama and went in the wrong room and did we know there's a dead body in there? True story and I'm sticking to it.
  2. by   NursesRmofun
    Quote from Cricket183
    Charge RN of 26 bed inpatient oncology unit: 22 pts. and expecting 4 direct admits for chemo, floor split between 2 LVNs and 1 new grad RN (just off orientation & not chemo certified) and a float RN (experienced but not chemo certified or use to oncology). Staffing is trying to get another RN to come in for expected admits. (Our normal ratio on days was 1:4-5). Don't recall the exact number but at least 1/3 of the patients getting chemo, which is the charge nurses responsibility, along with hanging all the blood products & IV pushes for the LVNs (both of which are numerous on oncology). I knew it was going to be an extremely busy day but...less than an hour into the shift the float reports a chemo spill. ������ In the middle of cleaning up said chemo spill new grad calls a code--had no idea her patient was going bad. We rarely run codes in oncology, most of our patients are DNRs. Thank God for code teams! Needless to say, it was a really bad day...
  3. by   ReadyToListen
    ...when I had to change into OR pants before 0900 and I don't even know my patients' names yet!

    Or in my home of ER, walk in and see the bright orange intubation box open, nobody in sight, and a potpourri of scents coming from rooms that ought to be closed on night shift! Yeeek!!!
  4. by   Twinmom06
    a bit different as I'm inpatient acute dialysis

    when you get a text that you have an assignment of 6 patients, walk in to 8 patients as there have been 2 admits overnight, and
    #9 is in the ER having skipped a week of dialysis with a K+ of 7+ and +4 pitting edema, and the nurse you're working with (only one other) can't possibly stay past 5 pm.
  5. by   Spookysushi
    When you receive a confused and combative direct admit for a liver transplant with and the attending tells you to move as fast as humanly possible to prep the patient for surgery. So you then drop everything, frantically try to get them lined and labed (with those great ESLD/ESRD veins ) send them for their pre op imaging studies, rush to get the paperwork together to then find out the liver was bad, then discharging them all within a few hours. So much work for nothing and sad for the patient and family.
  6. by   RN0310
    The off going nurse says, I'm sorry before she gives you report. You can hardly hear the nurse in report because the nurses station is full of organized kaos....
  7. by   Pixie.RN
    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..."
    When you come into TWO of those in your four-bed-plus-hallway assignment in the ED and are told they are holding for ICU beds, but the ICU is full with no discharges planned, and they just put a 90-year-old chest pain in one of your empty beds. Yep, pass me a bucket of java... Lol
  8. by   AvaRose
    Quote from sevensonnets
    Patient died on night shift but the family isn't here yet so patient hasn't been wrapped. Family isn't answering the phone. Central is out of morgue kits and doesn't know when they'll get more. And, by the way, admitting is on the phone. This is the only open bed in the building and they need it for an urgent admit that needs to be prepped for surgery by 8:00. Then a visitor comes to the desk all wide-eyed because they came to see mama and went in the wrong room and did we know there's a dead body in there? True story and I'm sticking to it.
    What did you do or hasn't it been resolved yet?
  9. by   CardiacDork
    When you have to travel with a newly graduated MD to MRI with your unstable patient (because policy says an MD has to come even though it always ends up being the new doc anyway so it makes little difference) on vasoactive drips/vented and labile MAPs and you know if shi-- goes down you gotta step in and it's you and RT running the code either in the hallway en route or in the hallway of the MRI room (no codes allowed in the MRI room because of the metals and the crowds that come in) until the code team get there.


    MRI is the scariest place to be at as an ICU Nurse. So if pressures start tanking you have to be ready to act. It's scary and I'm not afraid to admit it We are far away from the ICU nurses, from the fellows, minutes away and in minutes a lot can happen. So your initial interventions will make that difference.
  10. by   heron
    When I started out, they were still treating the DTs with rectal paraldehyde, a banana bag and four point restraints. I always knew my night was going to suck when I could smell the paraldehyde from the sidewalk
  11. by   WinterLilac
    *walk in to work*
    Night shift: "Make a coffee THEN I'll start..."
    "The new resident has gone AWOL, Unit 3 has trashed their bedroom because 'the Mafia' is after them, Unit 4 got blind drunk and vomited everywhere and I haven't had time to clean it up, Unit 1 was transferred to hospital by the police and Unit 7 saw Unit 1 get taken by police and cut chunks of his hair off. Now I'd love to stay and help but I have <insert excuse>". Good luck!
    Psych. Yep.
  12. by   AvaRose
    Quote from WinterLilac
    *walk in to work*
    Night shift: "Make a coffee THEN I'll start..."
    "The new resident has gone AWOL, Unit 3 has trashed their bedroom because 'the Mafia' is after them, Unit 4 got blind drunk and vomited everywhere and I haven't had time to clean it up, Unit 1 was transferred to hospital by the police and Unit 7 saw Unit 1 get taken by police and cut chunks of his hair off. Now I'd love to stay and help but I have <insert excuse>". Good luck!
    Psych. Yep.
    Did Unit 4 come in blind drunk or how did they manage that on a Psych floor?
  13. by   WinterLilac
    Quote from AvaRose
    Did Unit 4 come in blind drunk or how did they manage that on a Psych floor?
    We are a recovery facility where clients live in independent units after being in a psych ward

close