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Discussion

What is the hardest shift you ever had?

I'm a new nurse working on a med/geriatrics unit since july and I just had the woooooorst shift ever today!!

Got report in the AM, saw that I had a lot of anormlal labs, so a lot of phone calls to doctors.Plus, I had 8 IV's to give between 9-10h AM! Like okay I can do that no problem. 3 of the IV accesses I needed were infiltrated.First was a man who constantly tried to pull it out. Got a new one, started the IV just to see that he had cut the IV tubing with his teeth like 10 minutes later!!!!! Another was a lady that just could not have an IV access on her right arm because she had a breast surgery a few months ago. But her left one was swelling a lot she was a really hard stick. Another patient could not had his blood test done during the night because he was too aggressive also had to be stick and was a success thanks to my wonderful colleague. By the time all of this is done, I have 15 files with new consults and orders and doctors asking me various things. I felt that I could not help my coworkers at all this morning because I had so much work myself!! I try to help with patient hygiene every morning but just didn't have time.

By the time I had to go to lunch I was able to get everything done and was hoping that I could start to chart in the afternoon! Big mistake!

As soon as I came back from dinner, a woman became hysterical, pull her IV out, started screaming, crying, etc. Had a lot of trouble to give her some Haldol to calm her down and had to send someone start a new IV. The same aggressive patient that we had to stick in the morning and tried to hit us everytime we touched had fever. Doc called, septic workup was ordered (so a lot of manipulation agaaaain for this poor man) and eventually done. New orders just started to pile up on my desk, but had to give my afternoon IV's, write down report and actually start to chart!

WELL, eventually I got out of work (almost 1hour late!). Charge nurse told me to write overtime, but I felt like crap. I feel like I needed so much help today and felt overwhelmed most of the time. Never happened to me before! A doctor even asked me some questions about one of my patient and I actually just did not know what to answer because my head was so full of everything I had to do, write down, etc.!

I can definetly say that this has been the hardest shfit I have ever worked on.

Felt good to vent, and I was wondering about you, nurses of allnurses, how was your hardest shift?

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    My worst shift ever was way back in my early days - I had 3 back to back emergency deliveries with the death of one mother and all three infants. I went home exhausted and in tears. Still I got 6 hours sleep and went back for another day.

    Hppy

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    12 hr night shift on a hospice inpatient unit, full house with attendant families, the only nurse working with an agency CNA on his first shift with us. Started with 11 patients, ended with 6. It was Christmas Eve.

    Runner-up: 3 yrs out of school, working 3-11 at the old Boston City Hospital on acute medicine. Census 28. Only nurse working ‘cause the head nurse scheduled herself on so she could call in sick (Easter Sunday - she actually told me she would ahead of time!). Two aide's (no CNAs back then) who only did incontinent care and passed meals. Four pts on vents, three w/ett and one w/trach. The trached pt was a fresh transfer from ICU, wide awake and terrified. No such thing as a dnr or comfort measured back then, either. Had two code carts open at the same time for about an hour. House supe tried to help but she was one of two covering a 500 bed hospital. Good times ...

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    My first day off orientation as a new grad. Patient 1 had CPM machine ( post total knee replacement ). Patient 2 with critical lab but was asymptomatic ( low Hb / Hct ), patient 3, waiting to d/c and cranky about it, patient 4, been sitting on a bedpan too long with no CNA to be found and yelling and patient 5 pulled out their foley. All at same time. Patient 1 somehow their whole CPM fell off the bed with leg still in machine ( I will never forget that scream ). Apparently I did not prioritize right cause other nurses yelled at me for attending the CPM machine first. They said I should have called the critical lab first but hell, those screams were awful and I thought pain was priority since the guy with the labs was stable and asymptomatic. I thought get help for the CPM person then call the critical lab and then the foley ( who did not seem to realize the foley was out ). Yes, I asked my ex-coworkers for help. Nope, no help only criticized. It was pure awful.

    This all happened right after report and just after night shift left.

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    I've had some pretty bad shifts, but the worst was when my sister called my in hysterics because she had tripped and fallen, dropping my two month old nephew in the process. He got flown out from my ED with a skull fracture and a minor subdural hematoma. I freaked the hell out and left work several hours early to go with him. He ended up being fine, four years old now. Gave me a big hug and a kiss for my birthday today❤️ Ultimately no big deal, but it scared the crap out of me at the time, honestly have never been so scared before or after.

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    Gave me a big hug and a kiss for my birthday today❤️

    Happy Birthday.

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    having a patient admitted for short term respite who ended up becoming end of life and didnt go home again.

    The patients doctor was out of town which meant we couldnt just get the to review the patient and make the needed charting, they didnt have access to our electonic MAR and it was a case of fax tag to get what we needed.

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    Nursing rule - NEVER NEVER use the "Q" word .

    My next nsg rule - NEVER use the 'W' word. I always figure there could be something more that could come along just to add to the misery. Like your

    biter' pt could have bitten YOU!

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    I've had a few really hairy shifts over the 22 years I've been nursing. One that stands out particularly clearly was about half-a-dozen years ago; the patient was POD 3 heart transplant but requiring LVAD support that necessitated hourly blood gases and ACTs. Acute renal failure on manual peritoneal dialysis, hourly cycles: fill over 5, dwell for 45 and drain for 10. 18 infusions - four of them vasoactives - all needing to be changed. Sepsis workup and initiation of 3 new antibiotics. Multiple blood products to replace chest tube losses, dressing changes... and I was responsible for it all. When I said something about the workload to my (M-F, 0700-1500) manager, I was told none of the other nurses who'd had that assignment had complained. Hmm, it was a Monday, so how she knew nobody else had struggled is a mystery to me. I do know the nurse who'd had the patient on the Sunday had refused to have the same assignment on Monday.

    More recently I had back-to-back shifts with a mildly-obese ECMO?CRRT patient that we took on a total of 4 road trips to CT and the cath lab over the two days. I think that was about the sickest person I've ever cared for. Crazy busy, almost too busy to think about much more than putting one foot in front of the other. I had help those shifts, otherwise I'd never have gotten it all done.

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    I remember it specifically as the day John McCain named Sarah Palin his running mate. I had been a nurse for about a year. It wasn't just me, it was the whole floor. We had multiple emergent OR cases, kids seizing non-stop, 2 of my patients had acute hydrocephalus issues- one we had to place an emergent lumbar drain at the bedside (which was NOT typically done in this pediatric hospital but patient was a young adult and the OR was booked with the other emergent cases we had). Our Nurse Manager had to become the charge RN because the charge RN had to take a full patient assignment. I believe our nurse educator may have had to pick up an assignment too. No one had time to eat lunch which the leadership tea actually realized and ordered us pizza from across the street.

    Runner up was the time when I came in for a night shift and found that Neurosurgery had decided to pull the EVD on my shunt dependent baby (who had aqueductal stenosis and had previously failed multiple clamp trials and her past EVD removal). By her midnight VS, I knew she wasn't going to make it through the night without some kind of intervention. Her respiratory rate had dropped, her sats were in the low 90s, she hadn't woken to feed, her fontanelle was bulging and her pupils were sluggish. Down for a STAT CT scan we went- hydrocephalus was worse. The Resident lied to me and told me the baby would be going emergently to the OR for a shunt. The on-call Attending, however, decided that it could wait until the morning and sent the Chief Resident in to tap her fontanelle. We were still emergently in the OR by 6am. It was only when I finally got home around 9:30 am that I realized it was Friday the 13th.

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    1st night off ICU orientation - 12 hour code (septic pt and ended up passing away the following night not with me) plus another intubated pt. special thanks to whoever was my charge nurse that night for leaving me with both patients ;)

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    All that I read so far, I will not add mine. My worst shift does not compare.

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