What a way to end a great shift

Noney · Oct 15, 2003

You are human, like the rest of us. The fact that you're worrying about it now shows that you care. You can't be two places at once. Go to sleep.

Noney

oramar · Oct 15, 2003

You just described what happens to me frequently after a shift. It is the main reason I can't handle full time. I need one day to recover for each shift I work.

wowmomrn · Jun 20, 2004

My 7p-7a shift was going so smoothly for a change; I only had 6 patients and way just finishing up at 6am when my patient fell in the bathroom and had to go for a stat head CT. Where was I you ask...trying to get oxygen for the roomate who had a pulse ox of 78%. More paperwork, calling doctors, traveling with this patient down for the scan... I am so mad at myself, but I know it is not my fault. Instead of sleeping I am sitting here thinking about what I could have done differently. Oh well, such is life... thanks for listening!

Be aware you were prioritizing well. The patient with the low Sat needed you urgently. things that are urgent come first. after the urgent things, come less urgent but important things. The less urgent important things are those which we classify as Prevention. If your hospital has not tried bed alarms and chair alarms, I would like to suggest them. They can prevent falls. Think about anything that may have contributed to the fall. Maybe a nursing assistant should be toileting this type a patient every 2 hours. Remember You didn't push the patient, So don't feel guilty. Think of the future and what can be done for all patients to prevent this type of bad event.

Most importantly Be proud of yourself, for pursuing a vocation of giving! Nursing is noble and wonderful.

sharann, BSN, RN · Jun 20, 2004

You ONLY had 6 pts. I love when we talk like this. 6 patients is alot, no matter what we are USED to handling(by force). Well, I am sorry you had such a "great" shift end but you did everything right(A, B C's). Try to get some rest, you deserve it!

MelissaRN · Jun 20, 2004

Just remember A,B,C's airway, breathing, and circulation. You were handling the priority case. Just write up the incident report for the higher ups. They need to see that sometimes the nurse to patient ratios are not realistic in regards to safety. It's not your fault.

SCRN1 · Jun 21, 2004

I agree that you were no way at fault in what happened. But I do understand how you feel. Several months ago while I was in one patient's room changing a Morphine syringe in a PCA, another one of my patients down the hall tried to get out of bed and fell. Of course it also happened around 6:30 a.m. and I was SUPPOSED to get off at 7. The doctor of this patient came in to make rounds about the time I'd just finished assessing the patient and writing the incident report. He was really ticked off. The next shift's charge nurse told him what happened almost as soon as he stepped off the elevator before I had a chance to tell him myself. He just fumed straight to my NM's office (who was in early that morning) and cursed her out, saying that he'd written an order for a posey vest days ago on this patient and why didn't we have it on him? I went in her office as he was storming out the door and explained to her that there was no order since he'd first written one and during my whole shift, that patient had slept most of the time and NEVER tried to get out of bed at all (until he fell right before shift change). So, I had no reason to put him in restraints. An order for restraints has to be renewed every 24 hours and there must be a reason for using them. Only exception is if the patient is doing something to harm themself & warrants restraints, we can put on restraints THEN call the doc for a phone order to be signed when they come in next. Also, we have to do 2-hr checks and document everything on a certain form. She assured me that I was in the right because I could've gotten into BIG trouble had I restrained him for no reason. She said she told the doctor that and also explained to him about the time frame for a restraint order.

PMHNP10 · Jun 21, 2004

My 7p-7a shift was going so smoothly for a change; I only had 6 patients and way just finishing up at 6am when my patient fell in the bathroom and had to go for a stat head CT. Where was I you ask...trying to get oxygen for the roomate who had a pulse ox of 78%. More paperwork, calling doctors, traveling with this patient down for the scan... I am so mad at myself, but I know it is not my fault. Instead of sleeping I am sitting here thinking about what I could have done differently. Oh well, such is life... thanks for listening!

I may be missing something, but I don't see how anything indicates the need to prioritize. You were taking care of the one pt who needed your care. I didn't read where the pt who fell was not supposed to be ambulating or should have had someone standing by, or a hazard was not removed earlier from the floor. As I read this, it was just a freak thing, which as we all know, happens .

The other part of this story is...how is the pt.? I hope he/she is ok--no broken body parts and negative CT.

Having said all of this, I must add, I can empathize. Truly was an unfortunate situation.

bellehill, RN · Jun 21, 2004

Wow, can't believe this was restarted. The patient was fine, or no worse after the fall. She stayed one more night just as a precaution. I know what I did was right but just felt crummy. Thanks everyone for your words of support!

deathnurse · Jun 22, 2004

Take your breaks before they take your spirit. Insist that "night shift" can handle it. It's a 24 hour job and this mantra that day shift has to do it all is preposterous and shouldn't be fostered.

I had a good day Sunday. Was able to shave a patient, just for the 'l of it, and started an IV for another nurse who was swamped, because they actually waited for the NEXT SHIFT to bring up another patient.

Such simple concepts will keep nurses happy, increase retention, and cut down on recruitment costs.