hello,
i am a new grad working day shift from the er for 6 months;and by my choice decided i needed more priority setting, and basic skills for at least 6 months on a medical telemetry before i decided to go back to a specialty.
i have been off orientation for a week and a half now.
my last assigment was not bad 1st part of the day.
long story if you have time (if you want to skip down to blue that is the important part)
here goes the bla,bla,bla
i gave my ffp before my lady had to go down to specials to have a shunt put in for dialysis. took the report on gi bleed from er, and another report of a icu transfer from pacu of an infected peritioneal dialysis shunt.
prior to that i discharged two other patients,and was anticipating discharging another.
i took lunch. afterward,the fun began...
no help from the cna except vitals and accuchecks.
admitted my lady with hx of dementia, she was a gi bleed and she need 3 units of blood and had a protonix gtt and was a hard iv start.
10 minutes afterward got my lady from pacu that needed vitals q 15 for 1 hour, 15 minutes later got my lady back form specials also needed vitals q 15 for 1 hour, and also needing and order for phenergan due to n&v.
concent for blood not done ,had that done and initated blood for gi bleed.
nurses aide took my dinamap because she needed to do routine vitals, but did not come back to help with other vitals,left me to fend for myself.
gi bleed having stroke symptoms expressed by husband, along with vomiting blood. cleaned her up, got help with starting another iv while i got phenergan for post-op across the hall.
my other post-op next bed near gi bleed needed help calling husband that was still in surgical waiting and nobody ahd told him his wife was alright and in her regular room.
my help started me two new iv's and i was set to go. in the mean time my man that was suppose to go home was waiting for dischage was angry and wanted me to call his doctor. doctor called back gave orders for discharge with me to call all meds to pharmacy prior to discharge and arrange for a ride.
running around taking vitals for my post-ops making sure my transfusion is going well, keeping track of my other post-ops getting my 1700 meds done etc...
here is what you want to read:
after giving my 2nd unit of prbc's my lady vomited blood all over the place, was flaying around and trying rip out her iv's. the husband had called in a private aide to stay with his wife knowing she could not be left alone,afterward he left and she became worse the private aide tried to keep the patient from hurting herself and ripping out her iv's. i called for a order for 0.5 mg-1.0 iv adivan and restrain if needed. i gave my 0.5 order adivan
in the mean time a wonderful co-worker decided to give me a hand and dischage my other man who was angry and wanted to be discharged now!
i told the private aide that we will get the patient cleaned up after she settles down, because everytime we went to touch this patient she would get wild.
i hung my abx on room next door, then it was time for report.
my lady was sleeping, i figured to give report then help clean lady up afterward with the oncoming shift.
i gave report,and i offered to help clean lady up with oncoming rn, she told me i had so much charting to do,to just do that.
after i sat down to chart the door flew open, nurse said the doctor is furious and i need you to clean her up now.
as i went down the hall the doctor walking down the hall, he said to me, who is in charge? i told the doctor that i had been taking care of the patient. i went over to the doctor in a calm voice and tried to get him to calm down, i stated,"i was trying to keep her safe, she was tying to get out of the bed and i was trying to settle her down. he stated, "i do not care what the reason is, would you have your mother laying in blood like that? has anyone been in there to see this patient? i told the doctor the priority is to keep the patient safe then when she calms down,to then clean her up, and she was never left alone for one minute. i said to the doctor, "i do not blame you for feeling the way you do about your patient. he said i do not care, i just want this reported to anministration, enough said...
due to this being the change of shift doctors, nurses etc were at the station witnessing this event.
all the nurses could not belive how this doctor who has such a good manner could lose his temper like that?
i documented the incident and i documented in my nurses notes, i went to my director at 0600 and explained the incident, wrote my event report, and now i'm hoping this doctor will not give me touble later.
all in the life of a nurse... and i'm just starting!!!!
