My crazy day at work!

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Specializes in ACNP-BC.

Did you ever have an incredibly busy, nutty day where everything went wrong & everyone wanted you all at the same time? Well that was my day today! Today was the halfway point of my 12 week orientation as an RN (I just finished week 6! Woo-hoo!) I have had 5 patients all week & the whole week went fine for me, but not today! Of course, every nurse today was running around like crazy-is there a full moon on its way or something? :uhoh3: The second I get off of report, pt. #1 (TAH post-op)gets a fever, pt. #2 (history of stroke &seizures)has a sky-high BP, pt. #3 (another TAH post-op) wants pain med like yesterday, pt. #4 ( came in with CP-rule out MI) is demanding to know when her EEG is going to be (she has major anxiety issues & did I mention she is going through alcohol withdrawal?)& I cannot figure out where pt. #5 is! It turns out he went to dialysis (even though he was just there yesterday & at my hospital pts. usually go every other day-not every single day!) & the night nurse never told me he was going-it was not in his kardex-nothing! I was so mad cuz I would like to know what is going on. As soon as I got out of report, I tried to go assess him first, cuz I knew he wasn't doing too hot yesterday-& that's when someone said he is in dialysis! Geez! Of course he is diabetic too-so the dialysis nurse checked his blood sugar for me in the morning-but it was 175 (she called me to tell me) so I had to find time in my already nutty day to go up & give him his insulin-since they didn't have any in dialysis. So anyhow-I tried so hard to prioritize all day-however, easier said than done when everyone is breathing down my neck-my anxious patient, the rhymes with witchy nursing assistant (don't worry-I told her to cut it out! I was so proud of myself for standing up to myself & telling her to lay off cuz she was trying to order me around at first-& then I made sure after that she was doing what she was supposed to be doing) then dialysis kept calling me with info, the lab called me, ultrasound called me,the a million docs called me, & of course the patients too. I kept thinking, ok, but how do I take care of everyone's needs, answer the docs calls, & still pass meds & do assessments on time? And when do I run up to dialysis to give my insulin? And then I was giving report to the nursing assistant & since there were 11 patients on our team ( our team had me, another RN, an LPN & the NA) the NA can only take up to 8 patients-so she is asking me which patient of my five will I keep for myself & so I picked one, & she immediately goes "But she may go home!" Well, hello! What do you want me to do? Out of my five, I already told her 2 may go home & the dialysis guy was already washed before he went down-so that's 3/5 of my patients who were all set basically or in other words "easy" to do since their beds were either done already or don't need to be done if they're going home today-but she is still giving me major attitude. So I said "Look, I have 5 patients-they're all heavy for me cuz they're all very sick & need lots of meds & have fevers & a lot of pain, & I still need to go assess most of them. I'm running around with my head cut off right now. I will try to help you out as much as I can, like you KNOW I always do. However, I need help too, from you. So please go check mr. Blahh-blah's VS, weight, & blood sugar when he gets back from dialysis." (Of course, I had to tell her this multiple times!! Agh!) I'm getting more assertive every day with delegating-but honestly, it's so annoying to have to "baby-sit" some of the NAs! When I was a NA I was never like that. I mean I did not take a break until 2 PM today & only sat down for not even 20 min-I was so drained & just tired of being pulled in so many directions. I could have used a lot more help from the NA (but she too was called almost as much as me I have to say) & my preceptor. I basically did not see my preceptor until 1 PM-even though she knew I was going nutty (she saw me!) so I was not thrilled with today. Yeah sure, I'm learning virtually everything on my own, yes I ask questions on anything I don't know, and yes I am delegating more every day esp. on days like today when I absolutely needed the help-but I would've liked more help. I felt like I was going to lose my mind! I felt I did the best I could do-I called the doc first thing in the morning about the high fever & took a TO for tylenol & a cooling blanket, faxed it to the pharmacy, called the pharmacy, & gave it to the patient- then kept rechecking her temps all day, then my high BP pt. got an increased dose of lisinopril, then I discharged my other post-op (I feel very efficient at discharging pts. & explaining their instructions & going over meds with them :, then I even called the EEG dept. & found out what time my anxious, EtOH -withdrawal pt was going for it (that made her happy & less anxious, together with the prn Ativan I gave her!) & then of course as I was about to sit down & catch up with my charting, my dialysis guy comes back-so now I have to chase down the NA for VS, weight, blood sugar & then I myself do his assessment, give him insulin, all his morning meds, make sure his tele monitor is back on, read his tele strip, see what his Foley is putting out, etc. Phew! Then I furiously try to finish charting everything...what a day! Thank goodness I have the long weekend off! Boy do I need it. Thanks for letting me vent!

-Christine

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chrisvs- I have posted to your thread before that each time you vent or celebrate your days here I can tell the confidence you have gaine this summer! :yelclap:

I am just starting my unit orientation and right now what stresses me is having people ask me questions when I am giving meds. So I can't even imagine being at you level!!

You go girl!!

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Did you ever have an incredibly busy, nutty day where everything went wrong & everyone wanted you all at the same time? Well that was my day today! Today was the halfway point of my 12 week orientation as an RN (I just finished week 6! Woo-hoo!) I have had 5 patients all week & the whole week went fine for me, but not today! Of course, every nurse today was running around like crazy-is there a full moon on its way or something? :uhoh3: The second I get off of report, pt. #1 (TAH post-op)gets a fever, pt. #2 (history of stroke &seizures)has a sky-high BP, pt. #3 (another TAH post-op) wants pain med like yesterday, pt. #4 ( came in with CP-rule out MI) is demanding to know when her EEG is going to be (she has major anxiety issues & did I mention she is going through alcohol withdrawal?)& I cannot figure out where pt. #5 is! It turns out he went to dialysis (even though he was just there yesterday & at my hospital pts. usually go every other day-not every single day!) & the night nurse never told me he was going-it was not in his kardex-nothing! I was so mad cuz I would like to know what is going on. As soon as I got out of report, I tried to go assess him first, cuz I knew he wasn't doing too hot yesterday-& that's when someone said he is in dialysis! Geez! Of course he is diabetic too-so the dialysis nurse checked his blood sugar for me in the morning-but it was 175 (she called me to tell me) so I had to find time in my already nutty day to go up & give him his insulin-since they didn't have any in dialysis. So anyhow-I tried so hard to prioritize all day-however, easier said than done when everyone is breathing down my neck-my anxious patient, the rhymes with witchy nursing assistant (don't worry-I told her to cut it out! I was so proud of myself for standing up to myself & telling her to lay off cuz she was trying to order me around at first-& then I made sure after that she was doing what she was supposed to be doing) then dialysis kept calling me with info, the lab called me, ultrasound called me,the a million docs called me, & of course the patients too. I kept thinking, ok, but how do I take care of everyone's needs, answer the docs calls, & still pass meds & do assessments on time? And when do I run up to dialysis to give my insulin? And then I was giving report to the nursing assistant & since there were 11 patients on our team ( our team had me, another RN, an LPN & the NA) the NA can only take up to 8 patients-so she is asking me which patient of my five will I keep for myself & so I picked one, & she immediately goes "But she may go home!" Well, hello! What do you want me to do? Out of my five, I already told her 2 may go home & the dialysis guy was already washed before he went down-so that's 3/5 of my patients who were all set basically or in other words "easy" to do since their beds were either done already or don't need to be done if they're going home today-but she is still giving me major attitude. So I said "Look, I have 5 patients-they're all heavy for me cuz they're all very sick & need lots of meds & have fevers & a lot of pain, & I still need to go assess most of them. I'm running around with my head cut off right now. I will try to help you out as much as I can, like you KNOW I always do. However, I need help too, from you. So please go check mr. Blahh-blah's VS, weight, & blood sugar when he gets back from dialysis." (Of course, I had to tell her this multiple times!! Agh!) I'm getting more assertive every day with delegating-but honestly, it's so annoying to have to "baby-sit" some of the NAs! When I was a NA I was never like that. I mean I did not take a break until 2 PM today & only sat down for not even 20 min-I was so drained & just tired of being pulled in so many directions. I could have used a lot more help from the NA (but she too was called almost as much as me I have to say) & my preceptor. I basically did not see my preceptor until 1 PM-even though she knew I was going nutty (she saw me!) so I was not thrilled with today. Yeah sure, I'm learning virtually everything on my own, yes I ask questions on anything I don't know, and yes I am delegating more every day esp. on days like today when I absolutely needed the help-but I would've liked more help. I felt like I was going to lose my mind! I felt I did the best I could do-I called the doc first thing in the morning about the high fever & took a TO for tylenol & a cooling blanket, faxed it to the pharmacy, called the pharmacy, & gave it to the patient- then kept rechecking her temps all day, then my high BP pt. got an increased dose of lisinopril, then I discharged my other post-op (I feel very efficient at discharging pts. & explaining their instructions & going over meds with them :, then I even called the EEG dept. & found out what time my anxious, EtOH -withdrawal pt was going for it (that made her happy & less anxious, together with the prn Ativan I gave her!) & then of course as I was about to sit down & catch up with my charting, my dialysis guy comes back-so now I have to chase down the NA for VS, weight, blood sugar & then I myself do his assessment, give him insulin, all his morning meds, make sure his tele monitor is back on, read his tele strip, see what his Foley is putting out, etc. Phew! Then I furiously try to finish charting everything...what a day! Thank goodness I have the long weekend off! Boy do I need it. Thanks for letting me vent!

-Christine[/quote}

Boy can i feel you. I've been orientating for about a month and a half and today was one of my worst. It's hard trying to prioritize when your unit is primary nursing and you are responsible for everything . To top it off, our floor is a tele floor and i swear each pt has at least five specialists. I had a patient today who was bleeding from a tumor in his bladder. The urology resident wanted continous irrigation (250cc/hr) on top of the blood transfusion. He had a previous transfusion of 2 units prbc and his hbg/hct actually dropped to 7.3/22.9!!! Oh yeah, and his family decided to go ahead and do palliative care for him. If we stop the transfusions he will bleed to death. My other patient is in chronic a-fib,had sepsis,cancer and a scrotum the size of an orange. He was a little more stable but on deaths door. He was becoming short of breath,fluid overloaded and his pulse would jump up in the mid 140's and 150's. Oh and the baths? What baths. I feel somewhat embarressed though when i see how you other nurses pull off 5 to 7 patients and feel bad that i don't have it all together. Just keep doing what your doing and follow your instinct. God will see us through.(He got us this far). God Bless..AMARTIN1

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Wow!

Good job on how you handled your hectic day! You should be proud of yourself. I often have days like that too, you can be having a few quiet days in a row than all of a sudden BANG everything goes wrong!!! I guess you guys in the US have the same problem as us here in Canada; with the nursing shortage, we're just overloaded with complex patients with multiple problems. And of course, it's always the nurse who has to deal with everyone's problems, and we always get blamed for everything. I feel like it's us nurses who run the hospital!!! But in these working conditions you can only do your best; we're not superhuman or anything. Just remember, we're there for the patients but we also need to take care of ourselves too. I know the feeling when you work a 12hour shift and you only get one 40 minute break during the whole shift, and you see the patient care attendents getting to take all of their breaks, and they always get to leave on time!!! It's very maddening. :rotfl:

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Christine-- Sorry that you had the rough day, but it sounds like you handled it really well.

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