Just a bad shift...

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Specializes in Acute Care - Adult, Med Surg, Neuro.

I've had a string a bad shifts recently, and today was no different. A crashing patient in room A while my admission rolls into room B ... the blood is done in room C ... the UAP rings my phone, room D is vomiting ... a family member approaches me while I'm hustling down the hallway (a million things on my mind) saying there's something wrong with room E's television remote and it needs to get fixed NOW ...

I do my best and ask for help, but many of my co-workers are in the same position. What do you do? I try to triage needs, but how do you cope when you're patient's vomiting blood and room C is ringing for a pain pill, while your admission is being carted up next door with 6 family members in tow wondering where the nurse is?

When you think that you can stop by room B for just a few to hang their antibiotic, but then the elderly lady needs to use the toilet which can take up to 15 minutes, and you can't leave her alone because she's a fall risk? All the while, you hear the bed alarm of room C shrieking next door and the UAP calls your phone saying that room D's IV has infiltrated?

I guess I could go on and on... but the question is, how do you cope?

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One breathe at a time.

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.
I guess I could go on and on... but the question is, how do you cope?
I cope by staying the heck away from the acute care hospital. The pace is too fast for me to comfortably handle and there's too many things that need to be done NOW!

Nope. Not for me. I salute all of you who fight the battle, but I will not do it unless I was about to become homeless.

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Prioritize and delegate?

Tell the new admission's family (as you pass them in the hall) that there is an emergency on the floor (crashing patient) and please give me a minute I'll be with you as soon as I can! Let the transferring staff hang out with them for 5 minutes while you...

Call a rapid response on patient A

Shut off the pump and grab a quick set of vitals on C

Run past E and tell them you will get an "expert" to check out the remote

Ask the charge nurse to get the new admission settled...

Geez...is this vomiting falling old lady the same time as all the other stuff? Nevermind.

Go hide in a corner and cry.

Seriously, if you have had a lot of shifts like this, your unit sounds like it is severely, unsafely understaffed. Not all floors are like that, and they shouldn't be. I'd look for a transfer.

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I am thankful that crazy days seem to move the clock forward faster than calmer days. Sometimes you have to stretch to find something positive.

I can cope if the butt-kicking days are the exception and not the rule.

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Specializes in Critical Care, ED, Cath lab, CTPAC,Trauma.
Prioritize and delegate?

Tell the new admission's family (as you pass them in the hall) that there is an emergency on the floor (crashing patient) and please give me a minute I'll be with you as soon as I can! Let the transferring staff hang out with them for 5 minutes while you...

Call a rapid response on patient A

Shut off the pump and grab a quick set of vitals on C

Run past E and tell them you will get an "expert" to check out the remote

Ask the charge nurse to get the new admission settled...

Geez...is this vomiting falling old lady the same time as all the other stuff? Nevermind.

Go hide in a corner and cry.

Seriously, if you have had a lot of shifts like this, your unit sounds like it is severely, unsafely understaffed. Not all floors are like that, and they shouldn't be. I'd look for a transfer.

Pretty good triaging!

OP breathe...one patient at a time.....get HELP! Call for HELP! Page the supervisor.

Then...Get home. Take a LONG bath and indulge in something decadent. Hug your family and pets.

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Specializes in psychiatric.

Every day is like that in my old facility.....it's why I left. I'm with the Commuter, it's not for me.

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...and this is why I work in the ICU. Atleast there are only 2 patients that I have to worry about. Sorry that was no help to your post, but I applause you on being able to handle all those patients at once. :D I have a lot of respect for nurses that work on the floor.

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Specializes in Family Nurse Practitioner.
Prioritize and delegate?

Tell the new admission's family (as you pass them in the hall) that there is an emergency on the floor (crashing patient) and please give me a minute I'll be with you as soon as I can! Let the transferring staff hang out with them for 5 minutes while you...

Call a rapid response on patient A

Shut off the pump and grab a quick set of vitals on C

Run past E and tell them you will get an "expert" to check out the remote

Ask the charge nurse to get the new admission settled...

Geez...is this vomiting falling old lady the same time as all the other stuff? Nevermind.

Go hide in a corner and cry.

Seriously, if you have had a lot of shifts like this, your unit sounds like it is severely, unsafely understaffed. Not all floors are like that, and they shouldn't be. I'd look for a transfer.

That is a 5:1 nurse ratio, pretty typical in acute care. Minus the crashing patient, which yes, does happen from time to time, that sounds like my day, almost every day.

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Specializes in Acute Care - Adult, Med Surg, Neuro.

There is no transferring staff on a new admission, and often our charge nurse is dealing with other emergencies on the floor. I'd say 5/8 shifts are like this. Many of our patients are also on isolation, total cares who need turning q2-4, demented/fall risk, getting pain medications q2h, almost all are fall risks ... we do an average of 1 discharge and 1-2 admissions each shift. It's a good day when I don't have a rapid response. I know many units are like this. I like my job. I guess every once in a while it gets to be too much.

I'm still not good at triaging patient needs, especially since we focus so much on patient satisfaction. For example, while dealing with all of this, a patient's family member pushed the 'emergency' button in a patient's room, and of course I (being one of the only staff out on the unit at the time) ran over to make sure everything was okay. The patient's family member wanted their mom's food reheated. I said that because the patient was on Contact Precautions, we couldn't reheat the food, but could find her something else if she gave me a moment. She glared at me and said "You mean my mother has to eat COLD food?" (cue crashing patient puking in background) I just had to apologize and say we'd get back to them. I'm sure I will hear a compliant from it.

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Just a patient..... I think it is sad how hospitals overwork in my opinion one of their most valuable assets. Make sure to take time for yourself, and always remember you have patients who respect and admire the work that you do and will always be grateful for people like you.

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My heart goes out to you as I work on the same type of unit. It's a PCU and it is insane!! I was there 13 hours today, it's my second week off of orientation and I actually started to cry as I was giving report to the night shift nurse. Other than one PCA that is awful I am so thankful that everyone is so helpful and supportive, that makes it bearable and I love my patients! The only advice I have is pray, that's what I do:)

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