This is your patient "J" got back from surgery about 4 hours ago (open heart on an itty bitty). He's been acidotic since arrival, heres your last gas - 6.9/98/21/16 with a lactate >20, CV surgery is here and prepped and he's going on ECMO now - have fun!
Before you get report, go do the shift checks on the defibrillators, quick.
Remember that migraine in room 9 that you had yesterday? Well, they did a lumbar puncture this morning and we need to know if you're allergic to Cipro.
Which 2 GI bleeders do you want, we've got 5, and they're all on golytely for EGD/colonoscopy in the morning.
(with every ICU bed full, and a person in overflow in the recovery room) "Code Blue, East 423, Code Blue, East 423..."
You are getting floated to stepdown trauma...oh, by the way, you are going to charge once you are there.
We are short nurses who can care for LVAD pts, so you have all 3 that are on the unit, plus 2 other pts. ( Not so bad if the LVAD pts are in for a tune up, horrible, if they just came out of the unit.)
We just had a couple of deliveries and both babies are in the nursery in respiratory distress. Could you go relieve their nurses?
Could you take over the patient heading to c-section.
Oh...you got room xxx....sorry, she is a druggie and the baby is starting to show signs of withdrawl.
There is an ambulance in route with a 25 wk gestation bleeder.
Dr. xxx is on tonight and he is in a ****** mood. By the way, he has several triage patients here who are drop ins.
Your charge tonight and we couldn't find anyone willing to take OR call in the event of a c section.
There are only two nurses and a secretary tonight. You have a labor, 6 couplets, and remember there are 4 admits in the morning and one is a c section.
But the worse and most terrifying of all.....you are being floated to med-surg. They have 2 nurses and 31 patients. (Most of us have never been cross-trained and our poor med-surg nurses are so overworked that they are experiencing burnout=cranky).
Specializes in Certified Med/Surg tele, and other stuff.
Sorry, but Suzy RN called in sick and we can't get in another nurse. So you take her five. (on top of doing discharge, admits, d/c, education, mentoring, co signing)
umcRN, BSN, RN
867 Posts
This is your patient "J" got back from surgery about 4 hours ago (open heart on an itty bitty). He's been acidotic since arrival, heres your last gas - 6.9/98/21/16 with a lactate >20, CV surgery is here and prepped and he's going on ECMO now - have fun!