Published Jul 13, 2005
Ok. So, Monday, I just had my first shift off of orientation (yay for me) with the easiest assignment in the CVICU.
I find errors all over the place and spend the first 4 of my 8 hour noc shift refaxing and/or calling orders to pharmacy from day shift, readmitting the patients into the system (the monitors were still set up with the previous patients' info in both of my rooms) and catching up on night tasks (bath, stock, straighten, etc...). I helped out all up and down my hall when I finished meds or vitals. I educated, I assisted, I made sure my lines were in date and labeled, I ordered new meds for the next shift, I was all caught up on my paperwork. I was rockin'. I was so happy I blew that first shift out of the water...it was the one I was most worried about.
Then I sit down and do my totals and go to review my charts to freshen up on histories for report. AAAAAAAAAKKKKKKK!!!!!!
My two patients were so freaking identical that I had followed the Urine Output protocol that one of the patients was on for BOTH! :smackingf :selfbonk: I caught it 10 minutes before report. Luckily, the one I should have been stricter with (probably should have hung 5% albumin 3 hours prior) started picking up with a 40cc output for the last hour. Now, this should have been a no brainer, but both of these patients had their UOP orders changed 3 times a piece on evening shift (no, really, they did) AND I spent a good chunk of those first 4 hours piecing together the worst report I had ever received. It was from an orientee on her first day...(We were all there once and I didn't want to freak her out so I just asked a lot more questions than I usually have to)...so I know I shouldn't be too hard on myself. But, JEESH, c'mon! Urine? How freakin' basic is that and who on earth would normally think "Hey, one of these pts is on 15cc/hour UOP is 'ok' protocol so let's follow that for both." Poor woman's kidneys. Luckily for her the previous shift had aggressively treated her so she only missed one treatment from me and, like I said, she DID pick up on her own and she was always in the 20's or 30's otherwise.
I'm just so frustrated with myself because it was direct patient care, not something like forgetting to label my IV tubing or reordering meds or the like that I fudged up on.
Well, at least I know what my first action after report and assessment will be from now on. I have no clue how I missed it this time with the number of times I was in and out of those charts with pharmacy, but I sure won't miss it again.
Whew. Thanks for letting me vent. I feel better.
RosesrReder, BSN, MSN, RN
phew! what a ride :) . Seems like you are a great nurse good luck to you
Nurse Ratched, RN
If it makes you feel better, I wouldn't know a bag of albumin if it jumped up and bit me . I'm constantly in awe of ICU nurses.
Sounds pretty dang GOOD to me, for your first shift off orientation! :)
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