Med-Surg and leaving at 7:30

[Lev, MSN, RN, NP]

Is it possible?

Even if I'm all ready to go at 6pm, something always happens between then and 7pm. 5-7 - when stuff happens. Maybe if I stop taking a lunch break, I can get out on time. Today it was 97 y.o. femur ORIF with UTI who started sundowning at 6pm. She was so perfect all day (Took all her meds - crushed in apple sauce, let me draw blood, and insert an IV - put up with the second stick, and worked with PT and OT) even though she refused all meds and labs for night shift and was swinging her arms and kicking last night. She would not stay in the bed. She had just pulled all her sheets off again and then her son showed up. So I had to talk to him. Then my post op's EJ would not infuse unless literally you pushed the hub toward the neck - that's how I gave him dilaudid. He needed his IV abx so my manager (who used to work in the ED) put a line in his shoulder. So I took his EJ out bc it was bothering him. The PA had just increased the dose of his pain meds so I went in at 7:10pm to give him that. Then she discharged my other patient so I gave her pain meds and told them to get ready and night shift would discharge her. It seems like no matter what I do during the day, I still cannot get out on time! My other patient with the chest tubes, I left that for night shift. The surgeon wanted the collection chambers changed so he could record the drainage properly since they had been knocked over. I had never changed them before and the charge nurse was going to help me but then my demented lady started sun-downing.

[firstinfamily, RN]

Are you feeling guilty about leaving something for night shift?? I most likely would have let the night shift nurse give the pain medication as I would not have been there to assess the effects it had on the patient. Once you give report you are DONE!! It does seem anything and everything happens at change of shift, but as it has been said before, nursing is 24 hour care. Sometimes patients act up at the change of shift because they know they are losing the person who has been taking care of them all day. It sounds like some of the events that occurred were not ones that could have been ignored. Pt safety is huge and the sun-downer needed attention as well as her family member. But that should have been the only thing you needed to do. How often do you start your shift with everything done and all supplies restocked? Most likely not very often!! Do your last rounds about 1730 and see if that helps in nipping things in the bud so that you can get out on time!!! And of course, sh** happens and those things you cannot ignore!!!