What an evening. (kinda long)

[elizabeth8503RN, MSN, EMT-B, NP]

What an interesting evening.....

I work at a 20 bed ortho/neuro floor. At the beginning of the shift I was assinged 5 patients, but one in surgery....so that left me 4 patients.

RM1: lady in her 60's C1 fx, obese, diabetic, up with assist, (wore an Aspen collar when up)

RM2: lady in her 60's foot fx, kidney failure, no appetite, placement of a PICC, TPN, hospitalized for several weeks, becoming more and more depressed.

RM3: man in his 70's Rt total knee....family believes that he is becoming more demented...a/o x4 for me

RM4: man in his 50's Lt foot/knee surgery. PCA a/o x4

RM5: empty

When I started my shift I took a look at my patients...and figured....I can handle four patients....I will be fine...oh boy...was I wrong.

Report. RM2 had several orders...most of which were noted...but were not implimented yet. Med changes, TPN, that depended on PICC placement....Pap smear (which wouldn't be done til tomorrow). RM3 needed milk of mag that pharmacy had not put in the computer (and was not able to over-ride to take out) and 3 needed IV antibotics all at the same time.

Ok...I can handle that. Went and checked all the patients...all were breathing...major plus....#1 no issues... denies any needs at this time. #2 sick to stomach, family waiting for doc, refused nausea meds, no pain. needs IV atb #3 wants the CPM machine off, but doing ok. needs IV atb #4 states he feels like he can't empty his bladder...but is urinating. needs IV atb.

Have to check all of the PCA's (tech guy needs number off of the PCA to check to see if the need to be recalibrated)

took off the CPM off of 3...(off to walk with physical therapy). check in on 4, answer some family questions, started IV ATB. 1 wants pain meds....2 family has questions...back to give 1 pain meds...start 3's ATB...remember that 2 needs ATBs.

Each time I go to start something with one patient...another needs something. Start to chart...have to go and give 1700 meds. talk to a doc, back to answer family questions. BS...1 is low (gave juice)...RM2 is at 163 but won't eat, declines insulin. No PICC placement yet...no TPN yet.

Ok...putting out fires as I go...NOW THE KICKER...my pt in 5 ends up going to CCU...now I am getting a new admit. will be getting a report here soon.

PICC line on the way...placed and checked. starting IV KCl. get report on my lady in 5...bout an hour out. ....sit down to chart...1's family has some questions. 4 needs a diet order clarified.

Lady in 5 gets here. 90's Lt hip fx. alzheimers dementia. needs a new IV, BP is high. PA stops by to write orders. need to pass 2100 meds. BP went down by itself. internal med consult needed. IV started by stat nurse. waiting for IV pump.

Go to get TPN for 2, have to pass by CCU (my gpa passed away 11 months ago in this CCU...first time I had been back to that area since he passed. Flood of memories of those two nights pass through me, can barely keep the tears from coming)

Check BS...give insulins....still working on finding an IV pump for 5, need a double pump for #2. Starting to check orders for 5.

4 up to bedside commode, dressing to foot needs reinforced. 1 had a blow out in toilet. 5 needs a foley (CNA usually places in cath...but was having trouble. Foley in.)

Able to give report to 11-7 shift...but still gotta chart, start two IV atbs and finish noting 5's orders.

Actually got out only a few mins late....but WOW what a night.

[Ivanna_Nurse, BSN, RN]

Wooh! You made it :) Put your feet up and relax! ~Ivanna

[n87934]

Wow! You are a well-seasoned nurse demonstrating the great organizational skills and time management skills that come with experience.

[elizabeth8503RN, MSN, EMT-B, NP]

Wow! You are a well-seasoned nurse demonstrating the great organizational skills and time management skills that come with experience.

THANK YOU....some days I feel like a total newbie...other days I feel not too bad....yesterday I did the best I could...and muddled my way through...At the end of the day I was exhausted...but felt like I actually did something...

[sistasoul]

That sounds like a crazy night and you made it through. Good job on being able to get out of there with your sanity intact. I work ortho/neuro also and most nights are like this. I find that nursing is about putting out fires all evening long.

[MassED, BSN, RN]

sounds like a typical busy night for a nurse!

[canesdukegirl, BSN, RN]

GOOD JOB!!! You did a great job documenting this for US, and I can only imagine that your charting is STELLAR! WOO HOO! I would take you for my nurse any day of the week!

[RaziRN]

Sounds like a typical night on my floor....

(((Hugs)))

[jadu1106]

wow, job well done! :) i am exhausted just from reading the different pt scenes in your post, i can only imagine how your night must have been....

i agree with the above poster, you can be my nurse anytime! :)

i hope your next shift makes up for this busy night and it goes much smoother for you! :)

[elizabeth8503RN, MSN, EMT-B, NP]

Even tho I was BEYOND busy...it was a good day. The worst part of the day had nothing to do with patients...and more with having to walk down the hallway that led to CCU. The hallway in which I am WAY too familar with. October 22-24 of last year was spent pacing that hallway, listening to the rounding of doctors tell us the prognosis on my failing gpa. Our entire family (on my dad's side) gathered round saying our goodbyes. I had not visited that hallway in over 11 months...and still those memories were VIVID, and strong.

I know that gpa is in a better place, but walking down that hallway just brought up memories that I would have rather left a bit more buried until I was ready to deal with them. And last night was definately not a night I could endulge in those memories....so I made it through...and now I can better equipt myself for the next time I have to walk down that hallway.