Published Aug 20, 2010
nursej22, MSN, RN
4,448 Posts
So I work evenings on a busy cardiac unit, lots of admits and transfers from cath lab, a few dc's, a few transfers off. So you can count on a least 2 new pts in 8 hours, sometimes 3, and usually 1 leaves (home or another unit). That's cool, fast pace, shift goes quickly.
Except, why or why does it all happen at once?
For the last 2 weeks, I get 2 admits or 1 admit transfer at once, or 2 dc's at once, or the triple combo: 1 admit, 1 transfer, 1 dc all at the same time! Usually at the beginning or end of the shift.
I thought I had it beat last night, 2 dc's left an hour apart, transfer came in an hour later. Enough time to chart, have dinner, do some teaching (woot!).
An hour before the end of shift, newest pt " Mr. Hart", has a change in condition, do EKG, call doc. ED sends report on another very sick one. Doc comes in ,Mr. Hart going back to cath lab--get consent, help him call his family, report to cath lab, restart blown IV, help him to void. At the same time, here comes Mr. Ed, total care, soiled, painful, no O2 even though he uses it at home. Ackkkk!
So in the last 15 minutes of my shift, get O2 on, vitals done, pain med, dried stool cleaned off, fluffed and puffed. Oncoming nurse upset that I haven't charted a full head to toe assessment yet or given his scheduled meds.
WWRN
23 Posts
It's not just you... I think it's the 'nature of the beast.' You can't predict how a shift will go and there will always be those individuals who follow you and don't feel you did enough with the new admission, etc. At the end of the day you have to be okay with knowing you did the best you could and that you didn't intentionally leave things undone for the next shift to take care of.
GHGoonette, BSN, RN
1,249 Posts
Take this from an old, experienced nurse: MURPHY LOVES HOSPITALS! Wherever the B****R can find a reasonably peaceful situation, he will jump in and cause the maximum amount of chaos that he can instigate in the minimum amount of time!
Trust me on this; it will happen time and time again.
onetiredmomma
295 Posts
Shift change admits, crises, etc! If I get a pt with less than an hour before shift change I try to get as much of the admission done as I can but since the next nurse has to do a head to toe, I spend more time on the history, pain meds, IV orders etc. Our unit all seems to agree (for the most part) that just doing a focus assessment to assess admit dx problems is all that is necessary at shift change. (Hope that makes sense. It is kinda hard to explain)
Scarlette Wings
358 Posts
it is not you. it is murphy's law and the law of universal medical issues.(wink)
law of universal medical issues
[color=#002060]1. [color=#002060]never mention the name of any difficult patient not currently in the hospital or they will be in the er and through admissions by midnight.
[color=#002060]- [color=#002060]penalty for this infraction will be that the nurse using the name in vain has the patient assigned to them.
[color=#002060]2. [color=#002060]use of the "q" word as in the word quiet will insure all heck will break loose for no less than the next 72 hours.
[color=#002060]- [color=#002060]penalty for this infraction will be 30 lashes with a wet unrolled ace wrap and then being covered from head to toe in nursing tape without any scissors available.
[color=#002060]3. [color=#002060]rooms that are empty but contained a former extremely difficult and demanding patient will have strange things happen after said patient has expired such as the call light going off for no reason.
[color=#002060]action to take. act as if it is completely normal and go into room, nullify the call light, crack open the window and tell said patients spirit "you are free to go now." and leave the room. this usually resolves the call light issue.
wsuRN09
118 Posts
Murphy just does not like us nurses nope, not at all. One of these days we'll learn to outsmart him, but until then, hang in there and smile at the fact that Murphy will visit the oncoming shift as well :)
P_RN, ADN, RN
6,011 Posts
I can think of one time Murphy came to a patient's rescue. The admission office posted a bed and here came the patient w/ no orders just his own bodily self. I went to the room and there lay Mr J on the floor between the two beds.
Of course admissions had not put an arm band on but paper clipped it to his admission face sheet. Well so happens My partner and I recognised Mr j from a previous stay and knew him to be a BRITTLE diabetic. She gets on the phone, I go get a Jelco and the D50 and the glucometer.
She gets an order from the resident and within like 3 minutes we have him stuck, assessed his glucose as like 30 and given the D50. Our hospital 1st and 2nd year residents were a little scared of us old nurses, so he came to the floor in about 5 minutes. He said "Mr J looks just fine, why did you call me?"
We wanted to tell babydoc off, but instead my partner just gave him the stink-eye. And Mr J told him these angels saved his life and to shut up til he grew up. Bang Murphy we shot you down!