I'm a new grad, started working on a DOU (step down from ICU) floor in early February. About 75% of the time, I feel good when I go home from work. I feel like I did a good job and was on top of things, felt my patients were safe and had competent nursing care. Some days though, like yesterday, make me want to quit and never come back.
One of my patients went into V-tach as I was receiving report, first thing in the morning. The previous nurse noticed his IV was going bad, but didn't take care of it. After numerous attempts by multiple people, and even trying to start an IV on his feet, it was determined he needed a PICC, but our radiology department doesn't put them in on Sunday. It took the entire day for this guy to get a central catheter placed, and he was septic and not receiving his antibiotics or the electrolytes that were prescribed to treat his V-tach. Meanwhile, he was also incontinent of bowel and bladder, and had to be changed (bedding and gown) at least 6 times during my shift. Icing on the cake was that someone kept stealing his IV pumps since they weren't being immediately used, rather than contact central supply and get their own pumps. I had to put in orders for IV pumps 4 times, knowing they would eventually be needed, and I am quite sure they now think I am insane over in central supply.
My second patient went bad around 11:00. Her O2 SATs and blood pressure dropped to the point that we had to call a rapid response team. After trying for a couple of hours to stablize her, we ended up transfering her to ICU. She should have gone sooner, but there wasn't any room, and we had to wait for someone else to die.
My third patient was a lovely little old lady with a horrific, huge hematoma and wound s/p fall while on coumadin, with mild dementia and a hairline fracture to her ankle. (Incidentally, her IV was also no good, and she was another hard-stick.) She was fine unless you left her alone for more than 5 minutes, and then she'd be trying to climb out of bed so she could go home. Fortunately, her family was with her when my 2nd patient was crashing. I hate restraints, but at 6:00, overwhelmed with all of my other responsiblities, I finally had to get a doctor's order for a posey vest because I didn't have the time to stay close by.
My 4th patient was an isolation patient (MRSA and C-diff) with a recent BKA and poorly controlled pain. He didn't speak any English, and was (I suppose understandably) hostile each time I went into the room. (His doctor knew about the pain being poorly controlled.)
Icing on the cake was that I was so overwhelmed, that I actually welled up in tears when the charge nurse came to me late in the day to ask me a question, and now I am humiliated because I am normally a pretty hearty girl.
I hope these kinds of days will diminish in number as I gain experience, and that I am not so overwhelmed when they DO occur.
