Angelicpurl

I work just Monday through Thursday 5 pm to 8am. I don't do triage except as a rare occurrence. I have another nurse full-time nights with me and 2 nurses that are back up with us. They have caseloads and are rotated out. We have full time weekend crew. We have over 300 patients in a busy metropolitan area. I do have two admission nurses, but sometimes we have more admits that need done. I have had to call social worker and chaplain to a death visit because there wasn't enough of us to go around....

Reminded me of many years ago, I was new grad. I had a post-hysterectomy patient come back from PACU. She had a wash basin for vomiting. This was before Zofran was used.... Family had piled in so much that the PACU nurse had to have some of them vacate to put the patient's bed back in her room! They had a stack of about 8 or 10 pizzas from the local pizza place. The room reeked.... I followed them all back in where PACU nurse was holding back her hair. Between heaves, she screeched out to an older woman there, get them all out! Take your **** pizza with you! They all bolted with pizza to the waiting area. I assessed patient and got her meds. When I came back, she said to not let anyone back! I had a post colon surgery patient who had NG tube and colostomy. Family demanded we get patient a cheeseburger, fries, and large diet Coke immediately. It was 12 am. The patient was heavily sedated from surgery. When he came around, family was eating & I heard plates hitting the floor. They'd put several plates on his bedside table while standing over him eating! When he was coming around, he slung the bedside table aside so hard it hit the wall by his bed. We went running in and he growled, get these MF out! (He said words). The others on my team escorted them out and called for housekeeping. The family was saying he was just "hangry" and needs food. I talked to him and he said, they disrespected him and us. They wanted all of us off his care, but he told the supervisor if she made him take new nurses before day shift, she better come care for him herself, so we better be back the next night if we were scheduled. We all were and she made sure we had him too.

We hired 2 nurses knowing they were pregnant. One was due so soon that she actually had the baby before her background checks came back! The other decided to wait to start orientation until after she delivered. But as a supervisor who conducts a LOT of interviews, I know we cannot ask someone a whole list of questions, one being if they are pregnant or have children.

Since that amounted to shift change report, yes. They even paid me to go to get the drug test. I was told at the time it happened that I was the random test of the week. I found out when I came back what the truth was. Glad I had my Union rep when I went in for that conversation! I'm also glad my Union rep was also an RN that day.

I agree with other posts. As a former CPR instructor, I had many people question me when I would give the statistics for CPR survival. They're abysmal in the field, and not that great in the hospital. This wasn't a witnessed event. You don't know how long the child was down before grandma noticed, how long before she got him to the stable surface, and how long her efforts were before you took over. The rate of survival drops every minute. You said you performed CPR for over 10 minutes? This child was in a bad situation. Given that timing, I would guess that the EMS didn't have many runs with children on board either. It sounds like you did everything you were supposed to do. I wish we could give you a real hug. Doing CPR on a child is never a situation that anyone wants to be in. I've been there and it didn't go well any of the times I did it. I don't agree with calling the family, or making other contact yet. Your grief is still too fresh, and so is theirs. Let them approach you. I also agree you need to talk to someone about what happened. It really does help. I did CPR on a 16 year old boy a few years ago whom I had helped draget out of his car, no seat belt, head-on collision at about 60 mph each car. No skid marks. Boy had a flail chest. Our ER doc did a post-mortem CT. It was ugly, but he was able to help all of us who worked on the boy afterwards see that while we did everything, we were fighting a lost battle.

I took a box of Morphine PCA, opened the box in front of the patient, flipped off the yellow cap, had a pump that scanned it as Morphine...and because my patient didn't believe I would give them Morphine, they refused to press the button & called in the manager 90 minutes later. The manager immediately sent the syringe to pharmacy, called me off for that night, & replaced the PCA syringe, pump, & tubing. Patient even told them they saw me open the sealed box & flip off the yellow top. Said they had no idea how I diverted their Morphine for saline, but were sure I did. I also had to do a drug test. I didn't! I wouldn't! No, I never had any issues with the patient before that. I had only replaced the syringe while a coworker (scheduled RN) was at lunch. Of course, the syringe was loaded with Morphine. Only mine and the manager'said fingerprints were on the vial. If anyone else had been on there, and it wasn't Morphine, I would have had a case against the company. Weirdest reason to get drug tested! I came back clean. Never had ANY drug diversion accusations before that or since. I've worked with nurses who diverted them.

Anyone who needs a stethoscope gets a yellow "isolation" stethoscope. We have a drawer of them for when different items get more use than others. We throw away BP cuffs that get icky for one reason or another. But we need nothing else out of the kit. Rest goes in a drawer.

My favorite? Wife is in room, I'm in with roommate. Dr. X comes in, says, tell the nurses to have me called anytime you need me. I'll answer right away. So, wife calls out & she has a legitimate concern. I call Dr. X, he hangs up after screeching he's not on call. Ok....I call on call & they ask whof I'm calling about. Oh, Dr. X is covering that patient, so call him. I explained I already did....

I love it when they come into a room behind you after you close the door. I always say, is youreally mom/dad in the next bed (meaning same room)? I've only had a few say no, and at that, someone else in the room has said (usually patient or family), would you want some random person popping into your mom's room just because they want to talk to the nurse? I would love to say too, did you look at your mom's white board? Do I look like a Fred, Bill, Bob, John....to you? Or, you just heard me say, Mrs. Jones, my name is Angelicpurl, and I'll be your nurse until 11. After I take a listen to your lungs, heart, and tummy, I'm going to check your wound. Before I leave, I'll write my name on your white board. So, my name isn't Sandy, Brandon, Brenda, Jackie.... Once, after being interrupted at the med room door to them beating on it (same person!) with an ice pitcher, I wanted to say, how many times do I have to say I'm NOT the nurse for your mother? They even called me by my name! Their nurse was at the desk looking at a magazine. She said she even asked if they needed help, but not recognizing them, she thought they were with my patient since they said no & they were looking for me. I had heard her offer to help before med room door shut, and I did hear her say please don't hit the med room door for someone, and she got up to stop them, when I opened the door.

I had one particular Doctor hang up on any of us a lot. He even said before he hung up once, I saw that patient yesterday around 3 and she can't be coding now....I gave him a minute and called him back. He told a colleague a patient's potassium couldn't be 6.2, despite it being 5.6 the evening before and treatment ordered (& given). But he came in a room screaming at me once when I paged him overhead 3x, had a patient develop sudden pulmonary edema. Calcium was 15, had been put on meds and fluids that were running together at 300 mL/hour. Sounded like they were drowning from the doorway! We didn't have rapid response team back then, and ICU wouldn't come to help, house supervisor was helping with a literal train wreck survivor in the ER, and I was the charge nurse. I just shut everything off, grabbed Foley, O2, called ER....because I had no response. We applied O2, got Foley in, and I was pushing some Lasix (per ER doc recommendation) when the screaming doc came in. I looked up at him and said, Now can they go to the unit? (Day shift had fought not wanting the patient on the floor). His response was, how much Lasix did you give? And, who told you to do all this? I responded very sweetly, don't you remember talking to us on your way upstairs? I've given 40 mg so far....and he said I want them to have 100 mg, why haven't you given that yet? I just smiled and said, we don't push Lasix that fast on the floor, so 40 mg is all they've gotten so far. See, they're diuresing so well now. I'm glad we put in the Foley. He walked out of the room and asked the unit clerk why hadn't she called for a unit bed yet? She looked at him and said, I have them on hold for you. I did have to call a neurosurgeon once because the drain he sloppily put in came out when the ICU Doctor had to re-intubate the patient. It was a rapid reintubation, and the drain had been in a while. He started screaming profanities at me and the ICU doc grabbed the phone from me. He listened & when a break came to the ranting, he said, this is Fred, the attending ICU Doctor. I will NOT tolerate your behavior or screaming at my nurses for anything, but ESPECIALLY for something I did. He hung up, asked if he could give me a hug, and bought us all pizza that night. He asked for the house supervisor & helped write the surgeon up. That surgeon doesn't work there anymore.

I got fired from a patient because her ice cream was originally too cold, then it was too soft....I had also put ice in their water pitcher and water in the ice pitcher. So the wife poured a Coke into the water. No labels, I just was handed 2 pitchers & SHE put the lids on them....I wanted to say, "YOU put the lids on wrong. It was Coke for the patients, NOT families." I was on the phone one night with the doctor, discussing a critical patient that I had called rapid response team for (& they were transferring patient). He wanted a play-by-play on what had happened. During this, I was approached by family members. The LPN came to them and moved them down the hall, tried to help them. She worked closely with me and is very knowledgeable. They started yelling at her, demanding to speak to their mom's RN (me). She wasn't able to explain to them I was on the phone with their mom's Doctor. We both wanted to say, "give us a chance to talk to the doctor and let a NURSE who's been at mom's side talk to you." I know a lady on Lantus 150 units daily, Glucophage 1000 mg 3 times per day, and 3 other diabetic meds. But, she's adamant shes not diabetic. Even with her blood sugars over 350. She says she doesn't have a BP problem either, but she's on 5 BP meds, 2 diuretics besides, and her BP was 168/112. Yep....so that chest pain, headache, swollen legs, leathery skin....CKD stage 4, and deterioration of vision are???

Did we work together? I precepted a girl like that too. She was a nurse who could NOT figure out (& get it to stick) how to push ANY medications IV. I'm talking about someone working a busy med-surg floor. Lots of post-op patients.... So after explaining over and over, 16 weeks of doing IV push meds with another nurse along with her assessments (2 max and we carried 12 as a team with LPN and aide)....they gave her to me. I told the other RN'S I had an idea & they were good with me having this RN do ALL the IV meds with me for the entire floor (22 patients, and not even a heavy IV load for that many either). Scheduled and PRN, blood, the works. I wouldn't have done it except they knew I wouldn't leave them hanging over it. I also wasn't going to let her hurt anyone and they would've pitched in if we had really needed help (too many PRN requests at once, for instance. Young pretty girl, flirty with ANY male. She was 22 years old, maybe. Kept going to the bathroom every hour to check her makeup on prior shifts. She spent 15 seconds doing a rudimentary assessment, copied over other shift assessment....took maybe 5 minutes total charting on each patient. She was crying before 9:30 pm and we hadn't really gotten started yet. At 6 am, our manager came in & she threatened to quit because we were too rough on her. We were worse than day shift that made her do aide work! That aide work made her break a nail. Yes, she mentioned that too. Manager gave us a way to go. "Princess" took notes the night I had her as the preceptor. She quit asking how to push Morphine and Pepcid too. BTW, she's become a fine nurse. She's not afraid to ask questions, teaches others, and does aide work when needed. The key with her was repetition of the same tasks. We worked with another RN on our team a few nights later (instead of LPN) and I had her do all 12 assessments. She also charted all 12. Was it mean? Maybe. Did it work? Yes! She was top of her class, passed NCLEX on first try at 75 questions....guess how we taught her admissions? Yep, had her do ALL the admissions one night. Same with discharges. I came in with her and we did all the discharges from 1pm on....even for other floors! I've worked with nurses who took more than one try to pass NCLEX; they're great nurses. Just because you pass at 75 questions doesn't mean you're a great nurse.

Runs along the same as I got told one night when I was about 38 weeks pregnant. We were swamped with patients, but no one on my floor wanted me to lift more than 5 pounds, pull or push more than computer cart.... I went in patient's room. Lady weighed 350 pounds or more. Room full of people, several young men. She asked to be pulled up & repositioned in bed. I stated, let me call in my team to do that for you, & pressed call button. I got call back they were next door & as I was finishing up & told them she would be next, one family member said...are you just fat and lazy with a bad back? We offered to help you pull her up in bed! My response? No, I'm 38 weeks pregnant. No one wants me to have my baby tonight. My team heard everything and the patient apologized profusely to me for her children's rudeness. She threw them all out of her room!

Yep! I've seen a lot of crazy come from homes. One of my coworkers texted me that they finally got readings from the vent. Family had changed settings. I guess they forgot about that being possible. I think the patient had more issues than we thought....I mean, family changes settings, let the vent over heat, turned off alarms, and they were also breathing through water. I didn't see it, but a buddy told me she went in to troubleshoot a vent in a home and it wasn't working because roaches were inside it and mice had chewed through the cord. The tubing was growing it's own petri dish of microbes that were visible. That patient died after they got to the hospital. IV....I did have a patient who was told they could go home after they got their dose of Vancomycin that day. I started it and got called away for an emergency. About 20 minutes later, I went back for their emergency. I ended up sending them out from the nursing home I was at as a traveller. The patient turned the IV pumps off, took the tubing out and gave themselves a free flowing 500 ML bag of Vancomycin and their entire flush bag (about 900 mL). Over about 10 minutes or less. They had a PICC line. They were red! And in some respiratory distress from the fluid overload. They bought themselves a week stay in the local hospital instead of a trip home. That was before anyone came up with locks or automatic stops if you take tubing from the IV pump.

Yes! I'm so glad I found the lock on feeding pumps and IVS. Especially after one mom programmed the feeding pump to NOT go off when it was supposed. She filled bag to the top and set amounting infuse as 999 mL. With continous rate at 40 mL/hour and a bag of 500 mL.... And got mad because we ran out of formula a week early. Actually accused nurses of taking it home. Naturally the manager got involved. IV pumps....I made a family mad because I WANT my pumps to beep when I have back to back infusions (why do all the dailies seem to be at 9 pm?). Anyway, I locked that bad boy after it didn't beep when I expected it. They turned off my Zosyn drip and my Vancomycin infusion. I ended up restarting both IV sites because they clotted off. Real helpful because they shut off neighbor's IV too. Annoying back light! Don't bother asking me to shut it off, just let me find my Heparin drip had been off for over 2 hours! Another RN and I were working together and she did my round since another of our patients needed a CT (one of us had to take them since we had no transporter). She thought I turned the back light off....we didn't catch it until we were checking intakes. Since then, I'm glad they made a new locking system and we have to lock ALL medicated drips. Surprise! My antibiotics became medicated auto-lock. We had a home patient that came in with respiratory issues. Family turned up humidifier heater to 6 (usual is 2) and had stuffed cotton wadding in all the ventilator holes not taken up by tubing. Vent overheated and shut itself off. No one heard alarms because they had also turned them down and one of the holes was where the alarms were sounding. Water had actually backed up about a foot on each side of the overflow cup! They were in unit when I left because they kept getting worse so they called RRT.

We had a hospice patient with uncontrollable pain in the nursing home. We had very limited options back then given her allergies, agitation (she pulled out every SQ pump needle). So unfortunately, she moaned almost constantly for about 2 weeks, even comatose. I was an aide then on nights. I heard her stop moaning & said to the other aides, the nurse must have given her shot already. No, she's still at lunch, but look! A dark small being scurried out of her room at that moment. None of us would go in there until the nurse returned and, you guessed it, she was dead. When the dark shadow appeared 2 nights later, we were glad the nurse saw it too! Because the roommate had said she was going home. She hadn't talked in over 5 years due to a stroke

One of my bosses said she was caring for an atheist once, very late at night. Said that all the sudden, the woman's legs turned fired red and too hot to touch. The family had been doing a death watch for nearly a week because she was grey, cold, and had been essentially comatose that long. The lady sat straight up in bed, screaming for a priest! Being a very small area, there was no priest available. My boss said she was Catholic and between her and another nurse that backed out of becoming a nun, they listened to her final confession, gave last rites, & last thing lady did was say, "Jesus saved me," & she died with smile on her face. Mysterious as it showed up, redness left. My boss said they felt a breeze that left the room smelling very sweet.

I say get out of there! I quit working for a place many years ago because I gave report on a patient group, and as I was giving report on the last one, one of the others decided to climb over the bed rails. In view of the day nurse! The day nurse demanded that i: fill out the incident report, get the patient assessed and back in bed, and since during my assessment I noted sat of 60....I called the rapid response team. Suddenly I was staying over 4 hours documenting all that mess too. They ended up going to the ICU and guess who had to transport them? I got in trouble because I stayed over, because I filled out the incident report, and because I called the rapid response team. Oh, and because I had the NERVE to ask the house supervisor to get me help transporting the patient. Never mind that day shift refused to help saying it wasnt their patient, so they didnt need to help with the transport. Yep....I got out fast! That place had the talking out of both sides of their mouth going on....because we kept being told to utilize the rapid response team, but every time we did (always legitimate reasons), they found something to write us up about. My friend just got wrote up about a dead transfer from the ER. She went into the room as the ER attendant left and the patient was still sitting up in their wheelchair from home. Patient was stone cold dead. I don't know the whole story yet, but somehow she was supposed to have avoided calling a Code Blue. Not her fault they arrived dead already!

Maybe....maybe not.... I woke up the Chief Medical Officer one night. A surgeon....he wasn't on call and my patient had a different surgeon on his case (fresh from ER) & hadn't been seen yet by on call surgeon. Not only did I get orders, he came IN! Did surgery, AND gave all of us commendations that he sent to the Chief Nursing Office.... I found out he wasn't on call the next night. The secretary mentioned it when I paged for surgeon on call for someone else. Did I mention he bought us pizza??? No, not day shift, but my floor, the same people who worked that night!!! I also noted his sticker was on outside of chart the next time patient was on our floor (he went to ICU after surgery). The next time I saw the surgeon, I apologizedon't for my mistake. He said not only was he glad I did, but the patient needed more advanced care surgically than his ER Doctor had thought. He needed a procedure that only he could do & I saved the patient's life! He didn't have to wait until the other surgeon realized the need for more help....which would have been catastrophic.

I worked in a small rural hospital many years ago. The aide laid the telemetry monitor on the bed in preparation for an ER admission. We were SO small that it wasn't uncommon for a floor nurse to have to help the ER at night. I went after the patient. Charge nurse entered info into monitor on her desk. As we came around the desk, the charge nurse grabbed my arm & hissed, whose rhythm is that??? We had no one else on monitor....needless to say, we got patient in another bed with another monitor.

I'm over 40, but my stepsister in law was barely 14 when she had my nephew....a cousin'so wife was pregnant at 13 (in class with me & NO not my cousin's child; he met her at my brother's ball game 4 years later). I also remember my mom calling me my college freshman year & asking if I knew a girl who wanted to come spend the weekend. No....Come found out, she was planning on staying the night with my 15 year old brother! Parents put the brakes on her plans. Her plan? Sleep with the ENTIRE boys basketball team....

Is why I'm thankful we had a potassium & magnesium protocol if their creatinine was under a certain level. Covered just about everyone but dialysis patients

We felt sorry for him growing up. Everyone outside the family thought he was adopted, or he was my brother....we do all look alike. Hate to admit his parents were the "filthy" rich kind, because they're family.... His sister is a great person, even if she is spoiled. Now by a rich husband too....

He was when Dad talked to him....he's not now. But his situation was because his parents weren't buyingredients him basic supplies like SOAP and Deodorant.... He told me his mom gave him grief over using his dad's stuff. My dad helped him get neighbors together that let him do chores for money. Until he was old enough to get a real part time job.

I have a weird view on this from my own family: I have a cousin who is STILL (40+ years later), second to his sister. He's a year younger than her, but he didn't get any college help, always wore secondhand clothes, never got to participate in any extracurricular activities, no help with a car, etc. He was honestly lucky to get more than clothes as gifts & they were NEVER new. It was the only reason his mother went to thrift shops or yard sales with my mom (my mom couldn't afford anything better for us). My mom taught him how to do his laundry at 7 because his mom refused to wash his clothes anymore! I do know my dad had "the talk" with him about growing up....he's in between my 2 brothers that are 13 months apart. His sister got the BEST of everything--designer clothes, PAID college education (8 YEARS) by mommy & daddy at an Ivy league school, numerous activities, and an expensive new car at 16. When she totalled said car, daddy took her to the dealership for another one....her mom & dad even paid for her expensive wedding (over $100,000) and down payment for a house that I know from the address is pushing $1 million or more. When he got sick a few years ago and had a stroke (genetic abnormality), his mom refused to let him move in with them or visit! He ended up getting a cab home and paying a neighbor to cook for him....his sister has free babysitting services from their mom. Anytime she wants....mom & I have asked him to move closer to one of us, but he's come to terms with it & says he's doing fine where he is WITHOUT their help.