Alana211

I work in the cardiac cath lab and think some of your experience will be helpful. Many of the cath labs are very different in the way they staff from what I have seen. None of the nurses in the cath lab where I work scrub. We have a team of CIS/RCIS staff that scrub the cases. The nurses circulate and monitor. One of the reasons none of the nurses in our cath lab scrub is because we also run a small pre-post area. We are a small team of staff but get A LOT of cath lab experience. We are on call every 3rd day and every 3rd weekend. It is a lot of call but we plan on hiring more staff and going to every 4th day and every 4th weekend. The call can get to be a bit much sometimes. I'm not sure how much call other cath lab teams take and would be interested to hear. Our cath lab team is extremely good at what they do and we work together like a well oiled machine when things get hairy. Part of the reason we're so good at what we do is because we are small and get a lot of practice/cases. I was really nervous to work in the cath lab too when I first got the job but it is soooooo worth it. I love every day of it (minus when I have to work in pre-post anyway:yuck:) It was a learning curve for me but I was able to manage.

Guess I should've expected somethingspecial to happen:) I did hear someone talking about the super moon last Friday...

I still cantbelieve the timing....I definitely had to share that one...I love hearing all those weird nursing stories...all I can do when I think about the situation is laugh now but it was soooooo not funny at the time....I never was a believer of the moon phase stuff until I experienced it first hand every single time I worked during the full moon or the days just prior:) sounds like it was crazy everywhere...when we shipped several of our patients out the nurses @ the bigger hospitals said they were super busy too...the flight crew said the same thing:)

I worked 12 hour day shifts all weekend....holy craziness! We are a rural hospital and I worked ICU and med-surg Friday, Saturday and Sunday. The craziness started friday when I flew my patient out with an uncontolled heart rate on a cardizem gtt, dvt and probable DIC. That was an interesting day...Then I had the sweetest man in ICU with bone cancer and R/O MI and had to help L&D with a set of emergent delivered 34 week twins that flew out with respiratory complications and yesterday was completely different...heres my long, unbelievable story...I will describe it the best I can to you for the full effect of the situation:) Sunday was another one of those days. I had a patient that was declining and had a large family that was just told that she was going to die. I knew as soon as I saw her that she was not going to make it through my shift. I checked in with the patient and family often and at 1pm I went in and saw how shallow her breathing was. Her color had also changed. Her hands were now mottled. I felt for a pulse but could not feel one, she was barely breathing and I could barely hear a faint heart beat over her lung sounds. I looked around at the family and told them to say what they needed to say to her because these will be her last moments here on earth with them. They called their family to come up from the cafeteria downstairs and as soon as her son and daughter in law walked in she took her last breath. Everyone was standing around her bed as she passed...her closest friends and family. A streak of blood escaped her mouth, her grayish color turned to a more yellowish gray before my eyes and as I'm watching for anymore chest rise, a horrendous, loud vibrating noise shook the room. Then it stopped. Then another loud sound and vibration shook the room. I looked around with wide eyes to see what in the world it was...It was coming from the end of the bed. Another nurse ran in to see what it was and unplugged the bed. it got quiet for a few seconds and then bam! There it was again. I looked around and walked to the end of the bed and felt a big vibration under my feet. Everyone was looking around with wide eyes, one of the family members asked if we were going to fall through the floor. Keep in mind this is a Sunday afternoon when maintenance is on call only and we have the clinic triage right below us that is closed for the weekend. In my head I was thinking..."OMG...Lord, if you are doing this IT IS NOT FUNNY" and "OMG! WHAT IN THE WORLD IS THAT AND HOW DO I MAKE IT STOP FOR THIS POOR FAMILY!" I quickly exited the room and got the secretary to call maintenance to see if they were here doing something and alerted the charge nurse. I went back in the room and the noise had come and gone again sounding much like someone was coming up to us through the floor with a jackhammer. The noise ceased so I went out of the room to give the family some time to grieve their loss and the charge nurse comes up the stairs and tells me there was a contractor downstairs. Shelley (the charge nurse) said when she came in the door of the clinic triage room she scared the crap outta the guy as he was standing on a ladder with a large drill in his hand. She's almost yelling, "STOP, our patient died and you started drilling!". And the poor guy says "I'm done! IM DONE! I had 2 holes to drill, I'm done! They told me to come when I could to drill some holes, I'm done!" What UNBELIEVABLE timing! I apologized profusely to the family and told them what had happened. I sure wish someone would have communicated to the 2nd floor nursing staff that there would be a little work done on SUNDAY afternoon. Here I thought that heaven's gates needed some WD-40! What a day!

Thanks for the kind words...I definitely applaud the nurses that recieve these kind of patients all the time!

Today was one of those days... I work at a small rural hospital...we're 28 beds including ob, med surg and ICU. Today I had a patient with a GI bleed. I had admitted this patient on saturday evening and was surprised to find her still at the hospital when I got to work this morning. (I had hoped they would have shipped her out already). She had bloody emesis at home and black stools. We had her on Q6H hgb's, IV Zantac and were infusing PRBCs and had done FFP. Her admit hgb was 8.6, recheck after 2 units was 7.6, recheck 6 hrs later was 9.5....then 9.2...then for some reason lab had accidentally missed the midnight draw. The night nurse didnt catch it and her hgb this am was 7.2. I just finished transfusing the 1st unit and my student took the pt to the bathroom. She became diaphoretic, pale and skin was cool. She had a 1000cc of bright red bloody emesis with several golf ball size clots...then it started coming from the other end too...black stool along with bright blood. Got her back to bed...called the charge nurse and a rapid response....got her bolused plus a 2nd unit of blood going...called aircare and prayed to God they would make it there quickly...she was losing blood faster than I could put it in. We got her out the door by helicopter within 30 minutes....those last few minutes before she left I felt horrible...there was absolutely nothing more that I could do...the patient was crying and scared and i just looked at her, held her hand and thought in my head "what else can I do?" She prayed and her pastor showed up along with her son just before the chopper landed and he said a prayer. All she could do was cry once her son and pastor left and she told me "I will win either way...If i die I'll be with God...If I live I'll win and get to still be with my family." That poor student of mine too....it was her first day of clinicals....but one she will never forget! These are the days I love being a nurse but it breaks my heart at the same time...I'm not sure if she made it or not...it takes about 15-20 minutes by air to get to a bigger hospital where they could do more for her. Her vitals were starting to fade when we got her loaded up....

My 4 yo son was quite inquisitive as to how i got his baby sister out of my tummy. His dad told him that I pooped her out. He looked at me and asked "is that how you got the crack in your butt?" I just about died laughing!:lol2:

sonja- I did not say that the problem was lpns doing the infusions. I did ask whether or not they were supposed to do them or if it depended upon the facility's protocol. In nursing school i was told that LPN's dont do infusions that is why i was wondering.

At the facility I work at LPN's are aloud to do IV administration on peripherals and central lines. I have come on the shift more than a few times with the leur lock hub off the end of the piccs and central lines. I have taken these nurses aside and shownthem the correct way but there is one nurse that is consistently having problems. Last week one of my patients lines was left open to air because the hub was off, another had saline running with the tubing pushed in the end of the hickman and there was no hub at the end of that one either. Earlier that day she told me that a pt had blood all over the front of her that was coming from her central line after she had done her infusion. I have told my unit manager about this every time there has been an occurence but this nurse is still doing infusions. That seems very dangerous. The unit manager is going to send her to an IV training class but its not for another month. I thought LPN's weren't supposed to do infusions...or does this just depend on the facility's protcol?

It was a long term care resident. I work over in the subacute part of the building and occasionally get called over to LTC for things like this. The resident is doing ok. Thanks for the replies:) I'm not sure how things go about in LTC.

At work a couple days ago an aide had put a warm pack on the abdomen of a patient. An hour later the Lpn noticed the patient was grimacing and looked to be in severe pain. It turned out the warm pack was too hot and the patient received 2nd degree burns from this. The social worker, DON, Administrator, etc were notified. What happens to the employee after something like this and who does the social worker have to report this to? I've never ran into an incident like this before. Any info would be appreciated.

I work in a subacute rehab unit. We sometimes have patients that have orders to keep a peripheral in X 7 days if patent. If we have that order, we have standing orders protocol to flush the peripheral with heparin. The MD does have to sign the standing order sheet though before we hep flush......Otherwise we usually use the saline. I also agree with the above post that the patient did not die from the morphine. Also, it is very important to stay on top of the pain so it does not get out of control.

I recently graduated from MSCTC and passed my boards in August. I got a job working in a transitional care unit in Alexandria as a charge nurse. I have been working for 3 weeks now and I love it! I love working in MN because the people are so nice (Especially in the rural area where I live).