So do you treat the monitor or the patient first? I have to say this patient taught me a lesson by using humor. Do you run all night and fight the monitor or do you assess your patient first? In this one experience with my new admit I learned a valuable lesson with humor infused.
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Working nights can be very interesting and challenging at times. It can also be very exciting and fast paced. I was working one night from 7p to 7a. My co-worker and I had our night planned, report taken, all patients were stable and our shift was set for a nice quiet evenng. Or so we thought.
It was a small bed unit, only 6 beds but high acuity patients since it was a bone marrow transplant unit. Our census was four patients with one being a newly admitted patient from the day shift. We also had two out-patient infusion rooms that were currently empty, and no one scheduled to come in this shift. We both performed our rounds on our two patients. I had a rather stable patient and the new admit.
My main goal for the evening was to begin the chemo on the new admit and do all the patient teaching. So I was going to be with this patient for awhile. My co-worker understood this and we made a plan how to meet the needs of the other patients.
I begin my teaching and answering all the new admits questions. He had plenty which they all do. Explained the chemo he was going to receive would require him placed on a Cardiac Monitor. So I placed the leads on his chest, pre-medicated him, and began the chemo. I stayed for a few minutes to make sure everything was running properly and then went out to the nurses station to chart. My co-worker and I were chatting about the new admit and how nice he was, when the cardiac monitor alarmed "V-TACH!!" We looked at each other and ran to his room. He was sitting up in bed watching TV and after a vital sign check it was determined he was stable.
We went back to the nurses station and before we could sit down again, "V-TACH??" Again, patient was stable. When this happened a third time I had my suspicions. I didn't charge down the hall to his room but quietly entered his room and immediately noticed exactly what I had suspected was happening.
He was tapping one of his leads on his chest causing the arrhythmia. He saw that I had caught him and immediately looked like he had been caught with his hand in the cookie jar. I tried hard to maintain a straight face but it was too difficult. We both started laughing and from that point forward it was practical joke city between myself, my co-worker and the new admit. He would not play jokes on day shift. Only on night shift he felt comfortable enough.
He taught me that I should not take life too seriously in light of the situation you are in at the time. He taught me that there is always a light at the end of the dark tunnel and to enjoy what time you have. The big lesson was to "Check the patient NOT the machine!!"
