The worst day I've had as a nurse

Been there,done that, ASN, RN · Mar 31, 2016

Once the rapid response team and anesthesia arrived, they took over the patient's care. You were now able to take care of your other patients.

Where was the charge nurse and nursing supervisor? You obviously needed their direction.

RescueNinjaKy · Mar 31, 2016

The coding patient takes priority. Your charge nurse and co workers should be helping you with your other patients during this time. Medications will be late for the other patients if your co workers aren't able to pass it for you but they should at the very least go help you round on them. Where are the aides to help with your patients. If the patient is confused and wandering, where was the bed alarm or sitter? As the primary nurse you need to be at the bedside of the coding patient to give report to the code team and to help identify any reversible causes. After that you need to give report to the icu that they're going to. So why don't your co workers have your back?

And frankly if a patient's family was all up in my face like that, I would tell them that I was helping a patient in critical condition, and that their family is not. If they get belligerent still I direct them to my charge and ignore them. Complain all you want, dying person trumps all. And if my charge or manager don't have my back then They're not someone I want to work with.

**NickiLaughs, ADN, BSN, RN** · Mar 31, 2016

Sorry you had a rough shift.

your role is typically to chart and provide extra information in a code. The charge nurse should have helped or have someone else help your other patients.

emergencies are always first.

regarding the angry family member, there are people out there who only can see tunnel vision with their loved one. I Cant even count the amount of times I head family ask for ice water or the bed to repositioned when we are coding someone in the ER. Id refer them to the charge nurse and let them handle it because you have catching up to do.

Had you already taken report on the patient coming to the floor? Usually we will board a pt in the ED for a bit if the **** is hitting the fan on the floor and the charge lets us know.

It honestly sounds like a big fail on behalf of your coworkers. Teams make and break you in nursing.

hugs to you on your rough shift.

nutella, MSN, RN · Mar 31, 2016

Once the rapid response team and anesthesia arrived, they took over the patient's care. You were now able to take care of your other patients.
Where was the charge nurse and nursing supervisor? You obviously needed their direction.

In all the hospitals I worked at the primary nurse of the pat stays in the room to be present and assist with rapid response.

It is the job of the charge nurse to help and delegate in this situation - meaning making sure that the other patients are taken care off.

nutella, MSN, RN · Mar 31, 2016

So just to give some background first I have 1 year of experience in acute rehab and 1 year on the tele floor that I currently work on. I went to check on my patient tonight and found her lung sounds to be audibly crackly/wheezy, pox was in the 78% on RA, I put her on 5L O2 via n/c, stopped her normal saline, and got a full set of vitals which were stable once O2 was applied, I called the resident and fortunately she came up with the attending as well. Long story short the patients condition quickly deteriorated and there were no icu beds available so a rapid was called and they began to intubate the patient. I felt that I did ok up to this point but then the pt coded during intubation and I was like a deer in the headlights, the whole rapid response team was already there working on her and I was getting supplies as they were asking for them, one of the other nurses I work with had to do the code documentation sheet because I had no idea how to do it. While all of this is going on I got an admission that showed up too! After 5 minutes of cpr and 2 mg of Epinephrine the pt was alive again, the team also placed a central line and by the time she went to the icu it had been over 3 hours since I had placed her on 02. I had not been able to see any of my other 4 pts that whole time and as soon as I got back from the icu I had family members from one of my other pts immediately in my face yelling at me because they want to know why she is confused and when it will get better.....seriously w t f, they saw me running all over the place and the commotion in my other pts room, I'm exhausted, behind on med passes, waaaay behind on documentation,and didn't get to eat or go to the bathroom or sit all shift. Why are people so damn mean this week! (This has been an ongoing issue)
I guess I'd like to know what more I could've done, once the rapid response team and anesthesia was there I wasn't really doing anything and I felt like I should have, last I heard when I left tonight they had to do cpr again in the icu but the pt was still alive so I'm thankful for that but I can't help but feel frustrated and disappointed that I felt completely clueless and all I want to do is call out tomorrow

Don't call out.

What you experience is totally normal for a "newer" nurse, especially if you do not have a lot of rapid responses and codes on your floor. You will get the hang of it.

Usually the primary nurse stays at the bedside and helps /document and such. I would recommend that next time you get one of the nursing assistants if possible to help get things. When you have stuff like that going on you get the charge nurse and tell her that you need somebody to round and medicate your other patients. When I worked as a charge nurse, we would usually divide the patient and the other nurses would take one extra pat to medicate and round. The same for admissions somebody else settles them. In a situation like yours, where the patient can not get off the floor it is reasonable to ask if a nurse can be floated for 4 hours to help and catch up.

It is basically all a matter of practice. Next time this happens you know what to expect and do and delegate right away. Your coworkers should be helping you.

Other than that it sounds that you were doing the right thing and did well!

Been there,done that, ASN, RN · Mar 31, 2016

In all the hospitals I worked at the primary nurse of the pat stays in the room to be present and assist with rapid response.
It is the job of the charge nurse to help and delegate in this situation - meaning making sure that the other patients are taken care off.

I have only worked in one facility with a RRT. (no longer work at the bedside) I would call the team, give report and they took over the patient.

In any case, OP needed to be relieved of her duties with the rest of her patients.Whoever was in charge that day needs to be written up, so this can be evaluated and prevented in the future.

BeckyESRN · Mar 31, 2016

When you work tele, prioritization is key and you nailed it! When your non-critical patient's family gets crazy, you say "I'm very sorry for the wait, but I had a patient in critical condition. What can I help you with?" I cannot stand these types of people. Yes, I know mommy dearest is confused. Welcome to advanced age + unfamiliar surroundings + whatever medical issue.

At my old facility, we never handed care over to the rapid response team. It would have be nice if some of your co-workers could have helped out in your other rooms, but they didn't and meds and non-coding patients can wait. It is overwhelming to be part of code, especially when it's your patient. It took many, many codes for me to feel like I knew what I was doing. 7 years later and I still hated the medication charting during the code. There is nothing more that you could have done. You did what was right for your most critical patient. I'm sure that angry family would want your undivided attention if it were their loved one going south!