Worst shift, now depressed.

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Last night was such a horrible shift that I'm now feeling depressed.

I started off with 2 patients, nursing supervisor called saying there were patients waiting in the ED, they need to call another nurse in and I'll have to give up 1 of my patients when she comes in so we can both admit 1.

In the meantime pt A is on an insulin drip, I check her CBG it's 82, I call the resident that tells me her gaps not closed, give her glucose and continue the drip. I ran it by the senior nurse because I thought it was funny she didn't tell me to atleast decrease the dose. The senior nurse freaks out on me telling me to stop the drip and call the fellow. She lectures me that the resident is new and I should know better (I have been in the ICU less than a year). Fellow orders me to decrease the dose but continue the drip.

Pt B has a STAT CT ordered. I call the SWAT nurse (who doesn't like to work lol). She gives me attitude, tells me not to call her unless a patient is hooked up to a monitor and transportation is physically in the room. She says if my patient is not ready she will leave. The pt vomits blood, I call the resident, get an order for protonix, I wipe it off the blood, put towels around her and hook her up to the monitor. Transportation is in the room, The swat nurse comes in and freaks out that there's blood on the patient. We don't have Aides so I said I'll clean her. The SWAT nurse says that she's not waiting for me to clean a pt and I'll have to take the pt myself if I need to change her. I said I'll clean her later...that made her even mad. Saying she will write a complaint on me. She takes the pt to CT.

I'm taking report on pt C. Turns out while I was taking report, swat called and my pt B blood pressure tanked (she was on a nicardipine drip, literally right before transportation to CT!). The other nurse called the resident and got an order for levo. I call the fellow and get an order for a bolus.The SWAT nurse is still complaining about my pt being dirty while I'm hooking her up to the monitor. She then walks to the senior nurse and tells her how dirty I have the pt.

The senior nurse comes in and freaks at the pts MAP being 59, tells me I need to call the fellow. My pt C is on the unit but I can't go into the room till I get pt B started on levo. The senior nurse is telling me I wait last minute to call the fellow. Another nurse overhears and said that's not true, I did call before the senior nurse got in. Senior nurse is still complaining.

I was not able to take pt C because I was busy with pt B so I give pt C to the oncoming nurse.

Later in the shift, a code is called overhead. I know I have to take that pt. I give up pt A and take pt D. Pt D is in really bad shape, central line and A line needs to be put in. I started the cooling process.

I was not able to clean both my patients (I asked the nurses i was working with but they were too busy, they said they were not able to help) during report to the oncoming nurse I said I will help her wash them up. We get both clean but then pt D is getting worse. And of course....the levo was programmed to the exact amount in the bag! The tubing is dry! ( I did not program the pump, I always program 3/4 the bag so the tube never runs dry....it was the senior nurse that programmed the pump but I took the blame). The oncoming nurse is visibly upset.

The family for pt B is in the room and wants the OETT ties changed NOW (I didn't change it after she vomited blood).

It was a horrible shift...I was suppose to finish work at 0730 but finished at 1130! What still haunts me is the comments from the senior and SWAT nurse. They really bothered me. Not only did they yell at me but they let everyone else know, I don't understand why some coworkers feel they can talk to others anyway they feel. I hate being yelled at, I wanted to snap back but I'm still new and I'll need their help. I also hate that anything they feel is a mistake has to be broadcasted to everyone. It's very unprofessional to me.

Just venting.

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Sounds like a terrible shift :(. I'm sorry! It sure sounds to me like you did an awesome job and don't have anything to feel bad about. You can't do everything at once, it was very nice of you to stay so late and help the oncoming shift with THEIR patients. I'm all for getting your stuff done, but things just aren't always done by shift change.. (I'm talking to myself too, I feel terrible if there is a pt not fully wrapped up and presented to the next shift all nice and tidy with a bow on their head.)

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Specializes in Critical Care, Education.

Good grief. I'll bet that somewhere in your organization's Code of Conduct or HR Rulebook, it has a prohibition of disrespectful behavior. Take a look and see. If so, you should take appropriate actions (e.g., variance or incident report) so that their conduct does not go unnoticed. At the very least, it will make them think twice before they do it again. You did what you had to & your patients survived.

On a brighter note, this can serve as your baseline comparison for "horrible shifts" in the future. The next time you feel everything coming apart at the seams, you can think back "well, I make it through THAT shift... I can make it through this one". Heck, I still have one shift - involving coworkers with food poisoning, multi-vehicle MVA, and a 2 hour power failure - that still makes me shudder.

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Sounds like some very unsupportive staff were working with you, unfortunately. So sorry you had such a horrid shift. I agree with HouTx about reporting the nasty behavior. I've done that quite a few times, and yes, it does curb that kind of behavior on the unit.

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Why do you have three pts as an ICU nurse!!!? :no: P.s the pts map should be at Minimum >60 always (at least where I work)

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Specializes in Psych, Corrections, Med-Surg, Ambulatory.
Good grief. I'll bet that somewhere in your organization's Code of Conduct or HR Rulebook, it has a prohibition of disrespectful behavior. Take a look and see. If so, you should take appropriate actions (e.g., variance or incident report) so that their conduct does not go unnoticed. At the very least, it will make them think twice before they do it again. You did what you had to & your patients survived.

On a brighter note, this can serve as your baseline comparison for "horrible shifts" in the future. The next time you feel everything coming apart at the seams, you can think back "well, I make it through THAT shift... I can make it through this one". Heck, I still have one shift - involving coworkers with food poisoning, multi-vehicle MVA, and a 2 hour power failure - that still makes me shudder.

October 24, 1989. A shift that will live in infamy.

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Sound like your average nursing hospital environment. I have yet to find a place where people don't behave like this. Life and death, disorganization, and un-properly trained people etc., can bring out the worst in people. That won't be your last shift like that either. It is the nature of the beast. Try to stay positive.

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