I Can See it When You Smile

Every once in a while I have what amounts to be an awful night at work. Nurses Announcements Archive Article

I Can See it When You Smile

The night started out a bit rough. Of course, we were short-staffed, and my patients were high acuity. It seemed like every patient had a new med order that needed to be faxed to the pharmacy.

I had one patient who weighed close to 500 pounds, and when I went in to assess him he said, "I have a load down here that needs to be cleaned up." (like I couldn't smell it when I walked in the door). I told him that I would attend to it as soon as I could. He said, "can you do it now?" I forced myself to smile and said, "Let me go and find some help."

Another patient was elderly and on tube feedings. She kept calling for her daughter. I had to go in and reorient her at least once every hour. When I reminded her that she was in the hospital and that her daughter would be in tomorrow, she would look sad and disappointed. It was heartbreaking.

My other patient was only 50 years old, homeless, and going through massive dt's. He kept calling to say that he was "sweating one minute and cold the next". I told him that it was part of detoxing and that the alcohol was getting out of his system, making him feel sick. I loaded him up on Ativan and Librium and prayed that he wouldn't start hallucinating.

Another patient needed to have 4 units of blood, and 6 units of platelets. I definitely got my exercise running back and forth to the blood bank. I felt like camping out in this patients room with all the vs monitoring I had to do.

By this time I had about a million things on my mind at one time. I went in to start some new antibiotics on my 5th patient. He was a talker. One of those patients that are lonely and don't want to let you out of his room. So I'm trying to prepare his meds, listen to what he has to say, and answer him at the same time. I hook up his antibiotics and just out of habit I said, "what are you allergic to?" he said, "cephalosporins." my heart skips a beat and I say, "What happens when you take it?" he said, "cardiac arrest."

Guess what antibiotic I was about to hang? Rochephin. The medication order went through all the safety gates and still ended up being filled and sent to the floor. Even though the allergy was on his profile, the computer still allowed me to scan his armband and the medication.

Had I not asked him what his allergies were, I would have started the infusion.

By this time I am disgusted with myself; disgusted that I was almost complacent, horrified at the fact that I could have killed him, and furious that there have been times where I have taken for granted that a computerized system is fail-safe. What in the name of god was I thinking?????? Not only would I have lost my license, my job, and more than likely been sued, I could have taken a human life due to my near miss. It weighed on my mind and my heart for the rest of the night. I was a nervous wreck.

Then at 6 am, the charge nurse tells me I'm getting another patient. I am thinking, "You have got to be kidding me." instead, I smile and say "ok." but inside I am boiling and seriously considering leaving my job. I don't get paid enough for the literal and figurative crap I wade through each and every day. One of these days it's going to be more than a close call and I could really harm someone because of the increasing workload they put on nurses. In fact, I was ready to quit and work at Starbucks. Who cares if it's less money? Its good coffee and I don't have to put up with ridiculous requests from needy patients and it's practically impossible to kill someone doing it.

My little patient arrives on the floor and I am making every effort to appear calm and competent. Her son is with her and is mad at the er doctor. He tells me that we "better not even think about discharging her before the doctor sees her." I get her information into the computer and she tells me she needs "something to eat, some water, something to put my teeth in, my jammy pants put on, my special pillows, and something for pain." I go to adjust her precious little pillows under her neck and she laughs and says, "oh my! I thought you were going to kiss me! You are young enough to be my daughter you know."

I laughed and said, "is that right?" she says "Yes. You sure can. You know you are very good at your job."

I looked at her and thought to myself.....if only she knew....if she only knew what the last 12 hours have been like...

"I can tell that you really love what you do," she said. "It shows on your face when you smile."

2shihtzus

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Specializes in Psych (my husband says I fit right in!).

~~~VERY MUCH~~~ liked your article! Ain't it cool that God sends messengers to us, just when we need them? Someone once told me things like this are like "P.S., I love you" notes from God. From your article, sounds like He's got His hands and arms wrapped all around you, watching you, protecting you, and helping you! You are definately blessed! Moments like that are the REAL payments in nursing!

I completely feel you! The unfortunate staffing situations we are put in as nurses often put our licenses on the line. You are obviously well trained to routinely ask pts about allergies. And this is just another shining example for why we should ALWAYS follow protocol and safety measures set by hospital policy (translation: NO CUTTING CORNERS!). On the lighter side, just to nit-pick (sorry its late and I'm tired!) Do you really think you will not have ridiculous requests from needy people at Starbucks!!! ;)

Specializes in ICU, Telemetry, neuro,research.

i liked your article too. i agree. just when we think we have had enough and can take no more and that no one cares, we find that someone is listening and someone does care! how great is that?:loveya:

I completely feel you! The unfortunate staffing situations we are put in as nurses often put our licenses on the line. You are obviously well trained to routinely ask pts about allergies. And this is just another shining example for why we should ALWAYS follow protocol and safety measures set by hospital policy (translation: NO CUTTING CORNERS!). On the lighter side, just to nit-pick (sorry its late and I'm tired!) Do you really think you will not have ridiculous requests from needy people at Starbucks!!! ;)

*L* I bet I would, especially since I am one of those customers myself! "Can I have a extra hot soy latte made with sugar free vanilla, no whip and an extra shot of espresso?"

Thanks to everyone who appreciated my article...it helps so much to know that there are people out there who undersand!!!

Great article. You sound like a wonderful, conscientious nurse. You are a true blessing to our profession! :loveya: Isn't it wonderful how God sends us the right thing we need to hear when we need it the most?

Outstanding. Your article captures the essence of nursing on MedSurg. Far greater are the risks and challenges on the MedSurg unit vs. Critical Care!! Yet our greatest recognition is our patients. I look for those rewards to get me through the day. Thanks for sharing.