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

Editorial Team / Moderator · Sep 7, 2016

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..."

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

AvaRose · Sep 7, 2016

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.

:wideyed: What did you do or hasn't it been resolved yet?

CardiacDork, MSN, RN · Sep 7, 2016

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.

heron, ASN, RN · Sep 7, 2016

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 :no:

WinterLilac · Sep 7, 2016

*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 ". Good luck!

Psych. Yep.

AvaRose · Sep 7, 2016

*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 ". Good luck!
Psych. Yep.

Did Unit 4 come in blind drunk or how did they manage that on a Psych floor?

WinterLilac · Sep 7, 2016

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 :)

dream'n, BSN, RN · Sep 7, 2016

Luckily we had a great clinical manager who was on the phone with staffing as soon as she walked in the door. (Although we didn't get another RN, they did contact bed control and delay our direct admits.) And both the clinical manager and our oncology coordinator were the type of management who weren't afraid to get their hands dirty. So they helped out between meetings and cancelled/delayed what other responsibilities they could. We made it through the shift, but it was a bad day.

That's great. When I worked in Oncology my manager wasn't an Oncology nurse and didn't even have a chemo card

Alweissrn · Sep 7, 2016

Yep probably in DIC ~

AlwaysLearning247, BSN · Sep 7, 2016

When the nurse giving me report says "I've had an awful shift, good luck tonight." :down:

BeckyESRN · Sep 7, 2016

School nurse here: When it's the first day back after a 3 day weekend. Ugh.

When I worked cardio: when you smell c. diff, GI bleed, and DKA as you exit the stairwell

When the only staff you pass in hallway says "welcome to Hell" or "welcome to the detox unit"

When you hear the supervisor say "I know he's unstable and should be in the unit, but (your name) can handle them" **cringe**

When you log in and realize that you have 3 empty beds, the only empty beds on the floor

CardiacDork, MSN, RN · Sep 7, 2016

DIC otherwise known as .....

death is coming