What Is The Shift You Will Never Forget?

ChristineN, BSN, RN · May 2, 2013

My most unforgettable shift was when I was working a pediatric step-down unit. We had 3 DKA pts on the unit, which was our norm, all of which required frequent assessments and hourly labs. It was also the day before my unit was being moved to another building, so nurses were running around trying to pack and get things in order.

The day got crazy when one of the CNA's was bathing a child. Half way through the bath, the CNA realized the pt had stopped breathing. A code was called and they worked on the pt for over 1 1/2hrs and gave over 13 round of meds before they called it. As we finished his mother showed up. The pt was supposed to be discharged and the mother thought she would be taking him home.

As soon as we finished working on that child, the code team walked across the hall to work on saving another one of our pts that had gone into severe respiratory distress. He ended up going to ICU.

I think every nurse working that day cried at one point or another during the shift.

uRNmyway, ASN, RN · May 2, 2013

My most unforgettable shift was when I was working a pediatric step-down unit. We had 3 DKA pts on the unit, which was our norm, all of which required frequent assessments and hourly labs. It was also the day before my unit was being moved to another building, so nurses were running around trying to pack and get things in order.
The day got crazy when one of the CNA's was bathing a child. Half way through the bath, the CNA realized the pt had stopped breathing. A code was called and they worked on the pt for over 1 1/2hrs and gave over 13 round of meds before they called it. As we finished his mother showed up. The pt was supposed to be discharged and the mother thought she would be taking him home.
As soon as we finished working on that child, the code team walked across the hall to work on saving another one of our pts that had gone into severe respiratory distress. He ended up going to ICU.
I think every nurse working that day cried at one point or another during the shift.

Oh God...I can't even begin to imagine how anyone made it through that day. The parents or the nurses. How horrible.

Mine was kind of bittersweet. This was in nursing school, I know I have shared this story on AN before. Little old lady with terminal CA, sadistic doctor who was making her do the prep for a barium swallow. She was such a trooper and even though she was extremely nauseous, she drank most of the contrast. Since she was my only patient, my teacher allowed me to go with her and keep her company in the waiting room for her test. I sat and held her hand and rubbed her back while she rested. At one point, she opened her eyes and looked at me. She told me how special it was for her that I was there with her, and that people like me were what helped her to fight. I just barely held on to my tears until she fell asleep again.

She died that same week. Her family was coming from out of town for Mother's day that Saturday. She passed on Thursday.

emtb2rn, BSN, RN, EMT-B · May 2, 2013

Have had a few. Won't forget a shift I had last week for a while, had 3 unsuccessful codes. 3rd call to the ME, I just said "yo" when the investigator answered, he said "another one?" crazy day, pretty much like a complete ACLS refresher. CPR, electricity, drugs, paperwork.

HouTx, BSN, MSN, EdD · May 2, 2013

Manager for a small-ish 10-bed General Adult ICU on Thanksgiving. Full, of course. I am working the 7a-7p shift in order to give more staff the holiday. Volunteers brought in all types of goodies for us to eat. About 10 am, one nurse turns green and runs to the bathroom... projectile vomiting. I sent her home, regrouped so that the remaining 4 of us could handle the rest of the shift. By 12, I had another one down and the House Sup told me that other staff were experiencing N/V.. having to go home. Yikes - food poisoning.

From 1PM on, it was unbelievable. There were 3 of us with 10 very ill patients. Ever try to get someone to come in on Thanksgiving? Every try to keep visitors/family under control on a holiday? We were all semi-sick, the staff bathroom reeked of vomit. Of course, a couple of patients started going South & had to be intubated.. the responding doc took one look at us and put on a mask. I assured him that it was food poisoning, but he said it was because we stank. He came back later with Pepto and Emetrol for all of us.

I did persuade the night folks to come in early as possible. As soon as each relief nurse came in, I let one of the poor bedraggled day staff go home. Our CNO showed up at 6:30 - probably wanted to check out the carnage for herself. Bless her, she did manage to get housekeeping to clean & de-stink the staff bathroom.

Yep, most memorable. Afterward, I ALWAYS made sure that I had a couple of nurses scheduled on-call for all holidays... just in case.

Morainey, BSN, RN · May 2, 2013

I work in New England and I got snowed into work during the huge blizzard this winter. I got trapped with a few crazy, belligerent, and angry patients. We had a couple of people who came in to the ER because they lost power at home (nothing wrong with them, but they didn't have power for their feeding pump) who became SO nasty by the end of the weekend. Sorry you had to wait in the ER for ages but please don't bite our heads off when you arrive to the floor after your long wait for what is basically a favor (social admission). Those shifts were the longest shifts of my life.

Also, I haven't had any codes but I remember each shift where a hospice patient passed away.

LisaLPN7 · May 2, 2013

The one I'll never forget was a night shift in a small community hospital, on a post-op surgical floor. Must have been around 1992. I started the shift with 12 patients and one elderly CNA with a knack for disappearing most of the shift. I had like three fresh hips, a S/P TURP with CBI, and various and sundry other general surgeries. Most from that day, or like one day post op. Around 1:00am, we received word that a local nursing home had had a minor fire and the residents were being transferred to the hospital. I got 8 of them. And no help. EMS just brought them in, dumped them into beds, and high-tailed it out of there. It was winter, snowing, and brutally cold. The patients were freezing, confused, incontinent, most were covered in poop, and had no idea where they were, where the folks they recognized were, or what. I got no charts, no paperwork, no report. I didn't know who anybody was, nor what was wrong with them. I didn't even know code status! That was the night from Hell!!! Finally, around 5am, the shift supervisor showed up and helped some.

bsartor · May 2, 2013

Thank you all for sharing. ChristineN, your post had me in tears!

I have a few but they aren't that memorable. I can say that I will never forget the day I was working on our Neuro intermediate unit and I was assigned a 1:1 with a patient who was a suicide risk. What an interesting lady. She talked and talked. Eventually at some point she looked at me and said, "You are pregnant, aren't you?" I was shocked! I was in my first trimester and hadn't told a soul other than my husband that I was expecting. Kinda creeped me out.

The first time that one of my patients passed away on my shift, was a middle aged lady med/surge patient that ended up on our floor because we had a bed. She was tall and fair skinned. She had the most unbelievable jaundice that I have ever seen. She was literally orange. It took several hours but she passed peacefully. I had cared for her all day and in an moment she was gone.

Tait, MSN, RN · May 3, 2013

It wasn't so much a shift, but several months with a patient. I wrote it up here a few years ago.

https://allnurses.com/general-articles-about/destiny-forward-patient-406804.html

Tait, MSN, RN · May 3, 2013

Thank you all for sharing. ChristineN, your post had me in tears!
I have a few but they aren't that memorable. I can say that I will never forget the day I was working on our Neuro intermediate unit and I was assigned a 1:1 with a patient who was a suicide risk. What an interesting lady. She talked and talked. Eventually at some point she looked at me and said, "You are pregnant, aren't you?" I was shocked! I was in my first trimester and hadn't told a soul other than my husband that I was expecting. Kinda creeped me out.
The first time that one of my patients passed away on my shift, was a middle aged lady med/surge patient that ended up on our floor because we had a bed. She was tall and fair skinned. She had the most unbelievable jaundice that I have ever seen. She was literally orange. It took several hours but she passed peacefully. I had cared for her all day and in an moment she was gone.

I had a co-worker who knew I was pregnant at 6 weeks because I was rubbing my belly a lot lol.

meanmaryjean, DNP, RN · May 3, 2013

Mine was my last shift with my home care patient. (I also work in PICU and care for her in both places)

I started caring for Elizabeth when she was just six months old, newly home from the NICU - trach, home vent and post-Norwood (the first of three planned palliative surgeries for hypoplastic right heart/ pulmonary atresia).

Three years later she had survived her other two surgeries (barely in the case of #2), a pulmonary hemorrhage, got off the vent and was doing well. She got decannulated and parents no longer needed regular nursing care.

I had never (obviously) heard Elizabeth's voice. It was my last shift - a rare afternoon shift so mom and dad could go out and celebrate their anniversary. I knocked on the door and mom let me in. From behind the couch- up pops Elizabeth - all smiles. She and mom worked with speech for two weeks on this- my greatest gift. Elizabeth said, "Hi Mary!'

PS: In the intervening year and a half, Elizabeth's mom has had a healthy son, and in a few months, my girl will start kindergarten.

carolinapooh, BSN, RN · May 3, 2013

There was the night I was 007. I'm still a legend on that unit and I've not been on that floor in four years.

The first death was expected. The patient had terminal cancer and was a favorite of everyone on the floor. Young man, baby girl at home. He'd survived childhood ALL only to end up with head and neck CA as an adult, probably from the full body XRT he'd received as part of his chemo regimen. Early in the morning, around 0100, he passed away, all of his family around him - it was awful. The MD actually helped me get this pt ready for the morgue, helped with the paperwork and the phone calls, the whole bit. (He's an attending now and is still a wonderful MD - has a mom who's a nurse so he was raised right!)

So the charge RN comes down around 0430 to get updates on my remaining patients. The lab tech is coming around the floor and stops at one of my pt's rooms and comes back out - this pt has a port-a-cath and lab can't draw from central lines. "Okay," I said, "just leave the vials on the door and I'll get them in a few minutes." (This was pretty much what the techs would do - they'd tape the little baggies to the window on the door and then we'd go and draw the labs.)

So I finished my updates with the charge nurse, during which time this patient, whose door had been left open by the lab tech, was playing with either a straw or a plastic knife on the tray table and it was very disturbing. The Charge RN got up and spoke to him ("I'm just gonna pull your door shut, ok, Mr. X?") and he nodded his head and the charge RN closed the door. (This guy was lucid, A&Ox4, the whole bit - St IV SCLC - isn't it funny how you can remember dx?) The charge RN and I talked for no more than two or three more minutes, and she left.

Okay - so this is what happened next: I had five patients, not counting the earlier death. I stood up from the table, got my stuff to draw Mr. X's labs and put it in my pocket (keep in mind the supply pyxis was literally right in front of me, so that took probably all of five minutes), rounded on my other four patients (stuck my head in the door - are they breathing - everything good - maybe ten minutes?), and then knocked on Mr. X's door. I got no answer - not really a surprise - and slipped into the room and turned on an unobtrusive light.

"Mr. X? I'm here to get your labs."

No answer.

"Mr. X?" And I tapped him and that's when I realized he was dead. Well, I thought he was - I pulled out my stethoscope - nothing. (Putting your steth to a soundless chest is almost creepy in a way.) Holy crap.

I snuck outside the room - pulled down the chart box - confirmed he was DNR for my own sanity - pulled his door shut - went and found the doctor from earlier and told him my tale of woe.

His response? "You're &*#$ing me."

Well, I wasn't.

So after we checked him (and God bless this MD, the first words out of his mouth were, "I'll call donor services if you'll call the morgue"), I went and told the charge RN.

"Mr. X just passed."

No kidding - night shift offgoing charge AND day shift oncoming charge BOTH SAID AT EXACTLY THE SAME TIME "You're ^&$*ing me." And I answered, "Is EVERYONE going to say that when I tell them this?"

My best friend is still on this unit (I was civilian at the time) and this story is apparently still being passed around...I've even been introduced as, "This is Carolinapooh, she's the one who's 007" to RN's I've never met before who now work there.... :)